[PUBLIC ADMINISTRATION OF PERSONNEL POLICY IN REFORMING OF UKRAINIAN HEALTH CARE SYSTEM USING THE EXAMPLE OF DERMATOVENEREOLOGICAL SERVICE].

The health care system, its modernization and optimization are among the most important functions of the modern Ukrainian state. The main goal of the reforms in the field of healthcare is to improve the health of the population, equal and fair access for all to health services of adequate quality. Important place in the health sector reform belongs to optimizing the structure and function of dermatovenereological service. The aim of this work is to address the issue of human resources management of dermatovenereological services during health sector reform in Ukraine, taking into account the real possibility of disengagement dermatovenereological providing care between providers of primary medical care level (general practitioners) and providers of secondary (specialized) and tertiary (high-specialized) medical care (dermatovenerologists and pediatrician dermatovenerologists), and coordinating interaction between these levels. During research has been found, that the major problems of human resources of dermatovenereological service are insufficient staffing and provision of health-care providers;,growth in the number of health workers of retirement age; sectoral and regional disparity of staffing; the problem of improving the skills of medical personnel; regulatory support personnel policy areas and create incentives for staff motivation; problems of rational use of human resources for health care; problems of personnel training for dermatovenereological service. Currently reforming health sector should primarily serve the needs of the population in a fairly effective medical care at all levels, to ensure that there must be sufficient qualitatively trained and motivated health workers. To achieve this goal directed overall work of the Ministry of Health of Uktaine, the National Academy of Medical Sciences of Ukraine, medical universities, regional health authorities, professional medical associations. Therefore Ukrainian dermatovenereological care, in particular fixed, needs a deep and objective medical and social audit. A necessary condition for the harmonious development of dermatovenereological service is adequate staffing to ensure it to reflect changes in the structure of the provision of the assistance at various levels, as well as their effective coordination throughout the natient's medical route.

[Coxsackie B viral infection in the etiology and clinical pathogenesis of psoriasis]. / Rol' Koksaki B virusnoï infektsiï v etiolohiï ta patohenezi psoraiazu.

The data submitted point to the importance of the enteroviral infection, in particular, Coxsackie' B vira in the pathogenesis of many non-infectious diseases. Our studies explore the possibility for the Coxsackie B virus involvement in the etiopathogenesis of psoriasis. 25 examined patients with psoriasis revealed in 100% of cases antibodies to the Coxsackie B virus in diagnostic titres, with a number of patients having displayed a progressive increase in the titres of the above antibodies, which fact suggest to us that there may be an association between psoriasis and Coxsackie' B vira. The major proportion of seropositive psoriatic patients (88%) have been found to have antibodies to association of two, three or four Coxsackie' B vira, which fact can be taken as further evidence for their etiopathogenic part in the development of dermatosis. Antibodies to Coxsackie B1 and B5 virus have been shown to occur more frequently among seropositive patients, this underlying their particular importance in the development of psoriasis.

[Complex diagnosis of chronic prostatitis complicated by disorders in sexual and reproductive functions]. / Kompleksna diahnostyka khronichnoho prostatytu, uskladnenoho porushenniamy kopuliatyvnoï ta reproduktyvnoï funktsii.

A comprehensive clinical-and-laboratory evaluation was carried out in 132 patients with chronic prostatitis, the major proportion of these presenting with concomitant urethritis. It has been ascertained that infectious agents (chlamidia, gonococci, myco- and ureaplasms, trichomonads) play an important part in the origination and development of chronic prostatitis. In the examined patients spermograms were studied, with normospermia having been recorded in 45 (34%) patients, grade I oligospermia in 41 (31%), grade II oligospermia in 29 (22%), grade III oligospermia in 13 (10%), azospermia in 4 (3%) patients. There was no relatedness of changes revealed in qualitative characteristics of the ejaculate to etiology of chronic prostatitis. A comparative study was done on those parameters characterizing local (cell-mediated, humoral) immunity of the reproductive tract in patients with chronic prostatitis of different etiological (infectious) origin. Disturbances in local immunologic vigor in varying etiology chronic prostatitis have been shown to be of unidirectional character with no statistically significant difference in place.

[New approaches to the treatment and prophylaxis of the cicatrix formation]. / Novi pidkhody do likuvannia ta zapobihannia utvorenniu rubtsia.

Preparation Contractubex (gel for external application in tubes of 20 g each), manufactured by pharmaceutical company Merz GmbH (Frankfurt-on-Main, Germany), was used during the treatment of 30 patients with hypertrophic cicatrix and contracture.

[Experience in treating chronic urethritis in men by iontophoresis and inductothermy]. / Opyt lecheniia khronicheskikh uretritov u muzhchin ionoforezom i induktotermiei.

A method for therapy of chronic urethritis by exposure to ionized solutions of drugs has been developed (Authors' Certificate of the USSR No. 876138). Active electrode is placed in the flask with the drug, passive one on the external surface of the body as close to the focus of involvement as possible. Ionized solution of the drug (2.5-3.1) is introduced into the urethra via a double-lumen catheter, washes its walls and saturates the mucosa; the solution is aspirated from the urethra through the other lumen of the catheter, thus removing the inflammation products from the urethra. Current density has made up 0.01-0.03 mA/cm2, length of session 12-15 min, 6-8 sessions per course. A device for local therapy of chronic urethritis by a combination of ionophoresis and inductothermy has been suggested (Authors' Certificate of the USSR No. 1084031). This device permits a simultaneous administration of 2 drugs: one from the tube via urethral mucosa, the other from the cuvette outwardly. Current density has made up 0.01-0.03 mA/cm2, with the current of 200 mA in the inductor. Length of inductometry and ionophoresis session is 10-15 min.

[The treatment of urethral strictures of inflammatory origin by low-frequency ultrasound]. / Lechenie striktur uretry vospalitel'nogo proiskhozhdeniia nizkochastotnym ul'trazvukom.

Urethral strictures were treated by ultrasonic exposure by means of a Barvinok MT apparatus, developed by the KVANT Research and Production Amalgamation in Kiev, and special ultrasonic wave-guides. The developed method essentially reduced the time of treatment, was conducive to a complete recovery of the urethral urine-excretory function and of its anatomic and histologic structure; it ruled out the necessity of repeated examinations with a bougie, catheterization, or surgical intervention.

[A method of obtaining material for the bacteriological diagnosis of urethral diseases]. / Metod polucheniia materiala dlia bakteriologicheskoi diagnostiki zabolevanii uretry.

An installation is developed for sampling the contents of urethra (A. c. USSR 980726). The installation promotes acceleration of the correct diagnosis under the torpid and chronic inflammatory processes in the urethra. The above installation permits obtaining data on distribution of the microbic flora at a different depth of mucosa of the anterior area of the male urethra. In this case the mixing of samples taken for investigation from different sites is impossible.

[New approaches to the combined therapy of gonorrheal infection and accelerated methods for predicting its efficacy]. / Novye podkhody k kompleksnoi terapii gonoreinoi infektsii i uskorennye sposoby prognozirovaniia ee éffektivnosti.

The authors suggest a combined method for the treatment of new torpid and chronic gonorrheal urethritis, involving preliminary studies of the agent's cellular respiration activity, and offer the technique for predicting the efficacy of such treatment. If gonococcal cellular respiration activity is low, aerobic processes in these agents are stimulated with daily subcutaneous injections of plasmol (a biostimulant), starting from 1 ml and building up the dose by 1 ml daily, and local irrigations of the urethra with oxygen cocktails via specially designed irrigators (Authors' Certificate No. 827071 USSR); such stimulation is carried out for 4 days prior to specific therapy. This treatment modality is maintained by an Authors Certificate No. 1107867 USSR. To check up the efficacy of the antibiotic chosen for therapy, a rapid method has been developed, consisting in measurement of the patient's blood serum antibacterial activity carried out in special chambers for cell microcultivation.

[Predicting the effectiveness of antibiotic therapy in the treatment of gonorrhea]. / Prognozirovanie éffektivnosti antibiotikoterapii pri lechenii gonorei.

A complex method is suggested to prognosticate the efficiency of treating gonorrheal urethritis in men with allowance for a preliminary determination of the cell respiration activity in agents. In the case of low indices of these processes, it is possible to stimulate aerobic processes in gonococci if applying for 4 days before the specific treatment daily subcutaneous injections of plasmol (a biostimulator) by the ascending scheme and local irrigation of the urethra by oxygen cocktails through irrigators of special design. The developed method has the author certificate (A. c. 1107867 USSR). Application of the method shortens significantly the terms of treatment, the number of the infection recurrences being considerably decreased. To accelerate the determination of the sensitivity to antibiotics the procedure of genococcus microcultivation in special chambers is applied which permits observing the growth and reproduction of microorganisms in the phase-contrast microscope.

[A device for sampling the urethral contents]. / Ustroistvo dlia vziatiia soderzhimogo iz uretry.

This device (Authors Certificate of the USSR No. 980726) helps rapidly diagnose the disease in torpid and chronic inflammatory processes in the urethra.

[Chemotaxis of Yersinia pseudotuberculosis as a mechanism in its search for target tissues of the host organism]. / Khemotaksis Yersinia pseudotuberculosis kak mekhanizm poiska tkanevykh mishenei organizma khoziaina.

Y. pseudotuberculosis cells grown at biologically low temperature have been shown capable of chemotaxis with respect to carbohydrates and amino acids. During cultivation at 36-37 degrees C Y. pseudotuberculosis cells retain this property for 10-15 hours and then lose it. The mechanism of chemotaxis makes it possible for Y. pseudotuberculosis to "find" human and animal tissues and can facilitate the realization of the pathogenicity potential of these bacteria. When administered orally to mice motile bacteria, i. e. those grown at 6-8 degrees C, have been more virulent for the animals than nonmotile ones cultivated at 36-37 degrees C.