Vol 27, No 2 (2023)

Acute toxoplasmosis in immunocompetent persons most often proceeds subclinically and ends with the formation of latent toxoplasmosis, which does not require therapy and observation. The presence of clinical signs of a long-term disease forces an extensive diagnostic search to exclude/confirm chronic toxoplasmosis. In the treatment of toxoplasmosis in persons without immunodeficiency, repeated courses of antiprotozoal drugs are used, which do not guarantee clinical recovery and the absence of relapses. Perinatal aspects of toxoplasmosis will be discussed in a future publication.

Inflammatory bowel diseases, which include Crohn’s disease and ulcerative colitis, according to the World Gastroenterological Organization occupy one of the leading places in the structure of diseases of the gastrointestinal tract of the rate of spread and relevance of research in most countries of the world. The currently existing therapy regimens, which are standardized depending on the form of the disease and the severity of the course, do not take into account the psycho-emotional component of the disease. Progressive course, frequent exacerbations, restriction of social activity, the presence of extra-intestinal manifestations and complications lead to early disability and significantly worsen the quality of life of patients with inflammatory bowel disease.

BACKGROUND: According to the World Health Organization the number of people aged 60 and older continues to grow, resulting in an increased demand for geriatric medical care from physicians and junior medical personnel. However, there is a shortage of geriatricians due to the complexity of interacting with older adults, limited promotion of this field by the medical profession and healthcare system as well as a lack of interest among medical students in choosing geriatrics as a future specialization.

AIM: To investigate the personal values of medical students at Saint Petersburg State University Faculty of Medicine by assessing their level of empathy and personal profile. The goal was to provide a rationale for understanding the reasons behind positive or negative attitudes towards older adults and their reluctance to work in geriatrics.

MATERIALS AND METHODS: The study involved 139 medical students at St. Petersburg State University Faculty of Medicine, aged between 17 and 29 years. The level of empathy and personal profile of the respondents were assessed using the following methods: V.V. Boyko’s “Diagnosis of Empathy Level”, I.M. Yusupova’s “Diagnosis of Empathy Level”, and the 13-factor Cattell’s Personality Test. The moral and personal attitudes of medical students towards older adults as well as their willingness to work in geriatrics, were examined through questionnaire surveys.

RESULTS: The medical students exhibited average and below-average levels of empathy, which is presumably influenced by the particularities of their personal and professional development. Analysis of the students’ personal profiles revealed emotional stability, responsibility, a sense of duty, and a certain inclination towards empathy. Although the personal profile did not solely focus on assessing the desire to help older adults, the study showed that young people’s positive response to a request for assistance from an elderly person depended on their level of openness, tolerance, trust, social group expectations and the influence of public opinion. Insufficient gerontological competence often leads students to have stereotypical views about geriatrics and a lack of clear understanding of the specific needs of this age group.

CONCLUSIONS: The obtained data can be used in methodologies and educational programs to adjust the competency, moral values and personal attitudes of medical students towards older adults. This can lead to changes in future specialists’ perspectives on specialized geriatric care and facilitate the incorporation of these recommendations in the training of general practitioners.

BACKGROUND: The high incidence of COVID-19 has been a major challenge to health systems in virtually every country in the world during the pandemic. Under these conditions, the elderly were especially vulnerable and were at risk for an unfavorable course of the disease. The elderly were not only at higher risk of contracting COVID-19 and had a worse outcome, but they could also experience reduced access to care for existing chronic noncommunicable diseases and be lost to follow-up.

АIM: The aim of the study was to identify risk factors for the development of a severe course of COVID-19 in patients aged 60 years and older who applied for outpatient care during various periods of increased incidence of COVID-19: from March 2020 to February 2022.

MATERIALS AND METHODS: The study was performed on the basis of the Center for Family Medicine of the North-Western State Medical University named after I.I. Mechnikov. A retrospective cohort study is based on an analysis of outpatient records of patients enrolled in the framework of compulsory health insurance, who applied for medical care at Center for Family Medicine and underwent COVID-19 during various periods of increased incidence, namely: from 19.03.2020 to 30.06.2020 (1st period), from 01.10.2021 to 30.11.2021 (2nd period) and from 18.01.2022 to 28.02.2022 (3rd period). Elderly patients were defined as study participants aged 60 years or older.

RESULTS: The study included 343 patients: 137 men (39.9%) and 206 women (60.1%). The number of participants aged 60 and over was 85 (24.8%). It was found that in elderly patients such non-specific symptoms of acute respiratory viral infection as nasal congestion, rhinorrhea, sore throat, increased body temperature up to 38 ℃ (р < 0.05) began to occur significantly more often. The severity of COVID-19 in elderly patients is influenced by the SARS-CoV-2 variant: the incidence of pneumonia and the number of hospitalizations were significantly less during the 3rd period of increase in the incidence (р < 0.05), and the likelihood of developing a severe course of the disease was increased in 33.4 times and 23.8 times in waves 1 and 2, respectively, in comparison with wave 3.

CONCLUSIONS: Over time, nasal congestion, rhinorrhea, sore throat, and an increase in body temperature up to 38 ℃ became significantly more common (p < 0.05). Polymerase chain reaction testing for COVID-19 should be performed in all patients with symptoms of acute respiratory disease, regardless of severity. Pneumonia and hospitalization were significantly less common during the 3rd period of increased incidence (p < 0.05), and the probability of developing a severe course of the disease was increased by 33.4 and 23.8 times in the 1st and 2nd waves, respectively, in compared to the 3rd wave. The data obtained should be taken into account when predicting severe outcomes in outpatients, developing tactics for monitoring and managing such patients.

BACKGROUND: In the Russian Federation, high mortality and unsatisfactory treatment results of elderly and senile patients with low-energy fractures have been noted. Urgent implementation of a systematic approach to the treatment and prevention of osteoporotic fractures is needed, for which it is necessary to train a large number of medical professionals involved in care of these patients.

AIM: To create a distance learning course demonstrating the importance and effectiveness of a multidisciplinary approach to the management of an elderly patient with a fracture and to evaluate its effectiveness.

MATERIALS AND METHODS: The course used the TeleECHO technology based on the analysis of specific clinical cases by a multidisciplinary team of experts. Active interaction with the audience was carried out through interactive voting. The evaluation of the effectiveness of training was carried out using a questionnaire conducted before and after the course.

RESULTS: The training was attended by doctors and health care managers from 208 regions of the Russian Federation, as well as 10 other countries, most of whom were orthopedic surgeons. A survey conducted before the course showed an unsatisfactory audience’s understanding of current approaches to the care for elderly people with fractures. Upon completion of the training, most of the participants mastered the principles of the orthogeriatric approach and were ready to implement them into their practice. 94% of the attendees expressed their willingness to participate in future sessions on this topic.

CONCLUSIONS: Distance learning of the principles of a multidisciplinary approach in the health care for elderly patients with low-energy fractures, based on participation of trainees in the discussion of specific clinical cases along with experts, will allow the widespread introduction of current principles of orthogeriatrics into clinical practice.