36 research outputs found

    ΠŸΡ€ΠΎΠ±Π»Π΅ΠΌΡ‹ полиграфичСского изготовлСния Π½ΠΎΠ²Π΅ΠΉΡˆΠΈΡ… ΡƒΠΏΠ°ΠΊΠΎΠ²ΠΎΠΊ с Π½Π°Π½ΠΎΡ€Π°Π·ΠΌΠ΅Ρ€Π½Ρ‹ΠΌΠΈ Ρ„ΠΎΡ‚ΠΎΠ°ΠΊΡ‚ΠΈΠ²Π½Ρ‹ΠΌ элСмСнтами

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    Π£ статті розглянуто особливості виготовлСння Π°ΠΊΡ‚ΠΈΠ²Π½ΠΈΡ… Ρ– Β«Ρ€ΠΎΠ·ΡƒΠΌΠ½ΠΈΡ…Β» паковань, Ρƒ Ρ‚ΠΎΠΌΡƒ числі Ρ–Π· використанням Π½Π°Π½ΠΎΡ‚Π΅Ρ…Π½ΠΎΠ»ΠΎΠ³Ρ–ΠΉ. ВиявлСно моТливості застосування ΠΏΠΎΠ»Ρ–Π³Ρ€Π°Ρ„Ρ–Ρ‡Π½ΠΈΡ… Ρ‚Π΅Ρ…Π½ΠΎΠ»ΠΎΠ³Ρ–ΠΉ Ρƒ Π²ΠΈΡ€ΠΎΠ±Π½ΠΈΡ†Ρ‚Π²Ρ– Π°ΠΊΡ‚ΠΈΠ²Π½ΠΈΡ… Ρ– Β«Ρ€ΠΎΠ·ΡƒΠΌΠ½ΠΈΡ…Β» паковань Π· Π½Π°Π½ΠΎΡ€ΠΎΠ·ΠΌΡ–Ρ€Π½ΠΈΠΌΠΈ Ρ„ΠΎΡ‚ΠΎΠ°ΠΊΡ‚ΠΈΠ²Π½ΠΈΠΌΠΈ Π΅Π»Π΅ΠΌΠ΅Π½Ρ‚Π°ΠΌΠΈ, Π° Ρ‚Π°ΠΊΠΎΠΆ ΠΏΡ€ΠΎΠ°Π½Π°Π»Ρ–Π·ΠΎΠ²Π°Π½ΠΎ питання бСзпСчності Π½ΠΎΠ²Ρ–Ρ‚Π½Ρ–Ρ… паковань для споТивачів.In this article some features of manufacturing active and Β«intelligentΒ» packaging were considered, including with the use of nanotechnology. The prospects of using nanophotonic and photocatalytic elements in modern packaging were outlined. The functions of such systems in active and intelligent packaging were defined. The classification of modern packaging which may contain nanosized photoactive elements was created. The role of photonic processes (impact of light) at the stages of manufacturing, activation, and response of the systems was investigated. The perspectives of luminescent systems with nanosized components which respond to freshness/spoilage of a packaged product were studied, and it was determined, that these systems are quite promising, but they are generally at early stages of development and need further investigation. The possibilities of usage of printing technologies in the production of active and Β«intelligentΒ» packaging with nanosized photoactive elements were studied. The factors which influence the quality of nanophotonic and photocatalytic systems produced by printing techniques were defined. The composition of ink and varnish materials as well as substrates for modern packaging with photoactive nanosized elements was investigated. The analysis of safety issues of the modern packaging to consumers was made.Π’ ΡΡ‚Π°Ρ‚ΡŒΠ΅ рассмотрСны особСнности изготовлСния Π°ΠΊΡ‚ΠΈΠ²Π½ΠΎΠΉ ΠΈ ΡƒΠΌΠ½ΠΎΠΉ ΡƒΠΏΠ°ΠΊΠΎΠ²ΠΊΠΈ, Π² Ρ‚ΠΎΠΌ числС с использованиСм Π½Π°Π½ΠΎΡ‚Π΅Ρ…Π½ΠΎΠ»ΠΎΠ³ΠΈΠΉ. ΠžΠΏΡ€Π΅Π΄Π΅Π»Π΅Π½Ρ‹ возмоТности использования полиграфичСских Ρ‚Π΅Ρ…Π½ΠΎΠ»ΠΎΠ³ΠΈΠΉ Π² производствС Π°ΠΊΡ‚ΠΈΠ²Π½ΠΎΠΉ ΠΈ ΡƒΠΌΠ½ΠΎΠΉ ΡƒΠΏΠ°ΠΊΠΎΠ²ΠΊΠΈ с Π½Π°Π½ΠΎΡ€Π°Π·ΠΌΠ΅Ρ€Π½Ρ‹ΠΌΠΈ Ρ„ΠΎΡ‚ΠΎΠ°ΠΊΡ‚ΠΈΠ²Π½Ρ‹ΠΌΠΈ элСмСнтами, Π° Ρ‚Π°ΠΊΠΆΠ΅ ΠΏΡ€ΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡ€ΠΎΠ²Π°Π½Ρ‹ вопросы бСзопасности новСйшСй ΡƒΠΏΠ°ΠΊΠΎΠ²ΠΊΠΈ для ΠΏΠΎΡ‚Ρ€Π΅Π±ΠΈΡ‚Π΅Π»Π΅ΠΉ

    ΠŸΡƒΡ‚ΠΈ ΡƒΡΠΎΠ²Π΅Ρ€ΡˆΠ΅Π½ΡΡ‚Π²ΠΎΠ²Π°Π½ΠΈΡ ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»Π΅ΠΉ финансово-хозяйствСнной Π΄Π΅ΡΡ‚Π΅Π»ΡŒΠ½ΠΎΡΡ‚ΠΈ выставочно-ярмарочных прСдприятий

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    Π’ Π΄Π°Π½Ρ–ΠΉ статті розглянуті основні Ρ‚Π΅ΠΎΡ€Π΅Ρ‚ΠΈΡ‡Π½Ρ– засади визначСння ΠΏΠΎΠΊΠ°Π·Π½ΠΈΠΊΡ–Π² фінансово-Π³ΠΎΡΠΏΠΎΠ΄Π°Ρ€ΡΡŒΠΊΠΎΡ— Π΄Ρ–ΡΠ»ΡŒΠ½ΠΎΡΡ‚Ρ– Π½Π΅Π²ΠΈΡ€ΠΎΠ±Π½ΠΈΡ‡ΠΈΡ… підприємств, Ρ€ΠΎΠ·Ρ€ΠΎΠ±Π»Π΅Π½Ρ– Ρ€Π΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°Ρ†Ρ–Ρ— для покращСння СфСктивності фінансово-Π³ΠΎΡΠΏΠΎΠ΄Π°Ρ€ΡΡŒΠΊΠΎΡ— Π΄Ρ–ΡΠ»ΡŒΠ½ΠΎΡΡ‚Ρ– підприємств, які Π·Π°ΠΉΠΌΠ°ΡŽΡ‚ΡŒΡΡ виставково-ΡΡ€ΠΌΠ°Ρ€ΠΊΠΎΠ²ΠΎΡŽ Π΄Ρ–ΡΠ»ΡŒΠ½Ρ–ΡΡ‚ΡŽ.In this paper, the basic theoretical principles of determination of indicators of financial and business activity of non-manufacturing enterprises are considered, recommendations for improving financial and business activity of enterprises engaged in exhibition and fair activities are created.Π’ Π΄Π°Π½Π½ΠΎΠΉ ΡΡ‚Π°Ρ‚ΡŒΠ΅ рассмотрСны тСорСтичСскиС основы опрСдСлСния ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»Π΅ΠΉ финансово-хозяйствСнной Π΄Π΅ΡΡ‚Π΅Π»ΡŒΠ½ΠΎΡΡ‚ΠΈ нСпроизводствСнных прСдприятий, Ρ€Π°Π·Ρ€Π°Π±ΠΎΡ‚Π°Π½Ρ‹ Ρ€Π΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°Ρ†ΠΈΠΈ для ΡƒΠ»ΡƒΡ‡ΡˆΠ΅Π½ΠΈΡ эффСктивности финансово-хозяйствСнной Π΄Π΅ΡΡ‚Π΅Π»ΡŒΠ½ΠΎΡΡ‚ΠΈ прСдприятий, ΠΊΠΎΡ‚ΠΎΡ€Ρ‹Π΅ Π·Π°Π½ΠΈΠΌΠ°ΡŽΡ‚ΡΡ выставочно-ярмарочной Π΄Π΅ΡΡ‚Π΅Π»ΡŒΠ½ΠΎΡΡ‚ΡŒΡŽ

    Investigation of the Possibility of Immobilization of Mobile Forms of Arsenic in Technogenic Soils

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    Levels of contamination of three mining industrial zones in Irkutsk Oblast and Zabaykalsky Krai were revealed by means of geoecological and geochemical monitoring. Bulk contents and mobile forms of As in soils, stubs, bricks, and dumps of the mining and processing industry were defined. This allowed revealing features of chemical composition of technogenic substrates for the purpose of a choice of a way of their neutralization. The possibility of chemical immobilization of mobile ionic forms of As in natural and man-made objects by treatment with alkaline reagents was studied. X-ray diffraction (XRD) analysis revealed pharmacolite CaHAsO4Β·2H2O, calcium arsenate Ca3(AsO4)2, and segnititePb(Fe3+)3AsO4(AsO3OH)(OH)6 that are formed in the obtained solid insoluble precipitates. Formation of new solid insoluble compounds indicates the chemical binding (immobilization) of arsenic-containing compounds and the irreversibility of the process. This allows us to offer an effective way of fixing toxic agents to reduce migration in the environment by stabilizing immobilized forms. Experiments with the use of lignin sludge ash (accumulated waste of the closed Baikal pulp and paper mill) for the neutralization of arsenic-containing waste of mining and metallurgical industries were carried out. Application of modified coal sorbing agents for the sorption of residual mobile forms of As (after treating with an alkaline reagent) allows achieving a decrease in its concentrations to the TLV standard for a hazardous substance. NoritRO 3520 is the most effective sorbing agent. The results are of high applied importanceΒ  for the implementation of the method of chemical immobilization of mobile ion forms of As in technogenesiszones

    Analysis of the diet of 2nd year students of the Ural power engineering institute

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    The aim of the study – to find out how and what young people eat, namely, 2nd year students of the Ural Energy Institute of UrFU, and to analyze the information received in order to formulate clear recommendations for diet correction.ЦСль исслСдования – Π²Ρ‹ΡΡΠ½ΠΈΡ‚ΡŒ, ΠΊΠ°ΠΊ ΠΈ Ρ‡Π΅ΠΌ питаСтся молодСТь, Π° ΠΈΠΌΠ΅Π½Π½ΠΎ, студСнты 2 курса Π£Ρ€Π°Π»ΡŒΡΠΊΠΎΠ³ΠΎ энСргСтичСского института Π£Ρ€Π°Π»ΡŒΡΠΊΠΎΠ³ΠΎ Ρ„Π΅Π΄Π΅Ρ€Π°Π»ΡŒΠ½ΠΎΠ³ΠΎ унивСрситСта (Π΄Π°Π»Π΅Π΅ – Π£Ρ€Π°Π» ЭНИН Π£Ρ€Π€Π£) ΠΈ провСсти Π°Π½Π°Π»ΠΈΠ· ΠΏΠΎΠ»ΡƒΡ‡Π΅Π½Π½ΠΎΠΈΜ† ΠΈΠ½Ρ„ΠΎΡ€ΠΌΠ°Ρ†ΠΈΠΈ для Ρ‚ΠΎΠ³ΠΎ, Ρ‡Ρ‚ΠΎΠ±Ρ‹ ΡΡ„ΠΎΡ€ΠΌΡƒΠ»ΠΈΡ€ΠΎΠ²Π°Ρ‚ΡŒ Ρ‡Π΅Ρ‚ΠΊΠΈΠ΅ Ρ€Π΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°Ρ†ΠΈΠΈ ΠΏΠΎ ΠΊΠΎΡ€Ρ€Π΅ΠΊΡ†ΠΈΠΈ Ρ€Π°Ρ†ΠΈΠΎΠ½Π°

    The possibility of an effective alliance between practical health care and medical education for the 5th course students’ scientific research work performance during the practice

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    It is considering the questions of students’ research work organization at the medical university. The article describes the problems, which arise under the organization of the students’ research activities in medical university during their summer practice. It also reflects the students’ success in undertaking the case studies according to the needs of practical public health.Π’ ΡΡ‚Π°Ρ‚ΡŒΠ΅ освСщСны вопросы ΠΎΡ€Π³Π°Π½ΠΈΠ·Π°Ρ†ΠΈΠΈ Π½Π°ΡƒΡ‡Π½ΠΎ-ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Ρ‚Π΅Π»ΡŒΡΠΊΠΎΠΉ Π΄Π΅ΡΡ‚Π΅Π»ΡŒΠ½ΠΎΡΡ‚ΠΈ студСнтов. ΠŸΡ€Π΅Π΄ΡΡ‚Π°Π²Π»Π΅Π½Ρ‹ ΠΏΡ€ΠΎΠ±Π»Π΅ΠΌΡ‹, ΠΊΠΎΡ‚ΠΎΡ€Ρ‹Π΅ Π²ΠΎΠ·Π½ΠΈΠΊΠ°ΡŽΡ‚ ΠΏΡ€ΠΈ ΠΎΡ€Π³Π°Π½ΠΈΠ·Π°Ρ†ΠΈΠΈ Π½Π°ΡƒΡ‡Π½ΠΎ-ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Ρ‚Π΅Π»ΡŒΡΠΊΠΎΠΉ Ρ€Π°Π±ΠΎΡ‚Ρ‹ студСнтов Π² мСдицинском Π²ΡƒΠ·Π΅ Π² ΠΏΠ΅Ρ€ΠΈΠΎΠ΄ прохоТдСния ΠΈΠΌΠΈ производствСнной ΠΏΡ€Π°ΠΊΡ‚ΠΈΠΊΠΈ, продСмонстрированы успСхи студСнтов Π² ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠΈ ΠΊΠΎΠ½ΠΊΡ€Π΅Ρ‚Π½Ρ‹Ρ… исслСдований Π² соотвСтствии с потрСбностями практичСского здравоохранСния

    РСвматологичСская ΠΎΠ½Π»Π°ΠΉΠ½-школа ΠΊΠ°ΠΊ Π°Π»ΡŒΡ‚Π΅Ρ€Π½Π°Ρ‚ΠΈΠ²Π° Ρ‚Ρ€Π°Π΄ΠΈΡ†ΠΈΠΎΠ½Π½Ρ‹ΠΌ ΠΎΠ±Ρ€Π°Π·ΠΎΠ²Π°Ρ‚Π΅Π»ΡŒΠ½Ρ‹ΠΌ тСхнологиям для ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ²

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    During the COVID-19 pandemic, many patients with rheumatic diseases were left without specialized care and information support, however, the current level of digitalization makes it possible to transfer the training and education of patients and their relatives to an online format. Objective: to analyze the experience of holding a rheumatological school in an online format as a method of improving the medical literacy of the population.Patients and methods. A cross-sectional study was performed by voluntary anonymous questioning of 157 patients who, from September 2020 to November 2021, took part in the online school on rheumatology held at the Clinical Rheumatology Center "New Hospital" (Yekaterinburg). All patients filled out an online questionnaire that included 15 questions related to age, place of residence, motivation of students, sources of information about the school, assessment of the form and content of lectures, quality and novelty of the information provided, and degree of doctor’s credibility.Results and discussion. Analysis of the results of the survey demonstrated the interest of patients in obtaining high-quality medical information on rheumatology problems, a positive assessment of the format and content of the online school, its positive role in clarifying the essence of the disease and related problems.Conclusion. Online schools for patients seem to be a relevant and promising area of medical prevention.Π’ΠΎ врСмя ΠΏΠ°Π½Π΄Π΅ΠΌΠΈΠΈ COVID-19 ΠΌΠ½ΠΎΠ³ΠΈΠ΅ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Ρ‹ с рСвматичСскими заболСваниями ΠΎΡΡ‚Π°Π»ΠΈΡΡŒ Π±Π΅Π· спСциализированной ΠΏΠΎΠΌΠΎΡ‰ΠΈ ΠΈ ΠΈΠ½Ρ„ΠΎΡ€ΠΌΠ°Ρ†ΠΈΠΎΠ½Π½ΠΎΠΉ ΠΏΠΎΠ΄Π΄Π΅Ρ€ΠΆΠΊΠΈ, вмСсти с Ρ‚Π΅ΠΌ соврСмСнный ΡƒΡ€ΠΎΠ²Π΅Π½ΡŒ Ρ†ΠΈΡ„Ρ€ΠΎΠ²ΠΈΠ·Π°Ρ†ΠΈΠΈ позволяСт пСрСнСсти ΠΎΠ±ΡƒΡ‡Π΅Π½ΠΈΠ΅ ΠΈ ΠΎΠ±Ρ€Π°Π·ΠΎΠ²Π°Π½ΠΈΠ΅ Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… ΠΈ ΠΈΡ… родствСнников Π² ΠΎΠ½Π»Π°ΠΉΠ½-Ρ„ΠΎΡ€ΠΌΠ°Ρ‚.ЦСль исслСдования – ΠΏΡ€ΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡ€ΠΎΠ²Π°Ρ‚ΡŒ ΠΎΠΏΡ‹Ρ‚ провСдСния рСвматологичСской ΡˆΠΊΠΎΠ»Ρ‹ Π² ΠΎΠ½Π»Π°ΠΉΠ½-Ρ„ΠΎΡ€ΠΌΠ°Ρ‚Π΅ ΠΊΠ°ΠΊ ΠΌΠ΅Ρ‚ΠΎΠ΄Π° ΠΏΠΎΠ²Ρ‹ΡˆΠ΅Π½ΠΈΡ мСдицинской грамотности насСлСния.ΠŸΠ°Ρ†ΠΈΠ΅Π½Ρ‚Ρ‹ ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹. Π’Ρ‹ΠΏΠΎΠ»Π½Π΅Π½ΠΎ ΠΎΠ΄Π½ΠΎΠΌΠΎΠΌΠ΅Π½Ρ‚Π½ΠΎΠ΅ исслСдованиС ΠΏΡƒΡ‚Π΅ΠΌ Π΄ΠΎΠ±Ρ€ΠΎΠ²ΠΎΠ»ΡŒΠ½ΠΎΠ³ΠΎ Π°Π½ΠΎΠ½ΠΈΠΌΠ½ΠΎΠ³ΠΎ анкСтирования 157 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ², с сСнтября 2020 Π³. ΠΏΠΎ Π½ΠΎΡΠ±Ρ€ΡŒ 2021 Π³. ΠΏΡ€ΠΈΠ½ΡΠ²ΡˆΠΈΡ… участиС Π² ΠΎΠ½Π»Π°ΠΉΠ½-школС ΠΏΠΎ Ρ€Π΅Π²ΠΌΠ°Ρ‚ΠΎΠ»ΠΎΠ³ΠΈΠΈ, Π΄Π΅ΠΉΡΡ‚Π²ΡƒΡŽΡ‰Π΅ΠΉ Π½Π° Π±Π°Π·Π΅ Π¦Π΅Π½Ρ‚Ρ€Π° клиничСской Ρ€Π΅Π²ΠΌΠ°Ρ‚ΠΎΠ»ΠΎΠ³ΠΈΠΈ МО «Новая Π‘ΠΎΠ»ΡŒΠ½ΠΈΡ†Π°Β» (Π•ΠΊΠ°Ρ‚Π΅Ρ€ΠΈΠ½Π±ΡƒΡ€Π³). ВсС ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Ρ‹ заполняли ΠΎΠ½Π»Π°ΠΉΠ½-опросник, Π²ΠΊΠ»ΡŽΡ‡Π°Π²ΡˆΠΈΠΉ 15 вопросов, ΠΊΠ°ΡΠ°Π²ΡˆΠΈΡ…ΡΡ возраста, мСста ΠΆΠΈΡ‚Π΅Π»ΡŒΡΡ‚Π²Π°, ΠΌΠΎΡ‚ΠΈΠ²Π°Ρ†ΠΈΠΈ ΡΠ»ΡƒΡˆΠ°Ρ‚Π΅Π»Π΅ΠΉ, источников ΠΈΠ½Ρ„ΠΎΡ€ΠΌΠ°Ρ†ΠΈΠΈ ΠΎ школС, ΠΎΡ†Π΅Π½ΠΊΠΈ Ρ„ΠΎΡ€ΠΌΡ‹ ΠΈ содСрТания Π»Π΅ΠΊΡ†ΠΈΠΉ, качСства ΠΈ Π½ΠΎΠ²ΠΈΠ·Π½Ρ‹ прСдставлСнных свСдСний, стСпСни довСрия ΠΊ Π²Ρ€Π°Ρ‡Ρƒ.Π Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹ ΠΈ обсуТдСниС. Анализ Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚ΠΎΠ² анкСтирования продСмонстрировал Π·Π°ΠΈΠ½Ρ‚Π΅Ρ€Π΅ΡΠΎΠ²Π°Π½Π½ΠΎΡΡ‚ΡŒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² Π² ΠΏΠΎΠ»ΡƒΡ‡Π΅Π½ΠΈΠΈ качСствСнной мСдицинской ΠΈΠ½Ρ„ΠΎΡ€ΠΌΠ°Ρ†ΠΈΠΈ ΠΏΠΎ ΠΏΡ€ΠΎΠ±Π»Π΅ΠΌΠ°ΠΌ Ρ€Π΅Π²ΠΌΠ°Ρ‚ΠΎΠ»ΠΎΠ³ΠΈΠΈ, ΠΏΠΎΠ»ΠΎΠΆΠΈΡ‚Π΅Π»ΡŒΠ½ΡƒΡŽ ΠΎΡ†Π΅Π½ΠΊΡƒ Ρ„ΠΎΡ€ΠΌΠ°Ρ‚Π° ΠΈ содСрТания ΠΎΠ½Π»Π°ΠΉΠ½ΡˆΠΊΠΎΠ»Ρ‹, Π΅Π΅ ΠΏΠΎΠ·ΠΈΡ‚ΠΈΠ²Π½ΡƒΡŽ Ρ€ΠΎΠ»ΡŒ Π² Ρ€Π°Π·ΡŠΡΡΠ½Π΅Π½ΠΈΠΈ сути заболСвания ΠΈ ΡΠΎΠΏΡƒΡ‚ΡΡ‚Π²ΡƒΡŽΡ‰ΠΈΡ… ΠΏΡ€ΠΎΠ±Π»Π΅ΠΌ.Π—Π°ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠ΅. Онлайн-ΡˆΠΊΠΎΠ»Ρ‹ для ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² ΠΏΡ€Π΅Π΄ΡΡ‚Π°Π²Π»ΡΡŽΡ‚ΡΡ Π°ΠΊΡ‚ΡƒΠ°Π»ΡŒΠ½Ρ‹ΠΌ ΠΈ пСрспСктивным Π½Π°ΠΏΡ€Π°Π²Π»Π΅Π½ΠΈΠ΅ΠΌ мСдицинской ΠΏΡ€ΠΎΡ„ΠΈΠ»Π°ΠΊΡ‚ΠΈΠΊΠΈ

    ΠšΠ°Ρ‡Π΅ΡΡ‚Π²ΠΎ вСдСния ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с ΠΏΠΎΠ΄Π°Π³Ρ€ΠΎΠΉ Π² Ρ€Π΅Π°Π»ΡŒΠ½ΠΎΠΉ клиничСской ΠΏΡ€Π°ΠΊΡ‚ΠΈΠΊΠ΅

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    Despite the existing guidelines for the management of gout and its potential reversibility, the quality of patient management in general therapy practice remains a serious issue.Objective: to assess the current state of management of patients with gout in real clinical practice.Patients and methods. The first stage of the study included an interview with 97 physicians grouped according to their specialties: rheumatologists, general practitioners, and others. The second stage involved an interview with 64 patients with gout who were followed up by physicians of different specialties.Results and discussion. Physicians most frequently used nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, glucocorticoids (GCs), and allopurinol. Urate-lowering drugs were prescribed mostly by rheumatologists and more rarely by other specialists. The most commonly used drug was allopurinol at a maximum dose 300 mg/day. There was a tendency to a decrease in the number of tophi in the patients who were treated according to the EULAR (European League Against Rheumatism) guidelines. The patients of this group also had lower levels of uric acid (UA) and were more highly adherent to therapy.The predominant use of NSAIDs in the rare administration of colchicine and GCs, as well as the use of allopurinol to relieve an acute gout attack creates prerequisites for aggravating the disease and decreasing patient compliance. The insufficient dose of allopurinol and no use of prophylactic colchicine for chronic gout contribute to the progression of the disease and the development of its acute attacks. Following the EULAR guidelines makes it possible to achieve the target levels of UA and not only prevent, but also to ensure the regression of gout manifestations, such as tophi.Conclusion. For radical improvement of the situation, physicians of all specialties should be regularly trained in the management of patients with gout according to the EULAR guidelines.ΠšΠ°Ρ‡Π΅ΡΡ‚Π²ΠΎ вСдСния ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с ΠΏΠΎΠ΄Π°Π³Ρ€ΠΎΠΉ Π² общСтСрапСвтичСской ΠΏΡ€Π°ΠΊΡ‚ΠΈΠΊΠ΅ остаСтся ΡΠ΅Ρ€ΡŒΠ΅Π·Π½ΠΎΠΉ ΠΏΡ€ΠΎΠ±Π»Π΅ΠΌΠΎΠΉ, нСсмотря Π½Π° ΡΡƒΡ‰Π΅ΡΡ‚Π²ΡƒΡŽΡ‰ΠΈΠ΅ Ρ€Π΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°Ρ†ΠΈΠΈ ΠΏΠΎ Π»Π΅Ρ‡Π΅Π½ΠΈΡŽ ΠΏΠΎΠ΄Π°Π³Ρ€Ρ‹ ΠΈ ΠΏΠΎΡ‚Π΅Π½Ρ†ΠΈΠ°Π»ΡŒΠ½ΡƒΡŽ ΠΎΠ±Ρ€Π°Ρ‚ΠΈΠΌΠΎΡΡ‚ΡŒ заболСвания.ЦСль исслСдования β€” ΠΎΡ†Π΅Π½ΠΊΠ° соврСмСнного состояния вСдСния ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с ΠΏΠΎΠ΄Π°Π³Ρ€ΠΎΠΉ Π² Ρ€Π΅Π°Π»ΡŒΠ½ΠΎΠΉ клиничСской ΠΏΡ€Π°ΠΊΡ‚ΠΈΠΊΠ΅.ΠŸΠ°Ρ†ΠΈΠ΅Π½Ρ‚Ρ‹ ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹. На ΠΏΠ΅Ρ€Π²ΠΎΠΌ этапС исслСдования ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½ опрос 97Π²Ρ€Π°Ρ‡Π΅ΠΉ, Ρ€Π°Π·Π΄Π΅Π»Π΅Π½Π½Ρ‹Ρ… ΠΏΠΎ ΡΠΏΠ΅Ρ†ΠΈΠ°Π»ΡŒΠ½ΠΎΡΡ‚ΡΠΌ: Ρ€Π΅Π²ΠΌΠ°Ρ‚ΠΎΠ»ΠΎΠ³ΠΎΠ², Ρ‚Π΅Ρ€Π°ΠΏΠ΅Π²Ρ‚ΠΎΠ² ΠΈ Π΄Ρ€ΡƒΠ³ΠΈΡ… спСциалистов; Π½Π° Π²Ρ‚ΠΎΡ€ΠΎΠΌ этапС β€” опрос 64 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с ΠΏΠΎΠ΄Π°Π³Ρ€ΠΎΠΉ, ΠΊΠΎΡ‚ΠΎΡ€Ρ‹Ρ… наблюдали Π²Ρ€Π°Ρ‡ΠΈ Ρ€Π°Π·Π½Ρ‹Ρ… ΡΠΏΠ΅Ρ†ΠΈΠ°Π»ΡŒΠ½ΠΎΡΡ‚Π΅ΠΉ.Π Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹ ΠΈ обсуТдСниС. Для купирования острого приступа ΠΏΠΎΠ΄Π°Π³Ρ€Ρ‹ Π²Ρ€Π°Ρ‡ΠΈ Ρ‡Π°Ρ‰Π΅ всСго использовали нСстСроидныС ΠΏΡ€ΠΎΡ‚ΠΈΠ²ΠΎΠ²ΠΎΡΠΏΠ°Π»ΠΈΡ‚Π΅Π»ΡŒΠ½Ρ‹Π΅ ΠΏΡ€Π΅ΠΏΠ°Ρ€Π°Ρ‚Ρ‹ (ΠΠŸΠ’ΠŸ), ΠΊΠΎΠ»Ρ…ΠΈΡ†ΠΈΠ½, Π³Π»ΡŽΠΊΠΎΠΊΠΎΡ€Ρ‚ΠΈΠΊΠΎΠΈΠ΄Ρ‹ (Π“Πš), Π° Ρ‚Π°ΠΊΠΆΠ΅ Π°Π»Π»ΠΎΠΏΡƒΡ€ΠΈΠ½ΠΎΠ». ΠŸΡ€ΠΈ Π²Π΅Π΄Π΅Π½ΠΈΠΈ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с хроничСской ΠΏΠΎΠ΄Π°Π³Ρ€ΠΎΠΉ ΡƒΡ€Π°Ρ‚-ΡΠ½ΠΈΠΆΠ°ΡŽΡ‰ΠΈΠ΅ ΠΏΡ€Π΅ΠΏΠ°Ρ€Π°Ρ‚Ρ‹ Π½Π°Π·Π½Π°Ρ‡Π°Π»ΠΈ Π² основном Ρ€Π΅Π²ΠΌΠ°Ρ‚ΠΎΠ»ΠΎΠ³ΠΈ ΠΈ Π·Π½Π°Ρ‡ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎ Ρ€Π΅ΠΆΠ΅ β€” Π²Ρ€Π°Ρ‡ΠΈ Π΄Ρ€ΡƒΠ³ΠΈΡ… ΡΠΏΠ΅Ρ†ΠΈΠ°Π»ΡŒΠ½ΠΎΡΡ‚Π΅ΠΉ. Из ΠΏΡ€Π΅ΠΏΠ°Ρ€Π°Ρ‚ΠΎΠ² самым популярным являлся Π°Π»Π»ΠΎΠΏΡƒΡ€ΠΈΠ½ΠΎΠ» Π² максимальной Π΄ΠΎΠ·Π΅ 300 ΠΌΠ³/сут. ВСндСнция ΠΊ ΡƒΠΌΠ΅Π½ΡŒΡˆΠ΅Π½ΠΈΡŽ числа тофусов ΠΎΡ‚ΠΌΠ΅Ρ‡Π°Π»Π°ΡΡŒ Ρƒ Ρ‚Π΅Ρ… Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ…, Π²Π΅Π΄Π΅Π½ΠΈΠ΅ ΠΊΠΎΡ‚ΠΎΡ€Ρ‹Ρ… ΠΎΡΡƒΡ‰Π΅ΡΡ‚Π²Π»ΡΠ»ΠΎΡΡŒ Π² соотвСтствии с рСкомСндациями EULAR. Π’ этой ΠΆΠ΅ Π³Ρ€ΡƒΠΏΠΏΠ΅ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² Π±Ρ‹Π» Π±ΠΎΠ»Π΅Π΅ Π½ΠΈΠ·ΠΊΠΈΠΉ ΡƒΡ€ΠΎΠ²Π΅Π½ΡŒ ΠΌΠΎΡ‡Π΅Π²ΠΎΠΉ кислоты (МК) ΠΈ Π±ΠΎΠ»Π΅Π΅ высокий ΡƒΡ€ΠΎΠ²Π΅Π½ΡŒ привСрТСнности Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ.ΠŸΡ€Π΅ΠΈΠΌΡƒΡ‰Π΅ΡΡ‚Π²Π΅Π½Π½ΠΎΠ΅ использованиС ΠΠŸΠ’ΠŸ ΠΏΡ€ΠΈ Ρ€Π΅Π΄ΠΊΠΎΠΌ Π½Π°Π·Π½Π°Ρ‡Π΅Π½ΠΈΠΈ ΠΊΠΎΠ»Ρ…ΠΈΡ†ΠΈΠ½Π° ΠΈ Π“Πš, Π° Ρ‚Π°ΠΊΠΆΠ΅ ΠΏΡ€ΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ Π°Π»Π»ΠΎΠΏΡƒΡ€ΠΈΠ½ΠΎΠ»Π° для купирования острого приступа ΡΠΎΠ·Π΄Π°ΡŽΡ‚ прСдпосылки для усугублСния тСчСния заболСвания ΠΈ сниТСния комплаСнса. ΠΠ΅Π΄ΠΎΡΡ‚Π°Ρ‚ΠΎΡ‡Π½ΠΎΡΡ‚ΡŒ Π΄ΠΎΠ·Ρ‹ Π°Π»Π»ΠΎΠΏΡƒΡ€ΠΈΠ½ΠΎΠ»Π° ΠΈ отсутствиС профилактичСского назначСния ΠΊΠΎΠ»Ρ…ΠΈΡ†ΠΈΠ½Π° для лСчСния хроничСской ΠΏΠΎΠ΄Π°Π³Ρ€Ρ‹ ΡΠΏΠΎΡΠΎΠ±ΡΡ‚Π²ΡƒΡŽΡ‚ ΠΏΡ€ΠΎΠ³Ρ€Π΅ΡΡΠΈΡ€ΠΎΠ²Π°Π½ΠΈΡŽ заболСвания ΠΈ Ρ€Π°Π·Π²ΠΈΡ‚ΠΈΡŽ острых Π°Ρ‚Π°ΠΊ. Π‘Π»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ рСкомСндациям EULAR позволяСт Π΄ΠΎΡΡ‚ΠΈΡ‡ΡŒ Ρ†Π΅Π»Π΅Π²ΠΎΠ³ΠΎ уровня МК ΠΈ Π½Π΅ Ρ‚ΠΎΠ»ΡŒΠΊΠΎ ΠΏΡ€Π΅Π΄ΠΎΡ‚Π²Ρ€Π°Ρ‚ΠΈΡ‚ΡŒ, Π½ΠΎ ΠΈ Π΄ΠΎΠ±ΠΈΡ‚ΡŒΡΡ ΠΎΠ±Ρ€Π°Ρ‚Π½ΠΎΠ³ΠΎ развития Ρ‚Π°ΠΊΠΈΡ… проявлСний ΠΏΠΎΠ΄Π°Π³Ρ€Ρ‹, ΠΊΠ°ΠΊ тофусы.Π’Ρ‹Π²ΠΎΠ΄Ρ‹. Для Ρ€Π°Π΄ΠΈΠΊΠ°Π»ΡŒΠ½ΠΎΠ³ΠΎ ΡƒΠ»ΡƒΡ‡ΡˆΠ΅Π½ΠΈΡ ситуации Π½Π΅ΠΎΠ±Ρ…ΠΎΠ΄ΠΈΠΌΠΎ рСгулярноС ΠΎΠ±ΡƒΡ‡Π΅Π½ΠΈΠ΅ Π²Ρ€Π°Ρ‡Π΅ΠΉ всСх ΡΠΏΠ΅Ρ†ΠΈΠ°Π»ΡŒΠ½ΠΎΡΡ‚Π΅ΠΉ Ρ€Π°Ρ†ΠΈΠΎΠ½Π°Π»ΡŒΠ½ΠΎΠΌΡƒ вСдСнию ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с ΠΏΠΎΠ΄Π°Π³Ρ€ΠΎΠΉ, основанному Π½Π° клиничСских рСкомСндациях EULAR

    Ѐибромиалгия: клиничСская ΠΊΠ°Ρ€Ρ‚ΠΈΠ½Π° ΠΈ Π²Π°Ρ€ΠΈΠ°Π½Ρ‚Ρ‹ заболСвания

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    Fibromyalgia (FM) is a condition characterized by generalized pain syndrome and by the presence of fatigue, cognitive impairment, affective and multiple somatic symptoms. Pain syndrome can have national, ethnic, gender, and age characteristics.Objective: to evaluate the features of the course of FM in a large industrial center of the Russian Federation and to present its phenotypic options.Patients and methods. The investigation enrolled 92 FM patients (8 men, 84 women) aged 18 to 86 years (mean age, 50.5 years). The diagnosis was established according to the 2016 ACR criteria. Account was taken of data on disease duration, occupation, sport training loads, previous therapy, pain intensity, and somatic symptoms according to the 2010 ACR diagnostic criteria and on general health assessment in the patients. All the patients completed the hospital anxiety and depression scale (HADS).Results and discussion. The most significant somatic symptoms in the clinical picture of FM were shown to be muscle pain and muscle weakness, the manifestations of irritable bowel syndrome and fatigue; moreover, the prevalence of many symptoms in people over 60 years of age was lower than that in younger patients. Female gender was an additional risk factor for increases in pain and cognitive impairment. The presence of concomitant depression verified by HADS was associated with a substantial deterioration of the clinical manifestations of FM. At the same time, professional activities and sports were found to be protective factors against a number of symptoms of FM. It was hypothesized that there were several FM phenotypes (anxious, anxiety-depressive, egocentric, and vascular ones).Conclusion. The authors have demonstrated the features of the course of FM in a large industrial center of the Russian Federation and identified various disease phenotypes, which can be useful for determining the treatment policy for patients.Ѐибромиалгия (ЀМ) – состояниС, Ρ…Π°Ρ€Π°ΠΊΡ‚Π΅Ρ€ΠΈΠ·ΡƒΡŽΡ‰Π΅Π΅ΡΡ синдромом Π³Π΅Π½Π΅Ρ€Π°Π»ΠΈΠ·ΠΎΠ²Π°Π½Π½ΠΎΠΉ Π±ΠΎΠ»ΠΈ, Π° Ρ‚Π°ΠΊΠΆΠ΅ Π½Π°Π»ΠΈΡ‡ΠΈΠ΅ΠΌ усталости, ΠΊΠΎΠ³Π½ΠΈΡ‚ΠΈΠ²Π½Ρ‹Ρ… Π½Π°Ρ€ΡƒΡˆΠ΅Π½ΠΈΠΉ, Π°Ρ„Ρ„Π΅ΠΊΡ‚ΠΈΠ²Π½Ρ‹Ρ… ΠΈ мноТСствСнных соматичСских симптомов. Π‘ΠΎΠ»Π΅Π²ΠΎΠΉ синдром ΠΌΠΎΠΆΠ΅Ρ‚ ΠΈΠΌΠ΅Ρ‚ΡŒ Π½Π°Ρ†ΠΈΠΎΠ½Π°Π»ΡŒΠ½Ρ‹Π΅, этничСскиС, Π³Π΅Π½Π΄Π΅Ρ€Π½Ρ‹Π΅ ΠΈ возрастныС особСнности.ЦСль исслСдования – ΠΎΡ†Π΅Π½ΠΈΡ‚ΡŒ особСнности тСчСния ЀМ Π² ΠΊΡ€ΡƒΠΏΠ½ΠΎΠΌ ΠΏΡ€ΠΎΠΌΡ‹ΡˆΠ»Π΅Π½Π½ΠΎΠΌ Ρ†Π΅Π½Ρ‚Ρ€Π΅ Российской Π€Π΅Π΄Π΅Ρ€Π°Ρ†ΠΈΠΈ ΠΈ ΠΏΡ€Π΅Π΄ΡΡ‚Π°Π²ΠΈΡ‚ΡŒ Π΅Π΅ фСнотипичСскиС Π²Π°Ρ€ΠΈΠ°Π½Ρ‚Ρ‹.ΠŸΠ°Ρ†ΠΈΠ΅Π½Ρ‚Ρ‹ ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹. Π’ исслСдованиС Π²ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΎ 92 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π° (8 ΠΌΡƒΠΆΡ‡ΠΈΠ½, 84 ΠΆΠ΅Π½Ρ‰ΠΈΠ½Ρ‹) с ЀМ Π² возрастС ΠΎΡ‚ 18 Π΄ΠΎ 86 Π»Π΅Ρ‚ (срСдний возраст 50,5 Π³ΠΎΠ΄Π°). Π”ΠΈΠ°Π³Π½ΠΎΠ· устанавливали согласно критСриям ACR 2016 Π³. Π£Ρ‡ΠΈΡ‚Ρ‹Π²Π°Π»ΠΈ Ρ‚Π°ΠΊΠΆΠ΅ Π΄Π°Π½Π½Ρ‹Π΅ ΠΎ давности заболСвания, ΠΏΡ€ΠΎΡ„Π΅ΡΡΠΈΠΎΠ½Π°Π»ΡŒΠ½ΠΎΠΉ занятости, Π½Π°Π»ΠΈΡ‡ΠΈΠΈ спортивных Π½Π°Π³Ρ€ΡƒΠ·ΠΎΠΊ, ΠΏΡ€ΠΎΠ²ΠΎΠ΄ΠΈΠΌΠΎΠΉ Ρ€Π°Π½Π΅Π΅ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ, выраТСнности Π±ΠΎΠ»ΠΈ, соматичСских симптомов ΠΈΠ· диагностичСских ΠΊΡ€ΠΈΡ‚Π΅Ρ€ΠΈΠ΅Π² ACR 2010 Π³. ΠΈ ΠΎΠ±Ρ‰Π΅ΠΉ ΠΎΡ†Π΅Π½ΠΊΠ΅ состояния Π·Π΄ΠΎΡ€ΠΎΠ²ΡŒΡ Π±ΠΎΠ»ΡŒΠ½Ρ‹ΠΌ. ВсС ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Ρ‹ заполняли Π³ΠΎΡΠΏΠΈΡ‚Π°Π»ΡŒΠ½ΡƒΡŽ Π°Π½ΠΊΠ΅Ρ‚Ρƒ Ρ‚Ρ€Π΅Π²ΠΎΠ³ΠΈ ΠΈ дСпрСссии (HADS).Π Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹ ΠΈ обсуТдСниС. Показано, Ρ‡Ρ‚ΠΎ Π² клиничСской ΠΊΠ°Ρ€Ρ‚ΠΈΠ½Π΅ ЀМ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ Π·Π½Π°Ρ‡ΠΈΠΌΡ‹ΠΌΠΈ соматичСскими симптомами являлись ΠΌΡ‹ΡˆΠ΅Ρ‡Π½Π°Ρ боль ΠΈ ΠΌΡ‹ΡˆΠ΅Ρ‡Π½Π°Ρ ΡΠ»Π°Π±ΠΎΡΡ‚ΡŒ, проявлСния синдрома Ρ€Π°Π·Π΄Ρ€Π°ΠΆΠ΅Π½Π½ΠΎΠΉ кишки ΠΈ ΡƒΡΡ‚Π°Π»ΠΎΡΡ‚ΡŒ, ΠΏΡ€ΠΈΡ‡Π΅ΠΌ Ρ€Π°ΡΠΏΡ€ΠΎΡΡ‚Ρ€Π°Π½Π΅Π½Π½ΠΎΡΡ‚ΡŒ ΠΌΠ½ΠΎΠ³ΠΈΡ… симптомов Ρƒ Π»ΠΈΡ† ΡΡ‚Π°Ρ€ΡˆΠ΅ 60 Π»Π΅Ρ‚ Π±Ρ‹Π»Π° мСньшСй, Ρ‡Π΅ΠΌ Ρƒ Π±ΠΎΠ»Π΅Π΅ ΠΌΠΎΠ»ΠΎΠ΄Ρ‹Ρ… ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ². ЖСнский ΠΏΠΎΠ» выступал Π΄ΠΎΠΏΠΎΠ»Π½ΠΈΡ‚Π΅Π»ΡŒΠ½Ρ‹ΠΌ Ρ„Π°ΠΊΡ‚ΠΎΡ€ΠΎΠΌ риска усилСния Π±ΠΎΠ»Π΅Π²Ρ‹Ρ… ΠΎΡ‰ΡƒΡ‰Π΅Π½ΠΈΠΉ ΠΈ ΠΊΠΎΠ³Π½ΠΈΡ‚ΠΈΠ²Π½Ρ‹Ρ… Π½Π°Ρ€ΡƒΡˆΠ΅Π½ΠΈΠΉ. НаличиС ΡΠΎΠΏΡƒΡ‚ΡΡ‚Π²ΡƒΡŽΡ‰Π΅ΠΉ дСпрСссии, Π²Π΅Ρ€ΠΈΡ„ΠΈΡ†ΠΈΡ€ΠΎΠ²Π°Π½Π½ΠΎΠΉ ΠΏΠΎ HADS, Π°ΡΡΠΎΡ†ΠΈΠΈΡ€ΠΎΠ²Π°Π»ΠΎΡΡŒ с сущСствСнным ΡƒΡ…ΡƒΠ΄ΡˆΠ΅Π½ΠΈΠ΅ΠΌ клиничСских проявлСний ЀМ. Π’ Ρ‚ΠΎ ΠΆΠ΅ врСмя ΠΏΡ€ΠΎΡ‚Π΅ΠΊΡ‚ΠΈΠ²Π½Ρ‹ΠΌΠΈ Ρ„Π°ΠΊΡ‚ΠΎΡ€Π°ΠΌΠΈ Π² ΠΎΡ‚Π½ΠΎΡˆΠ΅Π½ΠΈΠΈ ряда симптомов ЀМ оказались ΠΏΡ€ΠΎΡ„Π΅ΡΡΠΈΠΎΠ½Π°Π»ΡŒΠ½Π°Ρ Π΄Π΅ΡΡ‚Π΅Π»ΡŒΠ½ΠΎΡΡ‚ΡŒ ΠΈ занятия спортом. Π’Ρ‹Π΄Π²ΠΈΠ½ΡƒΡ‚Π° Π³ΠΈΠΏΠΎΡ‚Π΅Π·Π° ΠΎ Π½Π°Π»ΠΈΡ‡ΠΈΠΈ Π½Π΅ΡΠΊΠΎΠ»ΡŒΠΊΠΈΡ… Ρ„Π΅Π½ΠΎΡ‚ΠΈΠΏΠΎΠ² ЀМ (Ρ‚Ρ€Π΅Π²ΠΎΠΆΠ½Ρ‹ΠΉ, Ρ‚Ρ€Π΅Π²ΠΎΠΆΠ½ΠΎ-дСпрСссивный, эгоцСнтричный ΠΈ сосудистый).Π—Π°ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠ΅. ΠŸΡ€ΠΎΠ΄Π΅ΠΌΠΎΠ½ΡΡ‚Ρ€ΠΈΡ€ΠΎΠ²Π°Π½Ρ‹ особСнности тСчСния ЀМ Π² ΠΊΡ€ΡƒΠΏΠ½ΠΎΠΌ ΠΏΡ€ΠΎΠΌΡ‹ΡˆΠ»Π΅Π½Π½ΠΎΠΌ Ρ†Π΅Π½Ρ‚Ρ€Π΅ Российской Π€Π΅Π΄Π΅Ρ€Π°Ρ†ΠΈΠΈ ΠΈ Π²Ρ‹Π΄Π΅Π»Π΅Π½Ρ‹ Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹Π΅ Ρ„Π΅Π½ΠΎΡ‚ΠΈΠΏΡ‹ заболСвания, Ρ‡Ρ‚ΠΎ ΠΌΠΎΠΆΠ΅Ρ‚ Π±Ρ‹Ρ‚ΡŒ ΠΏΠΎΠ»Π΅Π·Π½Ρ‹ΠΌ ΠΏΡ€ΠΈ ΠΎΠΏΡ€Π΅Π΄Π΅Π»Π΅Π½ΠΈΠΈ Ρ‚Π°ΠΊΡ‚ΠΈΠΊΠΈ лСчСния ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ²

    Key aspects of the management of patient schools as telemedicine technology of modern healthcare

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    Introduction. A feature of healthcare in 2020 was the work in conditions of massive incidence of COVID-19, limited and redistribution of human resources. One of the right decisions in these conditions is to manage schools for patients, which allow simultaneous education and convey the necessary information to a large number of people. For the first time, the key aspects of the management of telemedicine schools for patients are presented. The purpose of the study is to assess the feasibility of telemedicine schools for patients as a technology of modern health care. Material and methods. The work was carried out by the method of a one-stage cross-sectional study of the questionnaire survey of participants of two schools cycles, conducted in an on-line mode. Results. One thousand four hundred three1403 patients took part in the cycle for rehabilitation after COVID-19. Feedback from 171 listeners was received for the questionnaire based on the Google platform. The number of participants in rheumatology schools was 197 people, the results of the questionnaire were received from 36 respondents. Limitations of the study: The study analyzed two different in size and relatively small groups of participants who anonymously answered standardized questions about the appropriateness and quality of the training provided. Discussion. 10 key principles of managing online patient education at the present stage were identified as follows: the use of distance technologies, the interest of a medical institution administration, the team approach, the technical possibilities of implementing schools, adaptation of lecture material for patients, the role of a qualified specialist in the educational process, patient participation, measurement efficiency and timely correction, development and improvement of educational technology for patients, desire for cooperation and exchange of experience. Conclusion. The emergence of new opportunities related to online health education of the population, including educational activities for patients, opens up new prospects for improving clinical care aimed at promoting health and preventing disease.Π’Π²Π΅Π΄Π΅Π½ΠΈΠ΅. ΠžΡΠΎΠ±Π΅Π½Π½ΠΎΡΡ‚ΡŒΡŽ здравоохранСния Π² 2020 Π³. явилась Ρ€Π°Π±ΠΎΡ‚Π° Π² условиях массовой заболСваСмости COVID-19, ограничСнности ΠΈ пСрСраспрСдСлСния ΠΊΠ°Π΄Ρ€ΠΎΠ²Ρ‹Ρ… рСсурсов, Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚ΠΎΠΌ Ρ‡Π΅Π³ΠΎ стала нСдостаточная ΠΈΠ½Ρ„ΠΎΡ€ΠΌΠΈΡ€ΠΎΠ²Π°Π½Π½ΠΎΡΡ‚ΡŒ насСлСния ΠΏΠΎ Ρ€Π°Π·Π»ΠΈΡ‡Π½Ρ‹ΠΌ аспСктам Π·Π΄ΠΎΡ€ΠΎΠ²ΡŒΡ. Одним ΠΈΠ· ΠΏΡ€Π°Π²ΠΈΠ»ΡŒΠ½Ρ‹Ρ… Ρ€Π΅ΡˆΠ΅Π½ΠΈΠΉ Π² этих условиях являСтся организация школ для ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ², ΠΊΠΎΡ‚ΠΎΡ€Ρ‹Π΅ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΡŽΡ‚ провСсти ΠΎΠ΄Π½ΠΎΠ²Ρ€Π΅ΠΌΠ΅Π½Π½ΠΎΠ΅ ΠΎΠ±ΡƒΡ‡Π΅Π½ΠΈΠ΅ ΠΈ донСсти Π½Π΅ΠΎΠ±Ρ…ΠΎΠ΄ΠΈΠΌΡƒΡŽ ΠΈΠ½Ρ„ΠΎΡ€ΠΌΠ°Ρ†ΠΈΡŽ Π΄ΠΎ большого числа людСй. Π’ΠΏΠ΅Ρ€Π²Ρ‹Π΅ прСдставлСны ΠΊΠ»ΡŽΡ‡Π΅Π²Ρ‹Π΅ аспСкты ΠΎΡ€Π³Π°Π½ΠΈΠ·Π°Ρ†ΠΈΠΈ тСлСмСдицинских школ для ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² Π² условиях ΠΏΠ°Π½Π΄Π΅ΠΌΠΈΠΈ Π½ΠΎΠ²ΠΎΠΉ коронавирусной ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΈ. ЦСлью исслСдования являСтся ΠΎΡ†Π΅Π½ΠΊΠ° цСлСсообразности тСлСмСдицинских школ для ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² ΠΊΠ°ΠΊ Ρ‚Π΅Ρ…Π½ΠΎΠ»ΠΎΠ³ΠΈΠΈ соврСмСнного здравоохранСния. ΠœΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π» ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹. Π Π°Π±ΠΎΡ‚Π° ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½Π° ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΎΠΌ ΠΎΠ΄Π½ΠΎΠΌΠΎΠΌΠ΅Π½Ρ‚Π½ΠΎΠ³ΠΎ ΠΏΠΎΠΏΠ΅Ρ€Π΅Ρ‡Π½ΠΎΠ³ΠΎ исслСдования Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚ΠΎΠ² анкСтирования ΡΠ»ΡƒΡˆΠ°Ρ‚Π΅Π»Π΅ΠΉ Π΄Π²ΡƒΡ… Ρ†ΠΈΠΊΠ»ΠΎΠ² школ, ΠΏΡ€ΠΎΠ²ΠΎΠ΄ΠΈΠ²ΡˆΠΈΡ…ΡΡ Π² ΠΎΠ½Π»Π°ΠΉΠ½-Ρ€Π΅ΠΆΠΈΠΌΠ΅. Π Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹. Π’ Ρ†ΠΈΠΊΠ»Π΅ школ ΠΏΠΎ Ρ€Π΅Π°Π±ΠΈΠ»ΠΈΡ‚Π°Ρ†ΠΈΠΈ послС пСрСнСсённого COVID-19 приняли участиС 1403 Ρ‡Π΅Π»ΠΎΠ²Π΅ΠΊΠ°, обратная связь Π² Ρ…ΠΎΠ΄Π΅ опросника Π½Π° основС Google-ΠΏΠ»Π°Ρ‚Ρ„ΠΎΡ€ΠΌΡ‹ ΠΏΠΎΠ»ΡƒΡ‡Π΅Π½Π° ΠΎΡ‚ 171 ΡΠ»ΡƒΡˆΠ°Ρ‚Π΅Π»Ρ. Π§ΠΈΡΠ»Π΅Π½Π½ΠΎΡΡ‚ΡŒ участников школ ΠΏΠΎ Ρ€Π΅Π²ΠΌΠ°Ρ‚ΠΎΠ»ΠΎΠ³ΠΈΠΈ составила 197 Ρ‡Π΅Π»ΠΎΠ²Π΅ΠΊ, Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹ анкСтирования ΠΏΠΎΠ»ΡƒΡ‡Π΅Π½Ρ‹ ΠΎΡ‚ 36 рСспондСнтов. Π’Ρ‹Π΄Π΅Π»Π΅Π½Ρ‹ 10 ΠΊΠ»ΡŽΡ‡Π΅Π²Ρ‹Ρ… ΠΏΡ€ΠΈΠ½Ρ†ΠΈΠΏΠΎΠ² ΠΎΡ€Π³Π°Π½ΠΈΠ·Π°Ρ†ΠΈΠΈ ΠΎΠ½Π»Π°ΠΉΠ½-образования ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² Π½Π° соврСмСнном этапС: использованиС дистанционных Ρ‚Π΅Ρ…Π½ΠΎΠ»ΠΎΠ³ΠΈΠΉ, Π·Π°ΠΈΠ½Ρ‚Π΅Ρ€Π΅ΡΠΎΠ²Π°Π½Π½ΠΎΡΡ‚ΡŒ руководства ΠΈ администрации Π»Π΅Ρ‡Π΅Π±Π½ΠΎΠ³ΠΎ учрСТдСния, ΠΊΠΎΠΌΠ°Π½Π΄Π½Ρ‹ΠΉ ΠΏΠΎΠ΄Ρ…ΠΎΠ΄, тСхничСскиС возмоТности Ρ€Π΅Π°Π»ΠΈΠ·Π°Ρ†ΠΈΠΈ школ, адаптация Π»Π΅ΠΊΡ†ΠΈΠΎΠ½Π½ΠΎΠ³ΠΎ ΠΌΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π»Π° для ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ², Ρ€ΠΎΠ»ΡŒ ΠΏΡ€ΠΎΡ„ΠΈΠ»ΡŒΠ½ΠΎΠ³ΠΎ спСциалиста Π² процСссС просвСщСния, участиС ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ², ΠΈΠ·ΠΌΠ΅Ρ€Π΅Π½ΠΈΠ΅ эффСктивности ΠΈ своСврСмСнноС внСсСниС ΠΊΠΎΡ€Ρ€Π΅ΠΊΡ‚ΠΈΠ², Ρ€Π°Π·Π²ΠΈΡ‚ΠΈΠ΅ ΠΈ ΡΠΎΠ²Π΅Ρ€ΡˆΠ΅Π½ΡΡ‚Π²ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΎΠ±Ρ€Π°Π·ΠΎΠ²Π°Ρ‚Π΅Π»ΡŒΠ½ΠΎΠΉ Ρ‚Π΅Ρ…Π½ΠΎΠ»ΠΎΠ³ΠΈΠΈ для ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ², ΠΆΠ΅Π»Π°Π½ΠΈΠ΅ сотрудничСства ΠΈ ΠΎΠ±ΠΌΠ΅Π½Π° ΠΎΠΏΡ‹Ρ‚ΠΎΠΌ. ΠžΠ³Ρ€Π°Π½ΠΈΡ‡Π΅Π½ΠΈΡ исслСдования. Π’ Ρ€Π°Π±ΠΎΡ‚Π΅ ΠΏΡ€ΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡ€ΠΎΠ²Π°Π½Ρ‹ Π΄Π²Π΅ Ρ€Π°Π·Π½Ρ‹Π΅ ΠΏΠΎ Ρ€Π°Π·ΠΌΠ΅Ρ€Ρƒ ΠΈ ΠΎΡ‚Π½ΠΎΡΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎ нСбольшиС Π³Ρ€ΡƒΠΏΠΏΡ‹ ΡΠ»ΡƒΡˆΠ°Ρ‚Π΅Π»Π΅ΠΉ, ΠΊΠΎΡ‚ΠΎΡ€Ρ‹Π΅ Π°Π½ΠΎΠ½ΠΈΠΌΠ½ΠΎ ΠΎΡ‚Π²Π΅Ρ‡Π°Π»ΠΈ Π½Π° стандартизированныС вопросы ΠΎ цСлСсообразности ΠΈ качСствС ΠΏΡ€ΠΎΠ²Π΅Π΄Ρ‘Π½Π½ΠΎΠ³ΠΎ обучСния. Π—Π°ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠ΅. ПоявлСниС Π½ΠΎΠ²Ρ‹Ρ… возмоТностСй, связанных с тСлСмСдицинским ΠΎΠ±Ρ€Π°Π·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ насСлСния, Π²ΠΊΠ»ΡŽΡ‡Π°Ρ ΠΎΠ±Ρ€Π°Π·ΠΎΠ²Π°Ρ‚Π΅Π»ΡŒΠ½Ρ‹Π΅ мСроприятия для ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ², ΠΎΡ‚ΠΊΡ€Ρ‹Π²Π°ΡŽΡ‚ Π½ΠΎΠ²Ρ‹Π΅ пСрспСктивы для ΡƒΠ»ΡƒΡ‡ΡˆΠ΅Π½ΠΈΡ клиничСской ΠΏΠΎΠΌΠΎΡ‰ΠΈ, Π½Π°ΠΏΡ€Π°Π²Π»Π΅Π½Π½ΠΎΠΉ Π½Π° ΡƒΠΊΡ€Π΅ΠΏΠ»Π΅Π½ΠΈΠ΅ Π·Π΄ΠΎΡ€ΠΎΠ²ΡŒΡ ΠΈ ΠΏΡ€ΠΎΡ„ΠΈΠ»Π°ΠΊΡ‚ΠΈΠΊΡƒ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ
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