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Vol 27, No 4 (2023)

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Lectures

Diagnosis and management of patients with glaucoma in general medical practice

Degtyareva L.N.

Abstract

This article describes the importance of the timely diagnosis of suspected glaucoma. Data on the frequency of glaucoma are presented. Key clinical manifestations and diagnostic actions are described. Atypical symptoms are identified separately, according to which it is possible to suspect glaucoma. Recommendations on the interaction between a general practitioner and an ophthalmologist in the treatment of glaucoma are given. The multiplicity and volume of dispensary monitoring in patients with suspected glaucoma and glaucoma are indicated.

Russian Family Doctor. 2023;27(4):5-12
pages 5-12 views

Review

Artificial intelligence in medical practice

Fil T.S.

Abstract

With state support, artificial intelligence is being intensively introduced into the healthcare sector. This review provides general information about artificial intelligence and its place in the healthcare system. A part of the lecture is devoted to the Moscow experiment on the use of computer vision in real clinical practice and the experience of the Kirov region on the use of artificial intelligence in the medical examination of the population. The lecture will be interesting to doctors and students to expand their general understanding of artificial intelligence and the possibility of its application in practical healthcare.

Russian Family Doctor. 2023;27(4):13-20
pages 13-20 views

Lesions of the heart and parenchymatous organs in patients with COVID-19 and other acute respiratory infections

Khokhlov R.A., Yarmonova M.V., Tribuntseva L.V.

Abstract

Based on available literature, this study aimed to critically assess the effect of SARS-CoV-2 and other respiratory viruses on the heart and parenchymatous internal organs, identify their common and distinctive features, assess the frequency of cytokine storm and “post-infection” syndrome, and identify risk factors for severe systemic reaction and damage to internal organs, particularly the heart.

In the databases of MEDLINE/PubMed, eLibrary, Web of Science, CyberLeninka, and Openmedcom.ru, primary information (full-text and abstract databases) in English and Russian was searched using selected keywords from 2003 to 2023.

Acute respiratory viral infection pathogens can cause not only respiratory but also cardinal, gastroenterological, neurological, and other complications.

Acute respiratory viral infections have many similarities in their effects on parenchymal organs. The emergence of new viruses requires in-depth study, and it is important to consider both the distinctive features of the clinical picture of viral infections and the general patterns of influence on internal organs. In the medium term, patients who have COVID-19 may have complex heart damage in the form of a decrease in ventricular ejection fraction, appearance of pericardial effusion, and development of various types of focal myocardial lesions. The combined nature of damage to the heart and parenchymal organs is influenced by background diseases, nature of the course of viral infection, and features of therapy. The features of lesions of parenchymal organs and the heart after acute respiratory viral infection require further study, including their effect on the development of late complications.

Russian Family Doctor. 2023;27(4):21-32
pages 21-32 views

Original studies

Prevalence of smoking and consumption of nicotine-containing products among students of medical and technical universities (PROTECT)

Pokhaznikova M.A., Kuznetsova O.Y., Ovakimyan K.V., Fatkieva R.R., Goryaeva A.Y., Andreeva E.A., Sychev A.E., Litvinova A.V., Mamonkina D.S., Skornyakova M.S.

Abstract

BACKGROUND: The study of the prevalence of the use of tobacco and nicotine-containing products among young people is an ongoing and critical area of research. This article presents the analysis of data from the pilot phase of the study “Prevalence of smoking and consumption of nicotine-containing products among students of medical and technical universities” (PROTECT), which was planned for 2023 among students of the North-Western State Medical University named after I.I. Mechnikov (Saint Petersburg), Northern State Medical University (Arkhangelsk), and Saint Petersburg State Electrotechnical University “LETI” named after V.I. Ulyanova (Lenina) (Saint Petersburg).

AIM: To examine the prevalence and patterns of the use of tobacco and nicotine-containing products, attitudes toward smoking behavior, perceptions of smoking, use of nicotine-containing products, and their effects among students.

MATERIALS AND METHODS: A cross-sectional study design was followed. An only anonymous questionnaire survey was used as the main method of research.

RESULTS: The pilot phase involved 118 respondents from randomly selected groups outside the main study sample (mean age, 20.9 ± 2.6 years, 54.2% men). The analysis included demographic data, questions about the respondent’s environment, attitudes toward smoking/use of nicotine-containing products, and perceptions of smoking/use of nicotine-containing products. Students of medical universities and technical universities accounted for 70.3% and 29.7% of the sample, respectively. In total, 73.7% of the students did not smoke or consume nicotine-containing products. Nonsmoking students were younger than cigarette smokers and/or nicotine-containing product smokers: 20.3 ± 2 vs 24.8 ± 3.4 years (р < 0.01). The proportion of students who do not use any tobacco or nicotine-containing products was higher than that of smokers (cigarette/vaping/electronic cigarette/tobacco heating systems; 73.7% vs. 26.3%). Smokers included 71.0% predominantly nicotine-containing product users and 16.1% users that smoked a combination of tobacco and nicotine-containing products. Friends of smokers smoked more often than nonsmokers (90.3% vs. 56.3%; р < 0.01). Positive or neutral attitudes toward smoking (71.0% vs 47.1%; р < 0.05), vaping (74.2% vs 45.9%; р < 0.05), and vaping relatives (45.2% vs 18.4%; р < 0.01) were more observed among smokers than among nonsmokers. Compared with nonsmokers, smokers are more likely to attribute the benefits of smoking (25.8 vs 6.9%; р < 0.05) and believe that vapors are effective as a nicotine dependence treatment (29.0% vs 9.2%; р < 0.05) and are a safe alternative to smoking (22.6% vs 6.9%; р < 0.01).

CONCLUSIONS: The developed online questionnaire is simple and understandable to respondents, and the data are correctly stored, allowing it to be used in the main phase of the study. The identified trends indicate the popularity of nicotine-containing products among students, and more detailed studies are required.

Russian Family Doctor. 2023;27(4):33-40
pages 33-40 views

Medical Education

Creation of a model for training the communication skills of medical specialists

Shubina L.B., Lopatin Z.V.

Abstract

BACKGROUND: Effective interaction between medical workers and patients is not only a service function but also influences compliance with the implementation of recommendations for the prevention and treatment of diseases. The communicative competence of healthcare professionals affects treatment effectiveness and the success of health-preserving measures.

AIM: To examine the problems associated with the formation of communicative competence and determine the fundamental principles of the model of communicative skills of a medical worker.

MATERIALS AND METHODS: A literature review of 32 domestic and 54 foreign publications on teaching communication in medicine was performed. The work of an expert focus group within the framework of a strategic session on communication skills “A coordinated approach to teaching communication skills in medicine” was analyzed.

RESULTS: During the work of the focus group, experts reviewed and specified the main shortcomings in the work of medical personnel in ensuring communication with the patient. In the second part of the focus group work, based on communication defects, four blocks of skills were developed to avoid communication errors. Because of a review of literature data and a generalization of the results of the work of experts, a prototype model of the communication skills of a medical worker was proposed.

CONCLUSIONS: Existing models of medical communication must adapt to national characteristics based on research and joint discussions. The authors propose using fundamental principles of the model of communication skills of a medical worker in educational programs of higher and additional professional education, as outlined in this article.

Russian Family Doctor. 2023;27(4):41-50
pages 41-50 views

Case report

Clinical case of benralizumab use in severe eosinophilic bronchial asthma in the Republic of Dagestan

Akhmedkhanov S.S., Gadzhiyeva S.G., Beybalayeva A.T., Saidova Z.M.

Abstract

This article presents the results of the examination, observation, and treatment of a patient with severe persistent bronchial asthma with an eosinophilic phenotype who received benralizumab (Fazenra) in a complex treatment. Benralizumab is indicated for patients with severe bronchial asthma with an eosinophilic phenotype in adult patients as an additional maintenance therapy, in which the use of glucocorticosteroids does not achieve control over the symptoms of the disease. With complex therapy, the inclusion of benralizumab led to positive dynamics of both clinical symptoms and indicators of respiratory function, which allowed us to reduce the volume of therapy with corticosteroids and achieve disease control. The above case is of interest to both pulmonologists and therapists.

Russian Family Doctor. 2023;27(4):51-58
pages 51-58 views

Obituary

In memory of Professor E.V. Frolova

Kuznetsova O.Y., Turusheva A.V., Moiseeva I.E.

Abstract

This obituary is dedicated to Professor E.V. Frolova of the Department of Family Medicine, a member of the editorial board of the Russian Family Doctor Journal.

Russian Family Doctor. 2023;27(4):59-62
pages 59-62 views


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