Introduction. The economic aspects of providing cancer care to the public attract increasing attention of scientists, economists, physicians and other healthcare professionals. Currently, the healthcare economics of oncological institutions is defined as part of the national economy that implements cancer care programs and provide a wide range of medical and pharmaceutical services to the public.Aim. The study was conducted as part of the program for improvement of financial spending in order to facilitate cancer care for Moscow residents. The aim of this study was to identify the crucial areas of the cost analysis and thus improve the public health service.Materials and methods. We used the methodology of targeted and consistent search of the literature. The data search and analysis was carried out using the US National Medical Library (PubMed database), National Electronic Library (e-LIBRARY, Russia), and other Internet resources. Whenever possible, articles on the most common and socially significant types of cancer (breast, colon, prostate, lung etc.) were selected. In addition, we focused on significant studies conducted either on the national or international level.Results and discussion. In principle, the structure of total costs is determined by the health policy regarding the cancer care system. Six main areas of oncological care that require careful economic analysis have been identified: those are prevention, oncoscreening, diagnosis, treatment, rehabilitation, and palliative care. In order to implement the economic goals of the healthcare system, the cost of cancer treatment should be discussed. The relevant programs are expected to be based on 1) prevalence and incidence; 2) impact on health; 3) results of the integrative methodological approach to cancer treatment; 4) implementation of comprehensive measures of medical and social assistance; 5) use of financial mechanisms and their impact on economic indicators.Conclusion. The set of measures related to the direct costs as identified in this study include the development, planning and provision of cancer care. These specific features of the direct cost analysis are important for organizing medical care in oncological institutions.
A comprehensive study of the state of the spincter muscle complex in children after surgical correction of anorectal malformations was carried out,including MRI of the structure of the spincter muscle complex,fecal continence on the Rintala scale, manometric studies of the anal function.The poor development of the spincter muscle complexwas characterized by a decrease (p < 0,05) of the average values of the relative width of the puborectal muscle (PRWR) to 0,14 ± 0,03, for the relative width of the external anal sphincter (EASWR) to 0,12 ± 0,02, which turned out to be 2,4 times lower than patients with excellent and good results. Values of PRWR <0,18 and EASWR <0,15 in 63 % of cases corresponded to an unsatisfactory result on the Rintala scale and was accompanied by fecal incontinence. A good function of anal function was observed in 58 % of patients with PRWR >0,18 and EASWR >0,15.
Научно-исследовательский институт организации здравоохранения и медицинского менеджмента Департамента здравоохранения города Москвы 115088, Российская Федерация, г. Москва, Шарикоподшипниковская ул., д. 9 Введение. Угревая сыпь встречается у не менее 85 % юношей и девушек, часто протекает длительно, с рецидивами процесса на 3-м и 4-м десятилетиях жизни. С 2000 года технология фотодинамической терапии (ФДТ) стала активно использоваться во многих странах. За два последних года проведено много важных дополнительных исследований эффективности ФДТ для лечения акне. Цель исследования: получение и обобщение новых данных об эффектах ФДТ и ее применимости в реальной клинической практике. Методы. Поиск и анализ данных проведен с использованием Национальной медицинской библиотеки США (база данных PubMed), интернет-ресурсов E-library. В исследование включены оригинальные статьи, опубликованные за последние два года и посвященные или связанные с использованием ФДТ для лечения обыкновенных угрей. Результаты. Было найдено в общей сложности около 55 статей. Всего отобрано 9 клинических исследований или описаний клинических случаев отвечающих предъявляемым критериям анализа. В клинических исследованиях применялись различные и неоднозначные, нестандартизированные периоды инкубации фотосенсибилизатора, кумулятивные дозы энергии источника света, количество сеансов терапии. При анализе публикаций обнаруживается тенденция к применению сокращенного периода инкубации и менее активных формуляров фотосенсибилизаторов с целью снижения риска развития нежелательных явлений, таких как эритема, отек, гиперпигментация, образование волдырей. Обсуждение и выводы. ФДТ является эффективной и перспективной медицинской технологией лечения акне. ФДТ может применяться при легких и тяжелых воспалительных и кистозных акне, у пациентов с различными типами кожи и локализацией элементов. Данный вид терапии акне выполняется различными способами и необходимы дальнейшие исследования для разработки оптимальных и стандартных процедур реализации этой актуальной и клинически выгодной медицинской технологии. Ключевые слова: фотодинамическая терапия, вульгарные угри, акне, медицинская технология Конфликт интересов: авторы заявляют об отсутствии потенциального конфликта интересов, требующего раскрытия в данной статье.
The article presents a case of successful surgical treatment of the newborn with a rare congenital pathology – thoracoschisis. The newborn had been transferred urgently 6 hours after birth from the perinatal center. The initial examination revealed a chest defect measuring 6×3×3 cm in size and located along the midclavicular line from the 4th to 6th ribs through which the additional lobe of the liver prolapsed (Riedel’s lobe). After examination and preoperative preparation, 17 hours after birth, a surgical treatment was carried out – moving the liver to the abdominal cavity, closing defects of the diaphragm and thorax. In the postoperative period, serous pericarditis developed, requiring puncture and pericardial drainage. On the 21st day of life the child was transferred to the somatic hospital in a satisfactory condition. Observations conducted over the two years after the operation indicated the child's satisfactory condition, and revealed no complaints. The extreme rarity of this pathology causes certain difficulties in determining the appropriate treatment strategies, and concomitant congenital malformations contribute to high mortality.
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