The material and technical condition of the outpatient polyclinic in Russian Federation: analysis of the current situation

The article analyzes the main indicators of the technical condition of buildings of outpatient medical organizations (units) in the Russian Federation for the period 2012–2019. The number of outpatient medical organizations (units) in emergency condition and requiring demolition tended to decrease from 215 units to 96 for the period from 2012 to 2017 in the Russian Federation. The number of units requiring reconstruction in the Russian Federation declined from 511 to 179 for 2012–2019. The number of units requiring major overhaul in the Russian Federation went down from 4,347 to 2,378 for the period from 2012 to 2018, and in 2019 rose sharply to 4,113. The number of units located in adapted premises increased from 6,723 to 8,126 for 2014–2019 in the Russian Federation. The number of units located in the rented area in the Russian Federation decreased from 1,443 to 1,414 for 2014–2019. The number of units with central water supply went up from 17559 to 19440 for 2012–2019 in the Russian Federation. The number of units with hot water supply in the Russian Federation increased from 13,012 to 15,124 for 2012–2019. The number of units with central heating rose from 16,893 to 17,546 for 2012–2019 in the Russian Federation. The number of units with a central sewer went up from 17,111 to 18,969 in the Russian Federation for 2012–2019. The number of units with telephone communication increased from 17,806 to 19,266 for 2012–2019 in the Russian Federation. The number of units with autonomous power supply rose from 941 to 1,227 in the Russian Federation for 2012–2019. The total number of outpatient medical organizations (units) in the study period increased by 7.9 %. The number of buildings requiring renovation and modernization between 2012 and 2018 tended to decrease. Not all indicators have a positive trend. Health care modernization is not completely structural.

Issues of medical examination and selection of citizens for military service under a contract in Armed Forces of the Russian Federation

In the context of the reform of the Armed Forces of the Russian Federation and a significant increase in the proportion of military personnel doing military service under contract, the issues of manning the troops with healthy, physically developed citizens with high moral and business qualities are of paramount importance. Of particular importance in the selection of candidates for military service under the contract is the conduct of laboratory and instrumental studies, professional and psychological selection, determination of the level of citizens’ physical fitness. The Federal Law «On Military Duty and Military Service» defines a two-stage system for medical examination of citizens entering military service under contract, which is necessary as a barrier in order to prevent citizenswho do not meet the necessary requirements for military personnel from entering the Russian Armed Forces. At the first stage (preliminary examination), the military and medical examination of citizens was carried out by specialist doctors working in medical organizations of the outpatient-polyclinic link of municipalities at the place of citizens’ permanent residence. Medical specialists of the regular military medical commission of the military commissariat of the constituent entity of the Russian Federation participated in the second stage (final examination) of the military medical examination. During the five-year period under study, 5,133 citizens (72.9 %) were selected out of 7,043 candidates for military service under contract, who fully met all the criteria for defenders of the Fatherland.

Features of the course of coronavirus infection in patients with diabetes mellitus

Diabetesmellitus, overweight and the age of a patient over 65 years old are identified by clinicians as themain factors that can complicate the course of the coronavirus infection and increase the likelihood of fatal outcome. Although in the general human population mortality from coronavirus fluctuateswithin 3–5 %, sometimes very significantly differing in individual countries, this level can reach 15–25 % among patientswith diabetes, especially for those receiving insulin therapy. Diabetes mellitus as a concomitant disease in COVID-19 is considered one of the most significant risk factors for the development of adverse outcomes due to a more severe course of infection in conditions of hyperglycemia and other aggravating factors.

Instrumental diagnosis of cholesterol polyps of the gallbladder

Gallbladder polyposis is a common pathology, the detection of which has increased significantly in recent years. The dominant form of this disease is cholesterol pseudopolyps, mainly found inwomen. Clinical manifestations of gallbladder cholesterol polyps are nonspecific,which presents certain difficulties in diagnosis.Ultrasonography is one of themost informative and accessible instrumental diagnostic methods.

The state of the respiratory system of students in conditions of high-altitude hypoxia

The article presents the results of studies on the influence of mountain hypoxia on the state of the students’ respiratory system. When exposed to oxygen deficiency, only the respiratory capacity of the lungs undergoes significant changes. For instance, the RC level in female students under the influence of hypoxia gradually increased in conditions of medium altitude, reaching the maximum value of 0.64 liters (P ˂ 0.05), and on the plain - 0.44 liters. The RC value in young men reached the highest value of 0.74 liters in mid-altitude conditions, and on the plains, it constitutes 0.56 liters. The highest respiration rate for young men of 18.2 movements per minute was noted at an altitude of 600 meters, and the lowest - 17.4 at an altitude of 170 m. The maximum level of respiratory capacity while inhaling in girls is 1.24 liters, detected at an altitude of 600 meters, and the minimum level of 1.18 liters is noted at 170 m. The value of respiratory capacity while exhaling among young men living in the Sharoi region increased to 2.32 liters, and for those from Grozny - 2.24 liters. The highest VC level in girls - 3.87 liters - was found in the middle mountains, and on the plains, it was 3.58 liters. The VC value in young men, gradually increasing, reaches the highest value under the conditions of the Sharoi region - 4.57 liters, and in Grozny it was 4.28.

Healthcare of the Netherlands

The Netherlands is a state located in Western Europe bordering Germany and Belgium. The population of the country is just over 17million people. In terms of GDP, theNetherlands is among the twenty richest countries in the world, and in terms of exports, it is in the top ten. The average life expectancy in theNetherlands is 81.4 years; in the structure ofmortality, malignant neoplasms come out on top, which distinguishes the state from other European countries, where the main cause of deaths is cardiovascular diseases. The compulsory health insurance system was introduced in the country in 2006 after the medical reform. A distinctive feature of the Dutch healthcare system is its relative autonomy from the state, which performs only the function of an external controller, and all other powers belong to the municipal authorities. As a result, several private insurance companies have been admitted to health insurance in the Netherlands, which create healthy competition among themselves, thereby contributing to better quality and more affordable healthcare.

Differential diagnosis of tinnitus

Tinnitus is a common clinical symptomthat can be debilitating. Risk factors forits development are hearing loss, use of ototoxic drugs, head injury and depression. At the onset of the disease, the likelihood of ear pathology, the presence of anxiety and depression should be considered. There are no effective drug treatments for tinnitus, although a number of scientific studies are ongoing to determine the mechanisms of the development of this condition and to search for possible options for its treatment. When ear pathology is detected, surgical interventions can be effective, but tinnitus associated with this disease persists. Available treatment approaches include hearing aids for diagnosed hearing loss (even mild or unilateral), broadband sound therapy, and counseling. Cognitive-behavioral therapy is indicated for some patients, but availability remains inadequate. The evidence base is most significant for the combination of sound therapy and CBT-based counseling, although clinical trials are complicated by the heterogeneity of the tinnitus patient population.

The significance of ferritin as one of the markers of inflammation

Iron is an extremely important trace element that plays a large role in oxygen transport, DNA synthesis and muscle tissue metabolism. Ferritin is a protein compound inwhich iron is deposited as a reserve for the body; in laboratory diagnostics, it is usually evaluated as a marker of iron content, and the determination of its concentration is used to diagnose iron deficiency conditions. It structurally consists of the protein apoferritin and the ferric atom in the composition of phosphate hydroxide. One ferritin molecule can contain up to 4,000 iron atoms. The ferritin content in blood is measured in nanograms per milliliter. The normal concentration for men is 29–397 ng/ml, and for women, it is 6–159 ng/ml. A decrease in the level of ferritin in the blood is possible in iron deficiency, but an increase in its concentration may indicate not only the development of hemochromatosis, but also, along with C-reactive protein, be a marker of an active inflammatory reaction. An increase in the synthesis of C-reactive protein, fibrinogen, ferritin, serum amyloid by hepatocytes occurs under the influence of pro-inflammatory cytokines IL-6, IL-18, IL-1, TNF in severe acute processes, especially in the case of their viral etiology.

January 26 — International Day «Let's Talk»

January marks the beginning of the new year and the middle of winter, therefore, the holidays this month are celebrated accordingly, for example, in Canada and the United States, Walrus Day is celebrated on January 1 with the organization of traditional swims in ice water, but on January 5, it was proposed to celebrate Fasting Day, obviously, with the purpose of saving the body tired from the festive feasts. On January 14, in some countries, it is customary to celebrate an unusual day — the Day of Combating Procrastination, which in psychology means «constantly putting things off for later», some experts have already dubbed this fairly common feature «the disease of the 21st century». January 16 isWorld SnowDay and January 21 is International Hug Day. Besides, on the last Wednesday of January, concerned people proposed to establish Let's Talk Day, dedicated to the problem of difficult relationships between healthy people and patients with mental disorders. Canada was the initiator of the celebration of this day. Experts suggest that ordinary people protect themselves from mental illness by leading an active lifestyle, but does it always help? Let's try to figure it out in this article.

Coronary heart disease

Coronary heart disease is of great clinical importance in medical practice. The development of medical science makes it possible to introduce new modern methods of treating this disease. One of these is coronary artery bypass grafting, a modern method of treating coronary heart disease, which allows to reliably increase myocardial perfusion and prolong the life expectancy of patients with coronary heart disease.