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Vol 25, No 1 (2023)
Topical theme
Hypothermia in clinical practice
Abstract
Hypothermia or cold injury is a fairly common occurrence. The number of frostbite and cold injury varies annually in the regions of Russia and is directly related to the peculiarities of the local climate. In cities with a temperate climate, cold injury makes up no more than 1% of the total structure of injuries, while in the Far North it reaches 6-10%, being a characteristic problem for this area. The pathogenesis of frostbite is complex and diverse. Due to cold exposure, hemorheology disorders occur in the affected segments, persistent endothelial dysfunction is formed with changes in peripheral innervation in the focus of alteration and perifocally, which leads to thrombosis and necrosis of the affected limb tissues.
Basic help algorithm:
- To ensure transportation to a warm room, active outdoor warming,
- to cover with a heat-insulating blanket, in the absence of offer the usual.
- Offer warm water in a small amount for hypovolemia
- Warm infusions with isotonic solutions of crystalloids.
- Warming should be started from the trunk, not from the limbs, to avoid collapse.
- Hemodialysis, used only in a hospital setting.
3-11
Vitamin D in the complex treatment of tuberculosis
Abstract
Tuberculosis treatment is long-term, continuous for at least 6 months, includes a complex of 4-6 anti-tuberculosis drugs. In the course of treatment, there may be unwanted and side effects from drugs. At all times of the existence of the disease, people have been looking for effective methods of treatment based on non-specific treatment. Pathogenetic treatment at the stage of primary treatment should maximize the effectiveness of treatment. The appointment of hepatoprotectors, immunomodulators, vitamins is mandatory. One of the drugs discussed in scientific publications is vitamin D and its role in the treatment of tuberculosis. There are different opinions, the difficulty of an objective assessment of the value of vitamin D in the treatment of tuberculosis is associated with the complexity of evaluating the effectiveness. But, it must be admitted that in recent years, very much attention has been paid to the importance of vitamin D. In this paper, we propose to consider the domestic drug “Osteo-Vit D3”, which is recommended to be combined with antibiotic therapy. The term “osteobiotic” was proposed by the developers. This terminology is due to the ability to neutralize the negative impact of various drugs on the musculoskeletal system.
48-51
Profession: theory and practice
Modern medical-diagnostic and organizational technologies for the management of children with infections of the urinary system
Abstract
The article presents information about infections of the urinary system in children, their description, diagnosis, visualization of changes in the kidneys by instrumental methods, clinical symptoms, possible complications, principles of treatment, taking into account the characteristics of antibiotic therapy, and the role of a nurse in disease prevention. The need for continuous monitoring of the sensitivity of the isolated urine flora to antibiotics in each region and the development of modern clinical guidelines for the diagnosis and treatment of urinary tract infections in children, based on a rational approach, taking into account the changing sensitivity of uropathogens to antibacterial drugs, are emphasized.
12-20
The role of nursing staff in the organization of outpatient phthisiological care
Abstract
The primary health care unit is engaged in the identification of tuberculosis patients, the further role in reducing the incidence of tuberculosis in Russia falls on the shoulders of the TB service and its main performers - a phthisiologist and a nurse. Outpatient observation and treatment is central to the management of a patient with tuberculosis in a specialized anti-tuberculosis service. A patient with tuberculosis comes to an outpatient phthisiologist, is observed from 1 to 2-3 years (and sometimes more), and leaves him for a habitual life before the disease.
To achieve the goals and objectives of the TB service, a significant role belongs to the average medical staff, where there is a division of functional responsibilities.
22-25
On the question of antiviral therapy of a new coronavirus infection (COVID-19)
Abstract
Coronavirus infection, or COVID-19 (COronaVIrus Disease 2019), is a new epidemic infectious disease that poses a danger to the population due to its high contagiousness and the development of complications that are unfavorable for the patient’s life, such as ARDS, respiratory and multiple organ failure. The virus has spread worldwide since its detection in Wuhan, Hubei Province, China on December 12, 2019. The World Health Organization (WHO) has declared it a pandemic. Based on the Decree of the Government of the Russian Federation, the new coronavirus COVID-19 (SARS-COV-2) is included in the list of diseases dangerous to society, along with polio and plague. The world community, united by a common goal - to combat the pandemic, is taking measures to actively immunize the entire population through vaccination. However, despite the availability of many vaccines, the number of cases and deaths remains high. As of December 19, 2021, there were 274 644 270 confirmed cases of coronavirus infection in the world and 5 368 822 deaths. Based on the above data, it becomes obvious that the reasonable use of antiviral therapy drugs is necessary for a favorable outcome of the disease of each patient. The review examines the main antiviral drugs proposed by WHO for the treatment of new coronavirus infection (COVID-19). Studies with statistically significant data are selected, which make it possible to fully judge the effectiveness and make it possible to make an adequate decision on the prescription of these drugs. Based on the data obtained from in vitro studies and clinical trials, the prospect of using the above drugs in the treatment of a new coronavirus infection, their effectiveness in clinical practice, as well as the feasibility of using and possible combinations of prescribing these drugs, which can be used to treat and prevent a new coronavirus infection, are considered. The article discusses the effectiveness of the following drugs: remdesvir, interferon, lopinavir and ritonavir, riamilovir, ribavirin, umifenovir, darunavir and cobicistat, favipiravir, chloroquine and hydroxychloroquine, ivermectin and intravenous immunoglobu- lins.To achieve the goals and objectives of the TB service, a significant role belongs to the average medical staff, where there is a division of functional responsibilities.
26-31
Tuberculosis in dental practice
Abstract
In the practice of dentistry, it is always possible to diagnose various specific diseases with oral manifestations. These include infectious, systemic, immunologic, and oncologic diseases. Among infectious diseases, tuberculosis is the most common. In practice, the dentist may encounter tuberculosis lesions of rare localizations - skull and maxillofacial bones, oral cavity, tongue root and tonsils, as well as a dental cusp.
Mycobacterium tuberculosis bacteria (MBT) can remain latent in the body for a long time and manifest themselves at any age in the presence of debilitating factors with lesions of various organs and systems.
52-55
Nursing service in the healthcare system
The role of a nurse in conducting a spectrometric method of research
Abstract
The diagnosis of these diseases involves a number of laboratory and functional tests. Spirometry is the basic method of assessing respiratory function. Spirometry is an examination of airflow, which allows you to assess your external respiratory function (ERF) in many ways. Spirometry is an instrumental method of lung diagnosis. Spirometry is performed using a special apparatus which consists of a computer with software and a functional part consisting of a mouthpiece, airway part and airflow sensors. Spirometry is a non-invasive method and the risk of complications is minimal. However, it is worth bearing in mind that the brain briefly experiences hypoxia during the examination due to the special breathing technique. In addition, the pressure in the lungs, chest and small circulatory vessels rises and the strain on the respiratory muscles and abdominal muscles increases. As a rule, patients who come for a diagnostic examination are not fully informed about the procedure. The doctor is assisted by a nurse, whose help is essential for the quality of the result.
33-37
The role of the nurse in the work of the anti-tuberculosis cabinet and the prevention of tuberculosis
Abstract
Tuberculosis has always been and remains one of the socially significant diseases. The work of the anti-tuberculosis cabinet is based on close interaction between the doctor and the nurse, where the role of the nurse is very high. It is important to monitor the patient’s compliance with the rules of personal hygiene, as well as conduct sanitary and educational work. It is easier to fight the disease if the patient has full information about it. In the context of digitalization of medicine and the emergence of artificial intelligence, there are changes in the work of a nurse. Analyzes and examination data, especially X-ray data, are transmitted to the doctor’s workplace. Systems for automatic evaluation of results are being created. The duties of a nurse may change. Currently, more responsibility is assigned to conducting screening surveys of the population, their evaluation and monitoring of results, and assistance in maintaining documentation.
39-41
The role of a nurse in the organization of BCG-vaccination
Abstract
The importance of the nurse’s activity in the issues of vaccination of children against tuberculosis is relevant today, since it is the nurses who are the specialists responsible for the process of organizing vaccination and educating parents about tuberculosis prevention. According to the WHO tuberculosis remains a global problem in the world, despite significant advances in its detection, diagnosis and prevention. Currently there is an improvement in the epidemiological situation, a decrease in the incidence of tuberculosis, but at the same time up to 4% of children are infected with M.tuberculosis for the first time, forming a sufficiently large reservoir of infection with a potential risk of developing active forms of the disease. The main method of effective prevention of tuberculosis infection in children is mass specific immunization with BCG. The article presents the main issues of the organization of BCG vaccination in the Russian Federation. The main problems of BCG vaccination and revaccination and possible solutions are reflected. The main regulatory documents regulating vaccination and revaccination in our country are given.
42-46