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Association of visual, hearing and olfactory impairments with survival and quality of life of elderly people 视觉、听觉和嗅觉障碍与老年人生存和生活质量的关系
Pub Date : 2022-08-26 DOI: 10.17816/rfd108154
E. Frolova
The review is devoted to the analysis of publications on the problems of sensory disorders in elderly and senile people. Sensory disorders, which include violations of tactile sensitivity, hearing, smell, taste, visual impairment, are widespread in old age, and are associated with unfavorable aging options. These disorders are associated with other geriatric syndromes, affect the quality of life, morbidity and mortality in the elderly and senile age. The author reviews publications on hearing, vision and olfaction disorders.
这篇综述专门分析了关于老年人和老年人感觉障碍问题的出版物。感觉障碍,包括触觉、听觉、嗅觉、味觉和视觉障碍的侵犯,在老年人中普遍存在,并与不利的衰老选择有关。这些疾病与其他老年综合症有关,影响老年人的生活质量、发病率和死亡率。作者回顾了有关听觉、视觉和嗅觉障碍的出版物。
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引用次数: 0
A case of bronchial asthma in a patient with long-term cough 长期咳嗽患者支气管哮喘1例
Pub Date : 2022-08-26 DOI: 10.17816/rfd104664
I. V. Yubrina, I. Bozhkov, L. Degtyareva, D. V. Karostik
BACKGROUND: The regulatory documents determining the phthisiatric care for population do not provide diagnostics and treatment of comorbid somatic pathology with tuberculosis in tuberculosis dispansery. If patients with diagnosed tuberculosis or suspected tuberculosis need therapeutic specialists consultation, they have to be referred to the district polyclinic working in the medical insurance system. So, timeliness of diagnostics and chronic diseases management decreases. The course of tuberculosis becomes more complicated and lengthened. At the same time tuberculosis specificities are not taken in to account complicating comorbid pathology. For effective diagnostics and treatment tuberculosis and comorbid pathology the special algorithms of patient management were develop in Tuberculosis Dispensary No. 5. AIM: To describe the clinical case of bronchial asthma in a 35 year old female patient as an example of effective interdisciplinary communication between general practitioner, phthisiatrician and specialists of therapeutic profile. MATERIALS AND METHODS: Patients with suspected tuberculosis are comprehensively examined by the phthisiatrician and therapeutic profile specialists according to special developed algorithms of diagnostic search at Tuberculosis Dispensary No. 5. RESULTS: The patient with long-term cough was comprehensively examined. Within a short time tuberculosis was excluded, bronchial asthma was diagnosed. The effective treatment of asthma and a plan of further patient flow-up in the district polyclinic was recommended. CONCLUSIONS: An experience of the interdisciplinary communication phthisiatricians and specialists of therapeutic profile who have entered the department of medical-social care and rehabilitation demonstrated the relevance and appropriateness in diagnostics of tuberculosis and concomitant chronic uninfection diseases, that let minimize risks of cross adverse effects and choose the optimal tactics of patient management.
背景:确定人群肺结核护理的规范性文件没有提供结核病医院肺结核共病躯体病理的诊断和治疗。如果确诊结核病或疑似结核病的患者需要治疗专家会诊,他们必须转介到在医疗保险系统内工作的地区综合诊所。因此,诊断和慢性病管理的及时性降低。结核病的病程变得更加复杂和延长。同时,结核病的特异性并没有考虑到并发症的病理。为有效诊断和治疗结核病及其共病病理,第五结核病诊疗所制定了特殊的患者管理算法。目的:描述一名35岁女性支气管哮喘患者的临床病例,作为全科医生、眼科医生和治疗概况专家之间有效的跨学科沟通的一个例子。材料和方法:疑似结核病患者由肺结核医生和治疗侧写专家根据特殊开发的诊断搜索算法在5号结核病药房进行全面检查。结果:对长期咳嗽患者进行了全面检查。短时间内排除了肺结核,诊断为支气管哮喘。建议对哮喘进行有效治疗,并计划进一步在地区综合诊所进行患者流动。结论:通过对进入医疗-社会护理和康复科的临床医师和具有治疗背景的专家进行跨学科交流的经验,证明了结核病和伴随的慢性非感染性疾病诊断的相关性和适宜性,可以最大限度地降低交叉不良反应的风险,并选择最佳的患者管理策略。
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引用次数: 0
Comparative analysis of risk factors for hip fracture in patients of different nationalities living in Kazakhstan 哈萨克斯坦不同国籍患者髋部骨折危险因素的比较分析
Pub Date : 2022-08-26 DOI: 10.17816/rfd108304
S. Issayeva, O. Lesnyak, B. Issayeva, D. Dilmanova, Meruyert A. Bissembay, Gaukhar A. Burakhanova
BACKGROUND: Osteoporosis is a multifactorial systemic skeletal disease characterized by a decrease in bone strength leading to an increased risk of fractures. Hip fracture is a serious complication of osteoporosis. It is expected in Kazakhstan by 2050 the annual number of hip fracture will increase by 140% compared to 2015 data and will amount to 28,048 cases. There are differences in the incidence of fractures and low bone mineral density in different ethnic groups. However, low bone mineral density is only one of many risk factors for osteoporotic fractures. AIM: To study the risk factors of osteoporosis and related osteoporotic fractures in patients with hip fracture living in Kazakhstan. MATERIALS AND METHODS: The case-control study included 98 patients with hip fracture of Kazakh (main group, n = 49) and other nationalities (control group, n = 49). In the registration card, risk factors for osteoporosis and osteoporotic fractures from the Fracture Risk Assessment (FRAX) model were distinguished, and the Find cases Assess Confirm Severity algorithm (2019) was used to diagnose sarcopenia. Statistical analysis was carried out using the Statistics 26 (IBM SPSS, США). RESULTS: The groups were comparable in terms of gender, disability, fracture location and functional activity, surgical treatment. An increase in cases of hip fracture at an older age was found in the main group than in the control group (р = 0.035). There were no differences in the groups for clinical risk factors for osteoporotic fractures (body weight, height, history of fractures, family history of fractures, medication, comorbidity), except for smoking (lower in Kazakhs than in the other group) (р = 0.033). Differences in 10-year probability of major osteoporotic fracture and hip fracture between groups (р = 0.34 and р = 0.74) were not found. The proportion of patients who entered the intervention threshold and at low risk did not differ in the groups (р = 0.623). The average SARC-F (Strength, Assistance with walking, Rise from a chair, Climb stairs and Falls) score was lower among Kazakhs (р = 0.011), there is a difference between the groups when walking (р = 0.044), climbing stairs (р = 0.003). A decrease of grip strength was noted in the main group (р = 0.008), especially in men (р = 0.011), but low grip strength (р 0.001) and signs of sarcopenia (р 0.001) were determined only by age, not nationality. CONCLUSIONS: The Fracture Risk Assessment (FRAX) model and intervention threshold can be applied to all residents of Kazakhstan.
背景:骨质疏松症是一种多因素的全身性骨骼疾病,其特征是骨强度降低导致骨折风险增加。髋部骨折是骨质疏松症的严重并发症。预计到2050年,哈萨克斯坦每年髋部骨折的数量将比2015年的数据增加140%,达到28,048例。不同民族的骨折和低骨密度发生率存在差异。然而,低骨密度只是骨质疏松性骨折的众多危险因素之一。目的:探讨哈萨克斯坦髋部骨折患者骨质疏松及相关骨质疏松性骨折的危险因素。材料与方法:病例-对照研究纳入哈萨克族(主组,n = 49)和其他民族(对照组,n = 49)髋部骨折患者98例。在登记卡中,从骨折风险评估(FRAX)模型中区分骨质疏松症和骨质疏松性骨折的危险因素,并使用查找病例评估确认严重程度算法(2019)诊断肌肉减少症。采用Statistics 26 (IBM SPSS, США)进行统计分析。结果:两组在性别、残疾、骨折位置和功能活动、手术治疗等方面具有可比性。治疗组髋部骨折的发生率明显高于对照组(p < 0.035)。骨质疏松性骨折的临床危险因素(体重、身高、骨折史、骨折家族史、用药、合病)各组间无差异,但吸烟(哈萨克族低于其他组)差异无统计学意义(χ = 0.033)。两组间发生重大骨质疏松性骨折和髋部骨折的10年概率差异无统计学意义(分别为0.34和0.74)。进入干预阈值和低风险的患者比例在两组间无差异(χ = 0.623)。哈萨克族的平均SARC-F(力量,辅助行走,从椅子上站起来,爬楼梯和跌倒)得分较低(0.011),行走(0.044)和爬楼梯(0.003)组之间存在差异。在主要组中发现握力下降(0.008),特别是男性(0.011),但握力低(0.001)和肌肉减少症的迹象(0.001)仅由年龄决定,而不是由国籍决定。结论:FRAX模型和干预阈值适用于哈萨克斯坦所有居民。
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引用次数: 0
Beta-blockers in elderly patients: neuroprotective effect or risk of cognitive decline? -受体阻滞剂在老年患者中的作用:神经保护作用还是认知能力下降的风险?
Pub Date : 2022-08-26 DOI: 10.17816/rfd108434
T. Bogdanova, A. Turusheva
BACKGROUND: Due to the fact that the number of elderly people with cognitive disorders is steadily increasing worldwide, there is an increased interest in studying the effects of drugs of different pharmacological groups on cognitive function. For many years, beta-blockers have been one of the main groups in the therapy of cardiovascular diseases. The effect of beta-blockers on cognitive function has been studied for a long time, and there is different, sometimes contradictory data on this issue. AIM: To evaluate the incidence of cognitive impairment in elderly and to determine the associations between cognitive impairment and the beta-blockers use. MATERIALS AND METHODS: Cross-sectional study included all patients aged 60 years and older who attended the ambulance care from 24.10.2019 to 15.12.2019 at the polyclinic No. 78 in Saint Petersburg. Measurements: the Montreal cognitive assessment (MoCA) test, the 15-item Geriatric Depression Scale. Data collection included a full medical history, a medication review and questionnaire. RESULTS: The prevalence of cognitive impairment among the study participants was 71.1% (n = 138). Сognitive impairment was associated with high blood pressure and a history of stroke (p 0.05). Beta-blockers use was associated with decreased in total MoCA score, fluency (p = 0.0115), thinking (p = 0.0012), and memory (p = 0.0040). The identified association remained statistically significant after adjusting for gender, age, high blood pressure, a history of stroke, level of education, and decreased emotional background with odds ratio 2.245 (95% confidence interval 1.1564.358) for the fluency test and coefficient of regression 0.781 (95% confidence interval [1,233][0,328]) for delayed memory. CONCLUSIONS: Memory impairment (coefficient of regression 0.781, 95% confidence interval 1.233 to 0.328) and decreased fluency (odds ratio 2.245; 95% confidence interval 1.1564.358) were observed in the study in the outpatient elderly patient population taking beta-blockers. The beta-blockers may lead to memory impairment. When choosing hypotensive therapy, all possible effects of beta-blockers should be considered, including the effect on cognitive status.
背景:由于世界范围内患有认知障碍的老年人数量正在稳步增加,研究不同药理学组药物对认知功能的影响的兴趣越来越大。多年来,受体阻滞剂一直是治疗心血管疾病的主要药物之一。受体阻滞剂对认知功能的影响已经研究了很长时间,在这个问题上有不同的,有时甚至是相互矛盾的数据。目的:评估老年人认知功能障碍的发生率,并确定认知功能障碍与β受体阻滞剂使用之间的关系。材料与方法:横断面研究包括2019年10月24日至2019年12月15日在圣彼得堡第78号综合诊所接受救护车护理的所有60岁及以上患者。测量方法:蒙特利尔认知评估(MoCA)测试,15项老年抑郁量表。数据收集包括完整的病史、药物回顾和问卷调查。结果:研究参与者中认知障碍的患病率为71.1% (n = 138)。Сognitive损伤与高血压和卒中史相关(p < 0.05)。β受体阻滞剂的使用与MoCA总分、流畅性(p = 0.0115)、思维(p = 0.0012)和记忆力(p = 0.0040)的下降有关。在调整性别、年龄、高血压、中风史、教育水平和情绪背景后,所确定的关联仍然具有统计学意义,流畅性测试的优势比为2.245(95%可信区间为1.1564.358),延迟记忆的回归系数为0.781(95%可信区间为[1,233][0,328])。结论:记忆障碍(回归系数0.781,95%可信区间1.233 ~ 0.328)和流畅性下降(优势比2.245;95%可信区间为1.1564.358)。受体阻滞剂可能会导致记忆障碍。在选择降压治疗时,应考虑-受体阻滞剂的所有可能影响,包括对认知状态的影响。
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引用次数: 0
Etiotropic therapy of the new coronavirus infection. Expectations and realities. Part 2 新型冠状病毒感染的致病因治疗。期望和现实。第2部分
Pub Date : 2022-08-26 DOI: 10.17816/rfd108485
O. Kuznetsova
Part 2 of the review includes an analysis of the literature data related to the etiotropic therapy of a new coronavirus infection using drugs from the group of monoclonal antibodies and viral protease inhibitors. The difficulty of choosing a drug for the treatment of a new coronavirus infection caused by the Omicron strain due to the high degree of mutation is emphasized. The mechanism of action of the combined drug Paxlovid, consisting of nirmatrelvir and ritonavir, is described, data on its high efficacy and safety obtained in randomized multicenter placebo-controlled trials are presented. Attention is drawn to the World Health Organization recommendations on the use of this drug in people at high risk of a severe course of a new coronavirus infection and the need for early diagnosis of clinical symptoms for the timely appointment of etiotropic therapy.
第二部分综述了利用单克隆抗体和病毒蛋白酶抑制剂组药物治疗新型冠状病毒感染的相关文献资料。强调了由Omicron毒株引起的新型冠状病毒感染由于高度变异而难以选择治疗药物的问题。介绍了由尼马特利韦和利托那韦组成的联合药物Paxlovid的作用机制,并介绍了在随机多中心安慰剂对照试验中获得的高疗效和安全性的数据。提请注意世界卫生组织关于在新型冠状病毒感染严重病程高风险人群中使用该药物的建议,以及需要早期诊断临床症状以便及时预约致病因治疗。
{"title":"Etiotropic therapy of the new coronavirus infection. Expectations and realities. Part 2","authors":"O. Kuznetsova","doi":"10.17816/rfd108485","DOIUrl":"https://doi.org/10.17816/rfd108485","url":null,"abstract":"Part 2 of the review includes an analysis of the literature data related to the etiotropic therapy of a new coronavirus infection using drugs from the group of monoclonal antibodies and viral protease inhibitors. The difficulty of choosing a drug for the treatment of a new coronavirus infection caused by the Omicron strain due to the high degree of mutation is emphasized. The mechanism of action of the combined drug Paxlovid, consisting of nirmatrelvir and ritonavir, is described, data on its high efficacy and safety obtained in randomized multicenter placebo-controlled trials are presented. Attention is drawn to the World Health Organization recommendations on the use of this drug in people at high risk of a severe course of a new coronavirus infection and the need for early diagnosis of clinical symptoms for the timely appointment of etiotropic therapy.","PeriodicalId":432054,"journal":{"name":"Russian Family Doctor","volume":"303 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132691192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Atypical fracture of the femur in a patient with postmenopausal osteoporosis after four injections of zoledronic acid 绝经后骨质疏松患者注射四次唑来膦酸后的非典型股骨骨折
Pub Date : 2022-04-29 DOI: 10.17816/rfd100999
E. Gladkova, O. Lesnyak
Bisphosphonates are one of the most effective medications widely used in the treatment of osteoporosis. In the last 15 years, descriptions, and observations of unusual low-energy femoral fractures with atypical localization for osteoporosis after prolonged use of these drugs have been published. A 78-year-old patient applied to the osteoporosis center. She received parenteral bisphosphonate therapy for severe osteoporosis for 4 years. In 2017, a spontaneous fracture of the middle third of the femoral shaft was registered (the fracture occurred while walking). Regarding the fracture, metal osteosynthesis with a plate was performed. Subsequently, there was a delayed consolidation of the fracture with the formation of a false joint and the need for repeated surgical intervention. Examination of the patient revealed vitamin D deficiency, and significant negative trend in densitometry. A feature of this case is poor fracture consolidation and long-term uncompensated vitamin D deficiency. Physicians should be aware of this rare but serious complication of bisphosphonate therapy, as it requires discontinuation of antiresorptive drugs and the appointment of bone anabolic therapy for osteoporosis, which, in addition to treating the underlying disease, also promotes consolidation fracture.
双膦酸盐是治疗骨质疏松症最有效的药物之一。在过去的15年里,长期使用这些药物后,出现了罕见的低能量股骨骨折并伴有骨质疏松症的非典型定位的描述和观察。一位78岁的病人向骨质疏松症中心提出申请。她因严重骨质疏松症接受了4年的双膦酸盐静脉注射治疗。2017年,记录了股骨干中三分之一的自发性骨折(骨折发生在行走时)。对于骨折,行金属接骨板。随后,骨折延迟巩固,形成假关节,需要反复手术干预。患者检查发现维生素D缺乏,密度测定有明显的阴性趋势。该病例的特点是骨折愈合不良和长期无补偿性维生素D缺乏症。医生应该意识到这种罕见但严重的双膦酸盐治疗并发症,因为它需要停止抗吸收药物并预约骨质疏松症的骨合成代谢治疗,这除了治疗潜在疾病外,还会促进实变骨折。
{"title":"Atypical fracture of the femur in a patient with postmenopausal osteoporosis after four injections of zoledronic acid","authors":"E. Gladkova, O. Lesnyak","doi":"10.17816/rfd100999","DOIUrl":"https://doi.org/10.17816/rfd100999","url":null,"abstract":"Bisphosphonates are one of the most effective medications widely used in the treatment of osteoporosis. In the last 15 years, descriptions, and observations of unusual low-energy femoral fractures with atypical localization for osteoporosis after prolonged use of these drugs have been published. \u0000A 78-year-old patient applied to the osteoporosis center. She received parenteral bisphosphonate therapy for severe osteoporosis for 4 years. In 2017, a spontaneous fracture of the middle third of the femoral shaft was registered (the fracture occurred while walking). Regarding the fracture, metal osteosynthesis with a plate was performed. Subsequently, there was a delayed consolidation of the fracture with the formation of a false joint and the need for repeated surgical intervention. Examination of the patient revealed vitamin D deficiency, and significant negative trend in densitometry. \u0000A feature of this case is poor fracture consolidation and long-term uncompensated vitamin D deficiency. Physicians should be aware of this rare but serious complication of bisphosphonate therapy, as it requires discontinuation of antiresorptive drugs and the appointment of bone anabolic therapy for osteoporosis, which, in addition to treating the underlying disease, also promotes consolidation fracture.","PeriodicalId":432054,"journal":{"name":"Russian Family Doctor","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122296866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Disorder of the intestinal microbial tissue complex after a new coronavirus infection as an interdisciplinary problem 新型冠状病毒感染后肠道微生物组织复合体的紊乱是一个跨学科问题
Pub Date : 2022-04-29 DOI: 10.17816/rfd101087
M. Grigorovich
The occurrence of diarrhea in comorbid patients with COVID-19 infection against the background of microbiocenosis disorders may be a factor in the worse outcome of the disease. The biggest threat posed by diarrhea is dehydration. Evaluation, control and timely correction of disorders of the gastrointestinal tract, allowing to identify signs associated with dehydration, impaired water and electrolyte balance, intestinal microecology and phenomena of increased epithelial permeability. It is important to consider the risk of diarrhea in patients undergoing massive therapy for COVID-19. On the example of a specific clinical case, the most common mistakes in managing patients with acute/persistent diarrhea are analyzed. The tactics of managing a patient with diarrheal syndrome after a COVID-19 infection has been defined and substantiated, the importance of a holistic approach to solving patient problems from the standpoint of the one health concept has been substantiated.
在微生物群落疾病背景下,COVID-19感染合并症患者出现腹泻可能是导致疾病预后恶化的一个因素。腹泻造成的最大威胁是脱水。评估、控制和及时纠正胃肠道疾病,以识别与脱水、水电解质平衡受损、肠道微生态和上皮通透性增加现象相关的迹象。重要的是要考虑接受COVID-19大规模治疗的患者腹泻的风险。结合一个具体的临床病例,分析了急性/持续性腹泻患者管理中最常见的错误。COVID-19感染后腹泻综合征患者的管理策略已经确定并得到证实,从一个健康概念的角度出发,采用整体方法解决患者问题的重要性已经得到证实。
{"title":"Disorder of the intestinal microbial tissue complex after a new coronavirus infection as an interdisciplinary problem","authors":"M. Grigorovich","doi":"10.17816/rfd101087","DOIUrl":"https://doi.org/10.17816/rfd101087","url":null,"abstract":"The occurrence of diarrhea in comorbid patients with COVID-19 infection against the background of microbiocenosis disorders may be a factor in the worse outcome of the disease. The biggest threat posed by diarrhea is dehydration. Evaluation, control and timely correction of disorders of the gastrointestinal tract, allowing to identify signs associated with dehydration, impaired water and electrolyte balance, intestinal microecology and phenomena of increased epithelial permeability. It is important to consider the risk of diarrhea in patients undergoing massive therapy for COVID-19. \u0000On the example of a specific clinical case, the most common mistakes in managing patients with acute/persistent diarrhea are analyzed. The tactics of managing a patient with diarrheal syndrome after a COVID-19 infection has been defined and substantiated, the importance of a holistic approach to solving patient problems from the standpoint of the one health concept has been substantiated.","PeriodicalId":432054,"journal":{"name":"Russian Family Doctor","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128677130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pros and cons of using face masks for non-specific prevention of new coronavirus infection 使用口罩非特异性预防新型冠状病毒感染的利弊
Pub Date : 2022-04-29 DOI: 10.17816/rfd101091
N. I. Kuznetsov, I. Moiseeva
The article is devoted to the analysis of literature data regarding both the positive value of the use of masks during a pandemic caused by the SARS-CoV-2 and the negative effect that occurs when wearing masks. The analyzed data of studies on the effectiveness of the use of personal protective equipment in the form of masks did not indicate their type. The results of most studies have shown that the positive effect of using masks exceeds the identified short-term deviations in the physiological parameters of the body due to their use.
本文致力于分析在SARS-CoV-2引起的大流行期间使用口罩的积极价值和佩戴口罩产生的负面影响的文献数据。对口罩形式的个人防护装备使用有效性的研究分析数据没有显示其类型。大多数研究的结果表明,使用口罩的积极作用超过了因使用口罩而确定的身体生理参数的短期偏差。
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引用次数: 0
The impact of vaccination against the new coronavirus infection on the morbidity of university students 新型冠状病毒感染疫苗接种对大学生发病率的影响
Pub Date : 2022-04-29 DOI: 10.17816/rfd99623
S. Sayganov, A. Lubimova, A. V. Meltser, Z. Lopatin, O. Kuznetsova, O. Kovaleva
BACKGROUND: Vaccination is currently considered the most successful strategy against the SARS-CoV-2 virus. However, cases of infection despite vaccination, so-called breakthrough infections, have been reported worldwide. AIM: To evaluate the impact of vaccination against the new coronavirus infection COVID-19 on the morbidity of university students. MATERIALS AND METHODS: The incidence of new coronavirus infection (COVID-19) among the students of North-Western State Medical University named after I.I. Mechnikov (further University) from September 1 to December 15, 2020 and 2021 was analyzed. There were 4876 and 4681 students under observation. Data on vaccination, probable site of transmission infection were collected by interviewing the ill people. Statistical processing of data was performed using EpiInfo software. RESULTS: For the analyzed period 191 cases of COVID-19 among students were detected, the incidence of COVID-19 was 4.08 per 100 students, for the same period of the academic year 2020 it was 5.50, despite the fact that the incidence among St. Petersburg residents in 2021 was 1.75 times higher than in 2020. Re-infection was detected in 35 (18.3%) cases, 18 of whom were also vaccinated against COVID-19. A probable place of transmission infection was established in 36.1% of the cases, the most frequent being contact with a patient at their place of work in a health-care facility. By December 15, 2021, a total of 62.8% of students had been vaccinated against COVID-19. The incidence among vaccinated students was 2.72 per 100 students and 4.94 per 100 among unvaccinated students. A risk factor for breakthrough infections after vaccination was close contact with the source of infection: vaccinated persons had close contact in 50% of cases, compared with 28.9% of unvaccinated persons. The most important were contact with a patient in a health care setting and having multiple sources of infection, 31.1% and 5.6%, respectively. CONCLUSIONS: Vaccination against COVID-19 was an effective preventive intervention. A risk factor for disease after vaccination is close contact with the source of infection. Establishment of collective immunity after vaccination is decisive for the vaccination-to-disease ratio, which starts to develop with 70-80% of vaccinated individuals. The use of a mask in public places and social distancing remain important preventive measures.
背景:疫苗接种目前被认为是对抗SARS-CoV-2病毒最成功的策略。然而,尽管接种了疫苗,仍有感染病例,即所谓的突破性感染,在世界范围内已有所报告。目的:评价新型冠状病毒感染COVID-19疫苗接种对大学生发病率的影响。材料与方法:分析2020年9月1日至12月15日西北医科大学梅奇尼科夫分校(进一步大学)学生新型冠状病毒感染(COVID-19)的发病率。分别有4876名和4681名学生接受观察。通过与病人面谈收集疫苗接种和可能传播感染地点的数据。采用EpiInfo软件对数据进行统计处理。结果:在所分析的191例学生中检测到COVID-19病例,COVID-19的发病率为4.08 / 100名学生,而2020学年同期为5.50 / 100名学生,尽管2021年圣彼得堡居民的发病率是2020年的1.75倍。35例(18.3%)再次感染,其中18例也接种了COVID-19疫苗。在36.1%的病例中确定了可能的传播感染地点,最常见的是在卫生保健机构的工作地点与患者接触。截至2021年12月15日,62.8%的学生接种了新冠肺炎疫苗。接种疫苗的学生发病率为2.72 / 100,未接种疫苗的学生发病率为4.94 / 100。疫苗接种后发生突破性感染的一个危险因素是与传染源的密切接触:50%的病例中接种疫苗的人有密切接触,而未接种疫苗的人中这一比例为28.9%。最重要的是在卫生保健机构接触患者和有多种感染源,分别为31.1%和5.6%。结论:COVID-19疫苗接种是有效的预防干预措施。接种疫苗后疾病的一个危险因素是与传染源密切接触。在接种疫苗后建立集体免疫对疫苗接种率-疾病比率具有决定性作用,该比率在接种疫苗的个体达到70-80%时开始发展。在公共场所使用口罩和保持社交距离仍然是重要的预防措施。
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引用次数: 0
Etiotropic therapy of the new coronavirus infection: expectations and realities at the beginning of 2022. Part 1 新型冠状病毒感染的致病因治疗:2022年初的期望与现实第1部分
Pub Date : 2022-04-29 DOI: 10.17816/rfd101316
O. Kuznetsova
The review includes an analysis of the latest literature data on the etiotropic therapy of a new coronavirus infection. The search for an effective antiviral treatment for SARS-CoV-2 infection is ongoing. Often, the urgent need for an antiviral drug was a pretext for testing drugs without pharmacological justification, bypassing the generally accepted procedure for conducting multi-stage clinical trials. In this regard, many clinical trials involving thousands of patients did not demonstrate the high efficacy and safety of drugs that were chosen as etiotropic therapy. In this review, we focused on the efficacy and safety of those drugs that have been studied in sufficient detail, which are reflected in international publications, and are also included in Russian guidelines for use on an outpatient practice: favipiravir and molnupiravir. The mechanism of action of antiviral drugs, their effectiveness and possible side effects were studied in clinical trials, the results of which are in the open press, which made it possible to analyze these drugs in terms of the appropriateness of their use in real clinical practice.
这篇综述包括对一种新型冠状病毒感染的致病因治疗的最新文献数据进行分析。目前正在寻找治疗SARS-CoV-2感染的有效抗病毒药物。通常,对抗病毒药物的迫切需求是在没有药理学理由的情况下进行药物测试的借口,绕过了普遍接受的进行多阶段临床试验的程序。在这方面,许多涉及数千名患者的临床试验并没有证明所选择的药物作为致病因治疗的高疗效和安全性。在这篇综述中,我们关注的是那些已经得到充分详细研究的药物的有效性和安全性,这些药物在国际出版物中得到了反映,也被纳入俄罗斯门诊使用指南:favipiravir和molnupiravir。通过临床试验对抗病毒药物的作用机制、疗效和可能的副作用进行了研究,研究结果已公开发表,为实际临床应用这些药物的适宜性进行分析提供了可能。
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引用次数: 0
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Russian Family Doctor
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