Russian Family Doctor

The review includes an analysis of literature data on the etiotropic therapy of chronic viral hepatitis B and C. In this review, we focused on the efficacy and safety of drugs that have been included in international and Russian guidelines for etiotropic therapy of chronic viral hepatitis B and C. The analysis of the feasibility of using antiviral drugs in real clinical practice was carried out, based on research data on the study of the mechanisms of action, efficacy and possible side effects of these drugs.

BACKGROUND: The study of the true prevalence of chronic obstructive pulmonary disease remains a significant area of research, as there is still a large gap between the official record of detected cases of the disease and epidemiological data.

AIM: To study the prevalence of chronic obstructive pulmonary disease and its risk factors in two cities in the North-West region of Russia.

MATERIALS AND METHODS: A random sample of respondents (2121 residents of Saint Petersburg, 1012 residents of Arkhangelsk); 2974 received qualitative results of spirometry (including 2388 with a bronchodilator test). The questionnaire included demographic, socioeconomic indicators, and risk factors for chronic obstructive pulmonary disease.

RESULTS: The average age (54.9 ± 9.2 and 52.3 ± 9.2 years) and the proportion of respondents with higher education (37.4% and 29.7%) were higher in Saint Petersburg (compared to Arkhangelsk, p < 0.0001). The proportion of ever smokers (49.5% and 44.4 %, p = 0.008), as well as the prevalence of chronic obstructive pulmonary disease (7.6% and 5.4%, p = 0.044), were higher in Saint Petersburg. In Arkhangelsk, exposure to biomass fuel and occupational hazards were more often noted. The prevalence of chronic obstructive pulmonary disease was higher in smokers and increased with age; the prevalence of smoking and chronic obstructive pulmonary disease was higher in men.

CONCLUSIONS: The analysis of chronic obstructive pulmonary disease risk factors allows us to better understand not only the prevalence but also the structure and significance of each risk factor in different populations, which will improve the early diagnosis of the disease.

BACKGROUND: Malnutrition is associated with decreased levels of physical function, cognitive decline, and an increased risk of all-cause mortality, making it important to identify risk factors for malnutrition, especially in old age.

AIM: To identify factors associated with an increase and decrease in the risk of developing malnutrition, as well as to assess the impact of malnutrition and its correction on mortality in older adults.

MATERIALS AND METHODS: A prospective cohort study of a random sample of 611 people aged 65 years and older. Mini Nutritional Assessment, Geriatric Depression Scale, Mini-Mental State Examination, dynamometry, Barthel Index, chronic noncommunicable diseases, clinical blood count, C-reactive protein. 2 examinations, 9 years of total follow-up.

RESULTS: Risk factors for deterioration in nutritional status are decrease in emotional status (odds ratio 5.439; 95% confidence interval 2.794–10.588), progression of autonomy decline (odds ratio 2.428; 95% confidence interval 1.342–4.393), low physical function (odds ratio 2.877; 95% confidence interval 1.577–5.250). A high level of physical function reduces the risk of malnutrition by 64.1%. Malnutrition increases the risk of five-year mortality by 2.7 times. A normal nutritional status reduces the risk of nine-year mortality by 50.2%. Improve nutrition status leads to a lower risk of mortality.

CONCLUSIONS: The main factors in the deterioration of nutritional status are a decrease in emotional status, loss of autonomy and a low level of physical function. Early detection of older adults with malnutrition and its correction can reduce the risk of mortality.

The article is devoted to the results of the internship of a postgraduate student of the Tashkent Pediatric Medical Institute at the I.I. Mechnikov Northwestern State Medical University within the framework of the inter-university cooperation program dedicated to the development of research in the field of infectious diseases and the exchange of experience in the field of medical care for a new coronavirus infection.

The purpose of the internship of a postgraduate student of the Department of Infectious Diseases, Pediatric Infectious Diseases, Phthisiology and Pulmonology Sh.A. Khasanova was studying the specifics of providing care to patients with a new coronavirus infection in St. Petersburg. The program included a visit to the departments of Infectious Diseases, family Medicine, epidemiology, and disinfection, as well as a presentation at the All-Russian Conference with international participation “Science and Practice. Why does a family doctor need clinical recommendations?”, dedicated to the 25^th anniversary of the scientific and practical journal “Russian Family Doctor”. The report highlighted the Uzbek experience of implementing measures to combat the new coronavirus infection and demonstrated their effectiveness. As part of the internship, the graduate student got acquainted with the peculiarities of providing inpatient and outpatient care to patients with COVID-19, including in-depth medical examination and the operation of the system of statistical registration of patients with a new coronavirus infection in the federal register, as well as the organization of epidemiological control in different periods of the pandemic of a new coronavirus infection.

The main result of the internship was the creation of a basis for effective and long-term cooperation between Russian and Uzbek universities in the field of scientific research and training of personnel for national health systems in the field of infectious diseases.

The article provides information about the All-Russian Conference with international participation “Science and Practice. Why does a family doctor need clinical recommendations?”, dedicated to the 25^th anniversary of the founding of the scientific and practical journal “Russian Family Doctor”. The event took place on-line in St. Petersburg on October 20, 2022. The article summarizes the content of the reports in which the main principles of creating clinical guidelines, the problems of providing medical care to elderly patients with cognitive impairments in the light of updated clinical guidelines, the planning of scientific research aimed at studying the course of a new coronavirus infection, the problems of providing medical care to elderly people with arterial hypertension, and the choice of pain relief were considered. in comorbid patients, a strategy for detecting chronic obstructive disease in the primary health care setting, the main provisions of the latest clinical guidelines for the management of patients with bronchial asthma issues of predicting fractures in patients with osteoporosis in the framework of international projects, problems of managing comorbid patients with anemic syndrome, features of managing patients with gastroesophageal reflux disease on an outpatient basis, taking into account clinical recommendations.