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    More on acne therapy with systemic retinoids

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    The article deals with the modern concepts of the pathogenesis of acne, describes the impact of this pathology on the psychoemotional state of patients and the compliance to therapy. The article considers approaches to the treatment of moderate to severe forms of acne using the systemic retinoid - isotretinoin. It presents the results of our own observations and the prospects for eliminating undesirable phenomena during administration of this retinoid

    ΠΡƒΡΠΊΡƒΠ»ΡŒΡ‚Π°Ρ†ΠΈΡ Π»Π΅Π³ΠΊΠΈΡ…: патогСнСтичСскиС основы формирования Π΄Ρ‹Ρ…Π°Ρ‚Π΅Π»ΡŒΠ½Ρ‹Ρ… ΡˆΡƒΠΌΠΎΠ²

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    Auscultation of the lungs is one of the oldest diagnostic methods invented by Rene Laenneck. Nowadays, auscultation hasn’t lost its clinical significance. However, the development of science and technical progress have brought a lot of new ideas about the pathogenesis and interpretation of lungs sounds. This, in turn, caused some changes in the nomenclature. Moreover, the nomenclature of lung sounds in several European countries does not differ significantly but does not fully correspond to the recommended terminology for the English language. In addition, the mechanisms underlying some respiratory murmurs are interpreted ambiguously at present. For example, the main respiratory sound is designated both as β€œvesicular” and as β€œnormal” respiration because of persisting differences in explaining the pathogenesis of this murmur. There is also a considerable difference in the terminology of added sounds such as crackles, wheezing, rhonchi, as well as the difference in understanding of the underlying mechanisms.Aim. This review analyses the existing differences in the interpretation of lung auscultation and the terminology used to describe respiratory sounds in the Russian and foreign medical literature.Conclusion. Comparative analysis of Russian and foreign publications concerning the issues of lung auscultation demonstrates the existing differences in the terminology and understanding of the mechanisms that underly the main and adventitious respiratory sounds. Forming the common information space requires the unification of terminology and interpretation of physiological and pathological processes in the lungs responsible for the respiratory sounds. Recording the lung sounds with subsequent computer analysis will make it possible to objectify the auscultation data and classify the sounds more accurately.ΠΡƒΡΠΊΡƒΠ»ΡŒΡ‚Π°Ρ†ΠΈΡ Π»Π΅Π³ΠΊΠΈΡ… – ΠΎΠ΄ΠΈΠ½ ΠΈΠ· ΡΡ‚Π°Ρ€Π΅ΠΉΡˆΠΈΡ… диагностичСских ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΎΠ², основополоТником ΠΊΠΎΡ‚ΠΎΡ€ΠΎΠ³ΠΎ считаСтся Π Π΅Π½Π΅ ЛаэннСк. Π’ настоящСС врСмя Π°ΡƒΡΠΊΡƒΠ»ΡŒΡ‚Π°Ρ†ΠΈΡ Π½Π΅ потСряла своСго клиничСского значСния. Однако Ρ€Π°Π·Π²ΠΈΡ‚ΠΈΠ΅ Π½Π°ΡƒΠΊΠΈ ΠΈ тСхничСский прогрСсс внСсли ΠΌΠ½ΠΎΠ³ΠΎ Π½ΠΎΠ²ΠΎΠ³ΠΎ Π² прСдставлСния ΠΎ ΠΏΠ°Ρ‚ΠΎΠ³Π΅Π½Π΅Π·Π΅ Π·Π²ΡƒΠΊΠΎΠ²Ρ‹Ρ… явлСний Π² Π»Π΅Π³ΠΊΠΈΡ… ΠΈ ΠΈΡ… ΠΈΠ½Ρ‚Π΅Ρ€ΠΏΡ€Π΅Ρ‚Π°Ρ†ΠΈΡŽ. Π­Ρ‚ΠΎ ΠΏΡ€ΠΈΠ²Π΅Π»ΠΎ ΠΊ Π½Π΅ΠΊΠΎΡ‚ΠΎΡ€Ρ‹ΠΌ измСнСниям Π² Π½ΠΎΠΌΠ΅Π½ΠΊΠ»Π°Ρ‚ΡƒΡ€Π΅ Π΄Ρ‹Ρ…Π°Ρ‚Π΅Π»ΡŒΠ½Ρ‹Ρ… ΡˆΡƒΠΌΠΎΠ² (Π”Π¨). Π’ клиничСской ΠΏΡ€Π°ΠΊΡ‚ΠΈΠΊΠ΅ ряда СвропСйских стран Π½ΠΎΠΌΠ΅Π½ΠΊΠ»Π°Ρ‚ΡƒΡ€Π° Π»Π΅Π³ΠΎΡ‡Π½Ρ‹Ρ… Π·Π²ΡƒΠΊΠΎΠ² сущСствСнно Π½Π΅ различаСтся, ΠΎΠ΄Π½Π°ΠΊΠΎ Π½Π΅ соотвСтствуСт Ρ€Π΅ΠΊΠΎΠΌΠ΅Π½Π΄ΡƒΠ΅ΠΌΠΎΠΉ Ρ‚Π΅Ρ€ΠΌΠΈΠ½ΠΎΠ»ΠΎΠ³ΠΈΠΈ, ΠΈΡΠΏΠΎΠ»ΡŒΠ·ΡƒΠ΅ΠΌΠΎΠΉ Π² англоязычных источниках. ΠšΡ€ΠΎΠΌΠ΅ Ρ‚ΠΎΠ³ΠΎ, Π² настоящСС врСмя ΠΌΠ΅Ρ…Π°Π½ΠΈΠ·ΠΌΡ‹ формирования Π½Π΅ΠΊΠΎΡ‚ΠΎΡ€Ρ‹Ρ… Π”Π¨ Ρ‚Ρ€Π°ΠΊΡ‚ΡƒΡŽΡ‚ΡΡ Π½Π΅ΠΎΠ΄Π½ΠΎΠ·Π½Π°Ρ‡Π½ΠΎ. Π’Π°ΠΊ, Π½Π°ΠΏΡ€ΠΈΠΌΠ΅Ρ€, основной Π”Π¨ Π² Π»Π΅Π³ΠΊΠΈΡ… обозначаСтся ΠΈ ΠΊΠ°ΠΊ «вСзикулярноС» Π΄Ρ‹Ρ…Π°Π½ΠΈΠ΅, ΠΈ ΠΊΠ°ΠΊ Β«Π½ΠΎΡ€ΠΌΠ°Π»ΡŒΠ½ΠΎΠ΅Β» Π΄Ρ‹Ρ…Π°Π½ΠΈΠ΅, Ρ‡Ρ‚ΠΎ обусловлСно ΡΠΎΡ…Ρ€Π°Π½ΡΡŽΡ‰ΠΈΠΌΠΈΡΡ различиями Π² ΠΏΠΎΠ½ΠΈΠΌΠ°Π½ΠΈΠΈ ΠΏΠ°Ρ‚ΠΎΠ³Π΅Π½Π΅Π·Π° Π”Π¨. ΠžΡ‚Π»ΠΈΡ‡Π°ΡŽΡ‚ΡΡ Ρ‚Π°ΠΊΠΆΠ΅ тСрминологичСскоС описаниС сухих ΠΈ Π²Π»Π°ΠΆΠ½Ρ‹Ρ… Ρ…Ρ€ΠΈΠΏΠΎΠ² ΠΈ Ρ‚Ρ€Π°ΠΊΡ‚ΠΎΠ²ΠΊΠ° ΠΈΡ… Π³Π΅Π½Π΅Ρ€Π°Ρ†ΠΈΠΈ.ЦСль. Π’ настоящСм ΠΎΠ±Π·ΠΎΡ€Π΅ Π°Π½Π°Π»ΠΈΠ·ΠΈΡ€ΡƒΡŽΡ‚ΡΡ ΠΈΠΌΠ΅ΡŽΡ‰ΠΈΠ΅ΡΡ различия Π² ΠΈΠ½Ρ‚Π΅Ρ€ΠΏΡ€Π΅Ρ‚Π°Ρ†ΠΈΠΈ Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚ΠΎΠ² Π°ΡƒΡΠΊΡƒΠ»ΡŒΡ‚Π°Ρ†ΠΈΠΈ Π»Π΅Π³ΠΊΠΈΡ… ΠΈ Ρ‚Π΅Ρ€ΠΌΠΈΠ½ΠΎΠ»ΠΎΠ³ΠΈΠΈ, ΠΈΡΠΏΠΎΠ»ΡŒΠ·ΡƒΠ΅ΠΌΠΎΠΉ ΠΏΡ€ΠΈ описании Π”Π¨ Π² отСчСствСнной ΠΈ Π·Π°Ρ€ΡƒΠ±Π΅ΠΆΠ½ΠΎΠΉ мСдицинской Π»ΠΈΡ‚Π΅Ρ€Π°Ρ‚ΡƒΡ€Π΅.Π—Π°ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠ΅. ΠŸΡ€ΠΈ ΡΡ€Π°Π²Π½ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΠΌ Π°Π½Π°Π»ΠΈΠ·Π΅ отСчСствСнных ΠΈ Π·Π°Ρ€ΡƒΠ±Π΅ΠΆΠ½Ρ‹Ρ… ΠΏΡƒΠ±Π»ΠΈΠΊΠ°Ρ†ΠΈΠΉ, ΠΊΠ°ΡΠ°ΡŽΡ‰ΠΈΡ…ΡΡ вопросов Π°ΡƒΡΠΊΡƒΠ»ΡŒΡ‚Π°Ρ†ΠΈΠΈ Π»Π΅Π³ΠΊΠΈΡ…, продСмонстрированы ΠΈΠΌΠ΅ΡŽΡ‰ΠΈΠ΅ΡΡ различия Π² Ρ‚Π΅Ρ€ΠΌΠΈΠ½ΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΈ ΠΏΠΎΠ½ΠΈΠΌΠ°Π½ΠΈΠΈ ΠΌΠ΅Ρ…Π°Π½ΠΈΠ·ΠΌΠΎΠ² образования основных ΠΈ ΠΏΠΎΠ±ΠΎΡ‡Π½Ρ‹Ρ… Π”Π¨. Показано, Ρ‡Ρ‚ΠΎ ΠΏΡ€ΠΈ Ρ„ΠΎΡ€ΠΌΠΈΡ€ΠΎΠ²Π°Π½ΠΈΠΈ Π² настоящСС врСмя Π΅Π΄ΠΈΠ½ΠΎΠ³ΠΎ ΠΈΠ½Ρ„ΠΎΡ€ΠΌΠ°Ρ†ΠΈΠΎΠ½Π½ΠΎΠ³ΠΎ пространства трСбуСтся унификация Ρ‚Π΅Ρ€ΠΌΠΈΠ½ΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΈ Π΅Π΄ΠΈΠ½ΠΎΠΎΠ±Ρ€Π°Π·ΠΈΠ΅ Π² Ρ‚Ρ€Π°ΠΊΡ‚ΠΎΠ²ΠΊΠ΅ физиологичСских ΠΈ патологичСских процСссов Π² Π»Π΅Π³ΠΊΠΈΡ…, ΠΊΠΎΡ‚ΠΎΡ€Ρ‹ΠΌΠΈ обусловлСно Π²ΠΎΠ·Π½ΠΈΠΊΠ½ΠΎΠ²Π΅Π½ΠΈΠ΅ Π΄Ρ‹Ρ…Π°Ρ‚Π΅Π»ΡŒΠ½Ρ‹Ρ… Π·Π²ΡƒΠΊΠΎΠ². Π’ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎ, использованиС систСм для записи Π·Π²ΡƒΠΊΠΎΠ²Ρ‹Ρ… явлСний Π² Π»Π΅Π³ΠΊΠΈΡ… с ΠΏΠΎΡΠ»Π΅Π΄ΡƒΡŽΡ‰ΠΈΠΌ ΠΊΠΎΠΌΠΏΡŒΡŽΡ‚Π΅Ρ€Π½Ρ‹ΠΌ Π°Π½Π°Π»ΠΈΠ·ΠΎΠΌ ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΡ‚ ΠΎΠ±ΡŠΠ΅ΠΊΡ‚ΠΈΠ²ΠΈΠ·ΠΈΡ€ΠΎΠ²Π°Ρ‚ΡŒ Π΄Π°Π½Π½Ρ‹Π΅ Π°ΡƒΡΠΊΡƒΠ»ΡŒΡ‚Π°Ρ†ΠΈΠΈ ΠΈ Π±ΠΎΠ»Π΅Π΅ Ρ‚ΠΎΡ‡Π½ΠΎ ΠΊΠ»Π°ΡΡΠΈΡ„ΠΈΡ†ΠΈΡ€ΠΎΠ²Π°Ρ‚ΡŒ Π”Π¨
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