Vol 22, No 4 (2018)

Articles
Modern methods of treatment and rehabilitation of patients with acne vulgaris
Barinova A.N.

Abstract

The article reviews contemporary data on diagnosis and management of acne. Special attention is paid to differential diagnosis of acne and treatment of acne-like disorders. The contemporary approaches to the acne therapy are described in detail with special attention paid to the systemic treatment with hormonal contraceptives, isotretionin, antibiotics and systemic corticosteroids. The algorithms of acne management are given and also recommendations on prevention of relapses are provided.

Russian Family Doctor. 2018;22(4):5-18
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The experience of workflow optimization of the city polyclinic based on the principles of lean production and IT-based management
Grigorovich M.S., Starikov A.V., Voytko S.N., Koykova L.A., Nekrasova N.Y.

Abstract

The article presents the main principles of lean manufacturing, experience and results of lean production launch in a large city outpatient clinic as part of the Ministry of Health pilot project “Lean outpatient clinic”. In the clinic, redistribution of space, optimization of e-document management and registry workflow were performed. It reduced queueing time and time of blood sampling, simplified arranging a visit to General practitioner and other physicians, increased time of doctor and patient interaction, which allowed to serve much more patients with the same amount of resources, save time of medical staff and patients, and increase their satisfaction.

Russian Family Doctor. 2018;22(4):19-24
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The defeat of the temporal bone in Paget’s disease as a cause of hearing loss in elderly and senile age
Ivanov S.A., Zhuravskii S.G.

Abstract

Paget’s disease of bone is a localized disorder of bone remodeling. These functional and structural alterations, interacting with the specific characteristics of the site of involvement, account for most of the complications of the disease. Bilateral progressive hearing loss is the most frequently encountered complication of Paget’s disease, because of the involvement of the temporal bones. There may be difficulty in distinguishing patients with presbycusis from those with Paget’s disease-related hearing loss. Pagetic hearing loss seems to be stabilized by effective medical treatment. For patients with severe hearing loss, cochlear implantation may be recommended.

Russian Family Doctor. 2018;22(4):25-30
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Dynamic electroneurostimulation in the treatment of knee osteoarthritis
Kadochnikova E.Y., Lesnyak O.M.

Abstract

Transcutaneous electroneurostimulation is an effective method of chronic pain relief. Dynamic electrical neurostimulation is a type of transcutaneous electroneurostimulation based on the use of weak (200–400 mkA) low frequency (10–200 Hz) pulse currents. A feature of this type of physiotherapy is the pulse shape, which changes following the change of the total electrical resistance of underelectrode skin area, which enables prolonged use without “addiction”. A multicenter randomized double-blind placebo-controlled study with 132 patients was conducted. Dynamic electrical neurostimulation led to a rapid decrease in the intensity of pain in the knee joint by an average of 5–8 mm on a visual-analogue scale immediately after the end of the procedure in the absence of pain dynamics of the procedure performed by the placebo. After completing the course of treatment from 10 procedures during the month of follow-up, the intensity of pain according to visual-analogue scale in patients of the dynamic electrical neurostimulation group was lower than in placebo. The decrease in pain intensity was also accompanied by a decrease in the time of the “Get up and go” test and an improvement in the Leken index. The statistically significant difference between the groups in the time of the “Stand up and go” test appeared at the end of the course of therapy and persisted for a month after the end of the course of therapy. Dynamic electrical neurostimulation is an effective and safe method for reducing pain and improving the function of the knee joint in patients with
osteoarthritis.

Russian Family Doctor. 2018;22(4):31-36
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Harmful and hazardous alcohol consumption among individuals with high risk of HIV infection
Plavinskii S.L., Ladnaya N.N., Zaytseva E.E., Barinova A.N.

Abstract

Hazardous and harmful alcohol consumption was studied in high-risk groups for HIV infection acquisition using respondent-driven sampling and time-location sampling in 7 regions of Russian Federation. The prevalence of hazardous and harmful alcohol consumption was high with regional variations. Prevalence of hazardous and harmful alcohol consumption was highest among injection drug users in Tomsk (89.96% (95 % CI 87.14–92.78%)) and lowest among men who have sex with men in St. Petersburg (43.31% (95% CI 37.03–49.59%)). In general about two thirds of the groups reported hazardous and harmful alcohol consumption. As a marker of unsafe sexual behavior the answer to the question about non-use of condom was selected. There was heterogeneity among regions especially in female sex-workers reports. Use of meta-analytic summarization showed that people that reported hazardous and harmful alcohol consumption had tendency to more risky sexual behavior, though results were not statistically significant due to high prevalence of hazardous and harmful alcohol consumption. These results show need to incorporate screening for hazardous and harmful alcohol consumption into prevention programs for high-risk individuals.

Russian Family Doctor. 2018;22(4):37-48
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Problems of general practice in the materials of the XXVIII National congress on respiratory diseases(October 16-19, 2018, Moscow)
Brimkulov N.N., Belevsky A.S.

Abstract

The article highlights the problems of the relationship between the general practitioners and specialists-pulmonologists, which were discussed in the framework of the XXVIII National Congress on Respiratory Diseases, held in Moscow on October 16–19, 2018. Outlines the main provisions of the reports of the School “Problems of pulmonology in the work of the general practitioner”, highlights the activities of the Association of Russian-speaking specialists in respiratory medicine (ARSRM), focused on the development of pulmonology in general practice.

Russian Family Doctor. 2018;22(4):49-52
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