Professional Medical Community Research Articles

TIBBIYOTDA DEONTOLOGIYA VA BIOETIKANING DOLZARB MUAMMOLARI

The development of modern medicine directly depends on the synthesis of achievements in both fundamental and applied natural sciences. Medicine not only studies the human being but also extends beyond natural sciences, which not only allows but also includes the integration of ethical factors into explanatory research. In the late 20th century, the incorporation of the bioethical component into medical and biological knowledge became particularly relevant due to the rapid development and implementation of new biomedical technologies. The realities of biomedical science and practice, such as resuscitation, transplantation, genetic engineering, and artificial fertilization, make social and ethical issues pertinent not only to the professional medical community but also to society as a whole. Among these are the determination of the social and moral justification of resuscitation procedures, the recognition of socio-ethical restrictions on methods of artificial fertilization, including in vitro reproduction and cloning; the determination of the social and moral acceptability of genetic diagnosis and prognosis, etc. In this article, the author discusses the current issues of deontology and bioethics.

Results of the Russian Society of Cardiology survey "Chronic heart failure. Unsolved issues"

Aim. To analyze the readiness of the professional medical community for changes in the classification and implementation of novel approaches to heart failure (HF) treatment based on an online survey.Material and methods. Anonymous online survey of physicians on the official website of the Russian Society of Cardiology (www.scardio.ru) "Chronic heart failure. Unsolved issues" was held from September 30 to October 4, 2023. The survey involved 1015 doctors with an average length of work >10 years, mainly cardiologists (n=810, 83,2%).Results. The majority (n=591, 58,2%) of respondents considered it necessary to identify the HF prestage in the classification, similar to prediabetes or prehypertension, while only 2,2% (n=22) of respondents did not consider it necessary to indicate the HF risk in the classification. Simplifying the HF classification based on the left ventricular ejection fraction (LVEF) values with the identification of only two gradations of LVEF <50% and LVEF ³50% was supported by 60,3% (n=612) of specialists.The majority (80,8%) of respondents supported increasing the time of admission of a patient with HF to 30 minutes to ensure the healthcare quality. According to the survey, only 32% of respondents have the ability to determine the brain natriuretic peptide level in patients with HF without restrictions, which indicates insufficient material security for the implementation of clinical guidelines in practice. Quadruple therapy is prescribed to every patient with HF by only 37% of respondents who took part in the survey, which may indicate clinical inertia regarding following the guidelines.Conclusion. In general, the survey demonstrated high awareness of physicians about the problem of HF and readiness to assess the risk and diagnose HF at preclinical stages, as well as a positive attitude towards changing the classification.

The impact of media reporting of suicides on subsequent suicides in Asia: A systematic review

Introduction: This systematic review is aimed at (1) evaluating the association between media portrayals of suicides and subsequent copycat suicides or attempts among the general public in Asia, (2) understanding the factors associated with copycat suicides and (3) determining the positive impacts of the media reporting of suicides (e.g. increased help-seeking, coping). Method: A systematic review and narrative synthesis of English and Chinese articles from 8 electronic databases (i.e. PsycINFO, MEDLINE, Embase, CINAHL, Web of Science, Ariti, China National Knowledge Infrastructure and OpenGrey) from January 2000 to May 2023 was conducted. Observational studies were included, and the data were analysed through narrative synthesis. The protocol was registered with PROSPERO (CRD42021281535). Results: Among the 32 studies included (n=29 for evidence synthesis) in the review, there is good-quality evidence to show that copycat suicides and suicide attempts increase after media reports of a suicide, regardless of country, celebrity status, study design, type of media, mode of suicide or follow-up period. Females, younger age groups and those sharing similar characteristics as the deceased in publicised suicides (age, gender) were more susceptible to negative impact. Reporting of the mode of death of the deceased increased suicides by the same method among the public. Conclusion: Media portrayals of suicide appear to have a negative impact on copycat suicides at the population level in Asia. Thus, in addition to tighter media control, healthcare systems, professional medical bodies and community outreach services should work collaboratively to promote early help-seeking in those with psychological distress.

Direct Oral Anticoagulants’ Consumption and Expenditure in the COVID-19 Pandemic in Russia and Clinical Practice Guidelines for Their Use

Background: The coronavirus pandemic has led to the creation of clinical guidelines by a large number of professional medical communities. However, the quality and methodology of development of Russian clinical guidelines has been little studied. The continued relevance of studying the use of DOACs (Direct oral anticoagulants) in patients with COVID-19 was the basis for conducting this study. Aim: The objective of this study was to assess DOAC consumption and expenditure in the Russian Federation during the COVID-19 pandemic and to analyze whether it was supported by the domestic evidence base for the use of DOACs in COVID-19 patients through identifying all publicly available Russian-produced CPGs (Clinical practice guidelines) for the treatment of COVID-19 and assessing their quality as the source of recommendations for the use of oral anticoagulants for the prevention of thrombotic complications in COVID-19 patients. We searched Russian databases for CPGs, published between 2020 and 2023. We identified seven relevant documents that met our inclusion criteria. Three authors analyzed Russian clinical guidelines using an AGREE II questionnaire. We calculated DOAC DDD (defined daily dose) consumption according to Russian clinical guidelines and DDD consumption in patients with COVID-19 for the period 2020–2022. Results: Seven clinical CPGs were analyzed with the AGREE II tool. It was revealed that experts gave the highest scores for the sections on scope and purpose (from 62.98% to 100%), and clarity of presentation (from 96.30% to 100%). The lowest scores were given for the sections on stakeholder involvement (33.33% to 64.81%), rigour of development (from 0% to 49.31%), applicability (from 23.61% to 50%), and editorial independence (from 0% to 50%). When comparing the total score, it was found that two clinical guidelines received the highest scores—ROPNIZ (Livzan), and ROPNIZ (Drapkina). The minimum score was registered with the NIIOZMM (Khripun) clinical guideline. No guideline received a total score of more than 70%. According to clinical recommendations, the consumption of apixaban and rivaroxaban is 15 DDD (30-day course of therapy), or 22.5 DDD (45-day course of therapy). Consumption of apixaban in the Russian Federation in 2020 and 2021 corresponds to the indicators presented in clinical recommendations (in 2020—26.59 DDD per patient with COVID-19; in 2021—15.75 DDD per patient with COVID-19), and in 2022—10.67 DDD, which is below the recommended values. In 2020, consumption of rivaroxaban in the Russian Federation was 26.59 which corresponds to data from clinical recommendations; in 2021, consumption decreased to 7.87 DDD; in 2022 it decreased to 5.48 DDD, which is 2.74 times less than recommended. Conclusions: Analysis of seven clinical recommendations revealed that such sections of clinical recommendations as scope, purpose, and clarity of presentation had the highest degree of assessment in accordance with AGREE II. The lowest scores were given for the sections on stakeholder involvement, rigour of development, applicability, and editorial independence. When comparing the total score, it was found that two clinical guidelines received the highest scores—the Russian Society for the Prevention of Non-communicable Diseases (Livzan), and the Russian Society for the Prevention of Non-communicable Diseases (Drapkina). The minimum score was registered with the Research Institute for Healthcare Organization and Medical Management of Moscow Healthcare Department clinical guideline. No guideline received a total score of more than 70%. During the pandemic, the highest DDD consumption of DOACs was in 2020, which exceeded the DOACs’ recommended DDD by Russian clinical guidelines. DOAC consumption had decreased by 2022. There was a decrease in the consumption of rivaroxaban, with an increase in apixaban’s share in the structure of DOAC consumption during the coronavirus pandemic. Obtained data indicate that in 2021 the apixaban consumption in the Russian Federation corresponded to the recommended DDD in the national guidelines, which indicates the most correct use of apixaban according to Russian GPGs.

Health Preserving Practices of Russians with Post-COVID-19 Syndrome

Introduction: Post-COVID-19 syndrome, its symptoms, duration and treatment are the subject of discussion not only within the professional medical community, but also among various groups of the population. Health-related narratives of Internet users about post-COVID-19 syndrome help understand what behavioral strategies can be implemented in people facing this condition and increase the effectiveness of health-preserving measures. Objective: To characterize health preserving practices of the Russians suffering from post-COVID syndrome based on the analysis of digital narratives about the disease, rehabilitation methods and therapies. Materials and methods: This qualitative research explored health practices in narratives of a sample of 23 Russian Internet users that struggled with post-COVID-19 syndrome. Results: Narratives about post-COVID-19 syndrome include documenting a) symptoms of the disease, b) ways of searching for and maintaining information about treatment methods, c) details of communication with representatives of the medical community and the social environment (including medical gaslighting), and d) health care practices (in terms of therapy and rehabilitation) and their efficiency. The narrator’s initial focus on formal/traditional medicine or selftreatment largely determined the behavioral strategy in the context of post-COVID conditions. Three types of strategies have been identified: 1) a strategy of maximum institutionalized health care, which involves responsible behavior (visiting a doctor for the first symptoms, complying with recommendations), 2) a strategy of independent health care based on the importance of one’s own opinion (following “habitual algorithms”), and 3) a strategy of independent health care focused on the opinion of the social environment (Internet search for information about post-COVID-19 conditions, discussions with friends and acquaintances). For all types of strategies, health care practices included taking medications, maintaining a healthy lifestyle, and striving for psycho-emotional balance. Conclusion: The study of narratives about post-COVID-19 syndrome made it possible to describe human behavior in the face of a new health challenge, systematize basic health preserving practices, raise questions related to the functioning of the health care system, and establish certain manifestations of social attitudes towards health.

Analysis and assessment of psychological health and quality of life of nursing specialists in the oncological hospital

The study of the issues of psychological health of oncology nursing staff, as well as the identification of professional factors that affect the quality of life of nurses working in an oncology hospital, remain relevant at the present time, which determined the purpose and objectives of this study. Target. To develop recommendations for eliminating the causes that violate the psychological health of nursing specialists of the Togliatti City Clinical Hospital No. 5 and reduce their quality of life. Results. The professional activity of nursing specialists of the oncological hospital and their personal characteristics were analyzed, the quality of life of nurses/brothers of the oncological service of the Togliatti City Clinical Hospital No. 5 was assessed, the reasons causing problems in the psychological health of oncological nursing specialists were identified. Conclusion. The main recommendations for improving the conditions of psychological comfort and improving the quality of life of oncology nurses/brothers are: increasing the staff of clinical psychologists in oncology hospitals; conducting trainings in order to reduce tension in the team and build harmonious teamwork; conducting sessions of therapeutic physical culture in a hospital; creation of a room for psychological relief; development of a corporate culture that will make nurses/brothers feel involved in the professional medical community and strengthen respect for the profession.

Мнение детских оториноларингологов об основных проблемах в организации медицинской помощи и приоритетных направлениях деятельности профессионального врачебного сообщества.

A medical and sociological study was carried out in order to determine the opinion of specialists on current problems in the organization of children’s otorhinolaryngological care and on the priority areas of activity of the professional medical community. Five main medical and organizational problems in the organization of children’s otolaryngological care are identified: maintaining and developing human resources, stimulating the work of medical workers; improvement of resource support for assistance, stimulation of investments in the development of the material, technical and technological base; increasing the availability of qualified assistance; management optimization; improvement of methodological support and introduction of modern technologies for rendering assistance. Pediatric otorhinolaryngologists consider the main activities of the professional community to be: representing the legitimate interests of the Association members, promoting the protection of their professional and social rights; assistance and participation in advanced training and professional retraining of specialists; professional consolidation, strengthening and development of relations between specialists; meeting the needs of specialists in obtaining knowledge about the latest achievements, advanced domestic and foreign experience.

Open source automated insulin delivery systems: benefits, limitations and challenges in diabetes care

Open source closed loop automated insulin delivery (CL-AID) systems are increasingly used in the treatment of diabetes. Assembled on a do-it-yourself (DIY) basis, these systems integrate insulin pumps, continuous glucose monitoring devices, and algorithms that control the rate of insulin delivery based on glucose levels. In this review, we consider the technological features of open source CL-AID systems (OpenAPS, AndroidAPS, Loop, etc.), advantages and barriers to their use in clinical practice. Advantages of open source CL-AID systems over commercially available ones included lower cost, a choice of devices, a wide range of user settings, as well as continuous improvement of algorithms. A growing body of evidence indicates that open source CL-AID systems, such as OpenAPS, AndroidAPS, and Loop, provide an excellent time in range with minimal risk of hypoglycaemia and increase treatment satisfaction in patients with type 1 diabetes. A wide range of settings makes open source systems an effective tool for managing diabetes in situations with rapidly changing insulin requirement. However, some technological, medical, legal and ethical issues associated with the use of non-commercial CL-AID systems still need to be addressed. Assembling the system requires skills in diabetes technology. The issue of cybersecurity is also relevant. Lack of official approvals, low awareness of medical professionals, and reimbursement issues are slowing down the introduction of the technology into clinical practice. The professional medical community at the international and national levels needs to determine its position regarding the use of open source CL-AID systems in the treatment of diabetes.

Медицинская тема в социальном кино как средство транслирования нормативности

The article is devoted to the consideration of medical topics in social movies, which means film production as an instrument for the formation of social norms and models of behavior in society. Relying on the Entertainment-Educational (E-E) approach in the study of mass media, authors consider the impact of films and medical series on increasing public interest in health care problems, the formation of professional medical communities and the dissemination of knowledge in the field of medicine. According to the socio-cognitive theory of A. Bandura, a person is able to learn by observing and imitating actions broadcast on television. Starting from this situation, the authors analyzed the educational potential of social movies, using the phenomenon of the series "Simply Maria", "Happy Days", "Hum Log", "House M.D.", etc. The article provides examples of the worldview attitudes and strategies of behavior formation in relation to their health through the use in cinema of plots and scenes that demonstrate the work of doctors and talk about medical problems. Social films with medical topics contributed to a change in the attitude of society towards the elderly and people with special needs, considered outsiders in society, radically influenced the perception of HIV-infected people and played an important role in popularizing donation and solving the problems associated with the growth of cardiovascular diseases. Medical cinema and TV shows are not only case in social cinema, that determined the norms of human behavior in a modern society immersed in the media environment, but it performs an educational rule-making function in the development of health care and a healthy lifestyle.

The Follow-up of the digestive system (for primary care specialists: internist, general practitioner, paramedic) The experience of the Perm region

These recommendations are intended for primary care professionals: internists, general practitioners, paramedics and include a statement of the basic requirements for the follow-up of patients with a number of diseases of the digestive system. The main material of the methodological recommendations is presented by adapted sections from modern clinical recommendations of specialized societies on certain nosological forms of diseases and current regulatory federal documents on dispensary supervision of the adult population. The guidelines were approved by the Perm Regional United Organization “Professional Medical Community of the Perm Region” and the Ministry of Health of the Perm Region. Also, the main provisions of the recommendations were presented and approved at the National Congress of the Society of Therapists (November 19, 2021).

Case study of a healthcare virtual community model

The increase in the global life expectancy in current modern times concurs with the rise in chronic conditions and diseases. In addition to the threat to life posed by these diseases, they can also lead to chronic conditions in the elderly, which not only put an immense strain on the healthcare capacity but also poses a tremendous burden on social resources. Therefore, this study used the two-tiered business model, including innovation, resource, market, and value, as the basis to propose a healthcare virtual community model. Furthermore, this study identified social support as well as healthcare support as important factors to categorize four healthcare virtual communities, such as professional healthcare, ordinary, medical, and commercial communities. We list cases for each category to exemplify each category of communities.

. Patient community as a factor in the development of medical education practices in modern Russia

Introduction. The study draws attention to the need to transform the Russian system of medical education. It is connected with overcoming modern challenges and Russia’s focus on improving the quality of life of people as a key state priority. The authors substantiate the connection of the patient-centred approach with the values of the “anthropological turn” in the field of medical education. The results of the analysis of foreign experience in the implementation of patient-oriented pedagogical focus in the practices of medical education are given. The study analyses the cases related to the peculiarities of patient communities functioning in order to identify their possible influence on the development of medical education practices.Aim. The current research aimed to identify ways and conditions of using the opportunities of patient communities for the development of practices of Russian medical education.Methodology and research methods. System-based, activity-oriented and phenomenological approaches made up the methodology of the study. Research methods: theoretical analysis, phenomenological analysis, structural analysis, survey, Delphi technique, focus group.Results. The research results are the following:The main directions for the development of medical education practices in the patient-oriented paradigm were outlined, namely: the formation of new, defined in terms of polysubjectivity (students, teachers, practitioners, representatives of patient communities) ways of organising educational interaction; transformation of didactic characteristics of medical academic programmes; updating the forms and means of work to form the worldview of future doctors within the framework of humanistic values.The study revealed the features of the educational functionality of patient communities, which is significant for the development of medical education practices, shown through the following roles of patient community: diagnostician, content developer, designer, moderator, mediator, researcher, analyst, technologist, teacher (trainer), expert. The revealed roles allowed the authors to identify patient community as an actor in the development of modern Russian medical education practices.The organisational and pedagogical ways of patient community influence on the development of medical education were identified: interactive polysubject collaboration of pedagogical, medical and patient communities in the design and implementation of academic programmes; organisation of open design-reflective communication platforms for discussing topical problems of patient communities with the involvement of subjects of medical education; volunteer projects integrating the activity of patient communities and students of medical academic programmes.The study identified the conditions for using patient communities for the development of education practices and professional development of a modern physician, including: well-established organisational and methodological mechanisms for the implementation of roles of the patient community in the organisation of all didactic components of the educational process (its types) in the system of continuous professionalisation of physicians (objectives, content, teaching technologies, monitoring of educational results); availability of systemically functioning mechanisms for introducing students of medical academic programmes to the practices of medical communities.Scientific novelty. The study substantiates the expediency of the interaction of the professional and educational medical communities with the patient as a factor in the development of the Russian system of medical education within the framework of a patient-oriented paradigm that reflects the values of the anthropological turn.The study reveals the types of activities of patient communities. These types reflect their identity as a new actor in the development of Russian medical education practices, namely: communicative, informational, project, expert, and diagnostic; evidence-based motivation for change.The authors prove the potential of the patient community as an actor in the development of Russian medical education practices, the implementation of which is ensured by creating organisational and pedagogical conditions that actualise these communities as the subjects of the educational process through multifaceted and functionally defined roles.The study outlines the ways and conditions of using the potential of polysubject interaction (patient, professional and educational medical communities) to transform the basic didactic characteristics of the educational process (its variations) in the medical education system.Practical significance. The obtained scientific results can be used to develop the content and activity-technological formats of educational programmes of higher medical education, to enrich practices of continuous medical education, to expand the productive experience of interaction between patient, medical and educational communities.

Факторы социальной травматизации профессиональной группы врачей

The article reveals a sociological approach to the analysis of the concept of collective trauma understood as the destructive, dysfunctional consequences of social transformations concerning large groups of people. Currently, the professional medical community is particularly vulnerable to social trauma and often takes moral responsibility for it. The healthcare reform, begun in 2010, its economic, social, and psychological consequences became the main trigger for the formation and development of such a trauma. The novelty of this study lies in the substantiation of the application of the concept of social trauma concept application for analyzing the personal professional doctors’ activity. The aim of the study is to identify the factors of social traumatization of a social group of doctors. The objectives are: to substantiate special features of the social trauma concept actualization on the example of a professional group of doctors; to rank the identified factors of social traumatization; to determine the reasons for the formation of these factors. The qualitative sociological study using the in-depth interview method, attended by 35 doctors of various specialties, was conducted. The received interview texts were processed by using content analysis. The level of professional burnout of doctors was determined according to K. Maslach’s questionnaire. The socially traumatic factors of the professional activity of doctors were determined: high emotional stress from interactions with patients; the requirement to provide highly professional assistance; the serviceization of society; the level of managerial culture; work mode; rest mode; increasing responsibility for meeting professional standards; limiting the openness and publicity of professional activities; salary; the level of medical personnel training; occupational safety regime. It is concluded that a series of reforms in the Russian healthcare system brought doctors to the need to “fit in” with new requirements, when moral norms are deformed, and the performance of their professional duties is reduced. Such adaptation to “innovations” led to the formation of a social trauma in the professional medical community.

CLINICAL CASE OF BIPLASTIC CORRECTION OF ABNORMAL PULMONARY VEIN DRAINAGE WITH SINUS VENOSUS DEFECT IN A DOMINANT INNOMINATE VEIN IN ADOLESCENCE

Sinus venosus defectis an unusual type of interatrial communication and is almost always combined with partial abnormal pulmonary vein drainage (PAPVD) into the superior venacava (SVC) or right atrium (RA). Different types of venous outflow through the vena cava occur: the presence of an additional left vena cava with different drainage loci to both right and left atriaor, as in our case, the dominant unpaired vein directly draining into the right atrium with outprior communication with the superior right vena cava. This paper describes a clinical case of radical correction of partial anomalous pulmonary vein drainage combined with sinus venosus atrial septal defect (ASD) in a 14-year-old child with dominant venous outflow from the upper half of the body via innominate vein, by combined biplasty from auto pericardial patches, showing adequate upper-venous outflow under cardiopulmonary bypass. It is necessary to provide clear information about congenital heart disease and optimal timing of its surgical correction to a wide audience, not only to the professional medical community, but importantly, to the entire population of the Republic. The provision of publicly available professional information should be highlighted on the official websites of clinics and all available media opportunities, where parents and patients could be fully acquainted with the specific soft entire treatment processing an accessible and convenient information platform.

Teaching and Learning Medical Ethics: How to Bring Positive Change

Decision making in healthcare does not depend only on mastery of knowledge, clinical skills, and technical competencies, rather it is largely influenced by ethical competences of the physicians. Teaching medical ethics in undergraduate medical education (MBBS programme in Bangladesh) helps medical students recognize the importance of being sensitive to ethical issues within everyday clinical practice and develop in them the ability to effectively address the concerns of patients and families, as well as participants in health research and larger society. In medical practice, its ethical component is treated as an obligatory one, no matter what the specialty is. The importance of ethics in medicine is increasing greatly day by day; its dimensions are also changing. In this review paper, we have tried to discuss some effective changes in medical ethics curriculum, methods of teaching and learning, faculty development, and institutional culture. All stakeholders should think about it and take necessary actions into that direction, which will ultimately lead to building a more ethical, more patient-centred, more professional medical community in the country.
 CBMJ 2022 July: vol. 11 no. 02 P: 167-175

Are clinical guidelines important in pediatric practice?

Due to measures to optimize the healthcare system, the role of the primary care specialist is constantly increasing. The professional standard of a primary care pediatrician clearly defines his/her job functions, but a significant number of pediatricians do not always follow the regulatory documents on the provision of medical care to patients. Nevertheless, in case of any conflicts and in case of assessing the quality of medical care within the framework of various types of examinations, first of all, the compliance of the provided medical care with the current regulatory documents is assessed. The standard of medical care is not intended to make any decisions on the treatment of a particular patient, it is an economic tool. Amendments to the law №323-FZ "On the Fundamentals of Healthcare in the Russian Federation", adopted in 2018, gave clinical guidelines the status of mandatory for implementation along with standards, regulations, and procedures for providing medical care. Thus, clinical guidelines in our country are the basis for medical care, prepared by professional medical communities taking into account domestic and foreign meta-analyses and randomized clinical trials, and are aimed at protecting the rights of patients and medical workers. In the article on the example of clinical guidelines for salmonellosis in children the therapy option in the form of probiotics, the validity of their use in various clinical situations is analyzed.

Пандемия: возвращение в прошлое или окно в будущее?

The article analyzes political, social, economic and cultural consequences of the COVID‑19 pandemic for French society. The national strategies of the state management of the sanitary crisis that have developed in the world are investigated: the strategy of “zero tolerance to coronavirus”; the strategy of free circulation of the virus; the strategy determined by the formula “stop and go”. France, like many other Western countries, chose the last one, which implied a combination of harsh measures (lockdown, self-isolation, mandatory vaccination, introduction of sanitary passes) with relaxation caused by the demands of business and society. The increased role of the State in the fight against the pandemic is revealed. The political context of the pandemic crisis settlement is revealed: centralization of power; tight control of the head of state over the activities of the Cabinet of Ministers; dominance of political power over the professional medical community; reduction of the parliament’s role. It is shown that under conditions of the sanitary crisis, the process of informatization of production and services accelerated, significant shifts occurred in the labor market, and there was an increase in social and socio-spatial inequality. The problem of the middle class, which continues to fragment, is acute. The pandemic and especially the methods of combating it caused a protest in French society: the French did not just express disbelief in the effectiveness of the vaccine, with their speeches they demonstrated distrust of the authorities and state institutions. The pandemic has shown that France is in dire need of a new social compromise that would take into account not only the interests of global corporations, but also people who have remained beyond the threshold of the information economy. The issue of reviewing the lowest salaries and raising the status of a number of professions is acute.

ОБРАЩЕНИЕ ГЛАВНОГО РЕДАКТОРА К ЧИТАТЕЛЯМ ПЕРВОГО НОМЕРА «БАЙКАЛЬСКОГО МЕДИЦИНСКОГО ЖУРНАЛА». ЖУРНАЛ СО 100-ЛЕТНЕЙ ИСТОРИЕЙ

The history of the publication of a medical journal is closely connected with the life of the medical community of the Irkutsk province and began long before the establishment of Irkutsk State University. In 1858, a Circle of Doctors was created, on the basis of which, on June 26, 1863, the Society of Doctors of Eastern Siberia was created. Initiative of Irkutsk doctors G.I. Weirich, K.V. Kinasta, N.A. Belogolovoy was officially enshrined by the Minister of Internal Affairs of the Russian Empire, with the approval of the Charter of the Society. The "Society of Doctors of Eastern Siberia" was in dire need of an exchange of experience and an increase in professionalism. This required a publication that would meet the professional needs of physicians. So since 1863, the Society of Doctors of Eastern Siberia in Irkutsk began to publish the Protocols of the Society of Doctors of Eastern Siberia. The publication gained great popularity among members of the Society, and other professional medical communities became interested in it. The publication was published in a circulation of 50-100 copies, had appendices. Over the years of its existence, more than 50 issues have been published. After the opening of the medical department of Irkutsk University on August 26, 1919, and by the time of the separation of the medical faculty in January 1920, the professional needs of the medical community increased significantly. Of course, organizational work occupied the first years, and complete isolation from the center of our country did not contribute to scientific research, and after that, publishing activity was also hampered. However, without the exchange of scientific opinions, the development of medical science is impossible. Therefore, already in 1921, a group of members of the Faculty of Medicine took the initiative to create a Scientific and Medical Society. The initiative was supported and on November 15, 1921, the university board approved the charter of the new professional society of doctors. The newly created society set the next task of organizing its own printed organ. And in 1923, the publication of the Irkutsk Medical Journal began. The journal was published in the absence of any funding, but its quality corresponded to serious professional publications. The journal presented the work of students, residents, practitioners, graduate students and members of the faculty of the institute. It published clinical observations, new methods of research and treatment. The journal regularly published articles by foreign authors from the USA, France, Japan, Mongolia, Kyrgyzstan, Uzbekistan, Germany, and the Czech Republic. In 2019, due to changes in legislation, the Siberian Medical Journal was forced to suspend its activities in the previous format. In 2022, after major transformations and a change in the composition of the founders, the journal was re-registered as the Baikal Medical Journal. The journal was founded by the Irkutsk State Medical University and the Irkutsk Scientific Center for Surgery and Traumatology. Professor I.V. Malov, and the composition of the editorial board and the editorial board was significantly updated. Thus, a new page was opened in the history of the leading medical publication in Siberia, whose history in 2023 will be 100 years old.

The bioethical committee as an institute for social control of technological innovations in medicine: law analysis

The article provides a general description and classification of bioethical committees from the point of view of the subject and goals of their activities, the nature of their authority, legal status, organizational and legal foundations of their activity. The bioethical committee is interpreted as a special institutional form of organizing scientific (interdisciplinary) and public understanding of moral and legal problems in the field of medicine, generated by technological innovations. In the system of social control the bioethical committee is a social institution that is either integrated into the system of public administration, or creates its own channels of influence on the position of the professional medical community and public opinion. From this point of view the article analyzes foreign and Russian history of bioethics committees institutionalization. The author interprets bioethics as a field of scientific and practical activity, the social purpose of which is to translate actual bioethical dilemmas, unsolvable on the basis of abstract principles, into the communicative space, where a consensus can be based on common moral intuitions. The article substantiates the thesis that the main intention of bioethics and bioethics committees, as an expression of its practical function, is to find a legal solution to problems. The author made proposals for improving the legal support for the creation and operation of bioethical committees in Russia.

Vaccination against new coronavirus infection in patients with cardiovascular and autoimmune diseases

The review article is devoted to a discussion of the issues of vaccination against a new coronavirus infection in patients with cardiovascular and autoimmune diseases. Presented at the time of this writing are data on domestic vaccines safety in the Russian Federation: combined vector vaccines “Gam-COVID-Vac” and “Gam-COVID-Vac-Lyo”, peptide-based vaccine “EpiVacCorona”, concentrated, purified and inactivated whole-virion “KoviVac” vaccine, and a standalone vaccine/booster shot “Sputnik Light”. The analysis of the main contraindication applicable to the vaccines in different categories of patients has been carried out. A number of consensus documents published by Russian and foreign professional medical associations and communities on the issues of vaccination of patients with cardiovascular and autoimmune diseases are considered in detail.