卷 24, 编号 2 (2022)

Idiopathic pulmonary fibrosis is a specific form of chronic lung disease that is characterized by progressive fibrosis of the lung tissue. This disease is ransidered as a variant of interstitial pneumonia, but has other principles of treatment. The prevalence of this disease in the world varies, averaging 15-20 people per 100,000 populations. Patients complain of progressive shortness of breath, dry cough, discomfort in the chest, muscle weakness, subfebrile fever. According to the clinical history, it is difficult to make an accurate diagnosis due to non-specific complaints of the patient. For instrumental diagnostics, X-ray examination of the lungs, high-resolu-tion computed tomography is used, and a lung tissue biopsy can be performed. Fibrous changes will be observed in the basal and subpleural regions of the lungs, and there will also be an inhomogeneous distribution of the honeycomb zone. As a conservative therapy, the use of the antifi-brotic agent pirfenidone is recommended, which demonstrates high efficiency and economic feasibility compared to drugs similar in terms of the main active ingredient.

The role of secondary and junior medical personnel is an important factor during the COVID-19 pandemic, supporting the work of health systems. Global studies on the etiology, epidemiology and pathogenesis of the new coronavirus infection have provided important information about SARS-CoV-2, including data from genetic studies that have determined the creation of effective prevention and infection control measures that should be followed by doctors, secondary and junior medical personnel. The main purpose of this work is to consolidate the lessons of the COVID-19 pandemic and to familiarize secondary and junior medical personnel with the features and rules of work during the COVID-19 pandemic, which are presented in the Resolution of the Chief State Sanitary Doctor of the Russian Federation No. 64 dated 28.11.2013 “On approval of sanitary and epidemiological rules of SP 1.3.3118-13 “Safety of work with microorganisms of pathogenicity groups I-II (danger)”, registered with the Ministry of Justice of the Russian Federation on 19.05.2014 No. 32325. These sanitary rules establish requirements for organizational, preventive measures aimed at ensuring personal and public safety, environmental protection when working with pathogenic biological agents (hereinafter referred to as PBA) of groups I - II: including when working with SARS-CoV-2 and patients with COVID-19.

Recently, telemedicine has become one of the successful options for using information and communication technologies, the increased interest in which has provoked the COVID-19 pandemic. Thus, the use of innovative telemedicine programs makes it possible to detect the disease at the early stages of its development and start treatment in a timely manner, which undoubtedly increases the effectiveness of therapy and reduces the risk of adverse development of the disease. The introduction of remote technologies makes medical care available not only for residents of remote areas, but also for working and busy patients who often do not have enough time to go to the doctor. In this connection, telemedicine has become an important tool for the interaction of patients with medical professionals, including nurses. The effective use of telesestrinstvo allows you to: expand healthcare services, establish access to medical services, improve the quality of life of patients, adjust the volume of services provided and protect the confidentiality of medical information. Thus, the use of technologies of the medical decision-making support system, including those accompanied by telesistration, improves the quality of medical care, reduces the examination time and, ultimately, contributes to the prevention of the development of diseases.

Introduction. It has been shown that new coronavirus infection has the most severe course in patients with cardiovascular diseases. It is noted that the issues of rehabilitation of patients with COVID - 19 and cardiovascular pathology are very relevant and need additional study. Objective of the study. To study literature data concerning the tactics of management and rehabilitation in patients with COVID-19 and cardiovascular diseases. Material and methods. 12 publications devoted to the study of management and rehabilitation tactics of COVID-19 patients were analyzed. Results. Objectives of medical rehabilitation of patients who underwent COVID-19 are presented. The key principles of medical rehabilitation of these patients are described. The peculiarities of rehabilitation measures depending on the severity of COVID-19 are presented. Conclusion. The disease COVID-19 is associated with the increased risk of cardiovascular and thromboembolic complications. Cardiovascular disease has been and remains the leading cause of death not only in our country, but in most countries of the world. Weakened attention to effective cardiovascular risk management in COVID-19 patients may lead to increased cardiovascular and overall mortality. Undoubtedly, COVID-19 patients should be involved in medical rehabilitation programs for faster and better recovery of functions of different systems (primarily respiratory and cardiovascular), improving quality of life, reducing the risk of adverse outcomes and disability.

The value of prophylactic vitamin and mineral support as a factor capable of significantly facilitating the clinical manifestations of new coronavirus infection, reducing the risk of complications and lethal outcome and accelerating the recovery is considered. Particular attention is paid to the provision of vitamins D, B6, C, E, the trace elements selenium and zinc. A brief review of scientific research on the relationship of vitamin D and selenium levels with the course of COVID-19 is presented. The ways of correction and maintenance of the nutritive status by application of domestic complexes OSTEO-VIT D3 and SELENBIO fo vomen are offered.