On December 10, 2021, an International conference dedicated to the Universal Health Coverage (UHC) Day was held at the Al Farabi Kazakh National University. The purpose of the conference was to support and develop the main ideas of the UHC. The conference was attended by more than 100 representatives of universities and the medical community from Kazakhstan and other countries of the Commonwealth of Independent States (Russia, Ukraine, Belarus, Kyrgyzstan, Uzbekistan, Tajikistan, Azerbaijan). The reports of the conference participants were devoted to the discussion of global problems of the development and strengthening of primary health care and the achievements of UHC both at the level of the WHO European Region and in individual CIS countries. The issues of training doctors for primary health care, the successes, and prospects of the development of the primary health care system, issues of assessing and improving the quality of medical care, approaches to providing HEU during the COVID-19 pandemic were highlighted. The conference resolution noted the need to consider the principles of the UHC when developing and making proposals to regulatory documents, initiate scientific research in the field of development and effectiveness of PHC models in the CIS countries, review educational programs for the training of PHC specialists taking into account the ideas and principles of HEU. It was also decided to hold an annual International conference UHC: Opportunities and challenges, to carry out joint publications on HEU at the country and regional levels.
{"title":"Universal health coverage: opportunities and challenges (on the materials of the International conference on December 10, 2021 in Almaty, dedicated to the Universal Health Coverage Day)","authors":"G. Kapanova, N. Brimkulov, I. Moiseeva","doi":"10.17816/rfd105165","DOIUrl":"https://doi.org/10.17816/rfd105165","url":null,"abstract":"On December 10, 2021, an International conference dedicated to the Universal Health Coverage (UHC) Day was held at the Al Farabi Kazakh National University. The purpose of the conference was to support and develop the main ideas of the UHC. The conference was attended by more than 100 representatives of universities and the medical community from Kazakhstan and other countries of the Commonwealth of Independent States (Russia, Ukraine, Belarus, Kyrgyzstan, Uzbekistan, Tajikistan, Azerbaijan). The reports of the conference participants were devoted to the discussion of global problems of the development and strengthening of primary health care and the achievements of UHC both at the level of the WHO European Region and in individual CIS countries. The issues of training doctors for primary health care, the successes, and prospects of the development of the primary health care system, issues of assessing and improving the quality of medical care, approaches to providing HEU during the COVID-19 pandemic were highlighted. \u0000The conference resolution noted the need to consider the principles of the UHC when developing and making proposals to regulatory documents, initiate scientific research in the field of development and effectiveness of PHC models in the CIS countries, review educational programs for the training of PHC specialists taking into account the ideas and principles of HEU. It was also decided to hold an annual International conference UHC: Opportunities and challenges, to carry out joint publications on HEU at the country and regional levels.","PeriodicalId":432054,"journal":{"name":"Russian Family Doctor","volume":"4 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":"127113171","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}
The article provides information about the All-Russian conference with international participation The place and role of a general practitioner in a changing world, dedicated to the 25th anniversary of the founding of the Department of Family Medicine, which took place in a part-time format in St. Petersburg on October 5-6, 2021. The problems of organizing of primary health care, modern approaches to the training of general practitioners, tactics of providing medical care for cardiovascular diseases, issues of respiratory medicine, problems of osteoporosis, epidemiological and clinical aspects of providing care to patients during a pandemic of a new coronavirus infection were considered. The main provisions of the reports included in the conference program are presented.
{"title":"Results of the all-russian conference with international participation “The place and role of a general practitioner in a changing world”","authors":"O. Kuznetsova, L. Degtyareva, I. Moiseeva","doi":"10.17816/rfd84048","DOIUrl":"https://doi.org/10.17816/rfd84048","url":null,"abstract":"The article provides information about the All-Russian conference with international participation The place and role of a general practitioner in a changing world, dedicated to the 25th anniversary of the founding of the Department of Family Medicine, which took place in a part-time format in St. Petersburg on October 5-6, 2021. The problems of organizing of primary health care, modern approaches to the training of general practitioners, tactics of providing medical care for cardiovascular diseases, issues of respiratory medicine, problems of osteoporosis, epidemiological and clinical aspects of providing care to patients during a pandemic of a new coronavirus infection were considered. The main provisions of the reports included in the conference program are presented.","PeriodicalId":432054,"journal":{"name":"Russian Family Doctor","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124822179","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}
BACKGROUND: In older patients, the new coronavirus infection may present with atypical symptoms such as delirium, dizziness, and unusual fatigue. At the same time, restriction of movement and fear of infection during the COVID-19 pandemic affect decreased physical activity and increased frequency of anxiety, depression and sleep disorders. Due to these symptoms and conditions are significant falls risk factors, the risk of falls and the frequency of falls in older adults is expected to increase in the near future. AIM: To identify the new cases of COVID-19 infection in patients 65 and older and to determine the incidence and risk factors of falls in patients who have had COVID-19. MATERIALS AND METHODS: The study involved 86 patients territorially attached to the Family Medicine Center of the North-Western State Medical University named after I.I. Mechnikov. All patients who took part in the study had COVID-19 infection. 48 of them (available at the time of the study) were interviewed in order to establish falls risk factors and cases of falls. The control group consisted of 58 patients who had not had COVID-19 infection. Analysis of the outpatient records of all study participants, screening of frailty, questionnaires, assessment of emotional status, and detection of sleep disorders were performed. RESULTS: The frequency of neurological symptoms increased in COVID-19 infected patients: dizziness (p 0.05), unsteady gait (p 0.05), impaired or lost sense of smell (anosmia) and loss of taste (dysgeusia) (p 0.05), sleep disorders, symptoms of depression and anxiety. The proportion of patients with decreased body weight was significantly higher after the disease (p = 0.0127). Patients in the control group also had a high frequency of complaints of memory and attention disorders, decreased vision, symptoms of anxiety and depression, and difficulty moving around. The incidence of frailty symptoms in the control group was 63.1% (n = 53). Patients who have not been infected with COVID-19 were significantly more likely to report imbalanced walking 60.3% (n = 35) than patients who had COVID-19 infection 37.5% (n = 18) (p = 0.002). One-third of COVID-19 survivors had elevated plasma glucose levels for the first time, 3.4% had worsened diabetes, and 5.8% of participants were rehospitalized within 3 months of illness. CONCLUSIONS: The study demonstrated a high incidence of neurological symptoms in participants who had COVID-19: dizziness, unstable gait, sleep disorders, symptoms of depression and anxiety, and weight loss complaints. Patients who had not had COVID-19 infection showed a high frequency of complaints of memory and attention impairment, decreased vision, symptoms of anxiety and depression, and imbalanced walking. The syndromes and symptoms identified in both groups were risk factors for falls and the risk of developing a fear of falling.
{"title":"Features of geriatric status of patients during the pandemic COVID-19","authors":"T. A. Bogdanova","doi":"10.17816/rfd71130","DOIUrl":"https://doi.org/10.17816/rfd71130","url":null,"abstract":"BACKGROUND: In older patients, the new coronavirus infection may present with atypical symptoms such as delirium, dizziness, and unusual fatigue. At the same time, restriction of movement and fear of infection during the COVID-19 pandemic affect decreased physical activity and increased frequency of anxiety, depression and sleep disorders. Due to these symptoms and conditions are significant falls risk factors, the risk of falls and the frequency of falls in older adults is expected to increase in the near future. \u0000AIM: To identify the new cases of COVID-19 infection in patients 65 and older and to determine the incidence and risk factors of falls in patients who have had COVID-19. \u0000MATERIALS AND METHODS: The study involved 86 patients territorially attached to the Family Medicine Center of the North-Western State Medical University named after I.I. Mechnikov. All patients who took part in the study had COVID-19 infection. 48 of them (available at the time of the study) were interviewed in order to establish falls risk factors and cases of falls. The control group consisted of 58 patients who had not had COVID-19 infection. Analysis of the outpatient records of all study participants, screening of frailty, questionnaires, assessment of emotional status, and detection of sleep disorders were performed. \u0000RESULTS: The frequency of neurological symptoms increased in COVID-19 infected patients: dizziness (p 0.05), unsteady gait (p 0.05), impaired or lost sense of smell (anosmia) and loss of taste (dysgeusia) (p 0.05), sleep disorders, symptoms of depression and anxiety. The proportion of patients with decreased body weight was significantly higher after the disease (p = 0.0127). Patients in the control group also had a high frequency of complaints of memory and attention disorders, decreased vision, symptoms of anxiety and depression, and difficulty moving around. The incidence of frailty symptoms in the control group was 63.1% (n = 53). Patients who have not been infected with COVID-19 were significantly more likely to report imbalanced walking 60.3% (n = 35) than patients who had COVID-19 infection 37.5% (n = 18) (p = 0.002). One-third of COVID-19 survivors had elevated plasma glucose levels for the first time, 3.4% had worsened diabetes, and 5.8% of participants were rehospitalized within 3 months of illness. \u0000CONCLUSIONS: The study demonstrated a high incidence of neurological symptoms in participants who had COVID-19: dizziness, unstable gait, sleep disorders, symptoms of depression and anxiety, and weight loss complaints. Patients who had not had COVID-19 infection showed a high frequency of complaints of memory and attention impairment, decreased vision, symptoms of anxiety and depression, and imbalanced walking. The syndromes and symptoms identified in both groups were risk factors for falls and the risk of developing a fear of falling.","PeriodicalId":432054,"journal":{"name":"Russian Family Doctor","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125224572","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}
O. Kuznetsova, Dmitry V. Chentsov, Sofya P. Drovnina, K. V. Ovakimyan
BACKGROUND: Spirometry is a method of studying the function of external respiration, which is widely used for the diagnosis of various bronchial obstructive diseases. This diagnostic method was included in the list of studies required for the second stage of medical examination of the adult population for the purpose of additional examination and clarification of the diagnosis. The correct organization of the study increases its effectiveness: it affects the quality of the conduct, on the result of which early diagnosis and timely appointment of treatment depends on the detection of bronchopulmonary disease. AIM: To evaluate the organization of spirometry during the second stage of medical examination in real practice in outpatient medical organizations. MATERIALS AND METHODS: The study involved 9 polyclinics selected randomly from the list of polyclinics and polyclinic departments in St. Petersburg, which participated in the medical examination of the adult population in 2020 (n = 97). The evaluation of the process of conducting a spirometric study, as well as the analysis of the dispensary records of patients who underwent spirometry, were carried out according to pre-developed checklists. RESULTS: Among the medical organizations that took part in the study (n = 9), only in one polyclinic the prevention department was equipped with a spirometer. Employees of only four polyclinics (50%) had a certificate of training in spirometry or functional diagnostics. As part of the second stage of medical examination of the adult population, 251 spirometric studies were conducted, although there should have been much more, since the smoking factor in these polyclinics was established in 10,829 people according to the reporting form 131 Information on the medical examination of certain groups of the adult population for 2020. CONCLUSIONS: The results obtained indicate a low efficiency of the organization of the spirometry procedure.
{"title":"Problems of spirometry in the framework of the second stage of medical examination of the adult population","authors":"O. Kuznetsova, Dmitry V. Chentsov, Sofya P. Drovnina, K. V. Ovakimyan","doi":"10.17816/rfd79259","DOIUrl":"https://doi.org/10.17816/rfd79259","url":null,"abstract":"BACKGROUND: Spirometry is a method of studying the function of external respiration, which is widely used for the diagnosis of various bronchial obstructive diseases. This diagnostic method was included in the list of studies required for the second stage of medical examination of the adult population for the purpose of additional examination and clarification of the diagnosis. The correct organization of the study increases its effectiveness: it affects the quality of the conduct, on the result of which early diagnosis and timely appointment of treatment depends on the detection of bronchopulmonary disease. \u0000AIM: To evaluate the organization of spirometry during the second stage of medical examination in real practice in outpatient medical organizations. \u0000MATERIALS AND METHODS: The study involved 9 polyclinics selected randomly from the list of polyclinics and polyclinic departments in St. Petersburg, which participated in the medical examination of the adult population in 2020 (n = 97). The evaluation of the process of conducting a spirometric study, as well as the analysis of the dispensary records of patients who underwent spirometry, were carried out according to pre-developed checklists. \u0000RESULTS: Among the medical organizations that took part in the study (n = 9), only in one polyclinic the prevention department was equipped with a spirometer. Employees of only four polyclinics (50%) had a certificate of training in spirometry or functional diagnostics. As part of the second stage of medical examination of the adult population, 251 spirometric studies were conducted, although there should have been much more, since the smoking factor in these polyclinics was established in 10,829 people according to the reporting form 131 Information on the medical examination of certain groups of the adult population for 2020. \u0000CONCLUSIONS: The results obtained indicate a low efficiency of the organization of the spirometry procedure.","PeriodicalId":432054,"journal":{"name":"Russian Family Doctor","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126203327","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}
V. V. Vasiliev, E. Romanova, G. Startseva, N. I. Kuznetsov
The legal framework for the provision of medical care, its evaluation and control of quality in Russia requires the attending physician to strictly comply with the provisions of regulatory documents. At the same time, clinical practice shows that the recommended algorithms for the provision of care do not allow in all situations to provide medical care of adequate quality. Analysis of the clinical example shows that in the era of the COVID-19 pandemic, in addition to compliance with the established rules, a thorough assessment of a specific clinical situation in the dynamics of development is necessary and timely correction of treatment and diagnostic measures, including those in excess of the established requirements, are required. The methods of remote monitoring of the patients condition need to be improved, since in their current form they do not provide an objective assessment of the patients condition. Face-to-face examinations of patients with COVID-19 receiving medical care at home should be carried out at least every 72 hours, regardless of the result of the remote assessment. The absence of the effect of therapy within three days may be an indication for transferring the patient to a higher level of medical care.
{"title":"Outpatient treatment of patients with COVID-19: Normative documents and/or clinical thinking","authors":"V. V. Vasiliev, E. Romanova, G. Startseva, N. I. Kuznetsov","doi":"10.17816/rfd83780","DOIUrl":"https://doi.org/10.17816/rfd83780","url":null,"abstract":"The legal framework for the provision of medical care, its evaluation and control of quality in Russia requires the attending physician to strictly comply with the provisions of regulatory documents. At the same time, clinical practice shows that the recommended algorithms for the provision of care do not allow in all situations to provide medical care of adequate quality. Analysis of the clinical example shows that in the era of the COVID-19 pandemic, in addition to compliance with the established rules, a thorough assessment of a specific clinical situation in the dynamics of development is necessary and timely correction of treatment and diagnostic measures, including those in excess of the established requirements, are required. The methods of remote monitoring of the patients condition need to be improved, since in their current form they do not provide an objective assessment of the patients condition. Face-to-face examinations of patients with COVID-19 receiving medical care at home should be carried out at least every 72 hours, regardless of the result of the remote assessment. The absence of the effect of therapy within three days may be an indication for transferring the patient to a higher level of medical care.","PeriodicalId":432054,"journal":{"name":"Russian Family Doctor","volume":"274 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122949249","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}
Population aging is inextricably linked to an increase in the prevalence of dementia, which are one of the main causes of loss of autonomy in old age. However, early detection of cognitive decline is critical to proactively implementing interventions to slow the progression of cognitive decline and maintain the ability to live independently of outside help. Therefore, early detection of cognitive decline is one of the primary tasks of the general practitioner. The aim of the lecture is to present a low gait speed, frailty, neuropsychiatric symptoms, sleep disorders and hearing loss as biomarkers of high risk to development of dementia risk and suggest ways measuring these risk factors in primary health care.
{"title":"Evaluation of early non-cognitive markers of dementia","authors":"G. Jogerst","doi":"10.17816/rfd83791","DOIUrl":"https://doi.org/10.17816/rfd83791","url":null,"abstract":"Population aging is inextricably linked to an increase in the prevalence of dementia, which are one of the main causes of loss of autonomy in old age. However, early detection of cognitive decline is critical to proactively implementing interventions to slow the progression of cognitive decline and maintain the ability to live independently of outside help. Therefore, early detection of cognitive decline is one of the primary tasks of the general practitioner. \u0000The aim of the lecture is to present a low gait speed, frailty, neuropsychiatric symptoms, sleep disorders and hearing loss as biomarkers of high risk to development of dementia risk and suggest ways measuring these risk factors in primary health care.","PeriodicalId":432054,"journal":{"name":"Russian Family Doctor","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121581972","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}
The article is a lecture on the history of development and the current state of geriatric medicine. The purpose of the lecture is to consider the stages of the formation of geriatrics as a scientific and clinical discipline and to substantiate its significance. The lecture defines concepts such as holistic approach, complex geriatric assessment, geriatric syndrome. The role of the founders of international and domestic geriatrics, such as M. Warren, B. Isaac, D. Sheldon, I.I. Mechnikov, V.N. Anisimov, E.S. Pushkova, is described. Various directions of geriatric medicine are considered and the necessity of their study is justified. The results of scientific research in geriatrics are analyzed. The basic principles of the ortho-geriatric approach, which becomes crucial for the successful treatment of elderly patients with fractures, as well as the features of geriatric rehabilitation, geriatric cardiology, are described. In conclusion, the author offers several models for the development of geriatric medicine.
{"title":"Geriatric medicine: achievements and prospects","authors":"E. Frolova","doi":"10.17816/rfd71284","DOIUrl":"https://doi.org/10.17816/rfd71284","url":null,"abstract":"The article is a lecture on the history of development and the current state of geriatric medicine. The purpose of the lecture is to consider the stages of the formation of geriatrics as a scientific and clinical discipline and to substantiate its significance. The lecture defines concepts such as holistic approach, complex geriatric assessment, geriatric syndrome. The role of the founders of international and domestic geriatrics, such as M. Warren, B. Isaac, D. Sheldon, I.I. Mechnikov, V.N. Anisimov, E.S. Pushkova, is described. Various directions of geriatric medicine are considered and the necessity of their study is justified. The results of scientific research in geriatrics are analyzed. The basic principles of the ortho-geriatric approach, which becomes crucial for the successful treatment of elderly patients with fractures, as well as the features of geriatric rehabilitation, geriatric cardiology, are described. In conclusion, the author offers several models for the development of geriatric medicine.","PeriodicalId":432054,"journal":{"name":"Russian Family Doctor","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116715040","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}
BACKGROUND: About 70% of TB dispensary patients have chronic somatic diseases which not only prevent effective treatment of TB but also take progressive course themselves. AIMS: To timely detect and treat acute and chronic somatic disease combined with TB. MATERIALS AND METHODS: since 2020 the algorithm of patient complex investigation by specialists of therapeutic profile was developed in the Tuberculosis Dispensary No. 5, among them the general practitioner was the coordinator of the patients medical route. This became especially relevant during the COVID-19 pandemic. RESULTS: In accordance with the developed algorithms of diagnostic search the patient was comprehensively examined. There were no signs of tuberculosis were in him, however the general practitioner involving to specialists team could diagnose signs of complex cardiac arrhythmia the probable cause which was a new coronavirus infection that he had had six weeks before. CONCLUSIONS: The organization of a new form of medical service for phthisiatric patients allowed general practitioner to reveal serious cardiac pathology directly at the TB dispensary, to refer the patient for consultation to the cardiologist-arrhythmologist, to follow the patient and perform recommended cardiologic treatment simultaneously with measures or medical supervision over persons contacting with tuberculosis.
{"title":"The viral myocarditis with cardiac аrrhythmia as complication of COVID-19 in the practice of family doctor of the tuberculosis dispensary","authors":"I. V. Yubrina, L. Degtyareva, I. Bozhkov","doi":"10.17816/rfd77027","DOIUrl":"https://doi.org/10.17816/rfd77027","url":null,"abstract":"BACKGROUND: About 70% of TB dispensary patients have chronic somatic diseases which not only prevent effective treatment of TB but also take progressive course themselves. \u0000AIMS: To timely detect and treat acute and chronic somatic disease combined with TB. \u0000MATERIALS AND METHODS: since 2020 the algorithm of patient complex investigation by specialists of therapeutic profile was developed in the Tuberculosis Dispensary No. 5, among them the general practitioner was the coordinator of the patients medical route. This became especially relevant during the COVID-19 pandemic. \u0000RESULTS: In accordance with the developed algorithms of diagnostic search the patient was comprehensively examined. There were no signs of tuberculosis were in him, however the general practitioner involving to specialists team could diagnose signs of complex cardiac arrhythmia the probable cause which was a new coronavirus infection that he had had six weeks before. \u0000CONCLUSIONS: The organization of a new form of medical service for phthisiatric patients allowed general practitioner to reveal serious cardiac pathology directly at the TB dispensary, to refer the patient for consultation to the cardiologist-arrhythmologist, to follow the patient and perform recommended cardiologic treatment simultaneously with measures or medical supervision over persons contacting with tuberculosis.","PeriodicalId":432054,"journal":{"name":"Russian Family Doctor","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132137258","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}
BACKGROUND: Falls are one of the most common syndromes in old age. An estimated 646,000 deaths from falls occur each year worldwide. Moreover, most fatal falls occur in people over 65 years of age. Most falls are the result of the interaction of several factors. AIMS: To examine the long-term effectiveness of multifactorial interventions in preventing falls in elderly and senile patients. MATERIALS AND METHODS: A sample of patients territorially attached to the Family Medicine Center of the North-Western State Medical University named after I.I. Mechnikov was established four years ago. Individual fall prevention programs were developed for all study participants (n = 260) because they had different falls risk factors. Patient follow-up was continued for 12 months. The results of the multifactorial intervention were evaluated after 12 months and after 3 years, 2 times in total, the last study in a random subsample of patients (n = 84). Aging asthenia screening, questionnaires, assessment of emotional status, and presence of sleep disturbances were performed to assess the risk of falls. The effectiveness of multifactorial interventions was assessed based on repeated assessment of risk factors for falls. RESULTS: Participants with a history of falls were significantly more likely to have symptoms of depression, anxiety, symptoms of frailty, visual and hearing impairment (p 0.05). On average, each participant in the group with falls had 6.1 2.1 risk factors for falls and 3.8 2.3 in the group without falls (p = 0.000). During the follow-up period after the interventions, the incidence of falls decreased 9-fold after one year (from 28.5% to 3.1%) and then increased to 23.8%. All patients who fell after the multifactorial intervention had a history of cognitive impairment and falls. In addition, in the group of patients with falls, fall risk factors such as low levels of physical activity, hearing impairment, and the presence of a traumatic environment at home were not eliminated. As a result of the interventions, fear of falls disappeared in 9 patients, 95% CI (2.35-65.89), p = 0.039. CONCLUSIONS: The study demonstrated a decrease in the effectiveness of multifactorial interventions to prevent falls at three years. A less persistent effect was seen in patients with a history of falls. A history of falls, symptoms of frailty, complaints of fear of falls, sleep disturbances, and anxiety symptoms were factors that increased the risk of falls. Individualized fall prevention programs resulted in decreased fear of falls.
背景:跌倒是老年人最常见的症状之一。据估计，全世界每年有64.6万人死于跌倒。此外，大多数致命的跌倒发生在65岁以上的人群中。大多数跌倒是几个因素相互作用的结果。目的:探讨多因素干预预防老年患者跌倒的长期效果。材料与方法:西北州立医科大学以I.I. Mechnikov命名的家庭医学中心于四年前成立，其属地附属于该中心的患者样本。针对所有研究参与者(n = 260)制定了个人跌倒预防计划，因为他们有不同的跌倒风险因素。患者随访12个月。多因素干预的结果分别在12个月和3年后进行评估，共进行了2次评估，最后一次研究是随机抽样的患者(n = 84)。通过衰老衰弱筛查、问卷调查、情绪状态评估和睡眠障碍的存在来评估跌倒的风险。通过对跌倒危险因素的反复评估来评估多因素干预的有效性。结果:有跌倒史的参与者更有可能出现抑郁、焦虑、虚弱症状、视力和听力障碍(p < 0.05)。平均而言，跌倒组的每个参与者有6.1 2.1个跌倒危险因素，而没有跌倒组的每个参与者有3.8 2.3个(p = 0.000)。在干预后的随访期间，跌倒的发生率在一年后下降了9倍(从28.5%降至3.1%)，然后又上升到23.8%。所有在多因素干预后跌倒的患者都有认知障碍和跌倒史。此外，在跌倒患者组中，没有消除跌倒风险因素，如身体活动水平低、听力障碍和家中创伤性环境的存在。干预后，9例患者的跌倒恐惧消失，95% CI (2.35 ~ 65.89)， p = 0.039。结论:该研究表明，多因素干预预防跌倒的有效性在三年内有所下降。在有跌倒史的患者中，效果持续时间较短。跌倒史、虚弱症状、害怕跌倒的主诉、睡眠障碍和焦虑症状是增加跌倒风险的因素。个性化的预防跌倒项目减少了对跌倒的恐惧。
{"title":"Multifactorial interventions to prevent falls in older adults","authors":"Tatiana A. Богданова","doi":"10.17816/rfd71104","DOIUrl":"https://doi.org/10.17816/rfd71104","url":null,"abstract":"BACKGROUND: Falls are one of the most common syndromes in old age. An estimated 646,000 deaths from falls occur each year worldwide. Moreover, most fatal falls occur in people over 65 years of age. Most falls are the result of the interaction of several factors. \u0000AIMS: To examine the long-term effectiveness of multifactorial interventions in preventing falls in elderly and senile patients. \u0000MATERIALS AND METHODS: A sample of patients territorially attached to the Family Medicine Center of the North-Western State Medical University named after I.I. Mechnikov was established four years ago. Individual fall prevention programs were developed for all study participants (n = 260) because they had different falls risk factors. Patient follow-up was continued for 12 months. The results of the multifactorial intervention were evaluated after 12 months and after 3 years, 2 times in total, the last study in a random subsample of patients (n = 84). Aging asthenia screening, questionnaires, assessment of emotional status, and presence of sleep disturbances were performed to assess the risk of falls. The effectiveness of multifactorial interventions was assessed based on repeated assessment of risk factors for falls. \u0000RESULTS: Participants with a history of falls were significantly more likely to have symptoms of depression, anxiety, symptoms of frailty, visual and hearing impairment (p 0.05). On average, each participant in the group with falls had 6.1 2.1 risk factors for falls and 3.8 2.3 in the group without falls (p = 0.000). During the follow-up period after the interventions, the incidence of falls decreased 9-fold after one year (from 28.5% to 3.1%) and then increased to 23.8%. All patients who fell after the multifactorial intervention had a history of cognitive impairment and falls. In addition, in the group of patients with falls, fall risk factors such as low levels of physical activity, hearing impairment, and the presence of a traumatic environment at home were not eliminated. As a result of the interventions, fear of falls disappeared in 9 patients, 95% CI (2.35-65.89), p = 0.039. \u0000CONCLUSIONS: The study demonstrated a decrease in the effectiveness of multifactorial interventions to prevent falls at three years. A less persistent effect was seen in patients with a history of falls. A history of falls, symptoms of frailty, complaints of fear of falls, sleep disturbances, and anxiety symptoms were factors that increased the risk of falls. Individualized fall prevention programs resulted in decreased fear of falls.","PeriodicalId":432054,"journal":{"name":"Russian Family Doctor","volume":"76 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129884292","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}
Coronavirus infection, according to modern data, poses a threat not only to the respiratory system, in more than 15% of patients it can lead to cardiovascular complications, including in young and middle-aged people. COVID-19 is probably the trigger of a detailed clinical picture of chronic diseases occurring in a latent form. The article considers the case of sinus node dysfunction and polyneuropathy in a young patient after coronavirus infection against the background of concomitant diseases such as Sjogrens disease and Thompsons myotonia. To observe the dynamics of the three diseases, the timely organization of a multidisciplinary approach is important. It is necessary to consider all three diseases in the paradigm of the main and concomitant in order to timely and adequate therapy. Further study of the clinical features, therapeutic approaches and complications in patients with COVID-19 is required.
{"title":"The case of comorbidity of sinus node dysfunction and new coronavirus infection with Sjogren’s disease and Thompson’s myotonia","authors":"Maria O. Mohika Estepa, N. Muzhikina","doi":"10.17816/rfd71055","DOIUrl":"https://doi.org/10.17816/rfd71055","url":null,"abstract":"Coronavirus infection, according to modern data, poses a threat not only to the respiratory system, in more than 15% of patients it can lead to cardiovascular complications, including in young and middle-aged people. COVID-19 is probably the trigger of a detailed clinical picture of chronic diseases occurring in a latent form. The article considers the case of sinus node dysfunction and polyneuropathy in a young patient after coronavirus infection against the background of concomitant diseases such as Sjogrens disease and Thompsons myotonia. To observe the dynamics of the three diseases, the timely organization of a multidisciplinary approach is important. It is necessary to consider all three diseases in the paradigm of the main and concomitant in order to timely and adequate therapy. Further study of the clinical features, therapeutic approaches and complications in patients with COVID-19 is required.","PeriodicalId":432054,"journal":{"name":"Russian Family Doctor","volume":"88 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122492809","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}
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