Vol 21, No 5 (2015)

The article exposes the causes conditioned development of national system of maternity and childhood care in Russia, including organization of training of pediatricians in our country. The presented data testifies extremely high indicators of infant mortality in the beginning of XXI century. Among main causes are low standards of living and absence of children curative organizations and special medical manpower. The retrospective analysis of training of pediatricians in Russia is presented. It is noted that training of pediatricians is permanently developing and it is always implemented according the needs of health care. The considerable attention is paid to characteristics of training of pediatricians according to the Federal state education standard taking effect in 2010. It is demonstrated that progress in achievements of the most benevolent indicators of health of children population can testify high quality of training of pediatricians.

The stroke is one of the most significant medical social problems of the present time. The prevention of thromboembolism complications under cardiac fibrillation becomes a real mode of struggling with stroke. The formation of registries is often used as an instrument of evidence based medicine in this area. The article presents short review of recent studies in this field. The one's own original results are presented too: retrospective analysis of patient records and out-patient medical records of 1610 patients with fibrillation of atriums.

The chronic obstructive disease of lungs by its prevalence and severity of course represents real threat of increasing of morbidity and mortality all over the world. Alongside with cigarette smoke, such unfavorable production factors as dust, smoke, toxic and biologically active substances are the causes of disease in 15% of cases. The study was carried out to analyze publications of national and foreign researchers concerning issues of occupational chronic obstructive disease of lungs for comparing with materials of one's own investigations. The history of issue covers period of thirty years when for the first time the experts of American thoracic society in accordance with European colleagues proposed to acknowledge occupational chronic obstructive disease of lungs as an independent form of pathology. The dosage-dependent and cumulative effects of exposition of aerosols at working place on development of occupational chronic obstructive disease of lungs were established. The significance of work experience in decreasing of pulmonary function was detected too. The mutual intensification of effect of cigarette smoke and occupational dust on development of chronic obstructive disease of lungs and severity of its course was proved. The results of one's own studies demonstrated that diagnosis of chronic obstructive disease of lungs was established in 20.5%-35.1% of 986 workers of various "dust occupations". The clinical picture was dominated by cough and short breath. The character of symptoms and degree of their expression depended on concentration of aerosols and duration of exposition. The statistically reliable increasing of number of workers with disorders of external respiration and signs of chronic obstructive disease of lungs depending on augmentation of occupational work experience is noted. The treatment is targeted to relief of main symptom of chronic obstructive disease of lungs - short breath. The social rehabilitation of patient consists in establishment of optimal conditions for continuation of labor activity.

The article presents comparison of functions of mounted femoral endoprosthesis with hard friction pairs in two groups of patients of younger and middle age. In the first group the hard friction pair “ceramics-ceramics” with diameter of head 36 mm was used. In the second group hard friction pair “titanium nitride-titanium nitride” with diameters of heads from 44 to 52 mm were used. The purpose of study was to compare functional results depending on size of head of endoprosthesis and to determine indications for application of big heads. The results were evaluated according Harris hip scope. The statistical analysis of obtained data established no reliable difference between the groups. However, evaluation of range of motions of joints established significant higher range of motions in patients with mounted heads of big diameter. The given advantage can be actual for patients sportsmen and those individuals whose profession and style of life require greater physical activity.

The article demonstrates that in children with thymomegalia the process of T-lymphopoesis in thymus is depressed. The functional condition of thymus was evaluated by detection of T-receptor excisional rings using polymerase chain reaction technique in real time. The T-receptor excisional rings are circular molecular structures developing in the process of rearrangement of V-genes of T-cell receptor. The most intensive and statistically reliable decreasing of content of T-receptor excisional rings in lymphocytes of blood is detected during first two years of life: 29.6 (18.1-41.0) copies per 1000 lymphocytes against 73.3 (54.0-83.8) copies in control. Hereinafter, (after two years) difference in level of T-receptor excisional rings inc children with thymomegalia in comparison with children without enlargement of thymus is less expressed i.e. it amounts to 1.8 times at the age before 10 years. In individuals of older age thymomegalia is a rather rare pathology. The examination of single patient aged of 40 years and with thymomegalia factually total absence of T-receptor excisional rings in cells of his blood was established.

The article determines significance of neatly organized system of information about pharmaceuticals in rational application of remedies. The characteristic is given concerning sources of information about pharmaceuticals regulated by documents in the Russian Federation. The results of comparative analysis of information sources about pharmaceuticals and requirements to them according the Russian legislation and WHO guidelines are presented. The weak aspects of regulation and control in sources of information about pharmaceuticals are established. The main requirements for information about pharmaceuticals to be complied with according WHO guidelines are formulated.