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卷 32, 编号 12 (2021)
- 年: 2021
- 文章: 16
- URL: https://journals.eco-vector.com/0236-3054/issue/view/5861
Articles
The features of a humoral response in patients with COVID-19
摘要
The article provides a brief overview of the accumulated data on humoral and T-cell responses to SARS-CoV-2 in patients with COVID-19. It characterizes an antibody response, the neutralizing capacity of immunoglobulin G to the receptor-binding domain (RBD), the timing of antibody elimination, and avidity. RBD has been shown to be the main target for the production of neutralizing antibodies. Analysis and further study of the determinants of SARS-CoV-2 humoral response in patients with COVID-19 will be able to develop more advanced diagnostic techniques.
Vrach. 2021;32(12):5-11
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Difficult communication with patients
摘要
The article is devoted to topical issues of communication between a doctor and a patient in difficult situations. Special attention is paid to communication with cancer patients. Recommendations for informing the patient about the diagnosis of a life-threatening disease are presented. The tactics of the doctor when conducting conversations with patients, regarding their sexual problems, as well as communication with LGBT patients are described.
Vrach. 2021;32(12):11-17
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STADA and leading experts discuss the use of antiplatelet agents during and after COVID-19
Vrach. 2021;32(12):18-19
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«The healthy worker effect» and occupational selection in industrial medicine
摘要
The article deals with the «healthy worker effect» phenomenon that is understood as organized (by the employer) and/or unorganized (self-selection by workers due to their functional capabilities and health status) professional selection of healthier workers under unfavorable working conditions remaining in the profession. This effect is one of the most important problems in epidemiological studies in occupational medicine. The paper analyzes the scientific and medical terminology used when studying the problem of the «healthy worker effect», taking into account the possible inversion of the impact of harmful and unfavorable working conditions, taking into account this phenomenon, as well as the intensity of the «healthy worker effect» in various occupational cohorts.
Vrach. 2021;32(12):20-28
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Complications of surgical treatment of injuries and diseases of the cervical spine at the subaxial level
摘要
This article is devoted to the complications fixation of the cervical spine. The reasons for the failure of ventral cervical fixation and the ways of their correction are described in detail. Special attention is paid to neurological complications, esophageal injuries, dysphagia, damage to the main arteries of the brain, nerves and dura mater. Methods of primary prevention of liquorrhea in patients with intraoperative damage to the dura mater are widely presented. The following article presents the complications of dorsal cervical fixation.
Vrach. 2021;32(12):28-37
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Modern approaches to the complex treatment of osteoarthritis: present and future
摘要
Osteoarthritis (OA) is a chronic progressive joint disease that poses a serious general medical and social problem. The disease is associated with an increased risk of death and requires the earliest possible appointment of therapy. According to modern recommendations, the treatment of patients should include non-pharmacological and pharmacological methods. The article discusses the basic therapy of OA, including symptomatic delayed-action drugs (SYSADOA), paracetamol, nonsteroidal anti-inflammatory drugs, intra-articular administration of hyaluronic acid and glucocorticosteroids, as well as issues of anesthesia for severe pain syndrome. Total knee replacement is recommended only for patients with the last stage of OA.
Vrach. 2021;32(12):37-43
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To the problem of medical professional liability risk insurance in healthcare workers
摘要
The paper analyzes the existing provisions of the regulatory and legal framework governing the right of medical workers to insure the professional liability risk for the harm caused to the life and health of citizens. It considers three conceptual approaches to the professional errors made by healthcare workers. A basic thesis is formulated, which allows determination of fundamental differences between a healthcare worker’s professional offense and professional mistake. The authors propose and substantiate the normative definition of a professional error made by a healthcare worker.
Vrach. 2021;32(12):44-47
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Study of the prevalence of some cancer risk factors and public knowledge about methods of cancer prevention and early diagnosis
摘要
Cancer incidence in the world and in Russia continues to grow. It is possible to stop the growth of morbidity only by cancer prevention measures. These measures implementation and realization of their cancer prevention capabilities significantly depends on health literacy and motivation of people to follow prevention recommendations. Objectives: The purpose of the work is to study the spread of some cancer risk factors and to evaluate people's knowledge about cancer causes and risk factors. Methods: The study was conducted on a random sample of the adult population of Moscow numbering 310 people aged 20-79years. The main method of research is personal interviewing using a unified and structured questionnaire regarding the presence of bad habits, some characteristics of nutrition, physical activity and knowledge about cancer causes and cancer prevention and early diagnosis methods. Results: In the adult sample study, the percentage of all persons who ever smoked was 62.2% among men and 24.6% among women. The percentage of people who consumed alcoholic beverages 2 times a week or more often was 252% (95% Cl 17%-33%) among men and 4% (95%CI 3.3%-4.7%) among women. Only 16% surveyed respondents followed the healthy diet recommendation. Recommended as prophylactic against cancer regime of physical activity was observed by less than half of all persons, 45.5%. Majority, 53.8% the respondents were unaware of cancer causes or named only one true cause. 37.9% (95% Cl 32%-43%) respondents did not know about measures for the prevention of cancer diseases. About methods of early diagnosis of tumors, the majority, 60.0% (95%CI 55%-65%) respondents did not know anything or gave incorrect answers. Conclusions: Most of the respondents in a random sample of the population did not know or had incorrect or insufficient knowledge about the cancer causes, measures for their prevention and early diagnosis. It is necessary to organize active education of the population on the relevant topic using all available types and channels of information.
Vrach. 2021;32(12):47-51
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Modern pharmacotherapy of type 2 diabetes mellitus: focus on empagliflozin
摘要
In the current practice, the treatment of type 2 diabetes should be aimed at achieving glycemic control, and the effect on other risk factors for diseases of the cardiovascular system: increased body weight, hypertension, hypoglycemia. Jardins is the first effective hypoglycemic drug of the new generation, which reduces the risk of mortality from cardiovascular disease in patients with type 2 diabetes and concomitant diseases.
Vrach. 2021;32(12):52-59
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Telemonitoring of the health status in pregnant women during the novel coronavirus (COVID-19) infection pandemic
摘要
The paper presents the experience with telemedicine information technologies, which has allowed obstetric facilities in the Sverdlovsk Region to use the telemonitoring of the health status in pregnant and puerperant women, including those with asymptomatic and mild novel coronavirus infection during outpatient treatment (at home).
Vrach. 2021;32(12):59-62
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Current epidemiological features of risk factors for acute cerebrovascular accident in people of different ages
摘要
In the last decade, cardiovascular diseases, including acute cerebrovascular accidents (ACVA), occupy a leading place in the morbidity rates of the population. In Russia, >450 thousand new ACVA cases are annually observed, which makes them an urgent health problem and requires further study of methods that help prevent ACVA of various etiologies.
Vrach. 2021;32(12):63-68
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The clinical characteristics of occupational sensorineural hearing loss according to the spectrum of noise
摘要
Modern industrial noise has its own characteristics, one of which is the tendency to increase the contribution of high-intensity low-frequency and infrasonic components to the spectrum of noise, which has a more pronounced pathological effect. The classical presentation of noise-induced sensorineural hearing loss (SNHL) was considered only as a result of exposure to high-frequency industrial noise. In 2004, infrasound was included in the list of occupational diseases that cause hearing loss. However, there is no clinical presentation of occupational infrasound-induced SNHL (OSNHL), which creates difficulties in establishing an association between diseases and working conditions. Studying the clinical presentation of SNHL due to the impact of high-intensity noise containing high-intensity low-frequency acoustic vibrations (LFAVs) in the spectrum, the authors revealed the features of its formation and development, which allows its identification as a special form and its use in practice. When making a diagnosis of OSNHL, it is necessary to take into account not only the length of working with noise, but also to pay attention to the noise spectrum. OSNHL due to the combined effect of noise and LFAVs requires the consideration of its clinical characteristics and expert judgment.
Vrach. 2021;32(12):69-75
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The clinical and economic rationale for the efficiency of using bioplastics in the treatment of patients with neuropathic diabetic foot syndrome
摘要
Objective. To study the short-term and long-term results of treatment in patients with Wagner grade 3 neuropathic diabetic foot syndrome (DFS) in a day hospital and, by carrying out a clinical and economic analysis, to evaluate the efficiency of using the bioplastic G-derm in the topical treatment of chronic wounds in these patients. Subjects and methods. The investigation enrolled 64 patients with Wagner grade 3 neuropathic DFS who were divided into 2 groups: a study group (n = 33) that was topically treated with the bioplastic G-derm and a comparison group (n = 31) that received the standard treatment with hydrocolloid dressings. The investigation results were used to comparatively calculate the average cost of complex surgical treatment in both groups. Results. In a day hospital, the short-term results of treatment with the bioplastic G-derm demonstrated a rapider wound epithelialization in the study group than in the comparison group treated with hydrocolloid dressings. The long-term results of using the bioplastic material G-derm also showed high efficiency. Conclusion. The conducted clinical and economic analysis has shown that the treatment with bioplastic G-derm in DFS patients, despite its relatively high cost as compared with that with hydrocolloid dressings, is effective from both clinical and economic points of view due to the rapid regeneration of wound processes.
Vrach. 2021;32(12):75-79
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Prospects and possibilities of using a fixed combination of a solid dosage form of paracetamol and tramadol in traumatology (postoperative period)
摘要
Objective: to evaluate the effectiveness of postoperative analgesia with a fixed combination of paracetamol 325 mg + tramadol 37.5 mg in trauma patients over 18 years of age with moderate and high intensity pain syndrome (PS). Subjects and methods. The study included 60 traumatological patients in the early postoperative period with PS aged over 18 years. Postoperative anesthesia was carried out from the first day with a fixed combination of Paracetamol + Tramadol (Organica) film-coated tablets 325 mg + 37.5 mg. Daily and single doses were selected individually, according to the instructions. The anesthesia regimen varied in taking a fixed combination of paracetamol and tramadol: 1 tablet from 1 to 4 times a day or 2 tablets 4 times a day. Pain assessment before and after anesthesia was carried out according to the visual analog scale (VAS) of pain intensity. Results and discussion. The duration of anesthesia varied from 1 to 5 days depending on the pathology and averaged 2.9 days. The groups did not differ statistically by gender, age and concomitant pathology. The male sex prevailed in the trauma departments. The average age of patients was 48.75 years. In 100% of cases, effective anesthesia was observed - according to VAS, the score values after taking the painkiller in three centers varied from 0 to 3. The results of the study showed statistically significant differences in the score values on the VAS scale before and after taking the painkiller in three centers. The average score on the pain scale VAS before taking the painkiller was 6.400 in 1 center, 6.440 in 2 center and 6.467 in 3 center, after taking the painkiller - 1.650 (p=0.0012), 1.48 (p=0.0004) and 1.333 (p=0.0078), respectively. Side effects when using a fixed combination of paracetamol and tramadol (in the recommended maximum daily dosages of tramadol up to 400 mg): dizziness, nausea, vomiting, were not observed in patients in this study. Hypotension was observed in two patients (3.45% of the sample size) aged over 70 years while taking painkiller, the manifestation of which was stopped by intravenous administration of dexamethasone. Conclusions. The results of the study indicate that the fixed combination of Paracetamol 325 mg + Tramadol 37.5 mg produced by AO «Organica» (Novokuznetsk) allows for effective and safe therapy of moderate and high intensity PS and is an effective alternative to invasive medicinal forms of painkillers, while achieving a significant reduction in the side effects of the active components included in its composition.
Vrach. 2021;32(12):79-82
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The use of Osteomed, Osteomed Forte, and Osteo-Vit D3 in patients with osteoporosis: combination treatment for and prevention of fractures
摘要
An analysis of modern literature data reflecting the results using Osteomed, Osteomed Forte and Osteo-Vit D3 in the complex treatment and prevention of fractures in patients with osteoporosis.
Vrach. 2021;32(12):83-85
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Smoking behavior of adolescents
摘要
The features of adolescent smoking behavior have been studied and its dominant types have been established. The authors have undertaken an analysis of a number of scientific works considering the problem of adolescent smoking and established the risk of chronic diseases caused by smoking.
Vrach. 2021;32(12):86-88
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