State Medical Institute Research Articles

Valery Aleksandrovich Chereshnev – organizer of the immunological service in the Western Urals

The article is dedicated to the 80th anniversary of Valery Aleksandrovich Chereshnev, a Russian scientist, academician of the Russian Academy of Sciences, known for his works in the field of immunology and pathophysiology. V.A. Chereshnev began his career at Perm State Medical Institute, where he continued his postgraduate studies after graduating with honors. In 1970, he defended his PhD thesis on the topic “On the role of the properties of microbial cells and macroorganisms in the mechanism of development of an early phagocytic reaction to the introduction of typhoid vaccine”. In 1982, he defended his doctoral dissertation on the topic “Closed chest injury in combination with gamma irradiation (clinic, pathogenesis, treatment, medical protection).” He worked as a lecturer and professor in various educational institutions, and also headed scientific laboratories. In 1988, he became the director of the Institute of Ecology and Genetics of Microorganisms, Ural Branch of the Russian Academy of Sciences, and then organized a branch in Yekaterinburg, which was later transformed into the Institute of Immunology and Physiology, Ural Branch of the Russian Academy of Sciences, where he also became the director. Valery Aleksandrovich was elected a corresponding member of the Russian Academy of Sciences, academician of the Russian Academy of Sciences, Chairman of the Ural Branch of the Russian Academy of Sciences and Vice-President of the Russian Academy of Sciences, Chairman of the Committee on Science and High Technologies of the State Duma of the Federal Assembly of the Russian Federation. In addition, he was elected President of the Russian Scientific Society of Immunologists, organized the Society of Immunologists of the Urals. Currently he is actively developing immunological services in the Western Urals.

PUBLIC ANTI-CRISIS MANAGEMENT AND COMMUNICATIONS WHEN PROVIDING EMERGENCY MEDICAL AID IN THE MEDICAL INDUSTRY OF UKRAINE

In this article, the authors focus on several key problems that arise in the process of management and communication in crisis situations related to the provision of emergency medical care. The article examines approaches to managing crisis situations in the sphere of health care of Ukraine in conditions of increased uncertainty and instability. The authors emphasize the importance of effective communication between medical institutions, government structures and the public to ensure prompt response to emergency situations. The article examines various aspects of public crisis management, including planning, organization of resources, and coordination of actions during the provision of emergency medical care. The article analyzes the tools of public management, which allow to minimize various consequences of incoherence of actions between state institutions and medical institutions. Special attention is paid to the importance of prompt decision-making and establishment of communication links between state bodies, medical workers and the population. The possibilities of applying international experience in the field of anti-crisis management and its adaptation to Ukrainian realities are also discussed. The conclusions of the article emphasize the need to reform the health care system in the direction of strengthening its resilience to crises, improving communication mechanisms, and implementing innovative management solutions to increase the effectiveness of providing emergency medical care in emergency situations. The article emphasizes the need for quick decision-making, building effective communication chains between medical staff, patients and other stakeholders. Special attention is paid to the challenges associated with the lack of resources, the limited capabilities of the health care system in the context of crises and the role of leadership in implementing changes. The article also offers recommendations for improving communication processes and management approaches that will contribute to increasing the effectiveness of medical care during emergency situations, particularly in wartime.

ORGANIZATION OF METHODOLOGICAL PRINCIPLES OF THE STATE INNOVATION POLICY IN THE SPHERE OF INFORMATIZATION OF THE HEALTH PROTECTION SYSTEM OF UKRAINE

The article highlights the key issues related to the need to modernize the health care system, globalization and integration into international structures, health care reform. In Ukraine, the process of health care reform is underway, which involves increasing the efficiency of the medical services system, their availability and quality. Innovations can accelerate these processes, in particular through the introduction of digital technologies (e-health, telemedicine), automation of management of medical facilities, development of remote diagnosis and treatment. The state innovation policy will allow to more effectively prepare for similar challenges in the future through the development of new vaccines, diagnostic methods, monitoring systems and management of medical resources. Support from the state (for example, through preferential taxation) to the development of the private medical services sector will reduce the burden on the state budget. In addition, it contributes to the attraction of investments in this area. Therefore, the state innovation policy in the field of health care is a relevant tool for ensuring the sustainable development of the health care system of Ukraine, increasing its efficiency and competitiveness, which meets the modern challenges and needs of society. The authors analyze the key aspects of the state policy aimed at the informatization of medical institutions, in particular, the digitalization of medical services, the introduction of electronic medicine, the creation of unified information platforms and patient databases. The article examines the importance of developing a clear methodology for the implementation of innovative solutions, as well as the role of the state in creating favorable conditions for the informatization of the health care system. The authors also analyze the international experience and the possibilities of its adaptation for Ukrainian realities, emphasizing the need to establish effective cooperation between state bodies, medical institutions and technological companies. The article concludes about the importance of an integrated approach to the informatization of the health care sector in order to improve the quality of medical services and increase the efficiency of medical resource management.

ANALYSIS OF MODERN APPROACHES TO FINANCIAL SUPPORT OF HEALTHCARE FACILITIES IN UKRAINE

The purpose of the study is to analyze modern effective approaches to the financial support of healthcare institutions, which have been successfully implemented in the leading countries of the world, in order to form a unique model of their financing in Ukraine. The uniqueness of the model is ensured by taking into account the institutional features of modern Ukrainian reality. The article analyzes the financial instruments for providing healthcare under various models of financing the healthcare system, which are used in global practice. The process of reforming the healthcare system in Ukraine was studied, which made it possible to establish changes in the financing of healthcare. The components of the healthcare institution's budget are given. The main advantages and disadvantages of approaches to financing healthcare in Ukraine are determined. The volume and structure of expenditures of the Consolidated Budget of Ukraine on healthcare, as well as the main results of the activities of medical care providers covering all regions of Ukraine, were analyzed. The problems of financing healthcare facilities at the local level in Ukraine, which negatively affect the availability and quality of medical services, have been identified. The need to develop a mixed model of healthcare financing in Ukraine through a rational partnership between state medical institutions and the private sector is substantiated. Taking into account the identified problems and needs, a comprehensive approach to improving the financing of healthcare facilities through the introduction of mandatory health insurance and the development of public-private partnerships in the form of facility management, including resource optimization and technological innovations, is proposed.

Smart control in healthcare

The author analyzes the prospects of SMART control in healthcare, which provides monitoring of the activities of state medical institutions included in the healthcare system of the Russian Federation, while minimizing the administrative burden. SMART control — “smart” control to prevent violations of budget legislation. It is planned to create a unified electronic system for generating accounting and reporting data for public finances by 2027. This will make it possible to consolidate accounting information about public finances, including in the healthcare system, and improve the efficiency and quality of management of public medical institutions. The connection to the GIS “Electronic budget” of medical organizations will allow to reorient mainly on the methods of preliminary control.

Not to Betray Anatomy (Devoted to the 70th Anniversary of Professor A. K. Usovich)

In August 2024, Professor A.K. Usovich, the famous Belarusian morphologist, Doctor of Medical Sciences, Professor of the Department of Human Anatomy, Vitebsk State Medical University, turned to be 70 years old. Alexander Konstantinovich was born on August 27, 1954 in the village Ushachi, Vitebsk region. In 1977, he graduated from the Vitebsk State Medical Institute, where he worked his way up from a senior laboratory assistant to the head of the Department of Human Anatomy, which he led for 21 years. A.K. Usovich is a member of the Coordinating Council of the International Association of Morphologists, a member of the Board of the Belarusian Association of Morphologists. Professor A.K. Usovich focused on the improvement of anatomical techniques, structural organization and interstitial relationships in the prostate at the stage of ontogenesis, variant anatomy of the lymphoid, vascular, nervous systems, morphohistochemical changes in the structures of the visual, vestibular and auditory sensory systems in case of blood flow disorders, improving the educational process at the departments of the morphological profile. He trained 5 candidates and 7 masters. For his services to higher education, Professor A.K. Usovich was awarded the "Excellent Healthcare Worker" badge, honorary certificates, diplomas of the Ministries and Departments of the USSR, BSSR, the Republic of Belarus, regional legislative and executive authorities, universities of the CIS countries.

Oncological outcomes of stage I–II breast cancer treatment after subcutaneous/skin-sparing mastectomies with reconstruction

Aim. To study the recurrence of stage I–II breast cancer after subcutaneous/skin-sparing mastectomies with reconstruction with or without radiation therapy. Materials and methods. From 2013 to 2022, 984 patients diagnosed with breast cancer underwent 1020 subcutaneous/skin-sparing mastectomies with reconstruction at the P.A. Herzen Moscow State Medical Institute. Histological types are presented: cancer in situ – 7, invasive cancer without signs of specificity – 818, invasive lobular cancer – 105, combined cancer – 40, rare forms – 50. Subcutaneous mastectomy with reconstruction was performed in 617 (60.5 %), skin-sparing mastectomy in 403 (39.5 %) cases. Reconstruction with own tissues was performed in 5.7 %, expanders/implants in 94.3 % of patients. Patients with diagnosed mutations in the genes ВRCА1, 2, СНЕК2 amounted to 208 (21.1 %), while among patients with primary multiple synchronous cancer, the percentage with mutations was 25 %. Results. In the studied group of patients, recurrence of breast cancer was diagnosed in 40 (4.1 ± 0.1 %) cases, distant metastases – in 52 (5.3 ± 0.1 %) cases. The minimum time to relapse was 36 months, and the maximum was 108 months. In a single-factor analysis of the stage of the disease: at stage I, relapse was diagnosed in 25 (5.8 %) cases, at stage IIA (T2N0M0) – in 5 (2.0 %), at stage IIA (T1N1M0) – in 6 (4.2 %), at stage IIB T2N1M0 – in 4 (2.1 %) (p > 0.05). The recurrence in the group with radiation therapy was 2.5 ± 0.6 (odd ratio 0.98, 95 % confidential interval 1.52–3.48), without radiation therapy 5.1 % (odd ratio 2.13, 95 % confidential interval 0.92–5.18) regardless of the stage of breast cancer (t-criterion >2, p > 0.05). In our study, the recurrence of breast cancer at the edge of R1 was 6.8 ± 2.5 %, at R0 – 3 ± 0.6 % (p > 0.05). When analyzing age and risk of recurrence, we did not identify age dependence, up to 40 years the probability of recurrence is 4.3 ± 1 %, after 40 years – 3.3 ± 0.7 % (t-criterion 0.44, p > 0.05). The dependence of the degree of malignancy of the tumor node and the frequency of recurrence is as follows: G1 – 2. 3 ± 2.3 %, G2 – 3 ± 0.7 %, G3 – 3.9 ± 1 %, when compared G3 c G1 (t-criterion 0.52, p>0.05), when comparing G3 from G2 (t-criterion 0.49, p > 0.05). Recurrence of breast cancer with triple negative type was diagnosed in 2.5 ± 0.9 % relative to other molecular biological types (t-criterion 1.49, p > 0.05). We analyzed the dependence of relapse on the non-luminal and luminal HER2 positive types; the relapse was 5.4 ± 1.5 % (p > 0.05); the dependence on the level of Ki-67; at a level of 40 %, the probability of recurrence is 4 ± 0.8 %, at a level > 40 %, recurrence is 2 ± 0.8 % (t-criterion 1.77, p > 0.05). A statistically significant difference in our study was revealed, in addition to radiation therapy, during neoadjuvant polychemotherapy, so in the group with neoadjuvant polychemotherapy, the recurrence was 2 ± 0.8 %, without neoadjuvant polychemotherapy – 4.1 ± 0.7 % (t-criterion 2.16, р < 0.05). Conclusion. A link between breast cancer recurrence and morphological features (R1 resection margin, lymphovascular invasion, lymphatic tumor emboli, luminal and non-luminal HER2+ subtype, G3) and clinical characteristics (presence of mutations, location of a lesion in the gland, stages) was found. Further search for predictors of breast cancer recurrence after combination or integrated treatment is necessary.

Peptidergic and adenosinergic drugs administration to comatose patients caused by alcohol consumption on early hospital period

Introduction. Medical care for patients diagnosed with the toxic effect of ethanol (according to ICD-10 code T51.0) it turns out to be in specialized toxicological centers or in emergency departments of multidisciplinary hospitals. The purpose of this study was to study the effectiveness of the drug моликсан® (molixаn) at different levels of medical care for patients diagnosed with the toxic effect of ethanol. Material and method. 128 patients were included in the study, of which 76 patients were taken to the emergency department of St. Petersburg State Medical Institution "Alexandrovskaya Hospital" and 52 patients were taken to the intensive care unit No. 11 of the St. Petersburg Scientific Research Institute of Emergency Medicine named after I.I. Dzhanelidze. All patients met the inclusion criteria: age 18–60 years; impaired consciousness of alcoholic genesis 21–30 points on the Glasgow–Pittsburgh coma scale (PBSS: Pittsburg Brain Stem Score, Kelsey S.F., et al. 1991); ethanol concentration in the blood is more than 2.5%. 72 patients were included in the моликсан® group, 56 patients in the Placebo group. Results. The use of the drug моликсан® has a positive effect on the dynamics of restoring the level of consciousness, which is reflected in higher values of the Glasgow–Pittsburgh scale after 1, 3 and 6 hours from the start of therapy (p<0.01), reducing the period of stay of the patient in a coma from 150 [75; 178] minutes to 60 [50; 161.5] minutes (p<0.05) and restoration of consciousness to a clear level after 3.5± 0.3 hours (p<0.05).It was also revealed, that in the group of patients using моликсан®, normalization of heart rate (p<0.05) and a decrease in the frequency and severity of tremor (p<0.05) were noted. The hepatoprotective efficacy of моликсан® was shown, which manifested itself in a decrease in ALT, AST, GGTP, alkaline phosphatase, total and direct bilirubin (p<0.001). Limitations. The clinical efficacy of моликсан® in the toxic effects of severe ethanol was carried out in patients with depression of consciousness and elevated levels of ALT, AST, GGTP, alkaline phosphatase, total and direct bilirubin, which indicated the presence of alcoholic hepatopathy. Conclusion. The conducted study showed the expediency of using моликсан® at a dosage of 3.0 mg/kg intravenously with the toxic effect of ethanol of moderate and severe severity of the disease.

Kursk state medical institute: the first steps of formation

Kursk state medical institute: the first steps of formation

РАСПРОСТРАНЕННОСТЬ И ЗАБОЛЕВАЕМОСТЬ МОЧЕКАМЕННОЙ БОЛЕЗНЬЮ В ЯРОСЛАВСКОЙ ОБЛАСТИ

In modern society, urolithiasis is one of the most common diseases. The study of trends in the incidence and prevalence of the disease is important in practical medicine. The estimated annual increase in urolithiasis is about 3%. The causes of this phenomenon are discussed, and so far they are not fully known. The purpose of the study is to assess the cumulative incident and prevalence of urolithiasis among the adult population living in various municipal districts of the Yaroslavl region based on the analysis of statistical reports of state medical institutions and medical documentation for the period from 2018 to 2023. Materials and methods: A retrospective analysis of the statistical data of the work of state medical organizations of the Yaroslavl region for this period was carried out. An analysis of the total number of adult patients attached, changes in the number of patients attached, and the total number of patients diagnosed with urolithiasis was performed using the relevant International Classification of Diseases codes N20.0, N20.1, N20.2, N20.9, N23.Results and discussions. The results showed that in the city of Yaroslavl over the past 6 years there has been a natural increase in the adult population. However, a decrease in numbers was recorded between 2020 and 2021, possibly due to the negative consequences of the COVID-19 pandemic. There is also a steady trend towards a decrease in the adult population in regions outside the regional center. Conclusion: It can be noted that urolithiasis is a widespread chronic disease of the urogenital system among the adult population living in various areas of the Yaroslavl region.

Выстраивание механизма внутренних коммуникаций участников закупочного процесса государственного учреждения здравоохранения.

The relevance of the work is determined by the need to optimize the procurement process in state medical institutions to improve the quality and efficiency of medical services provided. The subject of the study is the socio-economic interactions between participants in the procurement process, including preparation, implementation, and monitoring of procurement agreements. The purpose of the study is to identify and systematize the main problems in the field of procurement activities of public medical institutions and develop proposals for solving them based on the principles of cost-effectiveness, transparency and fairness. Materials and methods. The study includes a comprehensive analysis of current regulations governing procurement activities, as well as a study of the experience of implementing procurement procedures in medical institutions. Methods of comparative analysis, systematization and synthesis of the obtained data are used to identify key problems and challenges. Results. The work identified the main problems associated with the procurement process in medical institutions, including shortcomings in the regulatory framework, lack of a clear distribution of responsibilities between participants in the process and ineffective management decisions. Proposals were developed to optimize the procurement process, including adapting procurement models to the size and specificity of the activities of institutions, improving the documentation of the distribution of responsibilities and using digital technologies to improve the monitoring and management of procurement. Conclusions. Optimization of the procurement process in state medical institutions requires a comprehensive approach, including improving the legislative framework, enhancing interaction between structural units, and applying modern technologies to increase transparency and efficiency of procurement activities. These measures will not only help eliminate existing problems but also ensure higher quality and availability of medical services. Application of results. The results of the work can be applied in the healthcare system at the level of state medical institutions for the development and implementation of effective procurement models. They can also be used in the development of regulatory documents regulating procurement in the healthcare sector, as well as in the educational process for training specialists in procurement and logistics management in medical institutions.

Effectiveness of organizational and legal measures and new practices to against HIV infection in the Novosibirsk region

The purpose of the study: to study the effectiveness of organizational and legal measures and new practices to against HIV infection introduced in the Novosibirsk region in 2019–2022.Materials and methods. The study was conducted on the basis of the State Medical Institution of the NGO «City Infectious Clinical Hospital No. 1», a division of the Center for the Prevention and Control of AIDS.Results. By Order of the Ministry of Health of the Novosibirsk Region No. 3429 of 10/15/2019, mandatory HIV screening was provided for all hospitalized with unknown HIV status during the year, which significantly increased the coverage of HIV screening. In 2019–2022, an AIDS Center information system was introduced for all patients with HIV infection admitted to inpatient treatment: 6,938 notifications were sent to the AIDS Center. Of the 2,717 patients who required measures to increase the level of adherence and involvement in ART, 18.9% of patients resumed ART after the measures taken; 36.5% started taking ART for the first time. The order of the State Medical Institution of the Infectious Clinical Hospital № 247 «On the organization of family support in the department «Center for the Prevention and Control of AIDS» dated 02.08.2021 provides the principle of monitoring the whole family with one doctor, which improves the adherence of children and parents to ART. For 4 months of functioning of family support, the share of parents receiving ART and having a high commitment increased from 15.5% to 77.3%. Among 45 children who had a previously determined level of HIV RNA viral load on the background of ART, 20% (9 abs.) registered an undetectable level of viral load for 3 months, and 13.3% (6 abs.) – for 2 months.Conclusion. The organizational and legal measures implemented in 2019–2022 in the Novosibirsk region and new practices to combat HIV infection have shown high efficiency: the coverage of dispensary observation of patients with HIV infection increased from 79.3% to 86.5%, and the coverage of antiretroviral therapy – from 74.5% to 85.2%.

Александр Рубенович Ханамиров – основатель школы оториноларингологии в Ростовском государственном медицинском институте

The formation and development of otorhinolaryngology at the Rostov State Medical Institute, which is closely connected with the name of the outstanding scientist, Doctor of Medical Sciences Alexander Rubenovich Khanamirov, are considered. The future scientist began his work in otorhinolaryngology at the clinic of the North Caucasus Railway. Since February 1938, his working and scientific-pedagogical activities have been associated with the ENT clinic of the Russian State Medical Institute. During the Great Patriotic War, A.R. Khanamirov was the chief otorhinolaryngologist of the Kalinin and First Baltic fronts, and in 1953 he was the head of the department of otorhinolaryngology. In 1959 he was awarded the academic title of professor. Since then, the A.R. Khanamirov attention - postgraduate training of doctors, organization of specialized departments in the healthcare system of the region and city. His scientific works are devoted to the problem of surgical treatment of various forms of hearing loss and the development of a new method of treating otosclerosis.

Endoscopic semiotics and pathological characteristics of primary malignant esophageal melanoma: a case report

Primary malignant melanoma of the esophagus is defined as a tumor, the frequency of which is 0.1-0.2% of all malignant lesions of the esophagus. This type of neoplasia is difficult to diagnose and is characterized by rapid progression, high recurrence rate and metastasis. Despite the diagnostic capabilities of X-ray examination methods, which make it possible to identify a tumor and determine its localization, the correct diagnosis can only be established by endoscopic examination of the upper digestive tract with biopsy and subsequent pathological and immunohistochemical studies. A 78 year-old male patient was admitted to the Herzen Moscow State Medical Institute with suspected esophageal cancer. It is known from the anamnesis, that the patient for 6 months notes a dysphagia, pain in the chest area. Based on the data of our expert endoscopic examination, we suspected primary esophageal melanoma with a mixed growth - exophytic and flat-type. According to the results of pathological examination of the biopsies, pigment epithelial-cell melanoma of the esophagus with high mitotic index (up to 3 mitosis figures per 1 sq.mm) with infiltrative growth type. This clinical case demonstrates the importance of a detailed endoscopic examination and performing a targeted biopsy, followed by expert pathological examination in the differential diagnosis of esophageal diseases characterized by pigmentation of mucosa.

Lymphology of Uzbekistan –55 years: the results and development prospects

In 2024, it will be 55 years since the birth of lymphology in Uzbekistan, as an actively developing scientific field. In 1969, a Lymphology research laboratory was created at the Department of Surgical Diseases of the Pediatric Faculty (currently the 1st Department of Hospital and Faculty Surgery) of the Andijan State Medical Institute. The initiator of the organization of the Lymphological Laboratory was the head of the Department, Doctor of Medical Sciences Satkul U. Dzhumabaev. In 1987, the laboratory was transformed into the Center for Clinical Lymphology of the Ministry of Health of Uzbek Soviet Socialist Republic. Today, Uzbekistan has its own School of Clinical Lymphology, recognized among specialists. 10 doctoral and 32 candidate dissertations have been defended, work continues on 6 doctoral and 10 candidate dissertations. More than 1 450 scientific papers, 12 monographs have been published, including the first manual in English “Regional lymphatic therapy” (Manchester, 1988), patents have been received for 14 inventions, and more than 35 lymphological techniques have been introduced into clinical practice. From 1992 to 2014 a specialized scientific and practical journal “Lymphology” was published. Cycles of training for doctors and nursing staff in lymphological treatment methods have been organized. A number of international scientific and practical conferences were held. In 2012, the scientific and practical activities and technologies developed in the field of clinical lymphology of the Republican Scientific Center for Clinical Lymphology were highly appreciated by the international foundation “International Arch of Europe for Quality and Technologies” and nominated for the award of the “golden sign” of this foundation.

THE ROLE OF PRIVATE CLINICS IN PUBLIC HEALTH CARE

In the course of reforms carried out in the years of independence in the field of health care, special attention was paid to the development of private sector activities along with state medical institutions. Strengthening all-round support for the development of the private sector in the health sector, creating the necessary conditions for private medical institutions to provide high-tech quality medical services to the population, expanding foreign investments, and attracting highly qualified specialists to the private medical sector, as well as medical tourism and to develop the export of medical services.

Violation of the Convention relative to the Protection of Civilian Persons in Time of War by the Russian Federation in relation to certain categories of socially vulnerable groups of the population (on the example of Chernihiv region)

The article is devoted to the analysis of violations by the Russian Federation of the provisions of the Convention relative to the Protection of Civilian Persons in Time of War in relation to certain categories of socially vulnerable groups of the population in the context of a full-scale invasion (on the example of Chernihiv region). It is emphasized that Ukraine is currently a socially oriented state, its activities are aimed at providing life support and support to socially vulnerable citizens, creating conditions for their decent existence in society. One of the elements of the national state policy in the field of social protection of the population is a well-developed system of state social and medical institutions for persons with mental disorders, the elderly, persons with disabilities, patients, etc. A significant number of people living in these institutions are unable to take care of themselves and need constant care and attention. Chernihiv region, which borders the Russian Federation and the Republic of Belarus in the north of Ukraine, is one of the ten regions most affected by the aggression of the above-mentioned states. During the period of occupation of Chernihiv region by the military of the Russian Federation, from February 24, 2022 to April 3, 2022, a number of episodes of violations of the laws and customs of warfare were documented - shelling of civilians and evacuation routes with prohibited weapons, executions, looting, rape, etc.
 Numerous cases of shelling of social welfare institutions and medical facilities where socially vulnerable groups of the population were permanently or temporarily residing were emphasized, which is a gross violation of Articles 16, 18, 20, 28 of the Convention relative to the Protection of Civilian Persons in Time of War. The documented war crimes committed by Russian military personnel against civilians from among socially vulnerable citizens need to be studied, made public and condemned by the international community.

THE ROLE OF PRIVATE CLINICS IN PUBLIC HEALTH CARE

In the course of reforms carried out in the years of independence in the field of health care, special attention was paid to the development of private sector activities along with state medical institutions. Strengthening all-round support for the development of the private sector in the health sector, creating the necessary conditions for private medical institutions to provide high-tech quality medical services to the population, expanding foreign investments, and attracting highly qualified specialists to the private medical sector, as well as medical tourism and to develop the export of medical services.

To 110th anniversary of cardiac surgeon and researcher Igor N. Meshalkin

Igor N. Meshalkin (1913–1996) was Soviet cardiac surgeon, Dr. Sci. (Medicine). He was a graduate of the 2nd Moscow State Medical Institute (2nd MSMI, now the N.I. Pirogov Russian National Research Medical University). He was a participant in the Great Patriotic War. Igor N. Meshalkin began his professional career as a medical resident and an assistant of the clinic of faculty surgery in the 2nd MSMI since 1947; then as a medical resident of the Main Military Hospital of the Armed Forces of the USSR since 1951 and an assistant of the general surgery department of the pediatric faculty in the 2nd MSMI since 1954. In 1958–1963, he headed the Department of Acquired Heart Diseases in the Institute of Experimental Biology and Medicine (now the E.N. Meshalkin National Medical Research Center). In 1963–1977, Igor N. Meshalkin was the head of the department in the Central Clinical Hospital of the 4th Main Directorate of the USSR Ministry of Health. His research interests were focused on urgent abdominal surgery, thoracic surgery, mitral stenosis surgery. Igor N. Meshalkin was the author of 55 scientific works including two monographs. Received 8 November 2023. Accepted 14 November 2023. Funding: The study did not have sponsorship. Conflict of interest: The authors declare no conflict of interest. Contribution of the authors: The authors contributed equally to this article. Acknowledgment: The authors would like to thank Marina, daughter of Igor N. Meshalkin, for providing personal documents and photographs.

Ангелина Константиновна Гуськова (к 100-летию со дня рождения)

Angelina Konstantinovna Guskova, Doctor of Medical Sciences, Professor, Corresponding Member of the Russian Academy of Medical Sciences, Laureate of the Lenin Prize, Honoured Scientist of the RSFSR, Laureate of the Sievert Prize, worked for 50 years at the A.I. Burnazyan FMBC. She was born on 29 March 1924 in the family of doctor Konstantin Vasilievich and pianist Zoya Vasilievna Guskov. In 1941, she entered the Sverdlovsk State Medical Institute, Faculty of Medicine, and successfully graduated in 1946. A.K. Guskova did her residency at the Clinic of Nervous Diseases and Neurosurgery. After her graduation, Angelina Konstantinovna was sent to Chelyabinsk-40 (Ozersk), where she started working in medical institutions serving the operating personnel of Plutonium Combine No. 817. There she gained her first experience in treating patients with acute and chronic radiation sickness. In 1957, A.K. Guskova became a senior researcher at the Institute of Biophysics in Moscow, from 1961 she headed the Radiology Department of the Institute of Occupational Hygiene and Occupational Diseases of the USSR Academy of Medical Sciences. In 1974 she returned to the Institute of Biophysics of the Ministry of Health of the USSR as Head of the Clinical Department. Under the leadership of A.K. Guskova in the Clinical Department of the Institute of Biophysics a number of methods of diagnostics and prediction of severity of radiation syndromes, as well as their treatment were developed and introduced into practice. This allowed the staff of the Department to successfully cope with the most difficult task of treating a large group of victims of the Chornobyl accident in 1986. A.K. Guskova is the author of more than 200 publications, 11 monographs (co-authored), and sections in monographs and manuals (independent). The most important of them are: «Human Radiation Disease» (1971), «Medical Assistance given to personnel of the Chernobyl N.P., after 1986 Accident». (1996). (editor and co-author), «Guidelines for Organisation of Medical Care for Persons Exposed to Radiation» (1986), «Guidelines for Radiation Medicine» (2001).