Aim. To assess the influence of medical and social risk factors in pipeline companies’ employees and to design measures to reduce unfavorable influence. Methods. The study included 369 employees of OJSC «Volgogaz» working on pipelines at 2007-2009. A special form for social and hygienic study was designed, including information about health and living conditions, eating habits, family relationship, obsessive habits and family history. Results. Employees aged 30-49 years and older (190 subjects, 51.4%), with technical secondary education (151 subjects, 40.8%) were the most common. The majority of employees assessed their job as hard, 48 (13.0%) and 261 (70.7%) patients reported significant and extreme fatigue after the working shift. 260 (70.5%) subjects lived in a separate apartments, mostly in rural areas (216 subjects, 58.5%), most have complete families with children (297 subjects, 80.5%), despite most having one-parent family at childhood. Over a half of all employees (192 subjects, 52%) had 3 meals per day, 310 (84%) subjects slept for 6-7 hours per day, 222 (60.2%) subjects are current smokers, 27 (7.3%) subjects drink alcohol more than 1 time per week. 149 (40.5%) assessed their living conditions, and 50 (40.7%) - their fare as satisfactory. The majority of all employees (175, 47.5%) were ailing less than 2 times per year, 228 (61.8%) assessed their health status as satisfactory. Thus, medical and social risk factors in pipeline companies’ employees were associated with significant physical efforts, bad working conditions, including rotational team method, and unhealthy behavior. Conclusion. Rehabilitative measures should include improving the social factors (work, living and leisure conditions), healthy behaviors, increasing motivation for perceiving information of healthy way of living and measures to improve health.

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The necessity of implementing clinical economic studies was conditioned by a significant prevalence of infections of urinary tracts, wide variety and high cost of antibacterial pharmaceuticals for their treatment. The sampling included 539 cases of application of step schemes of antibiotics treatment in patients of urological departments in 2014-2015. Overall, six the most prevalent schemes (87.4% of all cases) were picked out. Every scheme was analyzed by application rate, clinical efficiency, treatment cost and average duration of patient stay in hospital. The most clinical efficiency was established for the scheme that included amoxicillin + сlavulanic acid in injection and peroral components without implementing peri-operational antibiotics prevention (97.7%). However, period of hospitalization was in average 2.9 days longer and transition of patient from injection component of therapy to a peroral one occurred 2.3 days later than in case of application of the same pharmaceutical in combination with peri-operational antibiotics prevention (efficiency index 96.0%). It is established that the scheme with amikacin being from economic point of view the most attractive one (cost of treatment is 2.5-6.1 times lower and period of hospitalization the shortest) and differing by high clinical efficiency (95.2%) is applied only in 4.4% of analyzed cases because amikacin has many side effects restricting its application in medical practice. The received information permits physician to rationally prescribe optimal schemes of treatment that decreases costs of therapy, risk of development of complications initiated by antibacterial therapy and also increases quality of life of patient.

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