Multiprofile Hospital Research Articles

Strain diversity and antibiotic-sensitivity of staphylococcus spp. Isolates from patients of multiprofile pediatric hospital in St. Petersburg, Russia

Background. Staphylocci are the leading pus-forming Gram-positive bacteria in the childrens hospitals. The prevalence of the antibiotic resistant strains among them limits therapeutic effects of infections in children.
 Aim. The research is aimed at characterizing the species of staphylococcus, which are isolated from the different clinical specimens of the patients at the clinics of Saint Petersburg State Pediatric Medical University in 2019, and analysis of their susceptibility to antimicrobial agents.
 Materials and metods. According to the clinical recommendations of 2018, susceptibility to antimicrobial drugs (AMD) was revealed in 860 strains of staphylococci determined by the disc diffusion method, which were identified by the automated analyser Vitek-2 compact.
 Results. Six species of staphylococci were represented at the hospital departments, among which Staphylococcus epidermidis prevailed in the departments of the neonate pathology department and intensive care units (63.0% and 46.2% respectively), Staphylococcus aureus is commonly found at the departments of surgery and the departments of the therapeutic profiles (61.7% and 46.2% respectively). More than a half of the staphylococci strains (63.0%) were resistant to at least one of the antimicrobial drugs. Vancomycin and line solid showed the highest activity to these staphylococci. High specific weight of multidrug resistant (MDR) bacteria (37.8%) and extensively drug resistant (XDR) strains of the phenotype (33.0%) was revealed. The level of antibiotic resistant strains was the highest in Staphylococcus haemolyticus (98.1%) and S. epidermidis (82.0%), while the specific weight of the resistant ones, MDR and XDR strains was extremely low among S. aureus (16.2%, 1.5% and 0.4 respectively), as well as in methicillin-resistant isolates (0.8%).
 Conclusions. A great variety of antibiotic resistance was revealed among the staphylococci. The prevalence of these strains in the pediatric hospitals requires constant local monitoring of the antibiotic resistant staphylococci.

Post-cardiac surgery bacterial contamination

Background: Septic purulent nosocomial infections (SPNI) are one of the most significant healthcare challenges of post-surgical procedures. SPNI are associated with increased morbidity, mortality and admission costs. It is a priority to determine the level of nosocomial infections (NI). This study aims to evaluate the bacterial contaminations after cardiac surgery within the Department of Acquired Heart Defects (DAHD). Material and methods: A cross-sectional study was designed and the medical records of 1189 patients who underwent cardiac surgery within the DAHD of a multiprofile hospital were retrospectively analyzed. The data were collected and stored in a Microsoft Excel spreadsheet. Results: The incidence rate of SPNI following cardiac surgery was 317.57‰ compared to 15.02‰ officially reported (p <0.001). Of the most common infections among the total of 418 cases of SPNI studied, 32.06% were surgical site infections, 23.18% were associations of infections, 19.14% – respiratory tract infections. A patient with SPNI has an average of 22.25 days/bed spent in hospital, compared with the average for a patient without SPNI of 12.27 days/bed. The etiological structure includes 28 species of microorganisms including gram-positive (61.92%) and gram-negative (38.08%). Conclusions: Given the relatively high incidence of the SPNI and its impact, it is imperative to take more serious measures to prevent and control these infections

Nurses’ views on and compliance with the guidelines of hand hygiene, including nail hygiene in a multi-profile hospital in Lesser Poland Province – the evidence for need of continuous education and training

Abstract Aim. The aim of this study was to examine the current situation and potential needs for education aiming at improving Polish nurses’ views and attitudes in terms of compliance with hand hygiene guidelines. Material and methods. The study was based on a diagnostic survey method. A questionnaire based study and also visual evaluation of the nurses’ nails was carried out as well. Results. Our results reveal unsatisfactory nurses’ attitudes and compliance with the given area of hand hygiene recommendations. Especially, despite the nurses’ strong support for natural nails, in practice they did not always comply with the guidelines. Conclusions. It is necessary to develop and implement effective strategies of continuing education and training aiming at changing habits of healthcare workers, including nurses, in hand hygiene.

TINKAMA SVEIKATOS PRIEŽIŪRA: NAKTINIS MEDIKŲ DARBAS

The article aims to reveal the medics’ approach to night shift work in multiprofile hospitals of Lithuania. The night shift medics’ work and it singularity was analysed in several related and summarized aspects: approach to night shift work as a phenomenon (1), the impact of night shift on the physiological needs, health and family (2), the interface of night shift work with the environment and work organization (3). The differences of approaches of doctors and nurses to night shift work were disclosed in the article.

Antibiotic resistance: a modern view of the problem by the example of a multi-profile hospital

Relevance. Conducting microbiological monitoring allows controlling hospital-acquired infections and making timely strategic decisions for epidemiologists and clinical pharmacologists. Objective of the work is to determine the tendency of prevailing problem microflora and to develop a strategy of empirical antibacterial therapy for severe nosocomial infections and inflammatory processes. Materials and methods. The article analyzes the main groups of pathogens of hospital infections in dynamics for the first quarter of 2018, 2019 and 2020. The relation of positive cultures to the total number of investigated samples was taken for the analysis. Antibiotic sensitivity was isolated, identified and determined using conventional mass spectrometry methods. The results. The stable sowing rate of Acinetobacter baumannii and Klebsiella pneumoniae in the intensive care and surgical departments was noted for the analyzed periods. To solve the issue of antibiotic resistance in the inpatient department, a strategy to contain it has been developed.

To the question about detergents for sanitary and hygienic treatment in a multi-profile hospital

To the question about detergents for sanitary and hygienic treatment in a multi-profile hospital

Allergic Rhinitis and Rhinopharyngitis - How Often We Meet them in the Occupational Pathology?

Dermendzhiev S1,2 and Ilkova P2 Author Affiliations 1Division of Occupational Diseases and Toxicology, 2nd Department of Internal Medicine, Faculty of Medicine, Medical University of Plovdiv, Bulgaria 2Department of Occupational Diseases and Clinical Allergy Activity, University Multiprofile Hospital for Active Treatment, “St. Georgi”, Plovdiv, Bulgaria Received: September 10, 2020 | Published: September 23, 2020 Corresponding author: Ilkova P, Department of Occupational Diseases and Clinical Allergy Activity, University Multiportfolio Hospital for Active Treatment, “St. Georgi”, Plovdiv, Bulgaria DOI: 10.26717/BJSTR.2020.30.004986

Attitudes of registered nurses about the end \u2013 of \u2013 life care in multi-profile hospitals: a cross sectional survey

BackgroundEnd-of-life care is provided in a variety of healthcare settings, not just palliative care hospitals. This is one reason why it is very important to assess all barriers to end-of-life care and to provide safe and quality services to patients. This study was aimed at describing nurses’ attitudes in providing end-of-life care and exploring barriers and facilitating behaviors of nurses in multi-profile hospitals in Eastern Europe.MethodsA descriptive, correlational design was applied in this study, using a cross-sectional survey of 1320 registered nurses within 7 hospitals in Lithuania.ResultsRegistered nurses working in the three different profiles emphasized safe and effective care and the importance of meeting the patient’s spiritual needs at the end of life. The main barriers assigned by nurses caring for patients at the end of life were angry family members, inadequate understanding of nursing care by the patient’s relatives; lack of time to talk to patients, lack of nursing knowledge to deal with the bereaved patient’s family, lack of evaluation of nurses’ opinions, and the evasion by physicians to talk about the diagnosis and their over-optimistic view of the situation. The main facilitating behaviors to improve nursing care were end-of-life training, volunteering, and family involvement.ConclusionsSpiritual needs were identified by nurses as the primary needs of patients at the end of life. Family-related barriers remain one of the main barriers to end-of-life care. Also, the behavior of physicians and their relationship with nurses remains one of the most sensitive issues in end-of-life care.

Budd-Chiari syndrome at the young woman with thrombophilia and myeloproliferative disease

In the clinic of various diseases (especially hematological) Budd-Chiari syndrome occupies a signifi cant place. The occurrence of blood fl ow disorders in the portal vein system can be a manifestation and the only symptom that manifests itself in a number of diseases. Given the rapid development of portal hypertension, this syndrome requires rapid diagnosis and timely initiated therapeutic measures, as well as comprehensive research to identify the etiological cause of Budd-Chiari syndrome.Objectives: In this paper we demonstrated a clinical case of a young patient with Budd-Chiari syndrome, an unusual course and a combination of etiological factors.Materials and methods. Data from the medical history of the patient who was on treatment at the surgical department of the City Multi-profile Hospital № 2, Military-medical Academy St. Petersburg were used as materials.Result. The patient developed severe ascites 3 months after delivery, for which she was unsuccessfully examined by gynecologists to exclude ovarian tumors. Then, in the course of laboratory and instrumental studies, a final diagnosis was made of Budd-Chiari syndrom (thrombosis of the intrahepatic part of the inferior vena cava in the phase of partial recanalization against the background of chronic myeloproliferative disease and genetically determined thrombophilia.Conclusion: As this case shows, in the development of non-cirrhotic portal hypertension, it is necessary to exclude hepatic thrombosis, in the detection of which it is recommended to conduct a comprehensive examination to exclude all causes of this thrombosis (genetic analysis for thrombophylia, antiphospholipid syndrome, Jak-2 v617f for exclude polycythemia and myelofi brosis, examination for cancer pathology). Manifestation and the only symptom of thrombophilia and idiopathic myelofi brosis may be acute Budd-Chiari syndrome, which requires complex medical and surgical treatment, further observation and especially treatment of causal diseases.

Are postoperative pain and patient satisfaction influenced by the number of ports in VATS for malignant pleural effusion treatment?

ABSTRACTObjectives: The aim of this research is by using sociological methods of scientific research for tracking the pain and satisfaction indicators to prove that decreasing the number of ports in the VATS (Video-assisted thoracic surgery) for Malignant Pleural Effusion reduces postoperative pain and improves patient’s satisfaction.Methods: Our study included 117 VATS procedures performed in the period from 01 January 2013 to 31 September 2016. The sociological method used to measure the pain indicator was an interview. The severity of postoperative pain was determined and reported according to a ten-point pain visual analogue scale (VAS). The degree of satisfaction was determined and reported according to a six-point and ten-point grading systems on the basis of a research interview procedure.Results: In the single-port method, the verbal pain scale for all the days covered by the research study statistically showed significantly lower values (P ˂ 0.0001) in comparison with the conventional method (P ˂ 0.0001). With regard to the patient’s satisfaction, determined on the basis of the six-point system, the results were as follows: conventional VATS approach – average 3.1 with a standard deviation of 1.1 and ranging from 0 to 5; single-port VATS approach – average 4.3 with a standard deviation of 1.0 and within the range from 0 to 6. Conventional VATS approach – 6.8 – neutral. Single-port VATS approach – 8.1 – prevailing satisfaction.Conclusions: Based on our study and the studies of other authors, it can be concluded that postoperative pain and satisfaction after VATS in patients with MPE (Malignant pleural effusion) are influenced by the number of ports and the one-port technique shows better results than the conventional three-port method.The research study was registered and approved by the Clinical Research and Ethics Committee at the ‘Prof. Dr. Stoyan Kirkovich’ AD University Multi-Profile Hospital for Active Treatment Hospital, Stara Zagora. According to Protocol No. 11, Ref. No. 12471/30.10.2015 approved are the methods used by the sociological research study which uses predefined indicators to track patients who have undergone conventional VATS and single-port VATS. Indicators: postoperative pain and satisfaction.

Hospital knowledge and practice of doctors and nurses regarding hand hygiene in a survey.

The guidelines issued by the World Health Organization (WHO) in 2009 regarding hand hygiene (HH) in health care provided health care professionals with scientific evidence that argued that HH principles should be respected when dealing with patients. Despite the passage of years and strenuous attempts to introduce these recommendations to the Polish health care facilities for the prevention of healthcare-associated infections (HAI), these principles are still not being implemented in an optimal way for the patient's safety. The aim was to examine the views and attitudes of physicians (L) and nurses (P) towards the WHO rules of hand hygiene. The study was performed by means of a diagnostic survey using a questionnaire of our own design; random sampling was used. The study involved 231 LP: 173 (74.9%) women, 58 (25.1%) men, including 93 (40.3%) doctors and 138 (59.7%) nurses. The study was conducted in a multiprofile hospital in Małopolska in 2017. The difference between what the respondents think (their views) and what they do in reality (what attitudes they display) was examined in relation to WHO principles, such as wearing natural short nails and jewelry on their hands. Negative practice of observing these HH principles in relation to views was detected (R = -0.014, p<0.05, R2 = 0.016). Respondents supported the view that the ring could affect HAI and rarely used it in practice, the practice was positive (R = 0.298, p <0.001, R2 = 0.085). Women strongly emphasized the view that wearing long nails has an impact on HAI spread, but in practice they often declared keeping long nails, practice was negative (R = -0.241, p <0.01, R2 = 0.054). In response to the question about the impact of nail painting on the spread of HAI, this view was poorly represented, in practice some of them wore painted nails, the practice was negative (R = -0.226, p <0.01, R2 = 0.045). Despite high support for the principles of hand hygiene, in practice, these principles were not always respected, the impact on the practice was negative in areas such as: general adherence to the HH principles, wearing long and painted nails. The compatibility of views with practice was detected in relation to wearing a wedding ring.

Уровень профессионального выгорания врачей-ординаторов, проходящих стажировку в скоропомощном стационаре: данные до ситуации пандемии

The review of modern studies on the issue of professional burnout in young doctors and medical residents revealed the highest emotional distress in young residents doing internships in intensive care and emergency units. The paper presents the results of the study on 143 medical residents in the multi-profile hospital of emergency medicine. The methodical complex used included Maslach Burnout Inventory, Symptom Checklist‐90‐Revised (SCL-90-R) by L. Derogatis, and a survey on the attitude to professional troubles. Most young doctors pointed out the close relationship between problems with physical health and emotional wellbeing to their professional activity. The vast majority of the participants met the criteria for burnout, as indicated by high emotional exhaustion (69%) and depersonalization (85%) indications from the Maslach Inventory. Although most residents didn’t endorse any problems in communicating with the patients, their high level of depersonalization is more likely to attest to formalizing their relationships with the patients as opposed to having high social competence. The yielded results let us conclude that it is necessary to develop and implement into training programs for medical residents of the multi-profile hospital of emergency medicine programs promoting their communication competence, coping with distress, and preventing professional burnout.

Experience of treatment acute iliopsoitis in the conditions of urgent multi-profile surgical hospital

Between 2010 and 2019 17 patients in the age from 25 to 64 years with acute iliopsoitis were observed. It has been established that the most common cause of iliopsoitis is suppurative processes of the skin and subcutaneous fat ‒ 70,6 %, less often, as a result of osteomyelitis of the lumbar vertebrae and sacrum, tuberculosis spondylitis, pus leakage from the abdominal cavity and pelvis ‒ 29,4 %. To verify the diagnosis of acute iliopsoitis, it is necessary to use hardware diagnostic methods, of which the most informative is the MRI method (sensitivity up to 100%). With timely diagnosis of the disease, successful conservative treatment is possible, and if purulent complications develop or are detected, the operations of choice remain «open» drainage operations of the N.I. Pirogov, Crompton-Pirogov, Israel. With an adequately planned treatment strategy, a reduction in the number of postoperative complications and the mortality rate can possibly be achieved as 6,7 % and 5,9 %, respectively. More than 94% of patients may have a complete clinical and functional recovery.

Cardiovascular multimorbidity and temporary disability among health professionals of the multidisciplinary city hospital

Relevance. The article highlights the topical issues of cardiovascular mulimorbidity (CVM) and temporary disability (TD) among medical workers of a large multi-profile city clinical hospital. Aim. To assess the incidence of chronic noncommunicable diseases, CVM and TD in medical workers of the city clinical hospital. Materials and methods. 527 physicians (207 men and 320 women) aged 25 to 79 (42±9.8) years and 857 nurses (32 men and 825 women) aged 19 to 79 (41±9) years were included in a retrospective, open-label study. The medical documentations analysis was performed. Results. Hypercholesterolemia was diagnosed in 38%, overweight - in 26%, obesity - in 4.8%, smoking - in 27,2%, hypertension - in 9.1%, coronary artery disease - in 3%, diabetes mellitus - in 3.2%, CVM - in 2.3% of health care workers. Over the 3-year period, 42.3% of cases of TD were recorded. TD was associated with the female sex (OR 2.4, 95% CI 1.7-3.4; p

Expansion of opportunities in diagnostics of bacteremia and sepsis in children of a multi-profile hospital.

Primarily in the study of bacteremia, coagulase-negative staphylococci and representatives of the order Enterobacterales were found. To establish the etiological role of coagulase-negative staphylococcus in making a diagnosis of sepsis in each particular case, it is necessary to consider the condition and age of the child, as well as indicators of markers of systemic inflammation. In 1/3 cases of coagulase-negative staphylococcus indicate colonization of the catheter. Staphylococcus aureus in bacteremia and sepsis - 6.5%, Haemophilus influenzae - 0.6%, Esherichia coli - 7.8%, Streptococcus agalactiae - 2%. For the diagnosis of sepsis, it is necessary to conduct repeated (at least two times) blood culture studies using high-quality nutrient media containing all the necessary growth factors, followed by a mandatory determination of the susceptibility of the isolated strains of microorganisms to antimicrobial agents. Bacteremia as a whole in children of a multidisciplinary hospital amounted to 5.8%. In premature babies, bacteremia was detected in 4.4% of cases, of which sepsis was confirmed in 41,2%.

ORGANIZATIONAL AND ECONOMIC ASPECTS OF CLINICAL AND LABORATORY ACTIVITIES - POSSIBILITIES AND PERSPECTIVES OF OPTIMIZATION

“Clinical Laboratory” is an independent medical specialty, a dynamic clinical discipline of a scientific and applied nature. Laboratory researches, the results of which are objective indicators of the state of the organism, are of great importance in terms of modern medicine. Laboratory analyses help to achieve, within certain limits, such a result that can be used for the purpose of making the necessary medical decisions. “Laboratory Medicine” is a complex specialty, covering different directions: clinical chemistry, laboratory haematology, immunology, immunohematology, biology, drug monitoring and laboratory toxicology. A wide varietyof techniques is used for the analysis of biological fluids, the composition and properties of different types of cells, tissues, organs and systems.According to World Health Organization (WHO)data, in the past 20 years, the rate of morbidity within the population of nosologic units requiring high technologies and accuracy of diagnostic tests has increased. Modern revolution in clinical medicine complicates research methods and, as a result, increases significantly their value and cost.Laboratory units are widely considered to determine the status of each national healthcare system. Effectiveness of laboratory diagnostic process can be ensured by two key elements – high-tech equipment and professional staff. A need exists for identifying and using internal reserves with a view to the optimization of work volume and structures of laboratory and diagnostic units, being a promising and the most realisticdirection in the contemporary socio-economic situation.The mission of Clinical Laboratory departments is focused both on the provision of fast, adequate and accurate medical-diagnostic assistance, as well as on making effective use of any available material and technical resources and personnel potential. The problem being studied, its importance and the analysis of Clinical Laboratory activity are an essential component of the vision for this activity: high quality of clinical and laboratory results, timely and accurate diagnosis, adequate, timely and effective medical decisions.Main activities such as management; documentation of researches assigned and carried out; financial and economic aspects related to the valuation of laboratory analyses; tracking cost and available options for their optimization; reasonable time reduction for the production of laboratory analyses; introducing new high-performance technological equipment to improve the quality of laboratory activities and optimize the healing process have been researched and analysed in the Clinical Laboratory of “Kanev” University Multi-Profile Hospital for Active Treatment, Ruse.

Recent guidelined for the early endovascular management of patients with acute ischemic stroke and practical aspects of their implementation

Objective — to estimate safety and effectiveness of intra-arterial treatment for acute ischemic stroke in the interventional radiology department of multiprofile hospital. Materials and methods. Urgent endovascular treatment was applied at 15 patients with acute ischemic stroke in carotid circulation during 2015–2017. Mechanical intra-arterial therapy with thrombectomy by stent-retrievers and thromboaspiration was used at accordingly six and two recent cases (during 2017); in 7 cases intra-arterial thrombolysis was the treatment option (2015–2016). Results. The article consist brief review of literature about acute ischemic stroke treatment and discussion concerning results of treatment of selected patients. Mechanical thrombectomy or thromboaspiration were effective in 75.0 % of cases with good recanalization rate opposite to 42.9 % at 7 patients treated by either intra-arterial or bridging thrombolysis with rt-PA. Unexpected technical failures of mechanical thrombectomy regarding recent clinical guidelines for ischemic stroke management following are discussed on example of 2 clinical cases. Conclusions. Endovascular treatment of ischemic stroke has a high safety and well-known efficacy. It became evident at our patients that following current management guidelines for thrombectomy with stent-retrievers or thromboaspiration after thrombotic occlusions of extracranial and proximal segments of intracranial arteries allowed attaining in 2017 reperfusion rate 2b/3 Modified Treatment in Cerebral Ischaemia Scale in majority of cases. Intra-arterial thrombolysis contributed to the reperfusion rate 2b/3 on the Modified Treatment in Cerebral Ischaemia scale just in 42.9 % of cases, which indicates its lower effectiveness.

AN EXPERIENCE IN PROVIDING SPECIALIZED MEDICAL CARE IN CLOSED COMBINED INJURIES AND INJURIES AT THE LEVEL I TRAUMA CENTER OF SAINT-PETERSBURG RESEARCH INSTITUTE OF EMERGENCY MEDICINE N.A. I.I. DZHANELIDZE

Relevance.Mortality and unsatisfactory results of treatment with polytrauma are high, which is explained by the lack of an effective system of organizing specialized medical care for this category of victims.Intention.To study the effectiveness of organizing specialized medical care for polytrauma in the Level I Trauma Center of St. Petersburg Research Institute of Emergency Medicine n.a. I.I. Dzhanelidze.Methods.The 5-year (2013–2017) experience in the provision of specialized medical care in closed co-traumatic injuries in the trauma center of the St. Petersburg Research Institute of Emergency Care n.a. I.I. Dzhanelidze was analyzed. Of 3852 patients, 2970 had closed combined injuries, 882 – various wounds. 44.7 % of the victims with closed and 33.1 % with other injuries had signs of traumatic shock on admission.Results and Discussion.Owing to the up-to-date methods of examination and treatment of patients, treatment and tactical prognosis by “T”-criterion and Damage Control approach, mortality in severe closed co-trauma was reduced from 18.1 % in 2013 to 9.9 % in 2017, and in other injuries – from 7.4 to 2.3 %, respectively. An advanced effective system of specialized medical assistance to victims of polytrauma has been created at the present time in St. Petersburg.Conclusion.Аn experience of the Level I Trauma Center of Saint Petersburg Research Institute of Emergency Medicine n.a. I.I. Dzhanelidze as the oldest in the city and the country convincingly confirms the correctness of the modern concept of medical care in case of severe closed combined injuries. Our Trauma Centers uses the whole arsenal of diagnostic and treatment facilities of multi-profile hospitals with the involvement of various specialists, which results in reducing mortality and complications in polytrauma.

Hospital-Wide Surveillance of Healthcare-Associated Infections as a Source of Information about Specific Hospital Needs. A 5-Year Observation in a Multiprofile Provincial Hospital in the South of Poland.

Healthcare-associated infections (HAIs) are adverse complications of hospitalisation resulting in delayed recovery and increased costs. The aim of this study was an analysis of epidemiological factors obtained in the framework of constant, comprehensive (hospital-wide) infection registration, and identification of priorities and needs in infection control, both with regard to targeted surveillance, as well as preventative actions. The study was carried out according to the methodology recommended by the HAI-Net (Surveillance Network) coordinated by the European Centre for Disease Prevention and Control, in the multiprofile hospital in Southern Poland, between 2012 and 2016. A total of 159,028 patients were under observation and 2184 HAIs were detected. The incidence was 1.4/100 admissions (2.7/1000 patient-das of hospitalisation) and significantly differed depending on the type of the patient care: in intensive care units (ICU) 16.9%; in surgical units, 1.3%; non-surgical units, 1.0%; and paediatric units, 1.8%. The most common HAI was gastrointestinal infections (GIs, 28.9%), followed by surgical site infections (SSIs, 23.0%) and bloodstream infections (BSIs, 16.1%). The vast majority of GIs, BSIs, urinary tract infections, and incidents of pneumonia (PN) were detected in non-ICUs. As many as 33.2% of cases of HAI were not confirmed microbiologically. The most frequently detected etiologic agent of infections was Clostridium difficile—globally and in GI (49%). Comprehensive analysis of the results allowed to identify important elements of surveillance of infections, i.e., surveillance of GI, PN, and BSI not only in ICU, but also in non-ICU wards, indicating a need for implementing rapid actions to improve compliance with HAI prevention procedures.

К ВОПРОСУ О ВЫДЕЛЕНИИ ГРУППЫ РИСКА НАЛИЧИЯ ПСИХИЧЕСКИХ РАССТРОЙСТВ В ПРАКТИКЕ КАРДИОЛОГИЧЕСКОГО ОТДЕЛЕНИЯ

Differential diagnosis of somatic and somatoform pathology is a pressing issue in general practice. The aim of this&#x0D; study was to develop an algorithm for identification of the patients with indications for psychiatrist’s consultation and&#x0D; possible psychotropic therapy at the stage of admission to multi-disciplinary hospital.&#x0D; Material and methods. Regression analysis of data of 1031 patient hospitalized in the cardiology department of a&#x0D; multiprofile hospital was done with the aim of identifying factors determining the recommendation for receiving&#x0D; psychotropic therapy at discharge.&#x0D; Results. An algorithm for allocation among patients of cardiological profile individuals that require a multidisciplinary&#x0D; approach to treatment involving experts in the field of mental health is proposed. Factors included in the formula were&#x0D; labile or paroxysmal hypertension, the number of associated (non-cardiological) diagnosis, female gender and heart&#x0D; rate or heart rhythm disorders with the debut at the age below 55 or 50 years: I = 8 × L + D + 3 × F + 3 (6) × H.&#x0D; Conclusion. The revealed pattern may be useful in the clinic of internal diseases for screening of patients with a high&#x0D; contribution of the emotional state the severity of the condition. The doctors of the hospitals of somatic (therapeutic)&#x0D; profile should pay more attention to the psycho-emotional condition of patients with labile hypertension, early onset of&#x0D; cardiac arrhythmias, and large number of comorbidities. Patients that meet the criteria are likely to need a consultation&#x0D; of a psychotherapist or psychiatrist because of the presence of psychosomatic or other mental disorders.