Without Kevorda, the Sverdlovsk regional branch of the Social Insurance Fund of the Russian Federation informs you that from 01.07.2017 in accordance with the Federal Law of 01

Without Kevordo

GU-Sverdlovsk Regional Branch of the Social Insurance Fund of the Russian Federation informs you that from 01.07.2017 in accordance with Federal Law of May 01, 2017 No. 86-ФЗ in the constituent entities of the Russian Federation, including in the Sverdlovsk region, state medical organizations formulate Uplust sheets in the form of an electronic document (ELN).

The advantage of ELN is that it is created by a medical organization in electronic form, stored in the information system of the Social Insurance Fund, an electronic certificate of disability cannot be lost, spoiled or fake. ELN also contributes to the transition to “direct payments” (Clause 2 of Article 431 of the Tax Code of the Russian Federation).

The May decree of the President of Russia (2018), among the national development goals of the Russian Federation, is planned to ensure the accelerated implementation of digital technologies in the economy and the social sphere. Currently, more than 100 thousand policyholders are involved in the formation of ELN in Russia.

Currently, all medical institutions of the Sverdlovsk region and Yekaterinburg are ready to issue electronic disability certificates.

One of the participants in the ELN information interaction system is insured persons (working citizens subject to compulsory social insurance in case of temporary disability and in connection with motherhood).

Only with the consent of the insured person will the medical organization be designed by ELN.

Employees of the policyholder at any time through the personal account of the recipients of services located on the Internet at the address: https://lk.fss.ru/Recipient/ may clarify information about their electronic disability sheets and information about the amount of the time allocated for temporary benefits disability, pregnancy and childbirth. To enter the personal account of the recipients of the services, a login and password necessary for entering a single portal of state and municipal services are used.

In order to exercise the rights of citizens to execute a certificate of disability in electronic form, we ask you to bring the information to the organization’s employees, and your organization connect to work with ELN in the very near future.

More detailed information on electronic certificates of disability is presented on the website of the GU – Sverdlovsk regional branch of the FSS of the Russian Federation www.r66.fss.ru.

On all issues related to the work of Eln

You can contact the branches of the SRO FSS of the Russian Federation,

in which you are registered as insured,

to the regional branch of the FSS by phone

“Hot Line” (343) 359-83-67, 371-96-79.

All information about the project Electronic certificate of incapacity for work is presented on the website of the SRO FSS of the Russian Federation http://r66.fss.ru/

Every year on November 14, World War II Fighting Day, established in 1991 by the International Federation of Diabetes (IFD) and the World Health and Healthcare Federation (WHO), is celebrated in 1991. The date is connected with the birthday of Frederick Banging, who, together with Charles Best, played a decisive role in the opening of insulin in 1922. World Diabetes Day is celebrated around the world in more than 160 countries.

With the discovery of insulin, a new era in the history of endocrinology came, since it was possible to find a cure for a previously incurable illness and save the lives of hundreds of millions of people. For many centuries, people did not know the means to combat this disease, and the diagnosis of “diabetes mellitus” did not leave any hope not only for recovery, but also to life: without insulin, the sick body could not exist and is doomed to slow fading.

Since 2007, the day began to be celebrated under the auspices of the UN. In a special resolution of the United Nations, it was proclaimed that it is necessary to develop state programs designed to combat diabetes.

The purpose of World War II of Diabetes is to increase the awareness of diabetes is not only about the number of diabetes, but also about how to prevent the development of this disease.

World War II of the Combat Day of 2018/2019 – Family and Diabetes

A two -year term was chosen in order to best linen the World Warmar Day campaign against the current strategic plan of the International Diabetes Federation (IDF) and facilitate planning, development, propaganda. The materials and actions that the IDF will develop within two years of the campaign will be directed at:

* Increasing awareness of the influence of diabetes on the family and the support of the sick.

* Propaganda of the role of the family in management, care, prevention and education on diabetes.

Diabetes applies to every family!

More than 425 million people currently live with diabetes. Most of these cases is a type 2 diabetes, which can largely be prevented using regular physical activity, healthy and balanced nutrition and encouraging a healthy lifestyle. Families should play a key role in eliminating the variable risk factors of type 2 diabetes and should be provided with knowledge, resources and conditions for maintaining a healthy lifestyle.

1 out of 2 people living with diabetes do not know about their disease. Most cases are type 2 diabetes. Early diagnosis and treatment are of key importance to prevent diabetes and achieve healthy results. All families are potentially affected by diabetes, and therefore awareness of the signs, symptoms and risk factors for all types of diabetes is vital to help detect it at an early stage.

Diabetes can be expensive for humans and family.In many countries, the cost of insulin injections and daily monitoring alone can consume half the average available income of the family, and regular and affordable access to the main drugs from diabetes is not available for many. It is important to improve access to inexpensive drugs for the treatment of diabetes in order to avoid increasing expenses for each person with diabetes separately and for the family as a whole.

Less than 1 of the 4 family members have access to the educational programs on diabetes. It is shown that family support in the treatment of diabetes has a significant impact on improving the health status of people with diabetes. Therefore, it is important that the ongoing training and support in the field of independent diabetes be available to all people with diabetes, and for members of their families, in order to reduce the emotional effect of the disease, which can lead to negative quality of life.

What is diabetes mellitus?

Diabetes mellitus is a chronic disease that develops in cases where the pancreas does not produce enough insulin or, when the body cannot effectively use insulin it produced. Insulin is a hormone that regulates the level of blood sugar. The general result of uncontrolled diabetes is hyperglycemia, or an increased level of blood sugar, which over time leads to serious damage to many body systems, especially nerves and blood vessels.

With type 1 diabetes (previously known as insulin -dependent, youthful or childish), which is characterized by insufficient insulin production, the daily administration of insulin is necessary. The reason for this type of diabetes is completely unclear, so it cannot be prevented at present. Symptoms include excessive urination (polyuria), thirst (polydipsy), constant feeling of hunger, weight loss, vision change and fatigue that symptoms may appear suddenly. Such patients need constant injection supply of insulin and strict observance of the diet.

Type 2 diabetes (previously called insulin -dependent or adult) develops as a result of ineffective use of insulin by the body, which is largely the result of excess weight and physical inertia. Symptoms can be similar to type 1 diabetes symptoms, but are often less pronounced. As a result, the disease can be diagnosed after several years after its beginning, after complications. Until recently, diabetes of this type were observed only among adults, but at present it is striking in children. There is every reason to assume that a decisive role in this is played by a global growth of indicators of child obesity and physical inertia.

Gestational diabetes is hyperglycemia, which develops or is first detected during pregnancy. Women with this form of diabetes have an increased risk of complications during pregnancy and childbirth. They also have increased risk of type 2 diabetes later. Most often, gestational diabetes is diagnosed during prenatal screening.

Reduced tolerance to glucose (PTG) and violation of glycemia on an empty stomach (NGN) are intermediate states between the norm and diabetes. People with PTH and NGN are at high risk of type 2 diabetes, but this may not happen.

What are the general consequences of diabetes?

• In patients with diabetes, the risk of heart attack and stroke is 2-3 times higher than without diabetes.
• In combination with a decrease in blood flow, neuropathy (damage to nerves) of the lower extremities increases the likelihood of ulcers, infection and, ultimately, the need to amputated the limbs.
• Diabetic retinopathy, which is one of the important causes of blindness, develops as a result of long -term accumulation of damage to the small blood vessels of the retina of the eyes. Diabetes can be due to 1% global cases of blindness.
• Diabetes is among the main causes of renal failure.
• The general risk of death among people with diabetes is at least 2 times higher than the risk of death among people of the same age who do not have diabetes.

Up to 70% of the type of type of diabetes can be prevented or delayed by taking a healthy lifestyle:

• achieve a healthy body weight and support it;
• To be physically active – at least it is necessary 30 minutes of regular activity of moderate intensity daily;
• Refrain from the use of tobacco, because Smoking increases the risk of cardiovascular diseases;
• adhere to a healthy diet and reduce the consumption of sugar and saturated fats.

The basic rules of a healthy diet for the prevention of the development of diabetes are:

• an increase in the amount of consumption of vegetables and fruits;
• regular consumption of whole grain products;
• expansion of the consumption of mono- and polyunsaturated fats;
• reduction in transformation and saturated fats;
• Reducing the consumption of sweet carbonated drinks.

In the world from 40 to 80% of people with the diagnosis of diabetes, they do not realize the seriousness of their disease and often do not receive adequate treatment that prevents the development of irreversible complications. Screening of diabetes complications is an important part of effective management of this disease to preserve the quality of life.

With any type of diabetes, people suffering from them need to more strictly control their health.

To determine blood sugar, you should purchase a glucometer. Sugar is enough to measure once a day, but at different times (8-00, 13-00, 17-00, 21-00).Blood sugar should be 5-10 m/mol per liter during the day. It is advisable to maintain arterial pressure at 120/80 mm of an eg. Keep a diary of self -control. At least once a year, conduct an examination: inspection of an optometrist (eye bottom); inspection of a neurologist, surgeon; General clinical examination (general blood test, urine, biochemical blood test – lipid spectrum, renal function).

Remember! The implementation of the stated recommendations will allow you to avoid complications of diabetes, live an active and full life, do your favorite business, enjoy life and work!

On the World Course Day

This day falls on every third Thursday of November and is usually marked by the conduct of various actions and initiatives to combat smoking, for example, an increase in awareness regarding the connection between tobacco and diseases of the cardiovascular, respiratory system, and oncological diseases. This year, the International Day of Refusing Smoking falls on November 15.

According to statistics, in Russia every 10th woman smokes, and among men 50-60% are avid smokers, in some social categories this figure reaches 95%. According to the air, smoking is the cause of 85% of the fatal outcome from lung cancer, bronchi, trachea, 16% of deaths from coronary heart disease, 26% of deaths from tuberculosis, 24% of lower respiratory tract infections. Every day about 14 thousand people die from tobacco consumption in the world. Smoking takes an average of 10-12 healthy years of life.

The essence of the International Day of Refusing Smoking is an attempt to reduce the prevalence of this addiction, as well as attract representatives of various organizations, social strata, and doctors of various specialties to combat smoking. Also, this day is designed to increase citizens' awareness of the dangers of smoking. The negative impact of smoking is obvious, and most Russians consider it a bad habit. However, only a few are able to fight nicotine addiction.

According to the Ministry of Health of the Russian Federation, some reduction in the number of smokers in the Russian Federation is still observed. If in 2009 39.4% of the adult population was smoked in Russia, then in 2016 – 30.9%, which corresponds to a relative decrease in tobacco consumption by 21.5% (a decrease by 16% among men and by 34% among women). As a result of the adoption of the Federal Law on the protection of the health of citizens from the influence of tobacco smoke and the consequences of tobacco consumption, which entered into force on June 1, 2013, smoking at stadiums, schools, universities, hospitals, cafes, restaurants, shops, elevators, airports, airports, airports, Advertising and stimulating tobacco sales is prohibited.

Despite the active antipagand of smoking, not everyone understands the significance of its harmful effects on health. Smokers are urged at least on this day to abandon smoking, to protect their health and the health of people around you!

Why do smokers need to abandon smoking?

A cigarette is a small factory for the production of various chemical compounds. Moreover, the range of its products is very diverse and includes four thousand different substances, about sixty of them provoke the development of cancer.

The smoker is affected by all body systems, and he acquires a whole bouquet of diseases. Here are some of the diseases, the development of which provokes smoking.

The respiratory system suffers, of course, one of the first. Cancer diseases of the lips, oral cavity, tongue, pharynx, trachea, bronchi, lungs are considered associated with smoking. For example, it is proved that smoking more than 50 packs per year (one pack per week) receive the risk of getting cancer of the oral mucosa 77.5 times larger than non -smokers.

In addition, tobacco reduces immunity, and smokers resist other pathogenic factors (infections, adverse environmental influences, production factors, etc.), more often suffer from acute respiratory diseases, pneumonia.

The most visual and incurable consequence of smoking is a chronic obstructive lung disease (COPD). People suffering from COPD often cough due to a large amount of mucus released and accumulating in the bronchi, they have wheezing when breathing, shortness of breath and heaviness in the chest. With continuing smoking, the COPD progresses and, in the end, from a lack of oxygen and shortness of breath, the smoker is unable to even walk or take care of himself. To prevent COPD, do not start smoking, and if you smoke, try to quit as soon as possible. Even if the hobble has already developed, the rejection of smoking will significantly slow down its development and extend life.

The smokers are affected by the cardiovascular system of the body. Arterial hypertension develops, coronary heart disease, which are more often than that of non -smokers, are complicated by a stroke and myocardial infarction. Plus, do not forget about oxygen starvation – since there is less oxygen in the blood, the heart has to work hard to bring it to at least fabrics. The wear of the heart muscle in this case occurs much faster. With a predominance of damage to peripheral vessels (often the femoral arteries and their branches), vascular deficiency of the lower extremities develops, which, against the background of a constant need for loads (walking, running), leads to the occurrence of intermittent chromium – a disease that significantly limits a person’s workability and very often at the final stage development of legs leading to gangrene. Often in such cases, amputation of the limb is required to save the patient's life.

The digestive system suffers: if the smoker is not afraid of stomach cancer (due to the ingolines of tobacco smoke with saliva into the stomach), then heartburn, gastritis or even an ulcer will appear in the near future.

The involvement of tobacco metabolites in many links in the exchange, violates the excretion of the glands of internal secretion, aggravates and provokes hidden or initial changes, can contribute to the provocations of the manifestation of diabetes, dyskinesia (impaired contractile function) of the gallbladder. The consequence of prolonged and intensive smoking is often also pancreatic cancer and gall bladder.

Smoking destroys reproductive health. It often happens that young and healthy couples can not have a long -awaited baby. Among the factors of infertility are smoking. Toxic substances of tobacco smoke inhibit the production of hormones necessary during pregnancy, make it difficult to ripen the eggs and their movement through the uterine pipes, so the smoking women are difficult to conceive. Some scientists believe that many years of smoking acts on the female body in the same way as the removal of one ovary. Toxins from tobacco smoke damage sperm, making them non -viable, which means they reduce the chances that at least one of them reaches the egg and fertilizes it. There is a direct dependence: the more the man smokes, the more difficult it is for him to become a father!

Why do non -smokers convince smokers to abandon smoking?

Smoking until then is the personal case of the smoker, his individual harmfulness, the right to freedom of choice, until the smoke exhausted by him and/or the smoke of the smoldering cigarettes inhale the people around him. If he smokes at home, relatives suffer, if in a public place or at work – a toxic effect of smoke extends to others.

The toxic effect on the body of passive smoking has long been known. A smoker with a cigarette spreading tobacco smoke makes a non -smoker, who is with him in the same room, passively smoking, whether he wants it or not.

At first, it was believed that tobacco smoke has only an annoying effect on non -smoking people, in the sense that their mucous membrane of the nose and eyes was inflamed, dry mouth was noted. As the information accumulates, it became clear that non-smokers living or working with smokers, truly risk their health.

The most specific information is regarding the effects of passive smoking on children. In children from families where one or both parents smoke at home, colds, bronchitis and pneumonia often occur. These children are more likely to suffer in early childhood, more often miss school and generally get a lesser supply of health for future life. Smoking parents by 20-80% increases the risk of respiratory system, inhibits the growth of the lungs of the child.

The influence on the respiratory system of the child’s passive smoking child does not exhaust his toxic effect on the body: even after growing, the difference remains in the indicators of mental and physical development in groups of children from families of smokers and non -smokers.If the child lives in an apartment where one of the family members smokes 1-2 packs of cigarettes, then the child is found in the urine, the amount of nicotine corresponding to 2-3 cigarettes.

Passive smoking or tobacco smoke at the workplace or in a living room is considered conditional “production harm” to health. After 1.5 hours of stay at the workplace in a smoking room, in non -smokers, the concentration of nicotine in the body increases by 8 times, the content of other toxic components increases repeatedly.

The effect of passive smoking on the body can be expressed both in the immediate and in a delayed effect.

Immediate effects include irritation of the eyes, nasopharynx, bronchi and lungs. Non -smoking people, as more sensitive to irritation of tobacco smoke, can feel headache, nausea, dizziness. Passive smoking at the workplace and in everyday life creates an additional load on the cardiovascular system and can provoke an exacerbation of cardiovascular diseases and pulmonary pathology (an attack of bronchial asthma).

A delayed (after some long period of time) the effect of passive smoking can be expressed in the occurrence of cancer diseases of the respiratory system, cardiovascular diseases (ischemic diseases of the vessels of the heart, brain, lower extremities) and others.

Why is it difficult for smokers to refuse smoking?

According to statistics, to quit smoking on the first attempt, less than 20% of smokers. Why? Is smoking a bad habit or illness? If this is a bad habit, then why of 70% of smokers who want to quit smoking, only five percent refuse to smoking? Why do some smokers, passionately wanting to quit smoking, need three, or even five attempts to achieve the goal? Do they really have such a weak will? Or are they so poorly brought up? The answer is simple. Smoking leads to nicotine dependence, which is officially recognized as a disease. According to the international classification of diseases, it is encrypted by the F-17 and refers to the same class of diseases as alcohol and drug addiction.

Medical assistance to refuse smoking

When we come to an appointment with a doctor, we are conducting a number of studies, after which they prescribe treatment and give a number of recommendations.

If the smoker contacts the cabinet to refuse smoking, how is his meeting with a doctor going?

First, he will assess the status of smoking. She includes:

1. Assessment of the degree of nicotine dependence.
2. Assessment of the degree of motivation to quit smoking.
3. Assessment of smoking motivation.
4. Assessment of daily intensity and stereotype of smoking tobacco.

How is this done, and why is it needed?

Assessment of the degree of nicotine dependence is carried out using the Ferstrem test. It includes only six questions, which are given answers. The selected version corresponds to a specific ball.If the child lives in an apartment where one of the family members smokes 1-2 packs of cigarettes, then the child is found in the urine, the amount of nicotine corresponding to 2-3 cigarettes.

Passive smoking or tobacco smoke at the workplace or in a living room is considered conditional “production harm” to health. After 1.5 hours of stay at the workplace in a smoking room, in non -smokers, the concentration of nicotine in the body increases by 8 times, the content of other toxic components increases repeatedly.

The effect of passive smoking on the body can be expressed both in the immediate and in a delayed effect.

Immediate effects include irritation of the eyes, nasopharynx, bronchi and lungs. Non -smoking people, as more sensitive to irritation of tobacco smoke, can feel headache, nausea, dizziness. Passive smoking at the workplace and in everyday life creates an additional load on the cardiovascular system and can provoke an exacerbation of cardiovascular diseases and pulmonary pathology (an attack of bronchial asthma).

A delayed (after some long period of time) the effect of passive smoking can be expressed in the occurrence of cancer diseases of the respiratory system, cardiovascular diseases (ischemic diseases of the vessels of the heart, brain, lower extremities) and others.

Why is it difficult for smokers to refuse smoking?

According to statistics, to quit smoking on the first attempt, less than 20% of smokers. Why? Is smoking a bad habit or illness? If this is a bad habit, then why of 70% of smokers who want to quit smoking, only five percent refuse to smoking? Why do some smokers, passionately wanting to quit smoking, need three, or even five attempts to achieve the goal? Do they really have such a weak will? Or are they so poorly brought up? The answer is simple. Smoking leads to nicotine dependence, which is officially recognized as a disease. According to the international classification of diseases, it is encrypted by the F-17 and refers to the same class of diseases as alcohol and drug addiction.

Medical assistance to refuse smoking

Within 30-60 minutes

Other

1. 4. How many cigarettes do you smoke per day?
2. 10 or less
3. 31 and more

5. Do you smoke more often in the first hours in the morning, after you wake up, or during the rest of the day?

Yes

Not

6. Do you smoke, if you are very sick and forced to be in bed all day?

• Yes
• Assessment of the degree of motivation to quit smoking can be carried out using two simple questions: Would you quit smoking if it were easy? And How much do you want to quit smoking? Again, as in the previous test, answers and points are given. The amount of points on individual issues determines the degree of motivation of the patient to refuse smoking. The maximum value of the amount of points is 8, the minimum is 0.
• Question

Answers are points

1. Would you quit smoking if it were easy?

Definitely not – 0. Most likely there is no – 1. Perhaps yes – 2. Most likely yes – 3. definitely yes – 4

2. How much do you want to quit smoking?

I do not want at all – 0. weak desire – 1. In average – 2. Strong desire – 3. definitely want to quit smoking – 4

The larger the amount of points, the stronger the motivation of the patient to quit smoking:

The amount of points of more than 6 means that the patient has a high motivation for the rejection of smoking and he can be offered a long -term medical program in order to completely refuse smoking.

The amount of points is from 4 to 6, means weak motivation and the patient needs to conduct further conversations on strengthening and maintaining motivation for refusing tobacco.

The amount of points below 3 means the lack of motivation and the patient needs to assign a second visit to a motivational conversation.

It should be borne in mind that even among patients with high motivation for rejection of smoking, successful rejection of smoking within 1 year will not be 100%. This is due to the fact that many patients develop a high -degree nicotine dependence, the overcoming of which may require several treatment courses.

Assessment of smoking motivation is carried out by analyzing answers to a more complex test. Analysis of answers to the test questions enables the doctor, as well as the patient, to single out factors that stimulate the patient to smoking, which allows you to understand the causes of smoking and plan how to change the patient’s behavior for the period of smoking refusal. The patient must be prepared for the fact that the refusal of smoking leads to a certain change in the style of behavior, and the slogan should become the main one for the period of refusing smoking: Learn to live in a new way.

The assessment of the daily intensity of smoking is carried out individually, preferably with its graphic display, where the time of the day is postponed along the axis of the abscissa, and the number of cigarettes smoked along the order axis. The resulting schedule shows the distribution of the number of cigarettes smoked by hours and time of day. The doctor will use this information when prescribing nicotine substitutions. If you note the events on the graph, then this shows that it provokes smoking and use the information received for behavioral therapy.

In addition, a study of the functional indicators of the body will be carried out, including:

assessment of the functional state of the lungs;

• determination of the functional state of arterial vessels;
• Measurement of carbon monoxide in the alveolar air.
• After that, a treatment program will be drawn up for the smoker, including behavioral therapy, and, if necessary, medication.
• What is drug therapy for?
• If the degree of nicotine dependence is 7 or more, which corresponds to a high and very high degree of nicotine dependence, then one should expect severe manifestations of withdrawal symptoms and difficulty in quitting tobacco. In such conditions, drug treatment should be included in treatment programs. In Russia, two methods of pharmacological treatment of nicotine addiction are registered: the use of pharmacological preparations containing nicotine and pharmacological preparations that do not contain nicotine. The effectiveness of these methods has been proven.
• Where can I get help to quit smoking?
• 1. GBUZ SO Medical and physical education dispensary No. 2
• Address: Kamensk-Uraldsky, st. Titova, 7, room. 404
• Head: Klyashtornaya Tatyana Sarapionovna
• 2. Holy Trinity Cathedral

Address: Kamensk-Uralsky, st. Lenina, 126

Specialist: Tumashov Andrey Anatolyevich

• Tel: 8(3439)329-998, 89122638085
• Here are some tips for those planning to quit smoking:
• 1. The smoker himself must want to quit smoking – a person who refuses tobacco under the pressure of others or circumstances experiences severe stress and often returns back to smoking life.
• 2. Start with a motivation (a goal to quit smoking) that will help you make a decision. Formulating and accepting the goal of quitting smoking, highlighting the desired result can help during the period of quitting to control your behavior. Goals can be related to health or other priorities. As practice shows, it is useless to intimidate a smoker with illnesses or probable death – people usually live for today and try not to look into the future. It is better to define for yourself a future incompatible with smoking, in which you will go voluntarily (for example, start planning a pregnancy or seriously go in for sports).Below are examples of such goals – motives:
• My body will begin to recover immediately after refusing smoking;
• I will have more energy, I will feel better physically;
• I will have more white teeth and healthy gums, a cough will pass and breathing will become easier;

I will decrease the risk of cancer, myocardial infarction, stroke, pulmonary emphysemes (pathological condition of the lung tissue, characterized by an increased content of air), chronic bronchitis, cataracts and other diseases;