Vrach

Prevention and early manifestation of the disease are of primary importance in the fight against tuberculosis. One of the most obvious, safest and inexpensive methods is a skin test with a recombinant tuberculosis allergen (Diaskintest). The review presents an analysis of the literature devoted to the possibility of using Diaskintest in the early diagnosis of tuberculosis infection. Publications proving the effectiveness of using skin tests with a recombinant tuberculosis allergen as a screening method for diagnosing tuberculosis infection at the present stage.

Modern methods of physiotherapy used in the prevention and treatment of osteoporosis are considered. The prospects for using a Russian osteoprotector based on drone homogenate in combination with various physiotherapy procedures in the treatment of diseases and injuries of the musculoskeletal system are assessed.

In this article the relationship between COVID-19 and the onset of neurodegenerative diseases such as Alzheimer's disease and Parkinson's disease is observed. Possible mechanisms of pathogenesis are discussed: activation of microglia, formation of neurofibrillary tangles and amyloid plaques, which indicates a possible acceleration of pathological processes characteristic of neurodegenerative diseases. A review of the literature suggests that COVID-19 may act as a catalyst for the development or acceleration of neurodegenerative processes. The article presents a clinical observation of a patient admitted to the therapeutic department due to a hypertensive crisis, who developed mixed dementia after COVID-19 infection. The results of clinical and biochemical blood tests are within the reference values. On MRI of the brain – atrophy of the medial temporal lobe, signal changes in the basal ganglia, foci of vascular genesis. On EEG: Disorganized EEG type with dominance of slow activity in the theta rhythm range. Psychodiagnostics revealed cognitive decline to the level of moderate dementia (according to the MMSE scale – 13 scores). The importance of long-term monitoring of patients with post-COVID syndrome and the development of strategies for the prevention and treatment of neurodegenerative diseases in the context of the pandemic is emphasized.

The article examines the differential diagnostic aspects of chest pain syndrome from a cardiological point of view. Pathologies that may be similar in their manifestations to the angina pectoris include esophageal diseases, neurotic disorders and some neurological syndromes. Underdiagnosis of angina pectoris a direct threat to the patient's life. Overdiagnosis of angina leads to unjustified hospitalization, increases the risk of iatrogenism and exacerbates the course of an unrecognized extracardial disease. In practice, the greatest diagnostic difficulties arise when the paroxysmal chest pain is not associated with physical exertion, is absent during a medical examination, and the "pain history" itself is short – several hours or days.

Purpose. Compare the frequency of occurrence of comorbid pathologies in patients with psoriasis and concomitant hypertension and patients with psoriasis without hypertension, evaluate the severity of psoriasis in patients with concomitant hypertension.

Material and methods. The study was attended by 120 patients with psoriasis, divided into 2 groups: 1^st (n = 60) – patients with psoriasis and hypertension; 2^nd (n = 60) – patients with psoriasis without hypertension. The study included the analysis of the stories of the disease, the collection of complaints, the anamnesis of the disease, the anamnesis of life, the physical examination, the measurement of blood pressure, the calculation of the prevalence index and the severity of psoriasis (PASI).

Results. In patients with psoriasis and concomitant hypertension, the course of the underlying disease took place in a more severe form with a high PASI index. The predominance of exudative forms of the disease, the progressive stage with damage to the scalp, trunk, upper and lower extremities, was noted, and in 43.3% of patients and involving the skin of the face in the pathological process. The number of related diseases and the percentage of patients with polymorbid pathology in a group of patients with psoriasis and hypertension were significantly greater. In this group of patients, a longer stay in the hospital was also noted.

Conclusion. In patients with psoriasis, the concomitant hypertension contributes to a more severe course of the skin process, increase the comorbid load, increase polymorbidity and lengthen the temporary disability, thereby worsening the quality of life of patients.

The article presents the results of the positive effect of the drug Cardioton on blood pressure, cardio-pain syndrome by type of cardialgia in patients with hypertension with different daily blood pressure index. It was revealed that Cardiotone relieved cardialgia-type cardio-pain syndrome in 94% of cases. 83% of patients have normalization of blood pressure, 17% have a tendency to decrease blood pressure. After treatment, the hypotensive effect of Cardiotone was observed in all groups of patients, depending on the value of the daily blood pressure index: 90% in dipper patients (with a normal decrease in blood pressure at night), 76% in non-dipper (with insufficient nocturnal decrease in blood pressure), 69% in over-dipper (with excessive decrease in blood pressure at night night time). It should be noted that blood pressure tends to normalize in almost half (43%) of people with the most unfavorable prognosis for the development of CVD with a nocturnal increase in blood pressure (the profile was assessed as night peaker). Cardioton is a natural cardioprotector; strengthens the heart muscle by improving its oxygen supply, relieves inflammatory processes in the myocardium; has antihypertensive, anti-ischemic, cardiometabolic effects. It is recommended for disorders of the cardiovascular system, with increased physical exertion. Based on the conducted research, it can be concluded that Cardiotone is well tolerated by patients and is an effective treatment.

Purpose. To study the prevalence of complications associated with the use of direct oral anticoagulants (DOAC) in geriatric patients with polypragmasia and coordinity of atrial fibrillation (AF) and chronic kidney disease (CKD).

Material and methods. The study was attended by 113 elderly and senile patients with polymorbity who received an outpatient basis as AF therapy: apixban (n = 23), rivaroxaban (n = 54) and dabigatran (n = 36).

Results. It is shown that hemorrhagic complications (only “small” bleeding were considered, of which > 90% were found mainly in the first year of taking DOAC. At the same time, the frequency of complications increased with age, with a decrease in the stage of CKD, especially when taking dabigatran (whose elimination is 80% depends on the kidneys). The number of drugs taken in our examination did not increase the likelihood of bleeding, but some combinations were identified in which the risk of hemorrhagic complications was statistically significantly higher: metoprolol and rivaroxaban (r = 0.35); verapamil and dabigatran (r = 0.25).

Objective. To study the associations of alleles and genotypes of polymorphic markers of the ABCB1 gene with predisposition to the threatened preterm labor.

Material and methods. The study included 96 pregnant women with an established diagnosis of threatened premature birth (main group) and 87 practically healthy pregnant women with timely spontaneous labor (control group) in accordance with the inclusion/exclusion criteria. Genotyping to identify polymorphisms rs1045642 (3435C > T), rs2032582 (2677G > T), rs1128503 (1236C > T) of the ABCB1 gene was carried out by real-time PCR.

Results. The distribution of genotypes by the studied polymorphisms corresponded to the Hardy-Weinberg distribution in the control and main groups. No significant differences were found in the frequencies of alleles and genotypes of ABCB1 gene polymorphisms in the studied groups of pregnant women.

Conclusion. The studied ABCB1 gene polymorphisms are not associated with threatened preterm labor in Russian pregnant women. The allele and genotype frequencies of the rs11285503, rs2032582, and rs1045642 ABCB1 gene polymorphisms correspond to the literature data on their occurrence in the Caucasian population.

Objective. Based on international recommendations, to study the dynamics of quality of life (QOL) indicators of children with type 1 diabetes mellitus (DM1) and their parents to address the effectiveness of self-control training in this pathology, taking into account the length of illness, type of therapy, as well as the use of modern disease control capabilities.

Materials and methods. The observation group consisted of 56 children with DM1 and their parents (the sample was created by a continuous selection method and included all patients living in cities on the territory of the closed administrative-territorial formation of the Krasnoyarsk Territory). The survey was carried out using special questionnaires of the PedsQL diabetic module, compiled in the form of tests, including blocks taking into account the age groups 5–7, 8–12 and 13–18 years for children and parents. The work was carried out in 2 stages: assessment of QOL before self-control training and after 1 year (the time interval corresponds to clinical recommendations, in which the frequency of self-control training is indicated for a period of 1 year).

Results. The analysis of children's QOL on certain questionnaire questions showed a significant predominance of symptoms of decompensation of the disease (hypoglycemia, irritability and thirst) on the "Diabetes" scale and increased emotional lability, embarrassment, difficulties and awkwardness in communication and increased anxiety on the "Communication" scale in children with a disease duration of less than 5 years. Self-control training in order to maintain and expand the level of knowledge allowed parents to achieve improvements in quality of life indicators on almost all scales under consideration, and especially on the scales "Diabetes" and "Treatment. Our study showed an increase in the level of QOL on the "Treatment" scale in patients on pump insulin therapy in comparison with the use of syringe pens, as well as continuous monitoring of glycemia, the use of which significantly increased the score on the "Diabetes", "Treatment" and "Communication" scales in relation to traditional glycemic control with a glucometer.

Conclusion. The study of QOL is the best option for identifying the individual characteristics of the patient's condition with further use of the results in correcting the treatment of the disease.

This review examines multifunctional X-ray systems of the new generation and their role in expanding the diagnostic capabilities of regional medical institutions. It is shown that the implementation of multifunctional X-ray complexes contributes to the early detection of respiratory and musculoskeletal pathologies, expands the possibilities for minimally invasive interventions under visual control, and increases the availability of high-tech diagnostics in resource-limited settings. The economic and clinical effectiveness of universal X-ray systems for overcoming healthcare inequality between central and peripheral medical institutions is substantiated.

In clinical practice in order to Enzyme preparations are used to correct impaired digestive function, which differ in dosage form, chemical structure and mechanisms of action. The article presents a review of the literature about features and advantages of digestive enzyme preparations. Also presented information about new enzyme preparations qualified as dietary supplements. Presented line of enzyme preparations CREGRAN^® can be considered as effective means for the treatment of diseases, the therapy of which involves the use of enzymes.