[The first clinical experience with a new type of stents -scaffolds, under optical coherence tomography guidance].

OBJECTIVE: To analyze the first clinical experience with new types of stents, absorbable carcasses (scaffolds), under guidance of intravascular imaging techniques. MATERIAL AND METHODS: The paper gives the authors' experience in implanting eight Absorb BVS scaffolds in three patients during one operating session. All operations were performed under intravascular imaging guidance: three patients underwent 8 examinations of four vessels, by using optical coherence tomography (OCT) and 2 did using intravascular ultrasound study (IVUSS). RESULTS: The investigation demonstrated the possibility of implanting two devices partially applied to cover longer lesion lengths, the use of scaffolds after occlusion recanalization, and that of rather high pressure values to adapt a carcass if predilation was adequately performed. In one of the cases, control OCT could reveal timely the signs of extensive prolapse and early thrombosis, which had been unrecorded by angiography and IVUSS. To correct of the occurring problem, implantation of the second absorbable carcass into the first one was first successfully used by optimally adapting the girders and completely correcting the prolapse. CONCLUSION: The absorbable scaffolds may potentially signify a new stage in the development of interventional cardiology. However, their use requires the careful adherence of implantation specifications and primarily the accurate estimation of vessel sizes and accordingly a device that may be needed. The application of absorbable carcasses makes higher standards for the equipment and experience of interventional laboratories that plan their use. The possibility of using intravascular imaging is one the priorities in this series.

[A new approach toward analysis of quality of inpatient psychiatric care]. / Novyi podkhod k analizu kachestva statsionarnoi psikhiatricheskoi pomoshchi.

A new approach to assessment of quality of psychiatric hospital care is proposed. It is based on comparison of goals of hospitalisation and results achieved. The necessary condition for such assessment is formulation of these goals for each patient. Three components should be considered: clinical which coincides with the prognosis; social which includes achievement of the patient adaptation and psychological which assesses patient's satisfaction with the treatment. The preliminary results of practical use of the proposed method are presented.

[The patients of the psychiatric office of a polyclinic: patients undetected by the clinic or a new contingent?]. / Patsienty psikhiatricheskogo kabineta polikliniki: nedovyiavlennye dispanserom bol'nye ili novyi kontingent?

Epidemiology study of patients in primary care settings has shown prevalence of borderline mental disorders (41.58 per 1000 population) in comparison with patients of psychiatric outpatient clinic (11.4 per 1000). The question arises were those undetected by psychiatric out-patient clinics (those who didn't visit psychiatrist for individual reasons) or they represented another contingent. Comparative analysis of groups standardized on nosological, syndromal and educational levels revealed that there were various contingents of patients. The main difference was determined by different duration of disease before the first visit to psychiatrist, that reflected various severity of the disease (less severity of the disease was observed in patients of primary care institutions).

[Patient attitude toward the psychiatric hospital]. / Otnoshenie bol'nykh k psikhiatricheskoi bol'nitse.

The analysis of preconceived ideas about psychiatric hospital performed in 12 healthy individuals and 21 mental patients permitted the authors to identify basic components of negative attitude to psychiatric hospital. The 4 clusters were determined: fear of psychic disease; fear concerning the stay in psychiatric hospital; negative social attitude toward mental patients, loss of self respect; fear of possible social consequences. Essential differences of attitude exists in patients and in society. With growing experience of contacts with psychiatric service the fear about social discrimination became more significant.

[Patients with frequent hospitalizations: their clinical characteristics]. / Bol'nye s chastymi gospitalizatsiiami: klinicheskaia kharakteristika.

A clinical trial covered 69 schizophrenics subjects to frequent rehospitalizations because the patients' need in repeated inpatient treatment. The author points out, that frequent hospitalizations form psychological hospital dependence.