Innovative Medicine of Kuban #4 (2017)

InnovativeMedicineofKuban#4 (2017)

CONTENTS

METABOLISM IN VARIOUS EMBODIMENTS, THE RECOVERY

OF THE DIGESTIVE SYSTEM IN PATIENTS AFTER GASTRECTOMY

A.G. Baryshev 1,3, V.A. Porhanov 1,2, A.Y. Popov 1,3, A.N. Lishenko 1,3,

N.V. Hachaturyan 1,2, D.A. Valyakis 2, M.V. Bodnya 2, Y.V. Efremenko 3

1 Scientific Research Institute S.V. Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

2 Department of Oncology with course of thoracic surgery, Advanced Training Faculty, Kuban State Medical University, Krasnodar, Russia

3 Department of Surgery #1, Advanced Training Faculty, Kuban State Medical University, Krasnodar, Russia

Despite the relative decline in the incidence of cancer in Russia, stomach cancer continues to occupy the sixth place in the structure of cancer mortality. The surgical method is the main one in treatment, most often a gastrectomy with enlarged lymphodissection (D2) is performed. There remains the question of which method of digestive system reconstruction after gastrectomy that will provide a good quality of life and social rehabilitation of patients. Loop esophagoenteroanastomosis with intestinal sostem is the most simple option to restore the digestive system in which the passage of food off the duodenum, which in some patients leads to disruption of metabolic processes and development postgastrectomy functional disorders. To reduce the frequency of these problems using the recovery after gastrectomy physiological passage of food through the duodenum. Objective to study the characteristics of protein and carbohydrate metabolism in patients after gastrectomy and petilium option esophagoenteroanastomosis and reservoir enogastronomici with redoutensale. Materials and methods using samples with a double load Stаube-Traugott, hyperglycemic coefficient Bowden, determining the level of total blood protein and albumin-globulin ratio, were studied peculiarities of metabolic processes after gastrectomy in 25 patients, digestive system that was restored loop method esophageal-intestinal anastomosis and in 23 patients – enogastronomici. Results it was established an advantage in the recovery of protein and carbohydrate metabolism in the group of patients with a reservoir enogastronomico after 3 months after surgery. Tank possible small bowel transplant, replacement remote stomach and the reconstruction of the duodenal passage is allowed to eat more food in single dose (530±80 ml) than after loop reconstruction method (380±50 ml). Conclusion the best characteristics of protein and carbohydrate metabolism, as well as a good reservoir function of the proposed method gastric replacement with small intestine can achieve the optimum recovery of metabolic processes and to improve the quality of life of patients after gastrectomy.

Key words: gastric cancer, gastrectomy, gastric replacement with small intestine, protein and carbohydrate metabolism.

RELATION OF VOLEMIC SUPPORT TO ACUTE POSTOPERATIVE

RESPIRATORY INSUFFICIENCY DEVELOPMENT FOLLOWING

THORACIC ONCOLOGICAL SURGERY

V.A. Zhikharev 1, Y.P. Malushev 2, L.G. Shanina 1, O.I. Peschanskaya 3,

D.V. Rogovik 1, S.D. Sitnik 1

1 Scientific Research Institution – Ochapovsky Regional Clinical hospital #1, Krasnodar, Russia

2 Kuban State Medical University, Krasnodar, Russia

3 Maternity hospital #1, Krasnodar, Russia

Acute postoperative respiratory insufficiency is a serious complication after thoracic surgery. Our aim is to define the relation of rate and volume of infusion during the operation with development of acute postoperative respiratory insufficiency in patients operated on for lung cancer. We performed a retrospective assessment of 416 patients with various rate of intraoperative infusion that were divided into 2 groups: with acute postoperative respiratory insufficiency (ARI, n – 53) and without it (n – 319).

As a continuous covariate in each group we analysed intraoperative infusion rate in the range 2, 3, 4, 5, 6, 7 and 8 ml/kg*h. Intraoperative infusion rate more than 5 ml/kg*h, positive fluid balance, low measurements SvO2 and lower PaO2/FiO2 ratio intraoperatively , are shown as valuable predictors for postoperative ARI development. Intraoperatively we found a strong correlation (r 0,915697) between infusion rate and frequency of postoperative ARI, and defined optimal infusion rate (to 5 ml/kg*h) which allowed to decrease possible development of ARI, length of hospital stay to 53,4 % and mortality from 11,3 % to 0%.

Key words: acute postoperative respiratory insufficiency, fluid maintenance, venous oximetry, PaO2/FiO2 ratio.

OUTCOME ANALYSIS FOR PATIENTS WITH SEVERE COMPOUND

FRACTURES OF LOWER EXTREMITY LONGITUDINAL BONES

IN THE REGIONAL GENERAL HOSPITAL

A.N. Blazhenko 2, S.N. Kurinniy 1, A.A. Blazhenko 1,2, A.V. Shevchenko 1

1 Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

2 Kuban State Medical University, Krasnodar, Russiа

Background We have performed outcome analysis in patients treated for severe compound fractures of lower extremity longitudinal bones regarding a chosen treatment technique for initial surgical debridement and transfer terms in the regional general hospital.

Materials and methods We reviewed 151 patient reports treated in Scientific Research Institution – Ochapovsky Regional Clinic Hospital #1, Krasnodar, for 2012 – 2016. We defined four methods for initial surgical debridement at the first stage of surgery. Outcomes were analysed in patients regarding their initial surgical debridement and transfer terms into the regional general hospital from the primary admission sites.

Conclusions it is required to work out regional system for staged treatment in patients with severe compound fractures. At first stage initial surgical treatment is performed by techniques №2, 3 and then patients are transferred to the regional general hospital during the first day after being injured. In unstable patients initial surgical debridement should be divided in two stages.

Key words: compound fractures of lower extremities longitudinal bones, initial surgical debridement, staged treatment.

DIFINITION FOR LITHOGENICITY INDEX IN PATIENTS

WITH RECURRENT AND RESIDUAL CHOLEDOCHOLITHIASIS

BY INTEGRATED ASSESSMENT OF DYSCHOLIA INTENSITY

M.I. Bykov 1,2, V.A. Porhanov 1,2, I.M. Bykov 2

1 Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

2 Kuban State Medical University, Krasnodar, Russia

In this article we presented study results characterizing the lithogenicity changes in cases with biliary tract obstruction based on assessment of lipidic exchange indicators and condition of pro-oxidant – antioxidant activity at the local level. It is determined that in group with primary choledocholithiasis we observed decrease of anti-oxidizing activity by 47,1%, in the absence of reliable changes of intensity for free radical oxidation, rise of general lipids level to 9,9% at simultaneous lack of authentic changes of cholesterol content which are followed by ascending integrated lithogenicity index indicator in average for 59,7%. Besides, it has been shown that in patients with a recurrence of mechanical jaundice (in terms from 2 to 7 months) integrated indicator of lithogenicity index was very high at primary assessment (16,27 U). The possibility to research metabolic disturbances expression for various diseases of a biliopancreato -duodenal area at the local level on the basis of an integrated lithogenicity index indicator allowed to optimize an algorithm for the choice of the biliary tract decompression referred on early endoprosthetic incrustation and also to provide adequate techniques for patients management postoperatively and prove the necessity of performing the certain treatment referred to prophylaxis of the remote complications of endobiliar stenting.

Key words: lithogenicity index, cholangiolithiasis, chemiluminescence, lipids, cholesterol.

SUCCESSFUL ASPIRATION OF THROMBOTIC MASSES OUT OF THE LEFT INTERNAL CAROTID ARTERY LU MEN USING A PROXIMAL EMBOLIC PROTECTION DEVICE IN THE CONDITIONS OF THROMBOLYTIC THERAPY PERFORMANCE

A.S. Nekrasov, A.I. Beliy, O.S. Volkolup, P.A. Tupikin

Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

Combined techniques of treatment for ischemic stroke are even more often included into routine work of specialized teams. One of them based on a combination of systemic thrombolytic therapy and endovascular methods is characterized by a high rate of favorable outcomes. However, it is worth remembering that to achieve success it is necessary to keep within strictly limited therapeutic window, otherwise intravenous administration of a thrombolytic agent will be contraindicated that can significantly affect a positive outcome. Clinical observation for a combination with systemic thrombolytic therapy and endovascular mechanical thromboaspiration with use of the proximal embolic protection device at a total thrombosis of the left internal carotid artery lumen is presented in this article.

Key words: acute ischemic stroke, thromboaspiration, thrombolytic therapy, combined modality therapy, thrombolysis.

ENDOPROSTHESIS TRACHEAL REPLACEMENT IN ENDOSCOPIC

TREATMENT FOR CICATRICAL STENOSIS

I.N. Muntyan, V.A. Porhanov, I.E. Bondareva, A.I. Rassovsky

Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia


At present surgery is the main technique for cicatrical tracheal stenoses treatment. Sleeve tracheal resection is one of the radical operations which allows to repair tracheal patency. But, in some cases, performance of traumatic surgery could be limited by a severe patient condition or serious somatic disorders. In these patients, maintenance of a stable lumen in the invaded trachea is achieved by endoprosthesis replacement that is a method of choice among all endoscopic techniques. We present clinical experience of endoscopic stenting in 60 patients.

Background: analyze outcomes following stenting in patients treated for cicatrical tracheal stenosis.

Key words: tracheal stenosis, stent, endoprosthesis replacement.

DIFFERENTIAL DIAGNOSIS FOR NORMOTENSIVE

HYDROCEPHALUS SYNDROME

S.A. Zhade, E.R. Kharshudyan, E.I. Zyablova, V.V. Tkachev, G.G. Muzlaev

Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

Normotensive hydrocephalus is a complex with symptoms including the following triad: walking disturbance, dementia and incontinence of urine. Existence of the specified disorders brings patients to physicians of various specialties. Knowing special features of Normotensive hydrocephalus manifestation, well-timed and correctly carried out diagnosis allows to avoid disease advancement and gives chance to this group of patients to improve life quality carrying out a neurosurgical intervention. We present two clinical observations on the basis of which the differential diagnosis for normotensive hydrocephalus is carried out. The literary review of examination technique, diagnostic criteria and approaches to surgical treatment for these patients is offered in discussions.

Key words: normotensive hydrocephalus, ventriculo- peritoneal bypass.

CLASSIFICATION FOR THYROID GLAND TUMORS (WHO, 2017):

ATTENTION TO PROGNOSTIC FACTORS

O.N. Ponkina

Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

In this article we presented four main changes in the Classification for Thyroid Gland Tumors, the fourth revision (WHO, 2017) regarding the revision presented in 2004. The most essential of them are:

1) defining the «other encapsulated tumors of thyroid gland with a follicular pattern» group which are referred to the category containing boundary tumors and includes the following concepts: a follicular tumor of the uncertain malignant potential (FT-UMP), the high-differentiated tumor of the uncertain malignant potential (WDT-UMP) and a noninvasive follicular tumor with papillary and nuclear properties (NIFTP) and

2) the oncocytic tumors which were earlier considered in group of follicular adenomas / carcinomas are defined as a separate type of tumors with an independent biological entity.

Key words: WHO classification, tumors, thyroid gland.

GLUCOCORTICOIDS AND ARTERIAL HYPERTENSION

IN INTERNAL ORGANS RECIPIENTS

E.D. Kosmacheva 1,2, S.M. Martirosyan 1,2, N.A. Zubareva 1,2, A.E. Babich 1,2

1 Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

2 Kuban State Medical University, Krasnodar, Russia

In this paper we present a review of literary data about the modern views on glucocorticoid arterial hypertension arrangement in donor organs recipients. Arterial hypertension is one of the main risk, pacing for cardiovascular complications development. In cases with glucocorticoids uptake arterial blood pressure develops approximately in 15–20%. We generalized the main schemes participating in genesis of the arterial hypertension induced by glucocorticoids: a time delay of sodium and increase in circulating liquid volume, GC -dependent vasoconstriction, increased synthesis of catecholamines and beta 1 – adrenergic receptor expression, change of noradrenaline sensitivity as a result of the increased endothelin synthesis. In a practical manipulation it is necessary to use non-steroid protocols or minimize doses in internal organs recipients, weighing risks of transplant rejection and possible undesirable side responses in cases with glucocorticoids administration.

Key words: transplantation, arterial hypertension, glucocorticosteroids.

CAROTID SURGERY PATTERNS FOR CRITICAL STENOSIS

IN INTERNAL CAROTID ARTERY AND ITS OSTIA CALCINOSIS

R.A. Vinogradov 1,2, D.A. Popov 2

1 Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

2 Kuban State Medical University, Krasnodar, Russia

For many years cerebral circulation acute disorder occupies one of the leading reasons of mortality and disability among the population around the world. Despite extensive experience of surgical interventions for stroke prevention, there is a probability for serious complications emergence, including fatal ones. One of the numerous factors for their emergence is the missed morphology of atherosclerotic plaques in different patients preoperatively. The aim of this review was to confirm importance of the careful choice of surgical treatment and also to identify risk groups among intraoperative complications in patients with the stenosing process of carotids with calcification.

Key words: atherosclerosis, calcinosis, carotids, critical stenosis of internal carotid artery, carotid endarterectomy, carotid angioplasty, carotid angiostenting, risk stratification.

Innovative Medicine of Kuban #2 (2017)

InnovativeMedicineofKuban#2 (2017)

CONTENTS

CELL THERAPY ADVANCES IN COMBUSTIOLOGY

I.V. Gilevich, T.V. Fedorenko, E.A. Kolomytseva,

S.B. Bogdanov, A.A. Senenchenko, Y.V. Ivaschuk

Scientific research institution – Ochapovsky Regional clinic hospital #1, Krasnodar Region

Severe burns are life-threatening condition both local and general inflammatory disease, frequently with serious complications, despite significant progress in healing.

The golden standard is a surgical incision of necrotising skin areas with further autoplasty with perforated graft. But in cases with large and deep burns we observe deficit of skin resources and cell techniques are demanded.

In the present article we discuss development of cell technologies modern tendencies in cell therapy treatment for burns. In Scientific Research Institution – Ochapovsky Regional Clinic #1 a clinical study on autologous fibroblasts application for burn wounds is being performed. We described results of cell therapy treatment with complex of various autoplasty methods performed in two patients.

Key words: Cell therapy, fibroblasts, burn, keratinocytes.

EXPERIENCE OF ANKLE JOINT REPLACEMENT

D.L. Miroshnikov 1, O.V.Sabodashevsky 1, A.A. Afaunov 1,2,

I.I. Zamyatin 1, H.H. Matar 1, Y.V. Napakh 1

Background Study immediate and long-term results following ankle joint endoprosthesis.

Materials and Methods During the period from 2013 to 2016, we performed 26 ankle joint endoprostheses in patients aged from 19 up to 78 years with arthroses of various etiology. The average operative time was 1,6 hours. Average blood loss was 200 ml. There were 3 cases with an intraoperative fracture of an internal anklebone and they required additional synthesis by one or two screws. In the postoperative period one patient developed some regional necrosis in the postoperative wound area. Developed complications had no impact on observed positive results.

Results In 24 cases of 26 (92,3%) patients were satisfied with surgery results. In 18 of those (69,2%) the volume of postoperative movements significantly increased, but remained less normal. In 3 cases (11.5%0 the volume of movements remained at the preoperative limited level, however the pain syndrome while walking was completely stopped. In 3 patients (11,5%) who had no restrictions in movement amplitude neither prior to nor after the operation, the pain syndrome was also stopped. In 92,3% cases the positive results of ankle joint replacement were received. In 2 cases (7,7%) the received results were estimated as unsatisfactory because of deformation and the remaining pain syndrome. We continue observing patients.

Conclusions Ankle joint replacement with modern implants allows to achieve the positive immediate and longterm results in 92,3% cases and it is a hi-tech alternative to arthrodesis procedures.

Key words: ankle joint endoprosthesis, coxarthrosis, endoprosthesis complications.

SUCCESSFUL ENDOVASCULAR TREATMENT

FOR LCA TRUNK TRIFURCATION LESION

A.S. Nekrasov, A.A. Grechishkin, S.V. Mayngart

Scientific Research Institute – Ochapovsky Regional Clinic Hospital # 1, Krasnodar, Russia

Left coronary artery (LCA) supplies blood to 75% – 100% of myocardial volume of the left ventricle (LV). The atherosclerotic lesion of LCA trunk causes an ischemia in the sufficient area of the myocardium that often results in LV dysfunction, heart failure, and arrhythmia. The risk of death in cases with this pathology reaches 50% at drug treatment. Several decades, coronary artery bypass graft surgery (CABG) was considered as «the golden standard» of treatment for LCA trunk stenosis. Due to the skills and experience in treatment for coronary pathology, new technologies development and stenting techniques, percutaneous transluminal coronary angioplasty (PTCA) for LCA trunk stenosis became more effective and safe treatment. Despite this, trifurcation of LCA trunk remains extremely difficult pathology for endovascular treatment, for a lack of sufficient experience.In the present paper we described successful endovascular treatment for trifurcation lesion of LCA trunk in a case with acute coronary syndrome (ACS).

Key words: trifurcation of LCA trunk, PTCA, ACS, stenting.

GIANT CELL TUMOT OF THORACIC SPINE. A CLINICAL CASE OF EFFICIENT RADICAL SPONDYLECTOMY OF THREE VERTEBRAL BODIES

I.V. Basankin, V.A Porhanov, K.K. Takhmazyan, V.B. Kononenko, V.V. Shtraub, S.D. Sitnik, E.I. Zyablova, I.A. Pashkova, A.N. Fedorchenko, A.Y. Bukhtoyarov

Scientific Research Institute – Ochapovsky Regional Clinic Hospital # 1 Krasnodar, Russia

We present a clinical case of surgery performed for giant cell tumor of thoracic spine. This surgery was aimed to perform total en-bloc spondylectomy for three vertebral bodies invaded by tumor to follow principles of radicality and prevent local recurrence. We applied complex multidisciplinary approach when a team of thoracic surgeons, vertebrologists and x-ray experts was involved. We performed an operation of necessary volume for 420 minutes with 800 ml of blood loss. Postoperatively this patient showed no neurologic disorders. Spinal cord functions were completely preserved. The patient has been observing for 4 postoperative years and demonstrated no tumor recurrence and stability of the placed metal construction.

Key words: acute coronary syndrome, myocardial infarction, acute heart failure, levosimendan.

«CLASS OF EVIDENCE IIB» FOR ACUTE HEART FAILURE: WHEN, WHO, WHY?

A.M. Namitokov 1, F.R.Achmiz 1, A.S.Shimko 2, E.S. Dumanyan 1,

A.A. Skopets 1, P.V. Sukhoruchkin 1, O.A. Pozdnyakova 1, E.D. Kosmacheva 1, V.A. Porhanov 1

1 Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

2 Kuban State Medical University, Krasnodar, Russia

Despite a high level of standartization of principal approaches for acute coronary syndrome treatment, in acute cardiac care department there often occur cases when therapy is not to be included in present recommendations as they are non-effective and impossible for application. Myocardial infarction is one of those situations especially when it is complicated by cardiogenic shock and ventricular arrhythmia.

For overwhelming majority of ‘standard’ situations we apply recommendations with a high level of evidence I or IIa. Below we present a clinical case of treatment for acute coronary syndrome with ST-segment elevation, when non-routine used recommendations with class of evidence IIb were of great importance.

Key words: acute coronary syndrome, myocardial infarction, acute heart failure, levosimendan.

SURGERY FOR LATE RADIATION NECROSIS FOCI

IN THE FUNCTIONALLY IMPORTANT CEREBRAL AREAS

Kovalev G.I. 1, Blumenau I.S. 1, Muzlaev G.G. 1,2

1 Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

2 Kuban State Medical University, Krasnodar, Russia

Background Appearance and development of new radiotherapy methods for primary and secondary cerebral tumors resulted in more frequent diagnosis of post radiosurgical complications. A common sequel of treatment with linear accelerators is radiolesions of brain tissue.

Aim Study outcomes of surgical treatment for cerebral radiation necrosis foci.

Materials and Methods We included 3 patients with late radiolesion foci of brain tissue with progredient course, operated on in Scientific Research Institute – Ochapovsky Regional Clinic Hospital # 1, for the period since January 1, 2015 to April 30, 2017. Age rate was 61 – 65 years and mean age was 63 years. Below we present a clinical case of surgical treatment for post radiation surgery necrosis.

Results and discussion Increased focal volume in the late radiotherapy period with simultaneously expressed rise of local hypostasis in brain tissue could indicate development of a late post-radiation perifocal necrosis

Conclusions Our observations showed surgical efficiency for post radiosurgery complications treatment.

Key words: radiation necrosis, radiosurgery complications, cerebral metastases.

A CLINICAL CASE OF IDIOPATHIC PAROXYSMAL

LOWER JAW MYOCLONUS

L.I. Bonzuk, D.K. Sichinava, E.A. Kurinnaya, M.A. Barabanova

Scientific Research Institute – Ochapovsky Regional Clinic Hospital # 1,

Krasnodar, Russia

Idiopathic paroxysmal lower jaw myoclonus is a rare condition of movement and characterized with unexpected violent myoclonias of masticatory muscles that cause vertical movements of the lower jaw bone isolated or in cluster types.

In the paper we presented a clinical case of idiopathic paroxysmal lower jaw myoclonus. We described peculiarities of diagnosis, treatment and clinical findings.

Key words: paroxysmal myoclonus of lower jaw bone, epilepsy, masticatory muscles, antiepileptic agents.

PRIMARY PATIENT ASSESSMENT IS A BASIC

DIFFERENTIAL DIAGNOSIS FOR INTERMITTENT APSYCHIA

G. A. Golovina

Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

We assess differential diagnosis for intermittent apsychia considering primarily examinations. Special attention is paid to anamnestic criteria, active orthostatic trial, ECG tracing.

Key words: neutrally mediated syncopes, orthostatic hypotony, cardial syncopes, epilepsy.

STATE-OF-THE-ART: DIAGNOSIS AND TREATMENT

FOR LARGE INTESTINE DIVERTICULAR DISEASE

(APPROACHES AND TECHNIQUES REVIEW)

D.P. Puzanov, V.V. Polovinkin, I.A. Puzanova, N.A. Zebelyan

Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

For the last decade approaches to epidemiology and treatment for diverticular disease have changed significantly. Many principles used earlier lost their current relevance. At the same time we should carefully study etiological factors, pathophysiological mechanisms and cause and effect relationships for this pathology development. Diagnostic methods improvement, early prophylaxis and new approaches to treatment are capable to reduce risks of lethal outcomes in cases with this disease. The main aspects of an etiology, diagnostics and treatment of diverticular disease and its complications are presented in the present review.

Key words: diverticular disease, diverticulosis, diverticulitis.

CHANGES IN VALUES OF MEAN AGE IN PATIENTS WITH PRIMARY

DIAGNOSED MALIGNANCIES IN KRASNODAR REGION IN 2001–2015

(according to data of Population-Based Cancer Registries of Krasnodar Region)

R.A. Murashko, L.G. Teslenko, L.L. Stepanova, O.M. Golub, S.V. Sharov

Clinical Oncological Dispensary #1, Krasnodar, Russia

Stages of Formation and functioning of population-based cancer registries (PBCR) in Krasnodar Region are presented now in this article. Introduction of this registries in Krasnodar Region had great impact on reliability of statistical information. We presented dynamic research results of mean age values in patients with malignancies in the region (according to PBCR). All indicators are considered regarding localization of malignant neoplasms, sex, rank places in dynamics for 15 years (2001–2015). We revealed authentic increase (p < 0,05) of average age in patients in general regarding all localizations (for 2,6 years). In female patients it has increased more (for 2,3 years) than in male patients (for 1,6 years). In the majority of localizations we observed authentic (р < 0,05) increase in middle age both in men (in 49% cases), and women (in 53,9%). Direct high correlation link of mean age and such indicators of health in the population as mean age and average life expectancy of the population in Krasnodar Region, with oncological incidence is noted.

Key words: population-based cancer registries, malignancies, mean age of среднийвозраст primary diagnosed patients.

PSYCHOLOGICAL SELECTION CRITERIA

OF THE PERSONNEL POOL OF MANAGERS FOR NURSING CARE

L.A. Syzova

Scientific Research Institute – Ochapovsky Regional Clinic Hospital #1, Krasnodar, Russia

We considered modern vision of psychological aspects to form personnel reserve including middle managers – senior nurses in a multi-type healthcare institution. Possible application of an indicator for social and psychological adaptation of a person as a main selection criterion for a personnel reserve was checked. The research hypothesis has been defined: level of social and psychological adaptation of a nurse is a key professional and psychological competence which is closely connected with such organizational, professional and personal qualities of a subject as professional identity; organizational loyalty; career aspirations.

It is shown that the workers reaching the medium-to-high level of social adaptation have created professional identity, demonstrate organizational loyalty, they are focused on professional growth and career advance. Three factors connecting set of psychological competences of the manager in nursing care are allocated. We made a conclusion regarding a possible use of the marked-out social and psychological qualities as key psychological competences in selection experts for a group of linear management. Results of the conducted study allowed to distinguish three factors connecting set of psychological competences of the manager in nursing care that in general confirms the suggested hypothesis. It is shown that in each of the factors the leading role is carried out by the medium-to-high level of social adaptation.

The accounting of specifics in the personal and psychological qualities connected among themselves in each of factors allows to define focus of the educational and developing work with subjects of a personnel reserve. At the same time the increased level of social adaptation can be considered with the sufficient basis as key selection criterion of nurses in reserve pool.

Set of the social and psychological, organizational and psychological markers defining an indicator for social adaptation, undoubtedly is a component of professional competences of a middle manager that is to be considered in the course of occupational standards development in the field of nursing care.

Key words: nursing staff, personnel pool, social integration, occupational standards for nursing care.