[ASSESSMENT OF NOSOLOGICAL STRUCTURE ASSOCIATED WITH ANEMIC SYNDROME].

The anemic syndrome at the stage of primary health care delivery on an outpatient basis is a risk factor for an unfavorable outcome in patients with chronic somatic diseases, primarily cardiovascular and oncological pathologies. In order to understand the true prevalence of anemia among outpatients it is necessary to improve the registration of patients with this disease. Aim: to analyze the features of managing patients with anemia in the primary health care system using a computerized patient monitoring system. The study included 1498 patients aged 18 to 80 who were under dispensary observation by family physicians. For the analysis of the medical records, a computer program developed by the authors "Monitoring system for patients with anemic syndrome" was used. The structure of morbidity in two selected areas of the outpatient department in the context of the main classes of diseases of ICD-10 is analyzed. According to the analysis of the medical records carried out using the program developed by us, anemia was recorded in 208 patients (13.89%), while in the analysis using the computer register according to the WHO criteria, 500 people had anemic syndrome (33.38%), which indicates the underdiagnosis of this pathological condition and the need to direct the efforts of healthcare organizers to the early revealing of patients with anemia.

[On stomatological service in the Voronezh Oblast].

The article considers characteristics of organization of dental care for adult and children population in the territory of a large subject of the Russian Federation. In accordance with the action plan of the Health Department of the Voronezh Oblast, as well as in order to improve organization of dental services and statistical reporting and accounting in the autonomous health institution of the Voronezh Oblast, meetings concerning organization of dental services are organized. The issues are discussed concerning primary prevention of dental diseases in population of the Voronezh Oblast within the framework of the state program of the the Russian Federation "Health Care Development", organization and implementation of continuous medical education in dentistry, preparation and handing in annual report on dentistry in accordance with latest requirements of the Federal statistical monitoring in health care, new requirements of application of documents for preferential prosthetic dentistry in families of servicemen who perished during military service in peacetime. The consideration of actual state of scientific medicine and practical direction of population health promotion of the population, invariably focuses on actuality of dental research. The analysis of publications established significance of especially dynamic monitoring of medical social indices, conditions and style of life, level and structure of dental morbidity demographic situation. The necessity of analysis of dental morbidity for evaluation of overall population health is emphasized. Also, data of social hygienic monitoring of population of the Voronezh Oblast for 2015-2017 was used.

[The characteristics of application of computer registry in organization of ambulatory polyclinic care of patients with iron-deficiency anemia].

Anemia is a clinical hematological syndrome and also a risk factor for the adverse outcome of many chronic somatic diseases. To assess effectiveness of out-patient polyclinic care for patients with anemia, the computer program "Patient Monitoring System with Anemic Syndrome" was used. The study included 1498 patients (males - 491; females - 1007) aged from 18 to 80 years old, who were under medical observation by general practitioners. The prevalence of anemic syndrome in different age and gender groups varied from 11 to 58%. Statistically significant differences between subgroups of men and women were found in the categories 18-30 years, 31-40 years and 41-50 years. In adult patients of working age, anemic syndrome during routine examination was detected in 37% of cases of seeking outpatient medical care (anemic syndrome in women was three times more common than in men). In patients older than working age, the prevalence of anemic syndrome was lower and averaged 25.7%. In the structure of anemia, 48.4% are hypochromic, 5.4% are hyperchromic, 46.2% are normochromic. The study for serum iron was prescribed in 33.9% of cases of hypochromic anemia, in 22.5% of cases of normochromic anemia and in 11.1% of cases of hyperchromic anemia. Serum iron was detected in every second patient with diseases of the urogenital system, every third patient with neoplasm. Therapy with iron preparations was prescribed in 30.6%, and the administration of vitamin B12 - in 1.4% of cases.

[On the Issue of Labor Conflicts Control in Medical Stuff].

The article presents the results of study of inter-personal conflicts in medical staff. The awareness of psychological causes of development of conflicts, their dynamics and methods of counteracting, psychological characteristics of conflicting personalities permits to implement their prevention and outcoming. The particular attention is paid to types of reaction of personalities and their behavior in conflict situation and acquiring of full information about conflict to find out the most rational modes of their regulation.

[Gerontology and geriatric service in Voronezh region: from the origin into the future.]

The article concerns demographic situation in Voronezh region. The authors have analyzed morbidity and mortality from various diseases in senior age groups. Geriatric service quality in Voronezh region has been estimated.

[The development of higher stomatological education in the Voronejskaia oblast].

The article considers development of stomatological education in the Voronezhskaia oblast from 1920s. The issue of development of network of dental out-patient clinics in the Voronezhskaia gubernia and problem of inadequate number of dentists are considered. The organization of training courses of dentists from feldshers and paramedical personnel and training of dental personnel in dental school are presented. The role of professor A.I. Evdokimov is demonstrated related to organization of stomatological institute and training of stomatological personnel in the Voronezhskaia oblast and organization of the Voronezhskii stomatological institute. The plans of Oblzdrav of the Central'no-Chernozemnaia oblast are reflected concerning issues of training of stomatological personnel in the stomatological institute and assignment of the first stomatologists of the Voronezhskii stomatological institute. The issues are considered concerning organization of evacuation of the stomatological institute in Krasnoyarsk, joining up of parts of the four Leningradskii medical institutes and the Voronezhskii stomatological institute into the Krasnoyarskii medical institute during the Great Patriotic War and post-war restoration of teaching of stomatology at the chair of hospital surgery in the medical institute of Voronezh. The data is presented related to organization of the stomatological faculty in the Voronezhskii N.N. Burdenko medical institute, the chairs of therapeutic, orthopedic, surgical and children stomatology. The pedagogic and scientific research activity of stomatological chairs is considered, including their publication activity and international activity. The role of stomatological faculty of the Voronezhskii N.N. Burdenko state university is demonstrated.

[The primary medical sanitary care and characteristics of drinking water supply of population].

The article considers characteristics of organization ofprimary medical sanitary care on territory with carcinogenic risks related to drinking water supply as exemplified by the Orlovskaia oblast. The importance of registration by local health authorities the sources of permanent chemical pollution of drinking water. The analysis of the State program of the Orlovskaia oblast "The development of health care in the Orlovskaia oblast in 2013-2020". The necessity of additional inclusion of issue related to healthy drinking water supply of population to prevent development of malignant neoplasms and prevalence of oncologic morbidity on oblast territory.

[THE MEDICAL EDUCATION AND GLOBALIZATION CHALLENGES].

The article considers actual issues of medical education initiated by globalization. The impact of globalization on medical education has multi-vector, multi-factor, multi-directional, parallel and cumulative character. This singularity merges all factors, effects, changes and processes adding by globalization to medical education into heterarchy system formed by crossing, manifold, and simultaneously coexisting structures. The alterations of systemic conditions of functioning of medical education as priority of economic principle, substitution of notion "medical care" by "medical service", diseases of rich and diseases of poor, uncertainty factor, chaotization, priority of applied medical knowledge, individualistic paradigm of medical training are considered. The role and value of the World directory of medical schools in international medical organization is demonstrated.

[The evaluation of medicinal therapy under treatment of arterial hypertension in hospital].

The article presents the analysis of data of "Study on Global AGEing and Adult Health, 2007-2010" (SAGE) concerning subjective judging of health, prevalence of ischemic heart disease under different levels of arterial pressure in similar age groups. An attempt is made to evaluate spectrum of pharmaceuticals applied in treatment of patients with arterial pressure in hospital at the level of oblast hospital. According official statistics of Minzdrav of Russia, in 20102 prevalence of diseases characterized by higher arterial pressure amounted to 10.5% in adult population and to 22.3% in population older than able-bodied age. At the same time, according SAGE data, prevalence of various forms of hypertension disease in population older than 50 years amounted to 52.8%. That is, this pathology is often missed in conditions of mass medical network. Thereafter, patients receive no necessary medicinal therapy. The one or another treatment was provided to almost 94% of patients with hypertension disease diagnosed by physician. At that, among patients received treatment the normal levels of both systolic and diastolic pressure were established in less than 20% of patients with hypertension. Therefore, the issue of effectiveness of applied methods of correction of arterial hypertension become a matter of interest. The appropriate treatment of hypertension is a mean to decrease complications and as a result to diminish mortality of diseases of circulatory system.

[The seasonality of population contacts with medical organizations because of diseases of blood circulation system].

The comprehension of significance of health impacting of such unchangeable factors as climate and atmospheric phenomenons allows carrying out measures to decrease their negative effect on human health. The data of study implemented in Orel in 2009-2012 made it possible to distribute the annual totality of diagnoses registered in medical organizations on the groups of diseases of blood circulation system according ICD-10. The analysis established lower level of visits to physician because of these conditions both in ambulatory polyclinic institutions and hospital during summer period. The corresponding percentage came to 21.9% out of all diagnoses in polyclinic and 22% in hospital at highest levels of 27% in summer period. Therefore, in development of population contacts with medical organizations an expressed seasonality is detected. This occurrence is possibly related to characteristics of development of pathological conditions in different seasons.