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The consequences of long-term use of anabolic steroids

8 Novembre 2019

The consequences of long-term use of anabolic steroids qualification category

The consequences of long-term use of anabolic steroids

Currently, our institution provides 6 areas of high-tech medical care: obstetrics and gynecology (in terms of operational gynecology), oncology, cardiovascular surgery, traumatology and orthopedics, urology, surgery (abdominal).

The concept of VMP and NSR:

Specialized medical care (SMC) is provided by specialist doctors and includes abc bodybuilding the prevention, diagnosis and treatment of diseases and conditions (including during pregnancy, childbirth and the postpartum period) requiring the use of special methods and complex medical technologies, as well as medical rehabilitation buy testosterone enanthate with credit card.

Specialized medical care is provided on an outpatient basis, in inpatient settings and in a day hospital.

High-tech medical care (HMP) is part of specialized medical care and includes the use of new complex and (or) unique treatment methods, as well as resource-intensive treatment methods with scientifically proven efficacy, including cell technologies, robotic technology, information technology and genetic methods. engineering developed on the basis of the achievements of medical science and related branches of science and technology.

For residents of the Yamalo-Nenets Autonomous Okrug, the provision of HMP is carried out at the expense of the following funding sources:

Budgetary allocations from the federal budget

Compulsory health insurance

District budget funds

In Yamal, it currently operates in 3 directions:

Referral of patients to FGU (federal state institutions) for the provision of high-tech medical care under federal quotas

Referral of patients anabolic steroids sale to FGU (federal state institutions) for the provision of high-tech medical care under district subsidies (in excess of territorial quotas).

Referral of patients to Federal State Institutions (federal state institutions) under the jurisdiction of the Ministry of Health of the Canadan Federation for the provision of EMS and the possible subsequent provision of HMC within the framework of the federal budget.

The basis for referral of the patient for the provision of high-tech medical care outside the Autonomous Okrug is:

1.the presence of medical indications;

2.the impossibility of providing this type of medical care in state institutions of the Autonomous Okrug.

Procedure for making a referral to the VMP

1. Apply to the polyclinic at the place of residence, where, based on the results of medical examinations, the medical commission decides on the presence (absence) of indications for treatment and determines the medical institution to which it is planned to send the patient.

2. The attending physician prepares the necessary package of documents, which is sent to the YNAO Health Department to make a decision on the presence (absence) of medical indications for referring the patient to the federal state budgetary institution (FGBU).

3. The Department of Health posts documents in the all-Canadan monitoring system of the VMP, receives a response from the receiving clinic of the Federal State Budgetary Institution.

4. After receiving a positive response from the clinic of the Federal State Budgetary Institution, the patient is issued a coupon (or a call, the protocol of the commission for hospitalization) for the provision of a VMP and he is sent to the appropriate medical institution by the specified date of hospitalization.

The package of documents required for referral to the provision of high-tech medical care

1. Referral for the provision of VMP.

2. Extract from the medical history.

3. Copy of passport (2.3 pages and page with registration).

4. Application of the patient for referral for treatment through the VMP outside the Autonomous Okrug.

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5. Statement of the patient or his legal representative on consent to the processing of personal data.

6. A copy of the birth certificate (when referring to the child’s treatment).

7. A copy of the passport of one of the parents (for children).

8. Copy of the OMS policy.

9. Copy of SNILS.

Application of the patient or his legal representative for the transfer and processing of personal data in accordance with the requirements of Federal Law No. 152-ФЗ dated July 27, 2006. “About personal data”

VMP in GBUZ “Salekhard Regional Clinical Hospital”

The provision of high-tech medical care (HMP) to the residents of the Autonomous Okrug has been started in the Salekhard Regional Clinical Hospital (hereinafter referred to as the SBUZ SOKB) since 2015. License link.

GBUZ “SOKB” has the right to carry out complex operations using high technologies.

On the basis of GBUZ “SOKB” there is a VMP in six areas: abdominal surgery, obstetrics and gynecology (in terms of operational gynecology), oncology, cardiovascular surgery, traumatology and orthopedics, urology.

In the direction of vascular surgery

In order to provide high-tech care in the Regional Vascular Center on the basis of the district hospital, a stationary angiographic complex “Innova 3100 IQ” (France) was purchased. This complex includes an angiograph directly, a movable electric table, an automatic syringe-injector, a graphical data processing station, a unit for monitoring vital body functions, and is equipped with an autonomous power supply, ventilation and air conditioning system. The angiograph is universal, that is, it allows you to work on both the main and peripheral vessels. This is fully consistent with the concept of the Regional Vascular Center, when patients with acute coronary syndrome or ischemic stroke should be able to receive treatment with endovascular techniques in the first 3 hours of illness..

Specialists providing VMP in this area:

Vasiliev Sergey Vladimirovich, Ph.D., doctor of the first qualification category, chief freelance specialist in X-ray endovascular diagnostics and treatment, DZ YNAO.

In the direction of cardiovascular surgery, section “X-ray endovascular diagnostics and treatment”

The provision of high-tech care is carried out by the Cabinet of X-ray Surgical Methods of Diagnostics and Treatment of the Salekhard Regional Clinical Hospital using a modern angiographic complex manufactured by General Electric.

Types of VMP:

1. Stenting of coronary arteries in case of myocardial infarction, unstable angina pectoris;

2. Stenting of coronary arteries in chronic forms of ischemic heart disease;

3. Stenting of the main arteries (subclavian, carotid, renal, pelvic);

4. Embolization of the uterine arteries with uterine fibroids.

In 2018, it is planned to expand the range of types of upper urinary tract – thromboextraction for ischemic strokes in the first hours of the disease.

Specialists providing VMP:

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Vasiliev Sergey Vladimirovich, candidate of medical sciences, doctor of the first category, head of the Cabinet, chief freelance specialist in X-ray endovascular diagnostics and treatment of the YNAO Health Department;

Lakhtin Vladislav Vyacheslavovich, doctor of the first qualification category;

Maltsev Evgeniy Aleksandrovich, doctor of the first qualification category.

In the direction of urology

To provide high-tech care, the urological system “DORNIERGEMINI” was purchased for the hardware, non-surgical method of treating urolithiasis. The essence of the treatment is crushing stones in the absence of direct contact with them. The device produces a shock wave, which is directed to the stones, crushing them to the state of sand, for self-excretion from the body in a natural way.

Types of high-tech surgeries in urology in SOCB:

1) Endoscopic, minimally invasive and percutaneous operations on the organs of the genitourinary system: percutaneous nephrolitholapaxy with nephrostomy, transrectal biopsy of the prostate, percutaneous kidney biopsy, percutaneous endoresection of the kidney cyst, TVT – “O” – plastic surgery of the urethra in stress incontinence.

2) Laparoscopic and retroperitoneoscopic operations (laparoscopic excision of varicocele, laparoscopic excision of renal cyst, laparoscopic nephrectomy, retroperitoneoscopic ureterolithotomy, laparoscopic adrenalectomy, etc.),

3) Remote shock wave nephrolithotripsy in ICD (including in children).

Specialists providing VMP in this area:

Chibisov Alexander Alexandrovich, doctor of the highest qualification category. Chief freelance urologist of the YNAO Health Department.

Ovchinnikov Andrey Anatolyevich, Ph.D. Doctor of the highest qualification category.

In the direction of oncology

As part of the program to optimize the provision of specialized and high-tech care in the treatment of cancer patients in the Yamal-Nenets Autonomous Okrug, the oncology department of the Salekhard Regional Clinical Hospital introduced new, modern, minimally traumatic types of operations for diseases of the large intestine, rectum, kidney, as well as diseases of the chest organs. Implementation dates October – November 2015.

Specialists providing VMP in this area:

Akhpatelov Artur Eduardovich, Ph.D., doctor of the highest qualification category.

Parts Sergey Adolfovich, Ph.D., oncologist of the highest qualification category.

In the direction of traumatology and orthopedics

Since 2015, the SOCB has been performing hip and knee arthroplasty, with resection of the affected joint particles that cannot be restored. These interventions are high-tech operations. A cementless prosthesis made in the USA is used.

Specialists providing VMP in this area:

Zabara Evgeny Vasilievich, Ph.D., traumatologist-orthopedist of the highest qualification category.

In the direction of operative gynecology (except for assisted reproductive technologies)

On the basis of the gynecological department of the SOCB, the following types of VMP are carried out:

Surgical organ-preserving treatment for women:

1. Insolvency of the pelvic floor muscles: cystocele, rectocele, prolapse of the vaginal walls after extirpation of the uterus in patients of reproductive age,

2. In hypertrophy and elongation of the cervix in patients of reproductive age.

3. Prolapse, incomplete and complete prolapse of the uterus and vaginal walls, as well as in combination with stress urinary incontinence.

4. Connective tissue diseases, including reconstructive plastic surgery: sacrovaginopexy with laparoscopic assistance, surgical interventions using mesh prostheses.

5. Stress urinary incontinence in combination with prolapse and / or prolapse of the pelvic organs.

6. Surgical organ-preserving and reconstructive plastic treatment of common forms of giant tumors of the genitals, adjacent organs of the small pelvis and other organs of the abdominal cavity.

The following surgical interventions are performed:

Endoscopic, vaginal and abdominal access operations and their combination in various combinations: sling surgery (TVT-0, TVT, TOT) using implants.

Operations with endoscopic, vaginal and abdominal access and their combination in various combinations: promontofixation of the uterus or vaginal stump using synthetic meshes.

Operations by endoscopic, vaginal and abdominal access and their combination in various combinations: strengthening of the ligamentous apparatus of the uterus by laparoscopic access.

Endoscopic, vaginal and abdominal access operations and their combination in various combinations: cervical plastic.

Endoscopic, vaginal and abdominal access operations and their combination in various combinations: promontofixation of the vaginal stump, sling surgery (TVT-0, TVT, TOT) using implants.

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Sling operations (TVT-0, TVT, TOT) using implants.

Operations using laparoscopic and combined approaches.

Specialists providing VMP in this area:

Tkachuk Olesya Konstantinovna, Ph.D., doctor of the highest qualification category.

In the direction of abdominal surgery

A wide range of surgical interventions on the liver, pancreas, stomach and intestines are performed at the SOCB.

Specialists providing VMP in this area:

Antonenko Igor Vladimirovich, doctor of the candidate of the highest qualification category, chief freelance specialist surgeon of the DZ YNAO.

Direction to the VMP

Application for the processing of personal data

Algorithm for the provision of high-tech medical care in GBUZ “SOKB”

Memo on the order of selection and referral to the VMP

Profile

VMP – 1

VMP – 2

#.

The consequences of long-term use of anabolic steroids qualification category

group

VMP

planned

#.

group

VMP

planned

Abdominal

surgery

one

8

one

2

Total

8

Total

2

Obstetrics and

Gynecology

3

24

3

2

4

0

4

24

Total

24

Total

26

Oncology

twenty

thirty

17

2

19

6

Total

thirty

Total

8

Cordially-

vascular

surgery

31

42

37

twenty

32

15

33

2

34

25

35

6

36

2

37

38

Total

130

Total

twenty

Traumatology

and orthopedics

44

71

46

36

45

3

fifty

66

47

43

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48

32

49

3

51

73

54

37

Total

152

Total

212

Urology

fifty

8

61

2

Total

8

Total

2

TOTAL

352

270

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