Russian Family Doctor最新文献

{"title":"Association of visual, hearing and olfactory impairments with survival and quality of life of elderly people","authors":"E. Frolova","doi":"10.17816/rfd108154","DOIUrl":"https://doi.org/10.17816/rfd108154","url":null,"abstract":"The review is devoted to the analysis of publications on the problems of sensory disorders in elderly and senile people. Sensory disorders, which include violations of tactile sensitivity, hearing, smell, taste, visual impairment, are widespread in old age, and are associated with unfavorable aging options. These disorders are associated with other geriatric syndromes, affect the quality of life, morbidity and mortality in the elderly and senile age. The author reviews publications on hearing, vision and olfaction disorders.","PeriodicalId":432054,"journal":{"name":"Russian Family Doctor","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130518744","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 case of bronchial asthma in a patient with long-term cough","authors":"I. V. Yubrina, I. Bozhkov, L. Degtyareva, D. V. Karostik","doi":"10.17816/rfd104664","DOIUrl":"https://doi.org/10.17816/rfd104664","url":null,"abstract":"BACKGROUND: The regulatory documents determining the phthisiatric care for population do not provide diagnostics and treatment of comorbid somatic pathology with tuberculosis in tuberculosis dispansery. If patients with diagnosed tuberculosis or suspected tuberculosis need therapeutic specialists consultation, they have to be referred to the district polyclinic working in the medical insurance system. So, timeliness of diagnostics and chronic diseases management decreases. The course of tuberculosis becomes more complicated and lengthened. At the same time tuberculosis specificities are not taken in to account complicating comorbid pathology. For effective diagnostics and treatment tuberculosis and comorbid pathology the special algorithms of patient management were develop in Tuberculosis Dispensary No. 5. \u0000AIM: To describe the clinical case of bronchial asthma in a 35 year old female patient as an example of effective interdisciplinary communication between general practitioner, phthisiatrician and specialists of therapeutic profile. \u0000MATERIALS AND METHODS: Patients with suspected tuberculosis are comprehensively examined by the phthisiatrician and therapeutic profile specialists according to special developed algorithms of diagnostic search at Tuberculosis Dispensary No. 5. \u0000RESULTS: The patient with long-term cough was comprehensively examined. Within a short time tuberculosis was excluded, bronchial asthma was diagnosed. The effective treatment of asthma and a plan of further patient flow-up in the district polyclinic was recommended. \u0000CONCLUSIONS: An experience of the interdisciplinary communication phthisiatricians and specialists of therapeutic profile who have entered the department of medical-social care and rehabilitation demonstrated the relevance and appropriateness in diagnostics of tuberculosis and concomitant chronic uninfection diseases, that let minimize risks of cross adverse effects and choose the optimal tactics of patient management.","PeriodicalId":432054,"journal":{"name":"Russian Family Doctor","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130835064","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":"Beta-blockers in elderly patients: neuroprotective effect or risk of cognitive decline?","authors":"T. Bogdanova, A. Turusheva","doi":"10.17816/rfd108434","DOIUrl":"https://doi.org/10.17816/rfd108434","url":null,"abstract":"BACKGROUND: Due to the fact that the number of elderly people with cognitive disorders is steadily increasing worldwide, there is an increased interest in studying the effects of drugs of different pharmacological groups on cognitive function. \u0000For many years, beta-blockers have been one of the main groups in the therapy of cardiovascular diseases. The effect of beta-blockers on cognitive function has been studied for a long time, and there is different, sometimes contradictory data on this issue. \u0000AIM: To evaluate the incidence of cognitive impairment in elderly and to determine the associations between cognitive impairment and the beta-blockers use. \u0000MATERIALS AND METHODS: Cross-sectional study included all patients aged 60 years and older who attended the ambulance care from 24.10.2019 to 15.12.2019 at the polyclinic No. 78 in Saint Petersburg. \u0000Measurements: the Montreal cognitive assessment (MoCA) test, the 15-item Geriatric Depression Scale. Data collection included a full medical history, a medication review and questionnaire. \u0000RESULTS: The prevalence of cognitive impairment among the study participants was 71.1% (n = 138). Сognitive impairment was associated with high blood pressure and a history of stroke (p 0.05). Beta-blockers use was associated with decreased in total MoCA score, fluency (p = 0.0115), thinking (p = 0.0012), and memory (p = 0.0040). The identified association remained statistically significant after adjusting for gender, age, high blood pressure, a history of stroke, level of education, and decreased emotional background with odds ratio 2.245 (95% confidence interval 1.1564.358) for the fluency test and coefficient of regression 0.781 (95% confidence interval [1,233][0,328]) for delayed memory. \u0000CONCLUSIONS: Memory impairment (coefficient of regression 0.781, 95% confidence interval 1.233 to 0.328) and decreased fluency (odds ratio 2.245; 95% confidence interval 1.1564.358) were observed in the study in the outpatient elderly patient population taking beta-blockers. The beta-blockers may lead to memory impairment. When choosing hypotensive therapy, all possible effects of beta-blockers should be considered, including the effect on cognitive status.","PeriodicalId":432054,"journal":{"name":"Russian Family Doctor","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130021110","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":"Comparative analysis of risk factors for hip fracture in patients of different nationalities living in Kazakhstan","authors":"S. Issayeva, O. Lesnyak, B. Issayeva, D. Dilmanova, Meruyert A. Bissembay, Gaukhar A. Burakhanova","doi":"10.17816/rfd108304","DOIUrl":"https://doi.org/10.17816/rfd108304","url":null,"abstract":"BACKGROUND: Osteoporosis is a multifactorial systemic skeletal disease characterized by a decrease in bone strength leading to an increased risk of fractures. Hip fracture is a serious complication of osteoporosis. It is expected in Kazakhstan by 2050 the annual number of hip fracture will increase by 140% compared to 2015 data and will amount to 28,048 cases. There are differences in the incidence of fractures and low bone mineral density in different ethnic groups. However, low bone mineral density is only one of many risk factors for osteoporotic fractures. \u0000AIM: To study the risk factors of osteoporosis and related osteoporotic fractures in patients with hip fracture living in Kazakhstan. \u0000MATERIALS AND METHODS: The case-control study included 98 patients with hip fracture of Kazakh (main group, n = 49) and other nationalities (control group, n = 49). In the registration card, risk factors for osteoporosis and osteoporotic fractures from the Fracture Risk Assessment (FRAX) model were distinguished, and the Find cases Assess Confirm Severity algorithm (2019) was used to diagnose sarcopenia. Statistical analysis was carried out using the Statistics 26 (IBM SPSS, США). \u0000RESULTS: The groups were comparable in terms of gender, disability, fracture location and functional activity, surgical treatment. An increase in cases of hip fracture at an older age was found in the main group than in the control group (р = 0.035). \u0000There were no differences in the groups for clinical risk factors for osteoporotic fractures (body weight, height, history of fractures, family history of fractures, medication, comorbidity), except for smoking (lower in Kazakhs than in the other group) (р = 0.033). Differences in 10-year probability of major osteoporotic fracture and hip fracture between groups (р = 0.34 and р = 0.74) were not found. The proportion of patients who entered the intervention threshold and at low risk did not differ in the groups (р = 0.623). \u0000The average SARC-F (Strength, Assistance with walking, Rise from a chair, Climb stairs and Falls) score was lower among Kazakhs (р = 0.011), there is a difference between the groups when walking (р = 0.044), climbing stairs (р = 0.003). A decrease of grip strength was noted in the main group (р = 0.008), especially in men (р = 0.011), but low grip strength (р 0.001) and signs of sarcopenia (р 0.001) were determined only by age, not nationality. \u0000CONCLUSIONS: The Fracture Risk Assessment (FRAX) model and intervention threshold can be applied to all residents of Kazakhstan.","PeriodicalId":432054,"journal":{"name":"Russian Family Doctor","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127220927","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":"Etiotropic therapy of the new coronavirus infection. Expectations and realities. Part 2","authors":"O. Kuznetsova","doi":"10.17816/rfd108485","DOIUrl":"https://doi.org/10.17816/rfd108485","url":null,"abstract":"Part 2 of the review includes an analysis of the literature data related to the etiotropic therapy of a new coronavirus infection using drugs from the group of monoclonal antibodies and viral protease inhibitors. The difficulty of choosing a drug for the treatment of a new coronavirus infection caused by the Omicron strain due to the high degree of mutation is emphasized. The mechanism of action of the combined drug Paxlovid, consisting of nirmatrelvir and ritonavir, is described, data on its high efficacy and safety obtained in randomized multicenter placebo-controlled trials are presented. Attention is drawn to the World Health Organization recommendations on the use of this drug in people at high risk of a severe course of a new coronavirus infection and the need for early diagnosis of clinical symptoms for the timely appointment of etiotropic therapy.","PeriodicalId":432054,"journal":{"name":"Russian Family Doctor","volume":"303 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132691192","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":"Atypical fracture of the femur in a patient with postmenopausal osteoporosis after four injections of zoledronic acid","authors":"E. Gladkova, O. Lesnyak","doi":"10.17816/rfd100999","DOIUrl":"https://doi.org/10.17816/rfd100999","url":null,"abstract":"Bisphosphonates are one of the most effective medications widely used in the treatment of osteoporosis. In the last 15 years, descriptions, and observations of unusual low-energy femoral fractures with atypical localization for osteoporosis after prolonged use of these drugs have been published. \u0000A 78-year-old patient applied to the osteoporosis center. She received parenteral bisphosphonate therapy for severe osteoporosis for 4 years. In 2017, a spontaneous fracture of the middle third of the femoral shaft was registered (the fracture occurred while walking). Regarding the fracture, metal osteosynthesis with a plate was performed. Subsequently, there was a delayed consolidation of the fracture with the formation of a false joint and the need for repeated surgical intervention. Examination of the patient revealed vitamin D deficiency, and significant negative trend in densitometry. \u0000A feature of this case is poor fracture consolidation and long-term uncompensated vitamin D deficiency. Physicians should be aware of this rare but serious complication of bisphosphonate therapy, as it requires discontinuation of antiresorptive drugs and the appointment of bone anabolic therapy for osteoporosis, which, in addition to treating the underlying disease, also promotes consolidation fracture.","PeriodicalId":432054,"journal":{"name":"Russian Family Doctor","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122296866","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":"Disorder of the intestinal microbial tissue complex after a new coronavirus infection as an interdisciplinary problem","authors":"M. Grigorovich","doi":"10.17816/rfd101087","DOIUrl":"https://doi.org/10.17816/rfd101087","url":null,"abstract":"The occurrence of diarrhea in comorbid patients with COVID-19 infection against the background of microbiocenosis disorders may be a factor in the worse outcome of the disease. The biggest threat posed by diarrhea is dehydration. Evaluation, control and timely correction of disorders of the gastrointestinal tract, allowing to identify signs associated with dehydration, impaired water and electrolyte balance, intestinal microecology and phenomena of increased epithelial permeability. It is important to consider the risk of diarrhea in patients undergoing massive therapy for COVID-19. \u0000On the example of a specific clinical case, the most common mistakes in managing patients with acute/persistent diarrhea are analyzed. The tactics of managing a patient with diarrheal syndrome after a COVID-19 infection has been defined and substantiated, the importance of a holistic approach to solving patient problems from the standpoint of the one health concept has been substantiated.","PeriodicalId":432054,"journal":{"name":"Russian Family Doctor","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128677130","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":"Pros and cons of using face masks for non-specific prevention of new coronavirus infection","authors":"N. I. Kuznetsov, I. Moiseeva","doi":"10.17816/rfd101091","DOIUrl":"https://doi.org/10.17816/rfd101091","url":null,"abstract":"The article is devoted to the analysis of literature data regarding both the positive value of the use of masks during a pandemic caused by the SARS-CoV-2 and the negative effect that occurs when wearing masks. The analyzed data of studies on the effectiveness of the use of personal protective equipment in the form of masks did not indicate their type. The results of most studies have shown that the positive effect of using masks exceeds the identified short-term deviations in the physiological parameters of the body due to their use.","PeriodicalId":432054,"journal":{"name":"Russian Family Doctor","volume":"173 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116302870","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 impact of vaccination against the new coronavirus infection on the morbidity of university students","authors":"S. Sayganov, A. Lubimova, A. V. Meltser, Z. Lopatin, O. Kuznetsova, O. Kovaleva","doi":"10.17816/rfd99623","DOIUrl":"https://doi.org/10.17816/rfd99623","url":null,"abstract":"BACKGROUND: Vaccination is currently considered the most successful strategy against the SARS-CoV-2 virus. However, cases of infection despite vaccination, so-called breakthrough infections, have been reported worldwide. \u0000AIM: To evaluate the impact of vaccination against the new coronavirus infection COVID-19 on the morbidity of university students. \u0000MATERIALS AND METHODS: The incidence of new coronavirus infection (COVID-19) among the students of North-Western State Medical University named after I.I. Mechnikov (further University) from September 1 to December 15, 2020 and 2021 was analyzed. There were 4876 and 4681 students under observation. Data on vaccination, probable site of transmission infection were collected by interviewing the ill people. Statistical processing of data was performed using EpiInfo software. \u0000RESULTS: For the analyzed period 191 cases of COVID-19 among students were detected, the incidence of COVID-19 was 4.08 per 100 students, for the same period of the academic year 2020 it was 5.50, despite the fact that the incidence among St. Petersburg residents in 2021 was 1.75 times higher than in 2020. Re-infection was detected in 35 (18.3%) cases, 18 of whom were also vaccinated against COVID-19. A probable place of transmission infection was established in 36.1% of the cases, the most frequent being contact with a patient at their place of work in a health-care facility. By December 15, 2021, a total of 62.8% of students had been vaccinated against COVID-19. The incidence among vaccinated students was 2.72 per 100 students and 4.94 per 100 among unvaccinated students. A risk factor for breakthrough infections after vaccination was close contact with the source of infection: vaccinated persons had close contact in 50% of cases, compared with 28.9% of unvaccinated persons. The most important were contact with a patient in a health care setting and having multiple sources of infection, 31.1% and 5.6%, respectively. \u0000CONCLUSIONS: Vaccination against COVID-19 was an effective preventive intervention. A risk factor for disease after vaccination is close contact with the source of infection. Establishment of collective immunity after vaccination is decisive for the vaccination-to-disease ratio, which starts to develop with 70-80% of vaccinated individuals. The use of a mask in public places and social distancing remain important preventive measures.","PeriodicalId":432054,"journal":{"name":"Russian Family Doctor","volume":"203 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131681626","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":"Etiotropic therapy of the new coronavirus infection: expectations and realities at the beginning of 2022. Part 1","authors":"O. Kuznetsova","doi":"10.17816/rfd101316","DOIUrl":"https://doi.org/10.17816/rfd101316","url":null,"abstract":"The review includes an analysis of the latest literature data on the etiotropic therapy of a new coronavirus infection. The search for an effective antiviral treatment for SARS-CoV-2 infection is ongoing. Often, the urgent need for an antiviral drug was a pretext for testing drugs without pharmacological justification, bypassing the generally accepted procedure for conducting multi-stage clinical trials. In this regard, many clinical trials involving thousands of patients did not demonstrate the high efficacy and safety of drugs that were chosen as etiotropic therapy. In this review, we focused on the efficacy and safety of those drugs that have been studied in sufficient detail, which are reflected in international publications, and are also included in Russian guidelines for use on an outpatient practice: favipiravir and molnupiravir. The mechanism of action of antiviral drugs, their effectiveness and possible side effects were studied in clinical trials, the results of which are in the open press, which made it possible to analyze these drugs in terms of the appropriateness of their use in real clinical practice.","PeriodicalId":432054,"journal":{"name":"Russian Family Doctor","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124729615","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}