Saratov JOURNAL of Medical and Scientific Research

Krom I.L.

State Medical University n.a. V.I. Razumovsky, Department of Health Organization and Public Health (with the Courses of Law and History of Medicine), Head of Centre for Medical and Social Research, Professor, Doctor of Medical Sciences

Public health determinants in social context

Year: 2017, volume 13 Issue: №2 Pages: 292-295
Heading: Sociology of Medicine Article type: Author's opinion
Authors: Krom I.L., Yerugina M.V., Orlova M.M., Dolgova E.M., Chernyak M.D., Bochkareva G.N.
Organization: Saratov State Medical University, Saratov state university
Summary:

Demographic situation at the global and regional levels is designated by social context and social mechanisms. The probability of a certain pathological state may increase under the influence of factors, most of which can be considered as socially determined. Poverty and health care limited availability are considered by the authors in the context of the risk of the formation of a marginal situation for patients with chronic diseases, which is manifested in adaptation crisis, disability of the patient in a situation of chronic disease.

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The value of assessment of quality of life in realisation of medico-social rehabilitation of children-orphans in conditions of illness

Year: 2017, volume 13 Issue: №2 Pages: 288-291
Heading: Sociology of Medicine Article type:
Authors: Dubrovina M.S., Krom I.L., Chizhova V.M.
Organization: Saratov State Medical University, Volgograd State Medical University
Summary:

Purpose: interdisciplinary analysis of quality of life and objectifying strategies of medico-social rehabilitation of children-orphans in conditions of illness. Material and Methods. Included in the study on a random sample of 354 respondents aged 14-18 years of age (160 males and 194 female). The study of quality of life was conducted using the international questionnaire of WHOQOL-100. Statistical significance of differences of average indices of life quality of groups of respondents was determined by non-parametric Mann —Whitney test. Results. Analysis of the averages of quality of life in the group of clinically healthy respondents were allowed to define the indices on average significantly (p<0.01 — p<0.05) different in the group of children-orphans and children living in families. During the research it was found that the average quality of life of orphans in a situation of a disease in most points of questionnaire were significantly lower than in the control group. Statistically significant differences of average values of indicators of quality of life in the analysis of the quality of life of the respondents (orphans and children living in families) in the case of illness related to the effects of disease and child abandonment, somatically and socially determined. Conclusion. Established in the course of the study the statistical relationship between indicators of quality of life from disease and the effectiveness of re-socialization proves the possibility of the objectification of recovery strategies and the formation of personally identifiable medical and social assistance to children-orphans in conditions of illness.

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A modern interpretation of rehabilitation of patients with neurotraumas

Year: 2017, volume 13 Issue: №1 Pages: 85-88
Heading: Sociology of Medicine Article type: Review
Authors: Annikov Yu.G., Krom I.L., Yerugina M.V.
Organization: Saratov State Medical University
Summary:

In modern neurorehabilitation practice there is a trend of common approach to the content of rehabilitation of patients with various etiopathogenic features of brain damage. The urgency of the problem of medical and social rehabilitation of patients with brain injury is associated with a high prevalence of this pathology and medical and social uncertainty of the prognosis. The authors of the publications cited in the survey have considered the rehabilitation prognosis and predictors of disability in patients with traumatic brain injury. According to most authors' opinions, the effects of traumatic brain injury even of mild degree can be shown for the first time some years later, while at the same time it is not always adequate to the severity of the acute period of craniocerebral trauma and often having a progradi-ent course. The review presents the results of studies showing that significant progress in the recovery of patients with traumatic brain injury is possible by using an integrated approach, a coordinated multidisciplinary action aimed at the patient and his family, as well as the rehabilitation period of the sequence, starting with early intensive and ending late recovery period. Medical and Social Rehabilitation of patients after traumatic brain injury, in the current context — a multidisciplinary challenge, the effectiveness of regulation is determined by the coordination and solution of medical, social, psychological and organizational tasks.

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Issues on optimization of primary health care for working patients with diagnosed hypertension

Year: 2017, volume 13 Issue: №1 Pages: 007-009
Heading: Health Service Organization Article type: Original article
Authors: Shulpina N.Yu., Erugina M.V, Sazanova G.Yu, Krom I.L.
Organization: Saratov State Medical University
Summary:

Aim: to justify the ways of optimization of availability of primary health care for working-age patients with arterial hypertension. Material and Methods. The study of the availability of drug treatment of working-age patients with arterial hypertension was based on a survey of 409 patients and calculated the average cost of treatment of this group of patients for 1 month in accordance with the care standards. Results. On 01.06.2016, the cost of treatment for a patient with stage 1 hypertension amounted to 316.89 rubles per month, with 2 stage 652.68 rubles per month. 67% of patients of working age are unable to follow the doctor's recommendations and take the prescribed medicines. Conclusion. Provision of free medicines to patients with arterial hypertension of stages 1 and 2 and the formation of their commitment to preventive treatment causes a direct economic effect, which will be 7915979 rubles per year, and indirect economic effect of the decreased mortality from cardiovascular diseases, disability, reduce in disability days and increase of the gross domestic product.

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Interdisciplinary conceptualization of palliative care for patients with chronic kidney diseases

Year: 2016, volume 12 Issue: №3 Pages: 412-414
Heading: Sociology of Medicine Article type: Author's opinion
Authors: Petrov G.S., Krom I.L., Yerugina N.N.
Organization: Saratov State Medical University
Summary:

The article presents the author's analysis of modern interpretations of palliative care. Transformation of palliative care conceptualization during the last decade has led to the appearance of a palliative approach to treatment of patients with chronic diseases; quality feature of this approach is possibility to render a palliative care along with treatment of underlying disease and syndrome treatment of a patient. The authors note that due to increasing number of patients requiring renal replacement therapy, organization of palliative care is relevant in the group of patients with chronic kidney diseases. According to the authors' viewpoint, palliative approach to aging and fast-growing cohort of dialysis patients, many of which are in the period of living out, suggests implementation of individual program of dialysis therapy, in domestic literature there are only a few works devoted to palliative approach to patients with terminal chronic renal failure that suggests prospects of research in this direction.

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Tendencies of institutionalization of palliative care in modern Russia: interdisciplinary analysis

Year: 2016, volume 12 Issue: №2 Pages: 196-199
Heading: Sociology of Medicine Article type: Author's opinion
Authors: Krom I.L., Yerugina M.V., Dorogoykin D.L., Shmerkevich A.B.
Organization: Saratov State Medical University
Summary:

The analysis of the institutionalization of palliative care trends in contemporary Russian is given by the authors in the methodological plane of the system of social and structural functions (AGIL), proposed by Talcott Parsons. The medicalization of palliative care in Russia is considered by the authors from the perspective of the dysfunctional practices. It is noted that the legislative documents adopted in Russia define palliative care as palliative medical care. The organization of palliative care in Russia takes place simultaneously with the improvement of legal acts, which significantly slows down the process of becoming of palliative care to population and predetermines the limit of its availability. The principle of an integrative approach to the organization of palliative care was not reflected in the process of formation of the normative base. The interdisciplinary view on the organization of palliative care and increase of its availability will allow to verify and to overcome the dysfunctions in the organization of palliative care to the population.

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Anthropometric predictors of cardiovascular continuum in patients with ischemic heart disease

Year: 2015, volume 11 Issue: №4 Pages: 520-523
Heading: Macro- and Micromorphology Article type: Original article
Authors: Baleva E.S., Aleshkina O.Yu., Krom I.L.
Organization: Saratov State Medical University
Summary:

Purpose: the analysis of anthropometric characteristics of cardiovascular continuum of patients with coronary heart disease (CHD). Materials and methods. The study of the leading anthropometric predictors in the long-term prognosis of patients with coronary artery disease is based on the results of observation of 238 patients of both sexes of working age who are undergoing treatment for coronary heart disease in hospitals of Saratov. Anthropometric parameters included in the study of respondents with coronary artery disease, were measured by the common method of V. V. Bu-nak. The received data were processed by standard methods of mathematical statistics. Results. During the research of anthropometric characteristics of respondents with CHD, male, it was found that the average length of the patient's body up to 50 years is of 175,0±1,2cm, aged 51-55 years, is 172,0±0,7cm, age 55 is 175,0±0,9cm. In the process of study it is found that the dynamics of clinical, instrumental and anthropometric indicators for the period of observation is of the predictive value. Conclusion. The analysis of anthropometric predictors, including morphological characteristics and the human body type make it possible to objectify distant prognosis of patients with coronary artery disease.

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Content analysis of legal acts and the determination of the directions of optimization of palliative care in modern Russia

Year: 2015, volume 11 Issue: №4 Pages: 506-510
Heading: Health Service Organization Article type: Author's opinion
Authors: Yerugina M.V., Krom I.L, Shmerkevich А.В.
Organization: Saratov State Medical University
Summary:

The article presents the author's analysis of the normative documents of the Russian Federation necessary for providing palliative care. According to the authors regulatory — legal support of palliative medical care to the population allows to plan and to develop this kind of assistance in Russia. To ensure the availability of palliative care it is necessary to have scientific and methodological basis and to develop a general classification of the states under which the palliative care is needed and should be organized. The procedure for medical care must be brought into conformity with the mentioned above classification. The authors consider the trends of medicalisation of palliative care in Russia in the context of dysfunctional practices of the social institute of Public Health.

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Modern palliative care strategy

Year: 2015, volume 11 Issue: №4 Pages: 503-506
Heading: Health Service Organization Article type: Review
Authors: Krom I.L., Yerugina M.V., Shmerkevich А.В.
Organization: Saratov State Medical University
Summary:

Changes in the structure of public health are marked in health care round the world. Patients with chronic diseases which limit their life-important needs will live longer, suffer and as a result of these factors they will need palliative care. The article presents the author's analysis of modern interpretations of palliative care from the perspective of multi-professional and multidisciplinary approach. The article considers the main trajectory of a chronic disease, defining the modern palliative care strategy. Also the article presents the main objectives and directions of palliative care. The authors state that the adopted Russian legislative documents define palliative care as palliative medical care. The medicalisation of palliative care in Russia is considered by the authors from the perspective of the dysfunctional practices of the social institute of health.

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The quality of life optimization vectors of patients with ischemic heart disease

Year: 2015, volume 11 Issue: №1 Pages: 062-065
Heading: Health Service Organization Article type: Original article
Authors: Krom I.L., Erugina M.V., Sazanova G.Yu.
Organization: Saratov State Medical University, Saratov Institute of Social Education, Head of Centre of Medical and Social Research
Summary:

The purpose of research is an integrative analysis and justification of the priorities of the quality of life optimization with patients with coronary heart disease. Material and Methods. Some sociological and statistical methods were used in this study. Results. The article presents the results of the study of quality of life of patients with ischemic heart disease, using a questionnaire WHOQOL-100. The study established the statistical dependence of the quality of life of patients with coronary heart disease on the quality of medical care, which is considered by the authors as an obligate modifiable predictor of quality of life of these patients. Conclusion. Medical care is considered according to the research as the obligate modified predictor of quality of life of the patients suffering from coronary heart disease. Statistical dependence of indicators of quality of life of sick IBS on medical care is established during research. Correction of standards of medical care acts as one of conditions of optimization of quality of life of sick coronary heart disease.