Vrach最新文献

{"title":"The influence of HDBA organic complex with vitamin D and calcium on the effectiveness of medical rehabilitation of patients with osteoporosis","authors":"L. Marchenkova, E. Rozhkova","doi":"10.29296/25877305-2024-03-14","DOIUrl":"https://doi.org/10.29296/25877305-2024-03-14","url":null,"abstract":"Objective. To study the effect of basic pathogenetic therapy of osteoporosis and nutritional support using HDBA organic complex with vitamin D and calcium on the effectiveness and duration of maintaining the effect of medical rehabilitation, bone mineral density and the incidence of falls in patients with osteoporosis. Material and methods. The study included 119 patients aged 50 to 80 years, admitted to the inpatient stage of medical rehabilitation and diagnosed with osteoporosis according to one of the three diagnostic criteria formulated in the clinical recommendations of the Russian Ministry of Health, which were randomized in 3 groups. Patients in group 1 (n=41) were prescribed pathogenetic antiresorptive therapy for osteoporosis (bisphosphonates or denosumab) for 12 months, depending on the severity and clinical features of osteoporosis, contraindications to various types of therapy and the patient’s preferences regarding the frequency and mode of administration of the drug for the treatment of osteoporosis, in combination with nutritional support of the dietary supplement Osteomed Forte, containing an organic HDBA complex with vitamin D and calcium. Patients in group 2 (n=39) were prescribed only nutritional support with the dietary supplement Osteomed Forte in the same dosage. Patients of the third group made up the comparison group (n=39), in which patients did not receive any interventions. A control examination was carried out after completion of the rehabilitation course – 20 days after inclusion in the study, as well as 6 and 12 months after the start of treatment. Results. Long-term nutritional support of patients with osteoporosis using HDBA organic complex with vitamin D and calcium helps maintain muscle strength values achieved during rehabilitation for up to 6 months, indicators of quality of life and balance for up to 12 months after completion of rehabilitation, as well as significant increase in bone mineral density after 12 months compared to the baseline: in combination with pathogenetic therapy for osteoporosis – by 4.2% in the spine, by 3.0% in the femoral neck and by 2.7% in the proximal femur, without antiresorptive therapy – by 1.8% in the spine. Conclusion. Nutritional support in the form of correction of dietary calcium deficiency and vitamin D deficiency and the prescription of pathogenetic therapy for osteoporosis should be a mandatory part of complex rehabilitation measures in patients with osteoporosis to increase bone mineral density, improve efficiency and long-term maintenance of the results of medical rehabilitation.","PeriodicalId":23748,"journal":{"name":"Vrach","volume":"5 s11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140400263","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":"CURRENT DATA ON THE ROLE OF HOMOCYSTEINE IN THE FORMATION OF CARDIOVASCULAR DISEASES","authors":"A. Dudnikova, E. Sokolova, P. Poltorackaya, A. Storozhenko, D. Simakov, Z. Dorohin","doi":"10.29296/25877305-2024-03-11","DOIUrl":"https://doi.org/10.29296/25877305-2024-03-11","url":null,"abstract":"Recent research has made it possible to expand and complement the modern understanding of the regulation of many physiological processes of the body. At the same time, there are many controversial questions about the role of increasing homocysteine levels in the development of certain diseases, mainly cardiovascular pathology. Purpose. To analyze the current literature on the contribution of hyperhomocysteinemia to the formation of cardiovascular diseases (CVD). Material and methods. The data of foreign and domestic articles on the research topic found in Pubmed and eLibrary and published over the past 7 years are analyzed. Conclusions. Hyperhomocysteinemia leads to amplification of the adverse effects of classical CVD risk factors such as hypertension, smoking, lipid metabolism by participating in the formation of endothelial dysfunction.","PeriodicalId":23748,"journal":{"name":"Vrach","volume":"227 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140402774","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":"Contraception problems in the practice of a family doctor","authors":"V. Skvortsov, B. Levitan, E. Skvortsova, A. Mironov, A. Starova","doi":"10.29296/25877305-2024-03-17","DOIUrl":"https://doi.org/10.29296/25877305-2024-03-17","url":null,"abstract":"Unplanned pregnancy can end with artificial or spontaneous termination, as well as it is also associated with the risk of complications that jeopardize safe motherhood in the future. One of the main trends in modern reproductology is the improvement and wider application of methods for planned and emergency contraception. The frequency of abortions in Russia is one of the highest worldwide; the reason of which is the poor awareness of the population about contraception devices and techniques. The significance of the problem is undeniable and important in preserving a women’s health. To solve this problem, it is necessary to increase the level of health education for both women and men in contraception and birth control. The paper presents the main known contraception types with their methods of application, advantages and disadvantages.","PeriodicalId":23748,"journal":{"name":"Vrach","volume":"141 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140404754","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 prevalence of non-communicable diseases among working women","authors":"K. Amlaev, L. Blinkova, Kh. Dahkilgova, V. Mazharov","doi":"10.29296/25877305-2024-03-05","DOIUrl":"https://doi.org/10.29296/25877305-2024-03-05","url":null,"abstract":"Non-communicable diseases are the main problem of modern society. This review represent data on chronical diseases and their risk factors among working women. It also describes the global trends of main risk factors among working young women and the manifestation of non-infectious diseases, including coronary heart disease, overweight/obesity, arterial hypertension, diabetes mellitus and mental health problems. Long working hours, workload and stress at work were identified as the risk factors of non-communicable diseases. The double burden of work and household duties increased the risk of non-communicable diseases among working women in comparing with working men. State-level strategies were proposed to improve the situation of reducing the prevalence of non-communicable diseases and their prevention. For example, the strategy for the prevention of chronical pathology among working women, included the search of risk factors, strengthening of health policy, the interventions at the working place, including adherence to timetable, the balance between work and personal life.","PeriodicalId":23748,"journal":{"name":"Vrach","volume":"54 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140407150","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":"ROLE OF URIC ACID IN CLINICAL MANIFESTATIONS OF ANKYLOSING SPONDYLITIS","authors":"I. Bazina, D. Krechikova, O. Kozyrev, M. Pavlova, D. Rostkova, M. Konevskikh, A. Mukhina","doi":"10.29296/25877305-2024-03-07","DOIUrl":"https://doi.org/10.29296/25877305-2024-03-07","url":null,"abstract":"Prevalence of ankylosing spondylitis (AS) is about 0.2–0.8% and increasing during last decades in Russia. Coronary Heart Disease (CHD) plays an important role in mortality in patients with rheumatic diseases. AS mainly affects able-bodied age persons thus having a significant social and economic impact. There plenty of biomarkers of AS, including those for early diagnosis. \u0000Purpose. To study the level of uric acid (UA) in patients with AS and its role in development of AS.\u0000Materials and methods. A total of 72 medical charts of patients hospitalized at Smolensk Regional Rheumatological Center were evaluated, among them 73.6% were men and 26.4% – women. AS was diagnosed according to classification criteria. Lab tests were done in a central lab using standard methodology. All data collected for each patient was entered into an Excel spreadsheet and analyzed.\u0000Results. Average patients age was 49.6±12.4 years. BMI was 28.1±5.4 kg/m2. Arterial Hypertension (AH) and CHD was diagnosed in 44.4% of patients. Glomerular Filtration Rate (GFR) was 95.1±21.9 mL/min. UA concentration were equal to 301.3±94.3 mmol/L, total cholesterol (TC) – 5.0±1.0 mmol/L, CRP – 60.5±35.1 IU/L. A direct correlation between CRP and BMI was revealed (p<0.005). UA concentration in patients with AS and CHD was 347.3±73.9 mmol/L, while in patients with AS without CHD it was significantly lower: 261.8±77.4 mmol/L (p<0,001). UA concentration in patients with AS and HLA-B27(+) was 345.1±90.8 mmol/L, in patients with AS and HLA-B27(-) – 259.1±75.1 mmol/L (p<0,001). BASDAI in patients with AS was equal to 5.7±2.1. UA concentration in patients with mild to moderate AS was 255.4±77.7 mmol/L; severe AS – 343.4±75.3 mmol/L (p<0.001). Correlations between TC level and BASDAI (p<0.05) as well as between UA level and BASDAI (p<0.05) were revealed.\u0000Conclusion. In patients with AS increased level of UA supports inflammation activity, forces subjective symptoms of the disease (pain), correlates with disease activity and BASDAI. Hyperuricemia increases risk of CHD, worsens prognosis of AS. UA may be considered as a biomarker of disease activity and prognosis of AS, atherosclerosis and cardiovascular diseases","PeriodicalId":23748,"journal":{"name":"Vrach","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140399579","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":"Optimization of pathogenetic therapy of patients with tick-borne rickettsiosis caused by rickettsiae heilongjiangensis in Khabarovsk Territory","authors":"E. Mokretsova, G. Tomilka, YU. G. Kovalskiy, A. Schupak, N. Golubkina, V. Maleev","doi":"10.29296/25877305-2024-03-10","DOIUrl":"https://doi.org/10.29296/25877305-2024-03-10","url":null,"abstract":"Objective. To study the dynamics of selenium level and some indexes of oxidative status of blood serum in patients with the moderate form of tick-borne rickettsiosis caused by Rickettsiaе heilongjiangensis, in Khabarovsk Region, depending on the treatment in order to optimize the pathogenetic therapy. Materials and methods. Comparative analysis of combinations of treatment by basic means (antibiotics, detoxication therapy) and in combination with organic selenium was carried out on the basis of determination of nutrient selenium level and some parameters of oxidative status in blood serum of patients with tick-borne rickettsiosis determined by R. heilongjiangensis without accompanying chronic diseases at decompensation stage. Results. The daily dosage of «paprika» powder at a dose of 60 mcg/day allowed to level the selenium deficiency to a suboptimal level of supply. Besides, analysis of chemiluminescence of blood sera of patients who received organic selenium as a part of complex treatment showed activation of antioxidant antiradical protection and decrease of free radicals production against the background of improvement of clinical status. Conclusions. Thus, the complementary therapy with organic selenium promotes normalization of antioxidant protection processes and reliably restores suboptimal provision of selenium and can be recommended for treatment of tick-borne rickettsiosis patients caused by R. heilongjiangensis.","PeriodicalId":23748,"journal":{"name":"Vrach","volume":"225 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140402965","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":"Violation of psychological stability in adolescents with smartphone addiction, methods of correction and prevention","authors":"A. Kostyuchenko, T. Potupchik, Y. Kostyuchenko, L. Evert, I. Butakova","doi":"10.29296/25877305-2024-03-15","DOIUrl":"https://doi.org/10.29296/25877305-2024-03-15","url":null,"abstract":"The progressive growth of smartphone addiction (SА) among adolescents, the associated disorders in the psychological and emotional state and adaptive capabilities of the user’s body, is an urgent problem of modern medicine and psychology. Purpose. To assess the level of psychological stability in adolescents addicted to smartphones, to present methods for correcting and preventing its violations. Materials and methods. The object of the study was 217 adolescents aged 15–18 years (80 boys and 137 girls) – students of two secondary schools in the city of Krasnoyarsk, with the presence of SА (main group; n=33) and without SА (comparison group; n=184). Methods: online survey using Google forms of test questionnaires, statistical methods. Examination program: assessment of the presence of SM (according to the questionnaire Kwon M., Kim D.-J., Cho H., 2013); analysis of the prevalence of SА (taking into account gender and age); assessment of the level of psychological stability (stress resistance) of adolescents based on the “adaptation potential” indicator of N.B. Semenova’s questionnaire. Results. The prevalence of SM in the total sample of those examined was 15.2%, with a predominance in girls (21.2%) than boys (5.0%; p=0.0014) and a higher incidence in girls 15–16 years old (22.7%) than their peers aged 17–18 years (19.3%; p=0.0410). Among adolescents with SA, there were significantly fewer (9.1%) individuals with a high level of adaptive potential and, accordingly, lower resistance to stress than among individuals without SA (28.8%; p=0.0172). Conclusion. The results of the study revealed an association between smartphone-dependent behavior in adolescents and their lower level of psychological stability and greater susceptibility to the influence of stressful situations. It is necessary to carry out a set of corrective and preventive measures to increase the stress resistance of adolescents and level out the negative consequences of their problematic use of electronic gadgets.","PeriodicalId":23748,"journal":{"name":"Vrach","volume":"170 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140403249","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":"Immunological profile and quality of life in vibration disease and its combination with deforming osteoarthritis","authors":"S. Babanov, T. Kiryushina, L. Strizhakov, A. Melentev, A. Agarkova, V. Lotkov","doi":"10.29296/25877305-2024-03-06","DOIUrl":"https://doi.org/10.29296/25877305-2024-03-06","url":null,"abstract":"The features of the immune profile and cytokine regulation in vibration disease (VD) from exposure to local vibration and its combination with osteoarthritis (OA) are described. The prognostic significance of changes in the immune profile and cytokine regulation in VD from exposure to local vibration and its combination with OA has been established. It has been proven that when exposed to industrial vibration, there is a change in all indicators characterizing the quality of life, most pronounced in grade II VB from exposure to local vibration and its combination with OA.","PeriodicalId":23748,"journal":{"name":"Vrach","volume":"41 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140407623","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":"Indicators of hemostasis and fibrinolysis systems, clinical blood count and C-reactive protein in patients with chronic obstructive pulmonary disease after SARS-CoV-2 infection","authors":"R. Abdullaev, V. Shorokhova, N. Makaryants, O. Komissarova","doi":"10.29296/25877305-2024-02-02","DOIUrl":"https://doi.org/10.29296/25877305-2024-02-02","url":null,"abstract":"Objective. To study in a comparative aspect the level of markers of the state of hemostasis and fibrinolysis systems, indicators of clinical blood analysis and C-reactive protein (CRP) in patients with chronic obstructive pulmonary disease (COPD) of severe and extremely severe severity, who underwent and did not undergo infection caused by SARS-CoV-2. Material and methods. A prospective cohort study of 56 patients with severe and extremely severe COPD in the acute stage. Patients were divided into 2 groups: 1st (n=28) – patients with COPD and SARS-CoV-2 infection; 2nd (n=28) – patients with COPD without SARS-CoV-2 infection. The indicators of hemostasis and fibrinolysis systems, clinical blood analysis and CRP were evaluated. Results. It has been established that in patients with severe and extremely severe COPD who have had an infection caused by SARS-CoV-2, a hypercoagulable shift is more often observed compared to patients who have not had COVID-19. This was evidenced by the most frequent shortening of activated partial thromboplastin time, prothrombin time and an increase in fibrinogen levels. The frequency of increased D-dimer levels in the group of patients who had an infection caused by SARS-CoV-2 was twice as high compared with patients who did not have an infection caused by SARS-CoV-2. A decrease in the index of the relative width of platelet distribution was observed in both groups of patients. The indicator of systemic inflammation – CRP in the compared groups did not differ significantly. Conclusion. Patients with severe and extremely severe COPD who have had COVID-19 are more likely to have a hypercoagulable shift with manifestations of intravascular coagulation compared with COPD patients who have not had COVID-19.","PeriodicalId":23748,"journal":{"name":"Vrach","volume":"81 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140462518","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":"Patient complaining of cough in primary care","authors":"E. Borodulina, L. Katina, E. Yakovleva","doi":"10.29296/25877305-2024-02-06","DOIUrl":"https://doi.org/10.29296/25877305-2024-02-06","url":null,"abstract":"Cough is one of the most common symptoms when seeking primary medical care. Purpose. To increase the efficiency of diagnostic search for the cause of cough in the practice of a primary care doctor. Materials and methods. A comparative analysis of 2 different approaches to the tactics of primary admission of patients who complained of cough was carried out (n=1800): group 1 is the traditional approach in the work of a primary care physician; group 2 is the application before admission of the \"Diagnostic search algorithm in the examination of a patient with cough complaints\", developed on the basis of the generated database. Results. In the group 42,3% of patients were initially diagnosed with acute respiratory viral infection (ARVI), and 13,2% suspected pneumonia. Cough due to other causes was 44,5%. In the group 2, ARVI was diagnosed in 19% of cases, an exacerbation of COPD was detected in 11,8%, bronchial asthma in 8,9%, in 6,7% congestive heart failure, in 6,1% gastroesophageal reflux disease, in 2,1% focal pulmonary tuberculosis, in 23% pneumonia, in 6,7% COVID-19, in 15,7% chronic sinusitis. Conclusion. The use of the algorithm in the practice of a general practitioner to identify the cause of cough can significantly facilitate the diagnostic search and reduce the number of unjustified consultations of specialist doctors. Also, this approach in the world of digitalization allows us to develop an intelligent service to support medical decision-making.","PeriodicalId":23748,"journal":{"name":"Vrach","volume":"178 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140462309","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}