Consumer Limitations on the Digitalization of the Insurance Market and Ways to Overcome Them.

The article analyzes consumer dispositions (preferences) in the Russian insurance market. Their influence on the digitalization of insurance activities has been revealed. The consumer preferences of policyholders and their impact on the digitalization of business processes have been studied. The actual results of a statistical study of the Internet sales channel of insurance services, as well as the results of a sociological study of consumer preferences of policyholders have been presented. The presence of consumer dispositions (preferences) in the insurance market that hinder the development of digitalization has been shown. Key trends in the digitalization of sales procedures and their settlement under insurance contracts have been identified. Recommendations have been formulated to take into account the peculiarities of consumer dispositions in the insurance market in the process of digitalization of insurance activities.

[Evaluating an effectiveness of surgical treatment of gastroesophageal reflux disease combined with hiatal hernia]. / Otsenka éffektivnosti khirurgicheskogo lecheniia gastroézofageal'noi refliuksnoi bolezni v sochetanii s gryzhei pishchevodnogo otverstiia diafragmy.

AIM: To assess an effectiveness of surgical treatment of gastroesophageal reflux disease (GERD) combined with hiatal hernia (HH). MATERIAL AND METHODS: The trial included 96 patients with GERD and HH who were divided into 2 groups. The principal difference between groups was the use of surgery in the main group and therapeutic treatment in the comparison group. RESULTS: The effectiveness of surgical treatment is superior to therapeutic treatment of GERD by more than 2.5 times. CONCLUSION: HH combined with GERD is an indication for surgical treatment. Fundoplication cuff should not lead to angular and rotational esophageal deformation. Nissen procedure in Donahue modification (Short Floppy Nissen) simulates optimally the geometry of esophago-gastric junction and His angle.

[Single-port cholecystectomy - pros and cons]. / Odnoportovaya kholetsistektomiya - za i protiv (s kommentariem).

AIM: to study efficacy and safety of current laparoscopic techniques of cholecystectomy. MATERIAL AND METHODS: 3 groups of patients were defined. Single laparoscopic access with/without trocar support was used in group 1 (SILS+, n=10) and 2 (SILS, n=16) respectively. Conventional four-port laparoscopic cholecystectomy was applied in comparison group. RESULTS: SILS+ and SILS techniques were associated with less pain syndrome within first 12 hours after surgery compared with four-port cholecyst-ectomy. Better cosmetic result is also achieved in case of single-port technique. Both methods are comparable in their safety. CONCLUSION: SILS-techniques are current alternatives to four-port laparoscopic cholecystectomy due to better cosmetic result, mild postoperative pain syndrome and comparable safety.

[Therapeutic interventions under ultrasonic control in diseases of the abdominal cavity organs]. / Lechebnye vmeshatel'stva pro kontrolem ul'trazvukovogo issledovaniia pri zabolevaniiakh organov briushnoi polosti.

The results of 212 transcutaneous therapeutical abdominal interventions, performed under the ultrasound control, have been analysed. 190 patients have been treated. The sectorial ultrasound probe was acting at the frequency of 3 MHz. The electronic matrix guided the needle. One-stage percutaneous drainage with an "umbrella" stylet catheter was used in all cases. Percutaneous drainage of the gallbladder was performed in 140 patients; 111 of them had acute cholecystitis with a high surgical risk. The operation of cholecystectomy has been performed in 32 patients after control of the acute stage of the disease. In 47 patients percutaneous drainage was indicated in case of liver cysts and abscesses, intraliver hematomas, liver pseudocysts, liver pseudoabscesses, abdominal abscesses. These types of curative procedures have limited contraindications, can be performed irrespective of the patient's condition, and in certain cases may be an alternative to major surgical interventions.

[The complications of puncture catheterization of the subclavian vein and their diagnosis]. / Oslozhneniia punktsionnoi kateterizatsii podkliuchichnoi veny i ikh diagnostika.

The authors describe 21 complications which occurred in puncture catheterization of the subclavian vein in 1,276 (1.65%) patients. They varied widely in character--hemothorax, pneumothorax, thrombosis of the subclavian vein, etc. The case record of one patient with traumatic pneumothorax after puncture catheterization of the subclavian vein is discussed in detail.