The Bulletin of Contemporary Clinical Medicine最新文献

{"title":"THE HISTORY OF ESTABLISHMENT AND DEVELOPMENT OF MEDICAL CARE FOR CUSTOMS OFFICIALS IN THE XIX–XX CENTURIES","authors":"A. Morozov, N. Shishkina","doi":"10.20969/vskm.2021.14(5).117-123","DOIUrl":"https://doi.org/10.20969/vskm.2021.14(5).117-123","url":null,"abstract":"Aim. The article considers materials that allow evaluating the way of establishment of medical service for customs authorities during the XIX–XX centuries. Material and methods. The study was conducted in a combination of the main methodological principles – historicism, objectivity, and comprehensiveness of the research. Materials stored in the funds of the Central Museum of the Federal Customs Service, electronic resources allowing access to the Full Collection of laws of the Russian Federation were considered. Results and discussion. Before the beginning of the 19th century there was virtually no medical care for customs officials. The key role in the establishment of medical service provision was played by the «Charter of frontier and port quarantines», which determined the presence of doctors or staff-medics in the staff of Quarantine Offices, who were supposed to provide free of charge assistance to quarantined and quarantine survivors. Later, the emphasis in providing medical care for customs officials shifted to hospitals and military hospitals. Most likely, it was due to the huge length of the Russian Empire borders, along which the customs houses, customs outposts and posts were located. The changes in socio-political system in 1917 had their effect on the processes occurring with the provision of medical services in the country and in the customs office. In the period after the Great Patriotic War, medical services to employees of the department began to be provided in the outpatient clinic created under the USSR Ministry of Foreign Trade, and since 1957 – in the outpatient clinics of the USSR State Committee on Foreign Economic Relations, as well as in the inpatient clinics which were part of the structure of the USSR Ministry of Health. Conclusion. In the Russian Empire, customs houses, customs outposts and posts were located on the border, designed to solve a complex of problems in the border areas. The study of the historical experience of their medical service allows us to make more rational managerial decisions at the level of the Federal Customs Service in the future.","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134246050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"THE INFORMATIVE VALUE OF PELVIC ULTRASONOGRAPHY IN RECURRENT EXTERNAL GENITAL ENDOMETRIOSIS","authors":"Farakh T. Alieva, D. V. Bryunin, F. Alieva","doi":"10.20969/vskm.2021.14(5).14-17","DOIUrl":"https://doi.org/10.20969/vskm.2021.14(5).14-17","url":null,"abstract":"Background. In the structure of gynecological diseases, endometriosis ranks II after inflammatory diseases of the genitals and uterine myoma. The incidence of genital endometriosis is 92–94%, with an annual incidence ranging from 0,1% to 0,3%. The disease is characterized by tumor-like type of growth, affection of adjacent organs, and severe complications that lead to disability in patients. Aim. To study the informative value of ultrasound examination of the reproductive system organs in recurrent external genital endometriosis. Material and methods. Forty-eight patients with recurrent external genital endometriosis were examined. The mean age of the patients was (34,96±1,1) years. The history of endometriosis was in the range of (10,0±1,41) years (9–11). Recurrence rate averaged (2,02±0,44) years (1–4). The duration of remission averaged (6,1±0,84) years (1–15). All the patients underwent ultrasound examination with a transvaginal transducer. The length, width, anteroposterior uterine size, M-echo, and length and width of both ovaries were determined. Echographic features of endometrioid ovarian cysts and retrocervical endometrioid infiltrate were evaluated during ultrasound examination. The findings were compared with the echographic findings in women (n=20) with no history of endometriosis (comparison group). Results and discussion. Transvaginal ultrasonography in recurrent external genital endometriosis showed a significant increase in the echographic dimensions of uterine length (54,3±0,41) mm, width (47,9±0,13) mm, anteroposterior dimension (56,1±0,18) mm, endometrial thickness (6,6±0,09) mm, and increased echographic dimensions of both ovaries (p<0,05). Transvaginal ultrasound examination is informative in the diagnosis of endometrioid ovarian cysts. In 75,6% of patients, it manifests as a fluid mass with a heterogeneous suspension. In 75% of patients, retrocervical endometrioid infiltrate manifests as a heterogeneous, hypoechogenic, painful mass located behind the uterus. Conclusion. Transvaginal ultrasound is informative in the diagnosis of endometrioid ovarian cysts. Echographic diagnosis of endometrioid infiltrates of the vesicoureteral peritoneal fold, sacroiliac, broad uterine ligaments, and pelvic peritoneum presents difficulties, which justifies the necessity of laparoscopic diagnosis.","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130939007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EVALUATION OF EFFICIENCY AND THE DEGREE OF DEPENDENCE OF HEALTH INSTITUTION PERFORMANCE INDICATORS ON THE LEVEL OF ADMINISTRATIVE COMPETENCE OF THE MANAGER","authors":"A. Shulaev, Rustem Sh . Khisamiev, Pavel V . Zinoviev","doi":"10.20969/vskm.2021.14(5).68-73","DOIUrl":"https://doi.org/10.20969/vskm.2021.14(5).68-73","url":null,"abstract":"Aim. The aim of the study was to develop proposals for improving the administrative competencies in managers of health institutions. Material and methods. The main data for the study were obtained by questioning a group of managers of health institutions, namely state autonomous health care institutions of the Republic of Tatarstan. In total the questionnaire survey covered 31 health institutions. A total of 73 persons, including 31 heads of health institutions of the Republic of Tatarstan and 42 specialists from among the heads of departments and deputy chief physicians, who are the members of reserve of management personnel, participated in the questionnaire survey. Results and discussion. According to the data obtained, the group of heads of health institutions with the highest rating score differed from the representatives of health institutions with fewer rating scores by higher values of anticipatory statefulness. Among the heads of health institutions with the highest rating score, a higher level of overall anticipation competence was revealed, which allows us to conclude about the application of the algorithm of psychological tests for determining the level of anticipation competence to predict the effectiveness of the head when considering candidates for the appointment to the position of the head of a health institution. Conclusion. The developed algorithm of using the parameters of psychological tests to assess and predict the effectiveness of the respondent can be applied in the practice of the Ministry of Health, as a tool for human resource activities","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116654684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ADAPTIVE CAPACITY IMPAIRMENT IN CHILDREN WITH INSULIN-DEPENDENT DIABETES MELLITUS AS SHOWN BY TIME INTERVAL ASSESSMENT","authors":"Y. Bykov, V. Baturin","doi":"10.20969/vskm.2021.14(5).112-116","DOIUrl":"https://doi.org/10.20969/vskm.2021.14(5).112-116","url":null,"abstract":"Aim. The aim of the study was to diagnose and study the severity of impaired adaptive capacity in children with insulin-dependent diabetes mellitus using the method of assessment of time intervals. Material and methods. The study included 54 adolescents, aged 14 to 18 years. 27 adolescents with type I diabetes mellitus, who were urgently hospitalized in the intensive care unit in a serious condition, constituted the study group, the other 27 adolescents who were hospitalized for planned surgical intervention constituted the control group (conditionally healthy children). The diagnosis of type I diabetes mellitus was confirmed by clinical and laboratory data (hyperglycemia, ketoacidosis, impaired level of consciousness (deafening-sore). Study protocol: psychophysiological testing in adolescents was performed using the original «Rhythm» program, which presented patients with a reference sequence of sound signals and pauses between them, after which the patients played back the sound sequence using a personal computer. Adolescents in the study group were tested after diabetic ketoacidosis had subsided, glycemia had stabilized, and the level of consciousness had normalized (3–5 days after admission). The control group was tested upon admission to thehospital for planned treatment. Significance of the total index of deviations from the specified reference was determined using Student’s t-criterion. Results and discussion. Significant adaptation disorders were detected both in the study group and in the control group. However, in children with diabetes mellitus these disorders were more pronounced due to a greater shortening of the total duration of the cycle, as well as a greater aggregate index of deviations from the duration of set signals and pauses as compared to the «reference standard». Conclusion. The findings support the hypothesis that impaired adaptation mechanisms as a manifestation of desynchronization of biological rhythms may lie in the mechanism of insulin-dependent diabetes mellitus development.","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"193 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115465303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HORMONE LEVEL CHANGES IN ENDOMETRIAL ABNORMALITIES IN THE POSTMENOPAUSAL PERIOD","authors":"F. Alieva, D. V. Bryunin, Farakh T. Alieva","doi":"10.20969/vskm.2021.14(5).18-21","DOIUrl":"https://doi.org/10.20969/vskm.2021.14(5).18-21","url":null,"abstract":"Background. In recent decades, the increase in life expectancy has led to a significant increase in the duration of the postmenopausal period. Prolonged estrogen deficiency contributes to an increase in the incidence of chronic somatic diseases, including neurovegetative, metabolic-endocrine, and psycho-emotional disorders that define the menopausal syndrome. Aim. To study the prognostic and diagnostic significance of hormone parameters in endometrial abnormalities in the postmenopausal period. Material and methods. Forty-seven women with various clinical manifestations of endometrial pathology in the postmenopausal period were examined. The mean age of the examined women was (58,43±1,1) years. All the patients had luteinizing hormone, follicle-stimulating hormone, progesterone, testosterone, estradiol, dehydroepiandrosterone sulfate, and serum sex hormone-binding globulin measured by enzyme immunoassay. The results obtained were subjected to statistical processing using standard computer programs «Statgraph» designed for parametric and nonparametric methods of calculating mean values. We calculated mean and standard deviation (M±Se), as well as minimum-maximum values for the sample. Differences were considered significant at p<0,05. Results and discussion. As a result of the study the abnormality of the endometrium in the postmenopausal period was determined. Endometritis was observed in 4 (8,5%) of 47 patients, atrophic endometrium in 7 (14,9%) patients, diffuse endometrial hyperplasia in 3 (6,4%) cases, endometrial polyp in 29 (61,7%) cases, and endometrial carcinoma in 3 (6,4%) cases. A significant increase in follicle-stimulating hormone [(65,39±1,27) mmE/ mL], luteinizing hormone [(34,85±0,15] mmE/mL), estradiol [(88,73±2,1) pg/mL], and testosterone [(2,29±0,08) ng/mL] values was registered in the postmenopausal patients, which is an important prognostic and diagnostic criterion in this patient population. Conclusion. The study of hormone parameters in the postmenopausal period is one of the most important methods of early detection of various endometrial abnormalities, allowing timely implementation of appropriate therapeutic and preventive measures.","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134519795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MINIMAL CHANGE DISEASE IN THERAPEUTIC PRACTICE","authors":"O. Sigitova, R. I. ShayMuRatov, R. Sharipova, Lilya Kh . Safargaliyeva, Rita R . Yagfarova","doi":"10.20969/vskm.2021.14(5).95-103","DOIUrl":"https://doi.org/10.20969/vskm.2021.14(5).95-103","url":null,"abstract":"The disease of minimal changes occurs in 10–15% of adult patients with idiopathic nephrotic syndrome, it often has a relapsing course. Glucocorticoids are effective in achieving remission, but in some patients steroid resistance and progressive course of the disease are observed. Recent studies have investigated the mechanismsof minimal change disease development for the purpose of estimating the prognosis of the disease and the efficacy of immunosuppressive therapy. Aim. The aim of the present study was to review current data on the diagnosis, pathogenetic therapy of minimal change disease, and to demonstrate the clinical case of a relapsed disease in steroid resistant patient. Material and methods. A review of original research in the foreign and domestic literature on the subject over the past 5 years was conducted. Results and discussion. Minimal change disease is clinically manifested by rapid, almost sudden development of nephrotic syndrome (proteinuria, hypoalbuminemia, marked hypercholesterolemia, and massive generalized edema). Arterial hypertension and microhematuria occur occasionally. Glucocorticoids are being prescribed to achieve early remission even before morphological verification of the diagnosis. The course of the disease is mostly benign. The majority of patients with steroid sensitivity have long-term preserved renal function, while steroid resistance is associated with a progressive course leading to terminal renal failure. The presented clinical case is interesting because the unfolded picture of the disease of minimal changes including severe nephrotic syndrome and steroid-resistance, appeared in the patient a year after the disease debut. After receiving combined immunosuppressive therapy for 16 weeks incomplete remission was achieved. Conclusion. Unfortunately, at present, there are no available reliable methods to predict the development of steroid resistance and there are no effective therapies guaranteeing the achievement of remission in such cases.","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128185650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DEVELOPMENT OF ANTIBIOTIC RESISTANCE IN THE ASPECT OF OUTPATIENT SERVICES","authors":"A. Morozov, A. Sergeev, Victor A. Kadykov, E. Askerov, S. Zhukov, J. E. Minakova, A. D. Morozova, M. Belyak","doi":"10.20969/vskm.2021.14(5).43-50","DOIUrl":"https://doi.org/10.20969/vskm.2021.14(5).43-50","url":null,"abstract":"Background. Antibiotic resistance is a worldwide problem that is the main cause of the increase in the number of purulent-inflammatory diseases and postsurgical complications. Aim. The aim of the present study was to monitor antibiotic resistance of microorganisms isolated in the course of microbiological study in otorhinolaryngological and surgical patients of the outpatient department of a single preventive health institution. Material and methods. A statistical analysis of the results of microbiological studies, excretions of patients undergoing outpatient treatment in surgical and otorhinolaryngological departments of outpatient clinic No1 of the state budget institution «City Clinical Hospital No 7» of Tver is presented. We processed 280 findings of microbiological studies of ear, nose, pharynx and wound surface cultures for 2019. Results and discussion. It was found that the spectrum of dominant microorganism species in 2019 detected during swabbing of surgical and otorhinolaryngological patients treated in the outpatient clinic included gram-negative Escherichia coli and Klebsiella pneumonia and gram-positive Staphylococcus aureus and Streptococcus pyogenes microorganisms. Among the microorganisms presented, strains with multiple resistance to the action of antimicrobial drugs were identified. According to the total number of resistant microorganisms it was found that among antibacterial drugs, antibiotics of Aminopenicillin class, including those protected by protease inhibitors, as well as fluoroquinolones of the 2nd generation have the lowest clinical efficacy in the given medical institution. Conclusion. The findings of the present study indicate a rapid rate of spread of resistance genes among nosocomial strains of microorganisms, which necessitates continuous monitoring of antibiotic sensitivity by various specific laboratory methods. The results of laboratory studies should be used when prescribing antibiotic therapy for a particular patient, and the results of this study should be considered when selecting an empirical antibiotic, since they reflect the resistance of the most common pathogens. Key words: antibiotic resistance, antibiotics, cephalosporins, fluoroquinolones.","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121339623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COMPARISON OF THE STATE OF THE MAXILLARY SINUSES IN A NEW CORONAVIRUS INFECTION COVID-19 AND ACUTE RESPIRATORY VIRAL INFECTION","authors":"A. Kolsanov, Tatyana JU. Vladimirova, Pavel V. Zelter, Olesya V. Zelyova","doi":"10.20969/vskm.2021.14(5).28-33","DOIUrl":"https://doi.org/10.20969/vskm.2021.14(5).28-33","url":null,"abstract":"The aim of the study was to identify possible changes in the maxillary sinuses during new coronavirus infection in comparison with the changes in the sinuses occurring during acute respiratory infections and to correlate the gender structure of the study groups. Material and methods. The study included 40 patients (18 women and 22 men) with a confirmed new coronavirus infection, hospitalized at the Covid Hospital Clinics of Samara State Medical University in 2020. All patients underwent multispiral computed tomography of the paranasal sinuses on a Ge revolution Evo 128 tomograph on the 10th day after the appearance of the first clinical symptoms. We also examined a control group of patients with acute respiratory infections with similar complaints of impaired sense of smell, rhinorrhea, and upper maxillary sinus discomfort. This group also included 40 people (24 women and 16 men). Statistical processing of the study results was performed using Microsoft Excel software package, the Mann – Whitney method of statistical significance calculation was used. Results and discussions. In 18 (45%) patients with a confirmed new coronavirus infection, a slight mucosal thickening along the lower wall of the maxillary sinuses was found symmetrically on both sides. Six (15%) of them were women and 12 (30%) were men. The age of the examined patients ranged from 31 to 83 years. Chronic sinusitis was noted in the history of 8 (20%) of the examined patients. In 6 (15%) patients with chronic sinusitis no abnormalities were detected in the maxillary sinuses at the time of examination. Two of them had parietal thickening of the mucous membrane along the lower wall of the maxillary sinuses. In the control group, there was significant symmetric parietal thickening of the mucous membrane of the paranasal sinuses in 24 (60%) examined patients (14 women and 10 men). There were no statistically significant differences in the prevalence of changes in the studied and control groups. Conclusion. According to the results of this study, there were no data on the pattern of occurrence of changes in the mucosa of the maxillary sinuses in new coronavirus infection with gender background or the presence of chronic inflammation of the maxillary sinuses in the history compared with the control group of examined patients after acute respiratory infections.","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129347906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"КАЧЕСТВЕННАЯ И КОЛИЧЕСТВЕННАЯ ХАРАКТЕРИСТИКА ОДЫШКИ У БОЛЬНЫХ ПРОГРЕССИРУЮЩИМ ФИБРОТИЧЕСКИМ ФЕНОТИПОМ ИНТЕРСТИЦИАЛЬНЫХ БОЛЕЗНЕЙ ЛЕГКИХ, АССОЦИИРОВАННЫХ С СЕРДЕЧНО-СОСУДИСТЫМИ ЗАБОЛЕВАНИЯМИ","authors":"A. V. Medvedev, Anver F. Abubikirov, A. S. Zaitseva, Larisa A. Mazaeva, N. N. Makaryants, E. I. Shmelev","doi":"10.20969/vskm.2021.14(5).34-42","DOIUrl":"https://doi.org/10.20969/vskm.2021.14(5).34-42","url":null,"abstract":"Aim. Analysis of quantitative and qualitative parameters of dyspnea in patients with the fibrotic phenotype of interstitial lung disease associated with coronary artery disease. Material and methods. We examined 49 patients. Among those were 9 patients with idiopathic pulmonary fibrosis, 25 patients with chronic variant of hypersensitive pneumonitis, and 14 patients with nonspecific interstitial pneumonia. The main group consisted of 25 patients with interstitial lung diseases and coronary heart disease; comparison group consisted of 24 patients without ischemic heart disease. Clinical symptoms, questionnaire results, and instrumental study data were analyzed. Results and discussion. Patients with coronary heart disease experienced increased dyspnea earlier (after 3,21 days) than patients without it (after 7,18 days; p<0,05). On functional examination, a significant decrease in pulmonary diffusion capacity was recorded in cardiac patients, p<0,05. Presence of coronary heart disease was accompanied by intensification of dyspnea according to Borg scale, decrease of distance walked in 6 min, significant decrease in pulse oximetry indices (by 7,94% in the main group and by 3,26% in the comparison group). On computed tomography, the severity of «frosted glass» was statistically higher in patients with coronary heart disease, p<0,05. Pulmonary hypertension, changes of right heart sections were observed in both groups of patients, left ventricular hypertrophy was observed only in patients of the main group. Patients with «isolated» phenotype of interstitial lung disease complained of heaviness, shortness of breath, patients with coronary heart disease complained of compression, tightness in chest, patients with pulmonary heart disease and heart failure had combination of these sensations. Conclusion. In patients with interstitial lung diseases, associated with coronary heart disease, dyspnea intensification reflects progression of lung disease, development of heart failure, and chronic pulmonary heart disease. Study of quantitative and qualitative characteristics of dyspnea is a way to specify the origin of dyspnea at the stage preceding specialized instrumental diagnostic methods.","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"200 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122148157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 OUTCOMES: DRUG TREATMENT OPTIONS","authors":"R. Khamitov, A. Zhestkov, A. Vizel’, V. Fedotov","doi":"10.20969/vskm.2021.14(5).104-111","DOIUrl":"https://doi.org/10.20969/vskm.2021.14(5).104-111","url":null,"abstract":"Background. Since December 2019 there has been a rapid spread of the COVID-19 pandemic across most of the world. This has determined the enormous burden on the global economy. The burden of the new coronavirus infection is determined not only by the costs directly related to the treatment of the acute phase of the disease, but also by the successful rehabilitation of patients after COVID-19, risk reduction and timely management of adverse outcomes for optimal patient recovery. Aim. The aim of the study was to analyze the adverse outcomes of COVID-19 and to estimate the possibility of their correction and prevention. Material and methods. We analyzed the PubMed database for 2020–2021 using the keywords «COVID-19, pulmonary outcomes and treatment», as well as the online meetings of chief pulmonologists of the Volga Federal District (VFD) in April 2021, where we heard about the regional experience in prevention and correction of COVID-19 adverse outcomes. Results and discussion. More and more publications are appearing on the so-called «postdrome» after COVID-19. Postdrome problems are becoming increasingly important as more and more treated patients are discharged from hospitals. To date, there are already over 103 million COVID-19 survivors. In patients with severe or critical manifestations of the disease, widespread and progressive endothelial thrombosis with diffuse microvascular thrombosis is increasingly evident as the final stage of the proinflammatory cytokine storm. Adequate anticoagulant therapy primarily using heparins with direct antiviral activity, preventing venous thromboembolism, being used for pulmonary thrombosis, is relevant in the prevention of adverse outcomes. Many authors note long-lasting residual changes on lung CT after the acute phase of COVID-19. At the same time, unlike post-inflammatory pneumosclerosis in the outcome of bacterial pneumonias, these changes can often regress within 6–12 months after a viral infection. Along with the effects of optimal anticoagulant therapy in the prevention of adverse COVID-19 outcomes, the available literature discusses the possibility of different regimens of glucocorticosteroid therapy. At the expert council of pulmonology specialists of the Volga Federal District the regional experience of using a domestic drug bovgialuronidase azoximer (Longidase) with official indications for treatment of fibrosis was covered in the therapeutic complex of patients with severe forms of COVID-19. Conclusion. Accumulating the evidence base of different ways of prevention and correction of residual changes in COVID-19 patients, which significantly deteriorate patients’ ability to work as well as their quality of life, can be considered one of the main priorities of modern COVID-19 medicine.","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"349 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116672375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}