No 13 (2018)

Chronic constipation is a common pathology; in most countries around the world, about 12% of the total population suffer from this disease, its frequency reaches 60% in the age group over 65. The course of constipation in the elderly is burdened by age-related changes in all organ systems. Difficulties arising from the examination of patients with constipation and the appointment of additional medications are determined by polymorbidity, lack of mobility, and the intake of a variety of medicines. Attempt to create an algorithm of management for elderly patients with constipation is caused by features of the course of constipation in people of older age groups.

Background. The combination of chronic obstructive pulmonary disease (COPD) and tuberculosis (TB) is associated with the presence of common risk factors for the development of both diseases: smoking, smoke, industrial aeropollutants, low socioeconomic status; and each of them has an adverse impact on the course of the pathological process. Objective. Evaluation of the effect of various factors on the results of treatment of newly diagnosed TB in COPD patients. Methods. A simple retrospective study with participation of 514 patients was performed. Using the methods of mathematical statistics, the degree of influence of risk factors on the outcome of TB in patients with combined pathology was determined. Results. Likelihood of an unfavorable outcome is higher in case of combination of TB with COPD, the than for isolated TB (17.2 vs. 4.5%). The presence of smoking and smoking more than 20 cigarettes a day significantly increase the risk of an unfavorable outcome of TB in COPD patients. According to the ANOVA results, the factor «number of smoking years» - 23% in the total sum of the influence of all factors, high CAT-test scores -15.6%, visual analog scale - 4.2%. The cumulative effect of the trigger (smoking years-dyspnoea-CAT-test) on the outcome was 29.8% compared to the isolated effect of the signs studied. Conclusion. The use of the obtained data will allow predicting the possible outcome of TB in COPD patients, which will determine timely correction of therapy of combined pathology to improve prognosis, reduce disability and mortality.

Background. Nutrition regimen and dietary preferences, along with adequate drug therapy, are one of the most important factors in successful treatment of patients with chronic somatic pathology. Even greater importance is given in diet control and food pattern in the treatment of patients with chronic, diet-dependent diseases, when food restrictions are most significant, and deviations from them can lead to serious consequences. Objective: To evaluate the eating behavior and the effectiveness of nutrition management, including readiness for its modification, of respondents receiving or potentially needing of vitamin K-reductase inhibitors, compared to healthy volunteers and taking into account the geographic specificity of food rations. Methods. Dietary preferences and adherence to treatment were evaluated in 196 respondents (88 men, 108 women) in the cohort study by the method of questionnaire survey using authors’ questionnaires. Results. The absence of statistically significant differences in the food rations increasing (37.0±19.5 against 37.3±17.98 points, Wald-Wolfowitz (Z), р=0.16) and decreasing activity of vitamin-K-reductase inhibitors (62.2±26.3 vs. 63.4±23.8 points, Wald-Wolfowitz (Z), р=0.95) was revealed. The absence of differences also remained after assessment taking into account the regional features of nutrition (104.9±45.6 vs. 100.7±43.9 points, Wald-Wolfowitz (Z), р=0.78). It was shown that the medical recommendations aimed at correcting the eating behavior of vitamin-K-reductase inhibitor users are not effective. This can serve as an independent risk factor for complications of both the therapy using these drugs and the underlying disease. Conclusion. Further evaluation of the patients’ readiness for forced eating behavior in conditions of real clinical practice is necessary. It is recommended to use the analysis of diets controlled in local studies with a similar methodological basis for the formation of a single database with its subsequent use in comparative studies evaluating the effectiveness of interventions for nutrition correction. It is proposed to expand the studies devoted to the evaluation of the effectiveness of nutrition management in patients with functional dyspepsia, non-alcoholic fatty liver disease, ulcerative colitis, Crohn's disease, and other diseases.

Background. The level of awareness of the basis of pharmacotherapy, including knowledge of antibiotic resistance, is lacking in many practitioners. A survey of doctors studying in the cycle of advanced training on the basics of antibiotic therapy was conducted. Objective: to evaluate the knowledge of about the principles of antibacterial therapy of doctors of different specialties working at medical facilities in Omsk. Methods: survey, including questions compiled according to these instructions to medicines and Russian clinical recommendations. Test assignments were divided into 4 blocks, including questions on the basics of microbiology, clinical pharmacology of antibacterial drugs, antibiotic resistance and a strategy of control for the development of antibiotic resistance. Results. Most specialists correctly interpret the Latin names of microorganisms, but at the same time they have difficulties with the group membership of bacteria and their spectrum of action. The fewest difficulties were raised by questions concerning the group properties of antibacterial drugs. Among the most promising measures aimed at inhibition of antibiotic resistance, all specialists spoke in favor of continuing education in the basics of clinical pharmacology of antibacterial drugs and the principles of their rational use. Conclusion. The available knowledge about the features of the use of antibacterial drugs is not enough, and requires additional study.

At the stage of providing primary health care to the population, one of the most common changes in the general blood test is a decrease in the number of circulating red blood cells and/or hemoglobin per blood volume unit below the normal values for given age and sex; this is a characteristic feature of the group of diseases referred to anemias. Chronic iron deficiency anemia (IDA) occurs most often in practice of an internist. The most important aspect of the work of the therapist/general practitioner is prevention of IDA, along with its diagnosis and treatment. The article discusses the use of nutraceutical Feroglobin-B12 for IDA prevention.