Russian Family Doctor最新文献

{"title":"New coronavirus infection in patients with chronic non-communicable diseases in primary care","authors":"O. Kuznetsova, E. Frolova, K. V. Ovakimyan, Ruzanna V. Ambartsumyan, V.S. Dranets, A. Litvinova","doi":"10.17816/rfd114966","DOIUrl":"https://doi.org/10.17816/rfd114966","url":null,"abstract":"BACKGROUND: The pandemic of a new coronavirus infection, which began in the Chinese city of Wuhan in December 2019, has spread to more than 200 countries and territories. There are a number of studies, the results of which indicate that deaths are mainly registered among the middle-aged and elderly population with chronic non-communicable diseases. Most of these studies are based on the study of cases of COVID-19 with severe course or in hospitalized patients. At the same time, a greater number of patients, including those with chronic non-communicable diseases, carry COVID-19 to a mild degree and remain under the supervision of primary care physicians. \u0000AIM: To identify risk factors for the development of severe COVID-19 in patients with chronic non-communicable diseases who sought outpatient care during various periods of increased incidence of new coronavirus infection from March 2020 to February 2022. \u0000MATERIALS AND METHODS: The study was carried out on the basis of the Family Medicine Center of North-Western State Medical University named after I.I. Mechnikov, which provides primary health care to the population attached under compulsory health insurance. The design of the study was published earlier. A retrospective cohort study was conducted based on the analysis of outpatient records of patients who sought medical care at the Family Medicine Center during various periods of increased incidence of COVID-19: from 19.03.2020 to 30.06.2020 (group 1), from 1.10.2021 to 30.11.2021 (group 2) and from 18.01.2022 to 28.02.2022 (group 3). \u0000RESULTS: 343 patients were included in the study: 137 men (39.9%) and 206 women (60.1%). The number of patients with at least one chronic non-communicable disease was 232 (67.9%). It was found that the severity of COVID-19 is not affected by the presence of one or more chronic non-communicable diseases of mild severity in the patient. At the same time, grade II obesity and grade III hypertension are independent factors that significantly increase the risk of developing severe COVID-19 by 13.4 and 5.4 times, respectively (p 0.05). It should be noted that the combination of these diseases significantly increased the likelihood of developing severe COVID-19 by 11.9 times (p 0.05). \u0000CONCLUSIONS: Regardless of the period of morbidity, the clinical manifestations of COVID-19 in patients with chronic non-communicable diseases have their own characteristics: weakness, sweating, dry and wet cough are significantly more common (p 0.05). With each subsequent wave of increase in the incidence of COVID-19 in patients with chronic non-communicable diseases, there is a significant tendency to decrease the frequency of severe and very severe course of the disease, pneumonia and hospitalization, as in patients without chronic non-communicable diseases. It was found that the severity of the COVID-19 course is not affected by the presence of mild chronic non-communicable diseases in the patient. At the same time, grade II and highe","PeriodicalId":432054,"journal":{"name":"Russian Family Doctor","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130834355","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":"Modern principles of etiotropic therapy for chronic hepatitis B and C","authors":"N. I. Kuznetsov, I. Moiseeva","doi":"10.17816/rfd112383","DOIUrl":"https://doi.org/10.17816/rfd112383","url":null,"abstract":"The review includes an analysis of literature data on the etiotropic therapy of chronic viral hepatitis B and C. In this review, we focused on the efficacy and safety of drugs that have been included in international and Russian guidelines for etiotropic therapy of chronic viral hepatitis B and C. The analysis of the feasibility of using antiviral drugs in real clinical practice was carried out, based on research data on the study of the mechanisms of action, efficacy and possible side effects of these drugs.","PeriodicalId":432054,"journal":{"name":"Russian Family Doctor","volume":"94 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132393316","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":"Impact of malnutrition and its correction on mortality in older adults","authors":"A. Turusheva","doi":"10.17816/rfd115271","DOIUrl":"https://doi.org/10.17816/rfd115271","url":null,"abstract":"BACKGROUND: Malnutrition is associated with decreased levels of physical function, cognitive decline, and an increased risk of all-cause mortality, making it important to identify risk factors for malnutrition, especially in old age. \u0000AIM: To identify factors associated with an increase and decrease in the risk of developing malnutrition, as well as to assess the impact of malnutrition and its correction on mortality in older adults. \u0000MATERIALS AND METHODS: A prospective cohort study of a random sample of 611 people aged 65 years and older. Mini Nutritional Assessment, Geriatric Depression Scale, Mini-Mental State Examination, dynamometry, Barthel Index, chronic noncommunicable diseases, clinical blood count, C-reactive protein. 2 examinations, 9 years of total follow-up. \u0000RESULTS: Risk factors for deterioration in nutritional status are decrease in emotional status (odds ratio 5.439; 95% confidence interval 2.79410.588), progression of autonomy decline (odds ratio 2.428; 95% confidence interval 1.3424.393), low physical function (odds ratio 2.877; 95% confidence interval 1.5775.250). A high level of physical function reduces the risk of malnutrition by 64.1%. Malnutrition increases the risk of five-year mortality by 2.7 times. A normal nutritional status reduces the risk of nine-year mortality by 50.2%. Improve nutrition status leads to a lower risk of mortality. \u0000CONCLUSIONS: The main factors in the deterioration of nutritional status are a decrease in emotional status, loss of autonomy and a low level of physical function. Early detection of older adults with malnutrition and its correction can reduce the risk of mortality.","PeriodicalId":432054,"journal":{"name":"Russian Family Doctor","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121734199","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":"Results of the All-Russian Conference with international participation “Science and Practice. Why does a family physician need clinical recommendations?”","authors":"O. Kuznetsova, I. Moiseeva","doi":"10.17816/rfd112414","DOIUrl":"https://doi.org/10.17816/rfd112414","url":null,"abstract":"The article provides information about the All-Russian Conference with international participation Science and Practice. Why does a family doctor need clinical recommendations?, dedicated to the 25th anniversary of the founding of the scientific and practical journal Russian Family Doctor. The event took place on-line in St. Petersburg on October 20, 2022. The article summarizes the content of the reports in which the main principles of creating clinical guidelines, the problems of providing medical care to elderly patients with cognitive impairments in the light of updated clinical guidelines, the planning of scientific research aimed at studying the course of a new coronavirus infection, the problems of providing medical care to elderly people with arterial hypertension, and the choice of pain relief were considered. in comorbid patients, a strategy for detecting chronic obstructive disease in the primary health care setting, the main provisions of the latest clinical guidelines for the management of patients with bronchial asthma issues of predicting fractures in patients with osteoporosis in the framework of international projects, problems of managing comorbid patients with anemic syndrome, features of managing patients with gastroesophageal reflux disease on an outpatient basis, taking into account clinical recommendations.","PeriodicalId":432054,"journal":{"name":"Russian Family Doctor","volume":"121 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123704827","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 results of the internship of a postgraduate student from Uzbekistan on the basis of the North-Western State Medical University named after I.I. Mechnikov in the framework of interuniversity cooperation","authors":"Shakhnoza A. Khasanova, B. M. Tajiev, Shakhnoza R. Abzalova","doi":"10.17816/rfd112168","DOIUrl":"https://doi.org/10.17816/rfd112168","url":null,"abstract":"The article is devoted to the results of the internship of a postgraduate student of the Tashkent Pediatric Medical Institute at the I.I. Mechnikov Northwestern State Medical University within the framework of the inter-university cooperation program dedicated to the development of research in the field of infectious diseases and the exchange of experience in the field of medical care for a new coronavirus infection. \u0000The purpose of the internship of a postgraduate student of the Department of Infectious Diseases, Pediatric Infectious Diseases, Phthisiology and Pulmonology Sh.A. Khasanova was studying the specifics of providing care to patients with a new coronavirus infection in St. Petersburg. The program included a visit to the departments of Infectious Diseases, family Medicine, epidemiology, and disinfection, as well as a presentation at the All-Russian Conference with international participation Science and Practice. Why does a family doctor need clinical recommendations?, dedicated to the 25th anniversary of the scientific and practical journal Russian Family Doctor. The report highlighted the Uzbek experience of implementing measures to combat the new coronavirus infection and demonstrated their effectiveness. As part of the internship, the graduate student got acquainted with the peculiarities of providing inpatient and outpatient care to patients with COVID-19, including in-depth medical examination and the operation of the system of statistical registration of patients with a new coronavirus infection in the federal register, as well as the organization of epidemiological control in different periods of the pandemic of a new coronavirus infection. \u0000The main result of the internship was the creation of a basis for effective and long-term cooperation between Russian and Uzbek universities in the field of scientific research and training of personnel for national health systems in the field of infectious diseases.","PeriodicalId":432054,"journal":{"name":"Russian Family Doctor","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130651825","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":"Basics of professional communication in general practice","authors":"L. Degtyareva","doi":"10.17816/rfd108376","DOIUrl":"https://doi.org/10.17816/rfd108376","url":null,"abstract":"Knowledge and skills in the field of professional communication are necessary for the doctor to form a trusting relationship with the patient. The right approach to counseling based on this knowledge is important to ensure quality medical care. The consultation has two main tasks: to find out the essence of the problem that led the patient to the doctor, and to find possible solutions to this problem. At the same time, a combination of openness and structuring of the process is important. \u0000The lecture examines the Calgary-Cambridge model of counseling, its structure and features of each stage. The structure of the consultation in accordance with this model includes five stages the beginning of the consultation, the collection of information, inspection, explanation and planning, and the completion of the reception. Each stage has certain tasks, starting with establishing contact at the beginning of the consultation, and ending with summing up at the end of the reception. \u0000The principles and conditions of effective counseling include the availability of sufficient time; availability of consultation; respect for the personality of each patient and goodwill; confidentiality; provision of information in a language understandable to the patient; respect for the patients ability to make decisions. \u0000Communication with a patient in the conditions of primary health care is a long and multifaceted process, but the result of such communication often depends on the successful conduct of counseling by a doctor.","PeriodicalId":432054,"journal":{"name":"Russian Family Doctor","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128676632","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":"A family case of giardiasis manifested as allergic urticaria in the joint practice of a family doctor and a pediatrician","authors":"Maria O. Mokhika Estepa, I. Vasilenko, I. Moiseeva","doi":"10.17816/rfd96145","DOIUrl":"https://doi.org/10.17816/rfd96145","url":null,"abstract":"To date, giardiasis remains an urgent disease in the practice of family doctors, internists and pediatricians. Family cases of giardiasis are quite common. If one case of giardiasis is detected in the family, it is necessary to examine all family members. Currently, giardiasis remains relevant, especially in pediatrics. The difficulty of detecting giardiasis in children is primarily due to the fact that its manifestations are often disguised as various clinical variants of gastroenterological pathology (functional disorders of the gastrointestinal tract, syndrome of excessive growth of microflora in the small intestine, malabsorption syndrome) and often occur with the clinic of allergic diseases recurrent urticaria, atopic dermatitis, gastrointestinal forms of food allergies and others forms. \u0000The article presents a clinical case of familial giardiasis, in which the primary diagnosis of the disease in a child caused the greatest difficulty due to its allergic manifestations by the type of severe urticaria in the presence of possible allergens at home, which led to a long diagnosis and two emergency hospitalizations in childrens hospitals, where despite the examination and treatment, the correct diagnosis was not suspected timely. Differential diagnosis at the first stages of patient management was carried out between allergic urticaria, infectious mononucleosis and streptococcal infection, the possibility of giardiasis was not considered. Difficulties in diagnosis led to the appointment of systemic glucocorticosteroids and unjustified antibacterial therapy. Indirectly, prolonged diagnosis and untimely start of treatment led to a decrease in motivation for examination and treatment of the patients parents due to distrust of doctors.","PeriodicalId":432054,"journal":{"name":"Russian Family Doctor","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126872296","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":"Reactivation of chronic brucellosis infection after COVID-19 (case report)","authors":"Yu Khaidarova, O. Lesnyak, Gaukhar Kurmanova, Anarkul B. Kulembaeva","doi":"10.17816/rfd108303","DOIUrl":"https://doi.org/10.17816/rfd108303","url":null,"abstract":"It has been proven that the SARS-CoV-2 virus, interacting with persistent latent pathogens in the human body, including those living in the ecosystems of the intestine, mouth and lungs, causes dysregulation of the immune system and can contribute to the reactivation of these pathogens. The authors of the article suggested this pathogenic virus can play the role of a superantigen and trigger the phenomenon of polyclonal activation of lymphocytes, due to which various clones of lymphocytes may be activated, thereby giving impetus to the reactivation of a chronic persistent infection. This article describes a clinical case of a patient who had previously undergone an effectively treated form of chronic brucellosis in history, with signs of reactivation of brucellosis infection detected after infection with the SARS-CoV-2 virus, confirmed by clinical laboratory and instrumental studies.","PeriodicalId":432054,"journal":{"name":"Russian Family Doctor","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131314396","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":"Features of clinical manifestations, diagnosis, treatment and prevention of COVID-19 coronavirus infection in children","authors":"I. Melnikova","doi":"10.17816/rfd109302","DOIUrl":"https://doi.org/10.17816/rfd109302","url":null,"abstract":"Worldwide spread of COVID-19 coronavirus infection SARS-CoV-2 also affected the child population. Now, a sufficient number of studies have been described in adult patients, and only limited data are available with an analysis of the clinical course of the disease in pediatric patients infected with SARS-CoV-2. Currently, SARS-CoV-2 has spread around the world as a variant of omicron. The article is a lecture on the features of the clinical picture, diagnosis, treatment, and prevention of coronavirus infection in children, taking into account the latest domestic and foreign articles. \u0000The purpose of the lecture is to improve the knowledge of family doctors and pediatricians in the study of clinical features, course, diagnosis, therapy, prevention, and long-term consequences of a coronavirus infection. The lecture presents the etiology and epidemiology of coronavirus infection. The clinical picture of the omicron strain is described. The assessment of the clinical picture of the disease is presented based on the working criteria of the severity of the disease. The diagnosis of coronavirus infection is presented in detail. The algorithm for treating children with coronavirus infection is presented according to the latest recommendations of the Ministry of Health of the Russian Federation. The emphasis is on prevention and elimination of dehydration. Vaccine prophylaxis during the pandemic is considered.","PeriodicalId":432054,"journal":{"name":"Russian Family Doctor","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133290549","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":"Issues of the management of geriatric patients with valvular heart disease","authors":"E. Frolova, O. Y. Pankratova","doi":"10.17816/rfd110814","DOIUrl":"https://doi.org/10.17816/rfd110814","url":null,"abstract":"The present article describes a clinical case as an example of compiled treatment of a geriatric comorbid patient with aortic stenosis. The case mentioned in this article enhances and underlines the meaning of multidisciplinary approach in the treatment of such patients according to the contemporary and actual standpoints of geriatrics. Elderly patients are often reported to have comorbidities including valvular heart diseases which might be regarded as one of the most significant reasons for functional activity decrease and lower quality of life of an elderly patient. Meanwhile, it is necessary to admit that functional resources of some patients are very high. It must be taken into consideration when choosing the disease management.","PeriodicalId":432054,"journal":{"name":"Russian Family Doctor","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130508313","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}