ANALYSIS OF PERFORMANCE IN ROUTINE OF DAILY ACTIVITIES OF THE OPERATIONAL ADMINISTRATIVE SERVICE OF THE MOSCOW DEPARTMENT OF HEALTH IN PROVIDING QUALITY MEDICAL CARE TO POPULATION IN 2017-2021

The aim of the study is to analyze the effectiveness of the operational administrative service of the Department of Health of Moscow to ensure the health of the population. Materials and research methods. We analyzed the work of the operational administrative service of the Department of Health of Moscow in 2017-2021 basing on verbal complaints of citizens about shortcomings in the work on the provision of medical care to the population. Materials of the study – reports on the elimination of medical and sanitary consequences of emergencies;orders, instructions and other documents of the Department of Health of Moscow. Results of the study and their analysis. The work of operational administrative service proved its efficiency: opportunities for the citizens to seek medical assistance expanded, number of cases of operative response increased. Expansion of the operational administrative service staff due to epidemiological situation on COVID-19 increased the number of verbal appeals of citizens in comparison with 2019. Intensive work on detection of errors and their elimination by specialists of medical treatment organizations led to a decrease in number of requests for medical care and to a reduction of validity of verbal complaints about shortcomings of its provision. It is concluded that it is expedient to create similar services in other megalopolises of the Russian Federation. © Burnasyan FMBC FMBA.

DiagNostic findings in patients with chest pain, cough, and shortness of breath during the COVID-19 pandemic: What else besides pneumonia?

Purpose. Description and illustration of the most common alternative causes of shortness of breath, cough, and acute chest pain in pandemic COVID-19 conditions. Material and methods. Authors evaluated results of the retrospective single-center study and instrumental data of 67 patients with complaints of sudden chest pain, cough and shortness of breath. For patients admitted to the hospital between March, 27 and June, 30, 2020, the first stage of diagNosis was made with the performed multispiral computed tomography (MSCT) of the chest, confirming the presence of pulmonary manifestations of COVID-19. The study did Not include patients with pneumothorax identified at the pre-And hospital stages. We describe early radiographic changes in the chest organs, main vessels, and coronary bed in patients with CT-confirmed COVID-19 admitted to O.M. Filatov Municipal Clinical Hospital No. 15, Moscow for sudden chest pain, cough, and shortness of breath. Results. In CT of the chest organs, combinations of COVID-19 and pulmonary artery thromboembolism, central/peripheral lung cancer, and acute aortic syndrome manifestations were most common. Combinations of radiation techniques in pandemic settings are COVID-19 required by patients with the acute coronary syndrome. However, it will be possible to analyze all cases of a combination of acute chest pain and sudden shortness of breath in patients with COVID-19 only after processing an extensive array of data. Conclusion. In pandemic conditions, COVID-19 performing standard imaging methods should be Not lost about the most frequent causes of chest pain and sudden shortness of breath, complementing native MSCT with contrasting enhancement in suspected pathology of the main arteries, and small circulation in high-risk patients. © 2021 Izdatel'stvo Meditsina. All rights reserved.

The acute cholecystitis in COVID-19 patients: Treatment in conditions of reprofiled hospital

Introduction. Routine surgical care has been suspended during the COVID-19 pandemic. For the treatment of patients with acute cholecystitis, conservative treatment, percutaneous drainage of the gallbladder or cholecystectomy is offered. Tactics of treatment of patients with acute cholecystitis against the background of COVID-19 have not been studied. It is important to study the data concerning the time of cholecystectomy in acute cholecystitis, comparing "early" and "delayed" cholecystectomy, which is performed after a period of conservative therapy. Aim. To present and evaluate the results of treatment of patients with acute cholecystitis against the background of COVID-19 in the conditions of a repurposed multi-specialty hospital on the basis of the O. M. Filatov Clinic Hospital No. 15 in Moscow. Material and methods. A retrospective comparative study with history control included 16 patients with acute cholecystitis against the background of COVID-19. Mechanical jaundice syndrome was diagnosed in 3 (18.75%) patients. The diagnosis of coronavirus infection using PCR was confirmed in 5 patients, serological method-in 2 patients, and in 9 patients the diagnosis was confirmed by X-ray or CT examination with negative/doubtful PCR test results. Results. Nine (56.25%) patients were operated 4 (25%) percutaneous interventions were performed, in 3 (18.75%) cases conservative therapy was performed. Most patients were operated on within the first day of admission. In the main group, a fatal outcome occurred in 1 (6.25%) case (death from a thromboembolic complication in a patient with mechanical jaundice syndrome). Discussion. The choice of «early» cholecystectomy for acute cholecystitis, provided the condition is stable and the initial changes in the lungs are appropriate in most COVID-19 patients. Conclusion. Performing cholecystectomy in patients with coronavirus infection in an infectious hospital did not lead to an increase in the duration of inpatient treatment and the prevalence of complications. The approaches mentiobed in the results section can be used as a safe method in the discussed category of patients. © 2020 Izdatel'stvo Meditsina. All rights reserved.

Work of scientific and practical centre for emergency medical care of moscow city health department in context of covid-19 pandemic

The activity is analyzed of specialists of the Scientific and practical centre for emergency medical care (CEMP) of Department of health of the city of Moscow (DZM) in the context of the COVID-19 pandemic. The structure of trips of CEMP teams in the fight against COVID-19 from March 1 to July 1, 2020 is presented. It is noted that although all the structures under the jurisdiction of the DZM, starting from March 2020, are working on high alert in connection with the threat of the spread of coronavirus, CEMP specialists continue to work on providing emergency medical care (EMP) and medical evacuation of victims of road accidents and other emergencies, as well as emergency somatic patients with various nosologies. © ARCDM Zashchita.

Experience of reprofiling the reception department of a multi-disciplinary hospital under the conditions of the COVID-19 epidemic

Starting from March 27, 2020, in accordance with the Organizational Sanitary-Epidemic (Preventive) Measures Plan aimed at prevention of the outbreak and spread of infection caused by the new coronavirus SARS-CoV-2 in Moscow, according to the order of the Moscow City Health Department of March 27, 2020 No. 302 On the Organization of the Department In the Filatov State Clinical Hospital No.15 charged with hospitalization of patients and contact persons arriving from the countries with registered cases of coronavirus infection COVID-19, the Filatov State Clinical Hospital No. 15, was reprofiled to treat patients with viral pneumonia, including COVID confirmed infection. State Clinical Hospital named after Filatov was repurposed to admit patients with viral pneumonia, including those confirmed by COVID infection. Difficulties that arose in connection with the re-profiling of the treatment and diagnostic process, compliance with sanitary and epidemiological rules in respect of patients or persons in contact with patients with new coronavirus infection required the mobilization of all forces and resources of the hospital, additional equipment, procurement of non-core drugs. The article describes the experience of the first month of the reception department in converting a multidisciplinary hospital into an infectious disease hospital. © 2020, Media Sphera Publishing Group. All rights reserved.

Chronic obstructive lung disease and COVID-19: Topical issues

The problem of comorbidity of new coronaviral infection (COVID-19) and chronic obstructive pulmonary disease (COPD) is acute, considering similarity of clinical manifestations, diagnostic difficulties, the potential severe disease course. Patients with COPD represent a vulnerable group of infected SARS-CoV-2, with a complicated disease course and frequent adverse outcome. Features of the spread of the virus limit treatment and diagnosis for patients with COPD, making it difficult to provide medical care during the pandemic. The negative results of some clinical studies of antiviral drugs for patients with COVID-19 indicate the need for a search for new drugs;for this reason, analysis of the anti-inflammatory effect on the lungs in infection COVID-19 of drugs of basic COPD therapy is promising. © 2020 Medical Education. All rights reserved.