Vol 22, No 1 (2018)

Herpes virus infections caused by lymphotropic viruses (EBV, CMV, HHV-6, HHV-7, HHV-8). Part III
Neverov V.A., Demidenko T.P., Vasiliev V.V.

The lecture addresses the issues of provision of medical care and treatment to patients affected with herpes diseases caused by lymphotropic viruses (Epstein-Barr virus, cytomegalovirus, human herpesvirus-6, human herpesvirus-7, human herpesvirus-8).

Russian Family Doctor. 2018;22(1):5-11
Comparison of measurement results are obtained with dynamometers DK-50 and JAMAR® Plus
Turusheva A.V., Frolova E.V., Degryse J.

Introduction. Grip strength is a reflection not only of the strength of the hands, but also the strength of the muscles of the whole body, the functional capabilities of the body and an important diagnostic marker of the overall health of a person. The aim of this work was to compare the measurements obtained with the DK-50 and JAMAR® Plus digital handheld dynamometers.

Methods. A convenience sample was used of 94 health participants, men and women, aged from 15 to 65 years old. Grip strength of a dominant hand was conducted using a carpal mechanical dynamometer DK-50 (Nizhni Tagil, Russian Federation) and JAMAR® Plus digital handheld dynamometer. The simple Pearson correlation test, linear regression method and the procedure of Bland and Altman were used to estimate difference between an average value of results of measurements of grip strength (AGS) and maximum measurement of grip strength (MGS) of the dominant hand of two dynamometers.

Results. The grip strength using JAMAR® Plus dynamometer was higher than with the DK-50 dynamometer by 5.6 ± 4.2 kg for the average grip strength (AGS) and by 6.7 ± 4.3 kg for the maximum grip strength (MGS). The formulas for transferring the data of the car dynamometry of the DK-50 dynamometer to the values obtained from the JAMAR® Plus dynamometer are calculated: AGS JAMAR® Plus = = 1,7874 + 1,1208 × AGS DK-50 and MGS JAMAR® Plus = 1.7667 + 1, 1275 × MGS DK-50.

Conclusion. For avoiding errors in the interpretation of the results from different studies, it is necessary to take into account which type of dynamometer was used. The resulting formulas (AGS JAMAR® Plus = = 1,7874 + 1,1208 × AGS DK50 and MGS JAMAR® Plus = 1,7667 + 1,1275 × MGS DK50) can be used to correct the data of the dynamometer DK-50 for value of JAMAR® Plus dynamometer and to compare the results of Russian studies with data from foreign studies organized using JAMAR® Plus dynamometers.

Russian Family Doctor. 2018;22(1):12-17
Detection of exacerbactions of chronic obstructive lung disease in the ambulatory practice
Maliavko N.S., Shatyi N.O., Alagova E.V., Pokhaznikova M.A., Lebedev A.K.

The article presents the results of a retrospective study aimed at identifying exacerbations in outpatients with chronic obstructive pulmonary disease (COPD) during the previous 12 months. А telephone interview was conducted with 20 patients with COPD from the departments of general medical practice of three polyclinics in the Kalininsky district of St. Petersburg. The obtained data were compared with records in outpatient cards to determine the presence of registered cases of appeals to the polyclinic for exacerbation of the disease.

7 patients (35%) were identified retrospectively using the questionnaire, which can be attributed to the phenotype of COPD with frequent exacerbations. Among them, five people were hospitalized in a hospital for exacerbation of COPD, and two patients had 2 or more exacerbations in an outpatient card that did not lead to hospitalization. In 5 patients (33%), among those who were not in hospital for an exacerbation of COPD for the previous 12 months, indirect signs of low self-esteem were revealed, indicating that it is necessary to raise awareness of the exacerbation of COPD and the education patients self-management skills.

Russian Family Doctor. 2018;22(1):18-22
The evaluation of the physical characteristics of young football players
Turusheva A.V., Gora D.A., Rasmagina I.A., Vlaskina K.O., Berezovskaya V.A., Partnova N.V.

Introduction. Regular physical activity impacts on growth, development and health of children and adolescents. This study has been conducted with the aim of evaluating the physical characteristics of adolescents, who play football using the regional and WHO normative data.

Methods. Сomplete sample of 64 adolescents borned in 2002–2005 from the football sport school were assessed. Main study parameters: height, body mass, BMI, fat mass, skeletal muscle mass fat free mass and water. Comparison analysis was performed using the regional and WHO normative data.

Results. Participants of the present study was higher and heavier, but had a low level of body fat compared with the regional normative data for adolescents of this age. Depending on the method used, adolescents were defined to different centile groups for height, weight, BMI and fat mass. The agreement between regional and WHO data for height was poor with, a kappa coefficient of 0.17 for 12 years group, for 13 years — 0.56, for 14 years — 0.75, for 15 years and older — 0.90–100% of participants were overweight or BMI above normal range according to the regional or WHO normative data. At the same time, 30% of 13-year-olds, 50% of 14-year-olds and 100% of 15-year-olds and older had a deficit of fat mass according to the regional normative data. Using the normative data of fat mass for young athletes, a deficit of fat mass was discovered in 5% of 12-year-olds, in 47% of 13-year-olds and in 10% of 15-year-olds and older.

Conclusion. Playing football contribute to changing the proportions of the body, reducing fat and increasing muscle mass in the body of adolescents. Therefore, to assess the physical development of adolescents involved in sports, it is necessary to evaluate not only height, weight and BMI, but also fat and muscle mass. Using of general population normal ranges for assessing the physical development of this group of adolescents can lead to hypo- and overdiagnosis of overweigth and malnutrition.

Russian Family Doctor. 2018;22(1):23-31
Dependence of the risk of falls increasing from quantity of medication in elderly and old patients
Karaeva E.V.

Falls in elderly and senile patients increase as the population ages. The highest frequency is observed in “fragile” patients with several geriatric syndromes and comorbid pathology.

Today we have a serious problem remains the lack of awareness of doctors of all specialties about increasing the risk of osteoporotic fractures, femoral neck fractures and total mortality when taking 3 or more drugs in this category of patients. Therefore, it is necessary to consult a geriatric physician to correct therapy and reduce the risk of side effects of polypragmasy.

Russian Family Doctor. 2018;22(1):32-35
Features of cognitive disorders in elderly and old patients with hypertension
Sharashkina N.V., Ostapenko V.S., Runikhina N.K.

Aim. To assess cognitive status of the elderly and old patients with arterial hypertension, in outpatient setting. Material and methods. Totally, 356 patients included, age 74,9 ± 6,1 y., 80,4% females. For cognition assessment before and after the treatment, neuropsychological test was done, with MMSE — short scale of psychic status assessment, drawing test; literal and categoric associations test.

Results. In the group <80 y. o. The prominence of MMSE disorders correlated with blood pressure values (BP): for systolic BP (r = –0,22, p = 0,0003), for diastolic BP (r = –0,13, p = 0,03), i.e. in higher BP patients there were lower points in cognition scale by Spearman correlation. In the group ≥80 y. both correlations were non-significant, for systolic BP (r = –0,05, p = 0,64), and for diastolic BP (r = –0,13, p = 0,25). Conclusion. In older age and senile patients with arterial hypertension there should be differential approach to BP management according to the age and cognition disorders, complex approach to treatment in these patients might prevent further worsening of cognitive decline.

Russian Family Doctor. 2018;22(1):36-40

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