Otorhinolaryngological Diseases Research Articles

Analysis on the incidence of new occupational diseases in Weihai City from 2009 to 2020

Objective: To analyze the pattern and characteristics of occupational diseases in Weihai City from 2009 to 2020, and to provide scientific basis for the formulation of occupational disease prevention. Methods: In February 2021, retrospective analysis was performed on the cases of occupational diseases diagnosed from 2009 to 2020 in Weihai City. The relevant information and data were collected to analyze the types of occupational diseases, onset age, working age, diagnosis time, industry distribution, economic type and enterprise size distribution. Results: From 2009 to 2020, a total of 453 cases of new occupational diseases were reported in Weihai City. There were 431 males (95.14%) and 22 females (4.86%) . The average onset age was (49.16±8.51) years, and the average working age was (17.89±9.30) years. The incidence of pneumoconiosis and other respiratory diseases (322 cases, 71.08%) , occupational otolaryngology and oral diseases (71 cases, 15.67%) and occupational chemical poisoning (36 cases, 7.95%) were the top 3 cases, of which 313 cases were pneumoconiosis and 69 cases were noise deafness. The cases were mainly concentrated in the 40-59 years age group (357 cases, 78.81%) and the 10-19 years working age group (175 cases, 38.63%) . There were significant differences in the incidence of occupational diseases in different ages and different working ages (χ(2)=97.64, 80.74, P<0.001) . The new cases were mainly in mining industry (134 cases, 29.58%) , shipbuilding or maintenance industry (97 cases, 21.41%) , and private enterprises (350 cases, 77.26%) . Conclusion: Pneumoconiosis and noise deafness are the main emerging occupational diseases in Weihai City. Occupational disease prevention and control in private enterprises such as mining and shipbuilding or maintenance industry should be strengthened.

Efficacy and safety of ambroxol hydrochloride in the treatment of secretory otitis media: a systematic review and meta-analysis.

BackgroundSecretory otitis media is a very common nonsuppurative inflammatory disease in otorhinolaryngology. Ambroxol hydrochloride helps to improve ciliary movement in the ear canal and promote the dissolution and discharge of secretions. However, its effect still lacks systematic evaluation. We conducted a meta-analysis of clinical studies to systematically evaluate the application effect of ambroxol hydrochloride.MethodsA computer-based search of the Chinese Biomedical Database (CBM), China National Knowledge Infrastructure (CNKI), PubMed, and Web of Science databases was conducted using the keywords “Ambroxol hydrochloride” & “secretory otitis media”. Randomized controlled trials published after 2015 were selected and then screened and analyzed using RevMan 5.4 software.ResultsTen studies involving a total of 998 patients were included. Meta-analysis showed that adding ambroxol hydrochloride to the original glucocorticoid treatment improved therapeutic efficacy [odds ratio (OR) =4.95, 95% confidence interval (CI): 3.27, 7.50, P<0.00001], reduced tympanic pressure after treatment [mean difference (MD) =−19.04, 95% CI: −22.72, −15.36, P<0.00001], and increased the pure tone threshold (MD =6.37, 95% CI: 5.36, 7.37, P<0.00001), without increasing adverse reactions (OR =0.51, 95% CI: 0.14, 1.85, P=0.30).DiscussionOn the basis of the original treatment of secretory otitis media, adding ambroxol hydrochloride treatment improved the therapeutic effect, reduced tympanic pressure after treatment, and improved the pure tone threshold (hearing), without increasing adverse reactions.

A study of otorhinolaryngological diseases with ophthalmic complications: at a tertiary care center

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; The close proximity of the eyeball and the orbit to the ENT region, makes the involvement of the orbit and there of ophthalmological manifestations common in the practise of Otorhinolaryngology. The diseases of ENT with orbital extension must be considered whenever a patient presents with signs and symptoms of orbital disease such as proptosis, orbital mass, restriction of eye movements, neurological dysfunction of eye, chemosis, vision disturbances or epiphora.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients presenting with ophthalmological manifestations due to various ear, nose, throat and head–neck pathologies were constituted in this prospective study which was carried out on 50 patients of the age group 10 years to 60 years with ophthalmological complications along with ENT diseases who came to the department of ENT and department of Ophthalmology of N.S.C.B. Medical College, Jabalpur from August 2019 to August 2021.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results: &lt;/strong&gt;Males were affected more than female with ophthalmic complications. Sinonasal tumours were the most common cause of orbital complications, of which carcinoma of maxilla was the commonest , followed by sinonasal lymphoma .Nasal obstruction was the most common ENT complaint and proptosis was the commonest orbital sign.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;A firmer knowledge of orbital anatomy with respect to sinonasal region is required for any surgeon dealing with this important area, for a safer and more secure management in this complex region. Surgery remains the main stay of treatment for sinonasal diseases with orbital complications. Rapid diagnosis and treatment are of utmost importance in preserving vision and life in these patients.&lt;/p&gt;

Differential diagnosis of temporomandibular joint disease and otolaryngological disease: An examination from symptoms

Differential diagnosis of temporomandibular joint disease and otolaryngological disease: An examination from symptoms

Density of Health Workforce Correlates to Disease Outcomes: Evidence From Global Data in Otolaryngology.

ObjectiveTo better understand the impact of the otolaryngology-specific workforce on the burden of related diseases.Study DesignRetrospective analysis of existing workforce density data as compared with the incidence, mortality, and morbidity data for 4 otolaryngologic diseases.SettingAn overall 138 countries with known otolaryngology–head and neck surgery workforce and epidemiologic data.MethodsWe obtained raw data on workforce estimates of ear, nose, and throat surgical specialists from the World Health Organization. Disease burdens for 4 conditions were estimated via 2 ratios, the mortality:incidence ratio (MIR) and YLD:incidence ratio (years lost to disability), as specified in the Global Burden of Disease database. These were correlated to country-specific otolaryngologist density data in univariate and multivariate analyses.ResultsIncreased density of the ear, nose, and throat workforce correlated with better outcomes for otolaryngologic-treated surgical diseases. A 10% increase in otolaryngology workforce density was associated with a 0.27% reduction in YLD:incidence ratio for chronic otitis media, a 0.94% reduction in MIR for lip and oral cavity cancer, a 1.46% reduction in MIR for laryngeal cancer, and a 1.34% reduction in MIR for pharyngeal cancer (all P < .001)—an effect that remained after adjustment for health systems factors for all conditions but chronic otitis media.ConclusionThe density of the surgical workforce is assumed to affect disease outcomes, but ours is the first analysis to show that increased workforce density for a specific surgical specialty correlates with improved disease outcomes. While there is a consensus to increase access to health care providers, quantifying the effect on disease outcomes is an important metric for those performing health economics modeling, particularly where resources are limited.

Expression of Periostin in Vocal Fold Polyps.

Long-term voice abuse or sudden vocal fold microvascular disruption may lead to injury and subsequent repair/remodeling in the vocal fold mucosa. Periostin is known to be involved in airway remodeling and also in various otolaryngological diseases. The aim of this article was to investigate the expression and the role of periostin in the formation of vocal fold polyps. The expression patterns of periostin in 59 surgical specimens of vocal fold polyps from 54 patients were investigated immunohistochemically. Normal vocal fold mucosa specimens from 5 patients who had undergone total laryngectomy were used as the control group. Retrospective study with planned data collection was conducted at Tohoku Medical and Pharmaceutical University. Expression of periostin was detected in 43 (72.9%) samples and four patterns of periostin expression were observed in vocal fold polyps: negative type, superficial type, infiltrative type, and diffuse type. An association was observed between periostin expression patterns and the histological subtypes of vocal fold polyps. The infiltrative pattern of periostin expression was significantly dominant in vascular-hyaline types. Expression of transforming growth factor-β (TGF-β) was also detected in the vocal fold polyps. Our results confirmed that periostin might be involved in certain pathological changes in vocal fold polyps, such as extracellular matrix accumulation, local fibrosis, and formation and development of vocal fold polyps.

Otolaryngological diseases in the persons called up for the military service

Otolaryngological diseases in the persons called up for the military service

An ethnobotanical review on medicinal plants of the Lamiaceae family in Turkey

Medicinal plants have been used by humans for the treatment of various diseases for thousands of years from past to present. Members of the Lamiaceae family are among the most preferred medicinal plants due to the wide variety of secondary components they contain, particularly essential oils. In this review, Master?s and PhD theses and books based on ethnobotanical studies investigated between 1960 and 2021 as well as internationally recognized databases (PubMed, Scopus, Google Scholar, Web of Science, SciFinder, Springer and Elsevier) were used to determine the medicinal uses of Lamiaceae taxa among the people in Turkey. As a result of the study, it was found that a total of 221 taxa (192 species) belonging to 29 genera, 51 of which are endemic, have medicinal/therapeutic uses. The local names of these taxa, the usage which are used among the people, the diseases in which they are used, and the geographical regions given in the present study. The genera of taxa most commonly used for medicinal purposes by the local people are Salvia (37 taxa), Sideritis (25 taxa), Stachys (22 taxa), Thymus (16 taxa) and Origanum (13 taxa). It was observed that the most frequently used two methods while preparing these plants for use was infusion (61%), and decoction (24%). Studies conducted on National (TURK, BHP), Regional (EU) and International Pharmacopoeias (WHO) and various monographs (AHP, COMISSION E, EMA, ESCOP, PDR) have revealed that there are 29 taxa included in these pharmacopoeias and monographs whose purpose of use are similar to the diseases that local people are trying to treat. Diseases that people use plants for therapeutic purposes are grouped into 12 categories. It was determined that these plants were widely used for therapeutic purposes in gastric disorders as well as otolaryngology and respiratory system diseases. This review briefly discusses whether some taxa commonly used by the local people in the treatment of diseases can be useful in the treatment of the disease in question, in the light of scientific studies.

Screening for laryngeal disease in patients with gastroesophageal reflux disease

To improve the diagnosis of laryngeal disease in patients with gastroesophageal reflux disease (GERD). 171 patients (89 (52%) men, 82 (48%) women) with non-erosive (39 (23%) people) and erosive (132 (77%) people) forms of GERD were examined. None of the patients made active complaints about the condition of the larynx and pharynx. The examination included a questionnaire, examination by an otorhinolaryngologist, and videoendolaryngoscopy. The survey revealed the presence of symptoms of otorhinolaryngological pathology in 74% of patients. Videolaryngoscopy revealed no laryngeal pathology in 55 (32%) patients, and signs of GERD-associated laryngitis were detected in 116 (68%) patients. The most common pathology was pachydermia in interarytenoid region - in 89 people, laryngeal granuloma was detected in 7 patients, leukoplakia - in 2 patients, chronic edematous polypous laryngitis - in 2 patients, benign laryngeal formations - in 9 patients. In patients with GERD (erosive and non-erosive forms), an asymptomatic course of chronic laryngitis associated with this pathology was observed in 44% of cases. In 52% of patients, pachydermia in interarytenoid region was diagnosed, of which every second had pronounced hyperplasia and folding of the mucous membrane in interarytenoid region, which must be differentiated from laryngeal cancer (in this case, patients should be under the dynamic supervision of an otorhinolaryngologist). Other precancerous formations of the larynx (granulomas and leukoplakia) were found in 5% of patients. Benign neoplasms of the larynx (polyps and cysts) were also detected in 5% of cases. Despite the high frequency of detection of otorhinolaryngological diseases in the examined patients with gastroesophageal reflux disease, none of the patients presented complaints related to the pathology of the larynx, which indicates the need for active detection of this pathology in this category of patients by questioning, questioning, as well as examination by an otorhinolaryngologist.

Prevalence of Otolaryngology Diseases in an Urban Homeless Population.

Otolaryngology diseases are common among people experiencing homelessness; however, they are seldom evaluated in a specialist setting, and investigations on their prevalence have rarely been conducted. The aim of this retrospective study was to evaluate the prevalence of otolaryngology conditions in an urban homeless population. Retrospective study. Primary health care facility. The clinical records of patients referred to the medical facilities of the Primary Care Services of the Eleemosynaria Apostolica, Vatican City, between October 1, 2019, and July 31, 2021, were retrospectively reviewed; those reporting at least 1 otolaryngology disease were included in the study. A total of 2516 records were retrospectively reviewed, and 484 (19.24%) were included in the study. The most common otolaryngology disease was pharyngotonsillitis (n = 118, 24.13%), followed by rhinitis with nasal obstruction (n = 107, 21.88%), hearing loss (n = 93, 19.01%), otitis (n = 81, 16.56%), abscess (n = 46, 9.40%), and sinusitis (n = 33, 6.74%). Head and neck cancer or precancerous lesions were reported in 34 subjects (7.02%). More than 1 simultaneous otolaryngology disorder was found in nearly 50% of our sample. A wide range of comorbidities was also reported. Our results confirm an elevated otolaryngology demand in the homeless population and encourage the development of more efficient and effective strategies for a population-tailored diagnosis and treatment of these conditions.

Otolaryngology Utilization in Patients With Achondroplasia: Results From the CLARITY Study.

To quantify otolaryngologic surgery utilization in patients with achondroplasia, and to identify any changes in utilization over the past four decades. Retrospective cohort study. A retrospective cohort study of 1,374 patients with achondroplasia enrolled in the CLARITY retrospective cohort study at four centers of multi-specialty care for patients with achondroplasia. Otolaryngologic surgeries are presented by birth cohort decade. The main outcomes were number of primary and additional otolaryngologic procedures; age at surgery; likelihood of repeated surgery; temporal trends in surgical utilization. In this cohort of 1,374 patients with achondroplasia, 620 (45.1%) had pharyngeal surgery at least once, 150 (10.9%) had pharyngeal surgery on more than one occasion, and patients who had adenoidectomy first were 2.68 times more likely to require a second pharyngeal surgery than those who had adenotonsillectomy. Seven hundred and seventy-nine (56.7%) had tympanostomy tubes placed at least once, and 447 (32.5%) had tympanostomy tubes placed more than one time. Age at first pharyngeal surgery decreased by 1.2 years per birth cohort decade, and age at tympanostomy tube placement decreased by 1.1 years per decade. Patients with achondroplasia often require otolaryngologic surgery, particularly adenoidectomy and/or tonsillectomy as well as tympanostomy tube placement. Such surgery is performed now more frequently and at younger ages than in earlier decades. While otolaryngologic disease associated with achondroplasia is now recognized earlier and treated more frequently, long-term outcome studies are needed. 3 Laryngoscope, 132:1548-1554, 2022.

Extrapulmonary Tuberculosis: An Otorhinolaryngologist's Perspective.

The study aimed to determine the clinical manifestations and epidemiology of extrapulmonary tuberculosis (EPTB) of the head and neck in the otorhinolaryngeal regions. There is an increase in the incidence of EPTB in recent years because of increase in immunocompromised states and development of resistant bacteria. The clinical symptoms and signs of EPTB of the otorhinolaryngeal regions overlap with that of malignancies and other diseases in otorhinolaryngology thereby requiring correct early diagnosis so as to avoid unnecessary surgeries and procedures with initiation of appropriate anti tuberculous treatment under RNTCP. Our prospective study was done on 45 patients who attended the ENT OPD at a tertiary care centre in Southern India over a period of 18months with diagnosed EPTB of the otorhinolaryngeal regions. The study included 29 (64.4%) patients who presented with cervical lymphadenopathy, 11 (24.4%) patients with tuberculous laryngitis, 3 (6.6%) patients with tuberculous otitis media and 1 each with nasal and oral cavity tuberculosis. In our study 6 (13.3%) patients had co-existing pulmonary tuberculosis, 8 (18%) had diabetes, 5 (11%) had past history of tuberculosis and 7 (16%) had contact with patient with tuberculosis. A high index of suspicion of EPTB must be kept among patients where (i) the clinical symptoms are out of proportion to the signs, (ii) common treatment fails or (iii) there is persistence or recurrence of symptoms despite therapy. The challenge is in confirming diagnosis which requires histopathological examination (HPE) of the tissue specimen. The timely diagnosis and initiation of anti tuberculous treatment (ATT) as per RNTCP helps in complete recovery thereby reducing morbidity.

REVIEWING THE THERAPEUTIC ACTIVITY OF VITAMIN D WITH ASTAXANTHIN

This article is an examination of the Rar The scientific development and subsequent “vitamin D and astaxanthin” continues to influence the researchers all over the globe today. This article examines the research done and published by researchers and scientists. Consideration of current trends and data in scientific queries and demonstrates further aspects of Therapeutic activity of vitamin D with astaxanthin. Additionally, this article explores options for vitamin D with asthaxanthin in orthopaedic. The combination of both result in enhanced endurance and walking distance in senior adults, as well as increased muscular strength and size (sarcopenia). Thus, in elderly adults, mobility, endurance, and strength were all increased using a single training strategy. Vitamin D with astaxanthin in ENT. The vitamin D and astaxanthin has been proven to possess effective activity against reactive oxygen species, cell apoptosis, inflammatory and auto immune disorders. Vitamin D with astaxanthin in gynecology.Antioxidants and vitamin D have been found to play an important role in reducing the causes of diseases linked with female infertility.&#x0D; Keywords: Infertility, antioxidant, otolaryngological diseases, musculoskeletal system, cartilage homeostasis

A Clinico-Pharmacological Aspect of Kwatha Kalpana in ENT Disorders

Ayurveda is split into many branches. The branch which deal with the drug and use within the style of medicine for the treatment of diseases is thought as Bhaishajya Kalpana (Ayurvedic Pharmaceutics). Bhaishajya Kalpana endorses the five fundamental dosage form, namely Swaras (juice), Kalka (paste), Kwatha (decoction), Hima (cold infusion), Phant (hot infusion). This is often the real source of success for physicians. Among them, Kwatha Kalpana (decoction types of medicine) is that the most vital and widely used dosage form in Ayurvedic pharmaceutic. Shalakyatantra (treatment of disorder above clavicle) is one in all Ashtanga Ayurveda (eight clinical branches of Ayurveda), coping with the study of diseases occurring above the Jatru (part of body above the clavicle), which has Shiras (head), Karna (ear), Nasa (nose), Netra (eyes) and Mukha (mouth) and their management. Shalakyatantra is primarily concerned with preserving and restoring the health of the Indriyas (senses). In modern science ear, nose and throat are studied collectively within the specialized field called otolaryngology or upper tract diseases which is colloquially referred to as ENT. The monotonous mechanical life style, faulty food habits, restless schedule, stress, overpopulation, overcrowding of vehicle leading to the sound and air pollution, junk food habits is causing hazardous effects of receptor. Ayurvedic system of drug enunciates more of preventive measures which are lacking in contemporary science. Identifying the Nidana (etiology) and avoiding it forms the key role in preventing most of the ENT disorders. Hence, it’s is highly essential to spot and treat the common ENT disorder seen in clinical practice with Ayurvedic measures specially Kwath Kalpana. In present article a clinic-pharmacological aspect of the Kwath Kaplana is discussed with reference to ENT diseases.

The treatment progress of obstructive sleep apnea in children

Obstructive sleep apnea（OSA） is a common disease in otolaryngology in children, and its incidence rate is increasing gradually, which seriously endangers children's growth and development, behavior cognition and so on. There are many etiologies of OSA in children. Besides tonsil hypertrophy and/or adenoid hypertrophy, the most common one, there are many different levels of airway obstruction caused by inflammation, dysplasia, obesity and other reasons. Different individualized treatment plan should be taken according to different etiology. This paper summarizes the different treatment methods of children OSA.

Clinical Biomarkers in Otolaryngology-Head and Neck Surgery: Autoimmune Diseases.

The purpose of this article is to review the literature and compile promising and clinically relevant biomarkers in autoimmune disease related to otolaryngology-head and neck surgery. Narrative review. Pubmed and Google Scholar were queried using combined key words such as "biomarkers" and "otolaryngology." Additional queries were made with combined key words such as "biomarkers" and a particular subspecialty such as "autoimmune" or "Meniere's" to maximize yield of relevant titles. Subsequently, specific biomarkers identified, such as "anti-TPO-antibodies," were used as key words. Relevant titles were reviewed and selected for abstract review. Applicable abstracts were then selected for review of the full text. Biomarkers that are currently in clinical use for the management of autoimmune diseases within the field of otolaryngology were included in this review. The compiled biomarkers were then detailed individually regarding their molecular characteristics, function, and clinical significance. Based on this literature review, there are several biomarkers currently in clinical use within the field of otolaryngology relating to autoimmune diseases. The majority of these biomarkers are in the form of proteins such as Cogan peptide and c-ANCA. This survey may serve as a comprehensive resource on biomarkers for autoimmune diseases in clinical otolaryngology.

Otorhinolaryngological diseases of Geriatric visiting Tertiary Care Hospital in Nepal: An Overview of neglected and underrated field

Background and Objectives: In Nepal, person aged 60 years and above is considered elderly. The population of Nepal is approximately 30 million, and people aged 60 years and above makes about one tenth of the total population. This study aims to report the main complaints and prevalence of otorhinolaryngological diseases in patients aged 60 years and above, who visited outpatient otolaryngology department of Manmohan Memorial College and Teaching Hospital, Kathmandu, Nepal during study period.&#x0D; Material and Methods: It is a prospective descriptive cross-sectional study done in Manmohan Memorial College and Teaching Hospital, Kathmandu, Nepal for the duration of a year. All patients aged 60 years and above attending to Ear, Nose and throat (ENT) Outpatient Department were included in the study. The information including demographic data, ENT Complaints and physical examination were noted. Analysis of data was done and report was prepared.&#x0D; Results: Total of six hundred and ninety three patients were enrolled over the period of one year for the study. Number of Male and female patients in the study were almost equal. The otological problems had the highest prevalence constituting 51.7% of the study population. More than Twenty eight (28.3 %) percent had oral and oropharyngeal pathologies. Nasal complaints constituted 10.8% of the study population and 9.2% had pathologies related to neck and others.&#x0D; Conclusion: Hearing loss is the most common diagnosis among all the otological pathologies and epistaxis the most common nasal problem. Head and Neck malignancy is also increasing among the geriatric population.

Analysis of the characteristics of outpatient and emergency diseases in the department of otolaryngology during the "COVID-19" pandemic.

The pandemic of "Corona Virus Disease 2019" (COVID-19) has changed the lives of people. There have been changes in common outpatient and emergency cases in otolaryngology, so an analysis of data pertaining to this was completed. This study is to evaluate the impact of viral infection disease in otolaryngological common disease. This study uses the data of common diseases in the outpatient and emergency department during the "COVID-19" pandemic (from February to April 2020) and the same period in the past 3 years from the Department of Otolaryngology. During the "COVID-19" period compared with the same period last year, the ranking of cases by diseases has changed. Diseases such as chronic pharyngitis, allergic rhinitis, sudden deafness, and tinnitus increased, meanwhile acute pharyngitis and acute laryngopharyngitis decreased (p < 0.05). The viral infection has impacted the mental behaviors of people, therefore mental-related disease cases of the department of Otolaryngology have increased indirectly. This study provides real data to illustrate mental-related diseases. It also provides experience and shows the importance of keeping and maintaining mental health.

The use of decongestants in children in otorhinolaryngological practice

The data about the prevalence of ENT organ diseases in children and the necessity of prescription of nasal forms of vasoconstrictors (decongestants) are presented. A review of the data about the mechanism of action of decongestants, safety and evidence base of their effectiveness in treatment of otorhinolaryngological diseases is presented. It is concluded that decongestants with a higher safety level are chosen a modern combined preparation containing antihistamine (dimethinden) and vasoconstrictor (phenylephrine) components.

Algorithm of innovative medical and economic standards as a basis for the transformation of hypothetical predictions of the launch of insurance medicine

Introduction: Based of tht author's doctoral dissertation of tht problems of insurance medicine, relevant monographs and scientific articles, an attempt is presented to substantiate tht option of transforming our purely governmental national system of insurance medicine. Purpose: Using more than thirty of our innovative organizational and medico-economic standards, criteria and regulations, in tht process of their "activation" in the conditions of a full-scale experiment under the pilot project program in the Health Care institutions of various levels of medical district, to determine the level of their effectiveness to justify the specified transformation during the launch of our system of insurance medicine. Materials and methods: The object of the study was all residents (up to 2000) of the family physician's area of responsibility. On the basis of structural-logical analysis and the use of medical-economic standards, doctors' labor costs, distribution of otolaryngological diseases into clinical-statistical groups (CSG) and diagnosticrelated groups (DRG), as well as the degree of their complexity and the complexity of possible surgical interventions, thanks to the formula for calculating the labor costs of doctors and treatment process we obtained evidencebased information about real "budget" cost of treatment of diseases of a certain CSG. Results and discussion: At the first in trade part mental stage of insurance medicine, the main tool should be a system of medical and economic standards, which include the price of labor costs, in particular doctors, wage fund, rates of increasing coefficients for the treatment of complex diseases, the level of financial incentives for doctors and the like. The tables present a mechanism for calculating the evidence-based cost of treating diseases of varying degrees of complexity and physician salaries, as well as the possibilities of forming both an adequate amount of funds that "follow the patient" and forecasting the health improvement budget for the family physician's area of responsibility. Conclusions: Presented an algorithm for the implementation of our medical and economic standards, the feasibility of which has been proven in the "field" conditions of the field experiment in the process of professional management, can constitute, under conditions of its continuous improvement, the medical and economic basis for the start of our system of budgetary and insurance medicine.