36 research outputs found
ΠΡΠΎΠ±Π»Π΅ΠΌΡ ΠΏΠΎΠ»ΠΈΠ³ΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΈΠ·Π³ΠΎΡΠΎΠ²Π»Π΅Π½ΠΈΡ Π½ΠΎΠ²Π΅ΠΉΡΠΈΡ ΡΠΏΠ°ΠΊΠΎΠ²ΠΎΠΊ Ρ Π½Π°Π½ΠΎΡΠ°Π·ΠΌΠ΅ΡΠ½ΡΠΌΠΈ ΡΠΎΡΠΎΠ°ΠΊΡΠΈΠ²Π½ΡΠΌ ΡΠ»Π΅ΠΌΠ΅Π½ΡΠ°ΠΌΠΈ
Π£ ΡΡΠ°ΡΡΡ ΡΠΎΠ·Π³Π»ΡΠ½ΡΡΠΎ ΠΎΡΠΎΠ±Π»ΠΈΠ²ΠΎΡΡΡ Π²ΠΈΠ³ΠΎΡΠΎΠ²Π»Π΅Π½Π½Ρ Π°ΠΊΡΠΈΠ²Π½ΠΈΡ
Ρ Β«ΡΠΎΠ·ΡΠΌΠ½ΠΈΡ
Β» ΠΏΠ°ΠΊΠΎΠ²Π°Π½Ρ, Ρ ΡΠΎΠΌΡ ΡΠΈΡΠ»Ρ ΡΠ· Π²ΠΈΠΊΠΎΡΠΈΡΡΠ°Π½Π½ΡΠΌ Π½Π°Π½ΠΎΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΡΠΉ. ΠΠΈΡΠ²Π»Π΅Π½ΠΎ ΠΌΠΎΠΆΠ»ΠΈΠ²ΠΎΡΡΡ Π·Π°ΡΡΠΎΡΡΠ²Π°Π½Π½Ρ ΠΏΠΎΠ»ΡΠ³ΡΠ°ΡΡΡΠ½ΠΈΡ
ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΡΠΉ Ρ Π²ΠΈΡΠΎΠ±Π½ΠΈΡΡΠ²Ρ Π°ΠΊΡΠΈΠ²Π½ΠΈΡ
Ρ Β«ΡΠΎΠ·ΡΠΌΠ½ΠΈΡ
Β» ΠΏΠ°ΠΊΠΎΠ²Π°Π½Ρ Π· Π½Π°Π½ΠΎΡΠΎΠ·ΠΌΡΡΠ½ΠΈΠΌΠΈ ΡΠΎΡΠΎΠ°ΠΊΡΠΈΠ²Π½ΠΈΠΌΠΈ Π΅Π»Π΅ΠΌΠ΅Π½ΡΠ°ΠΌΠΈ, Π° ΡΠ°ΠΊΠΎΠΆ ΠΏΡΠΎΠ°Π½Π°Π»ΡΠ·ΠΎΠ²Π°Π½ΠΎ ΠΏΠΈΡΠ°Π½Π½Ρ Π±Π΅Π·ΠΏΠ΅ΡΠ½ΠΎΡΡΡ Π½ΠΎΠ²ΡΡΠ½ΡΡ
ΠΏΠ°ΠΊΠΎΠ²Π°Π½Ρ Π΄Π»Ρ ΡΠΏΠΎΠΆΠΈΠ²Π°ΡΡΠ².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 ΡΡΠ°ΡΡΠ΅ ΡΠ°ΡΡΠΌΠΎΡΡΠ΅Π½Ρ ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠΈ ΠΈΠ·Π³ΠΎΡΠΎΠ²Π»Π΅Π½ΠΈΡ Π°ΠΊΡΠΈΠ²Π½ΠΎΠΉ ΠΈ ΡΠΌΠ½ΠΎΠΉ ΡΠΏΠ°ΠΊΠΎΠ²ΠΊΠΈ, Π² ΡΠΎΠΌ ΡΠΈΡΠ»Π΅ Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ Π½Π°Π½ΠΎΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΠΉ. ΠΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Ρ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠΈ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΡ ΠΏΠΎΠ»ΠΈΠ³ΡΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΠΉ Π² ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΡΡΠ²Π΅ Π°ΠΊΡΠΈΠ²Π½ΠΎΠΉ ΠΈ ΡΠΌΠ½ΠΎΠΉ ΡΠΏΠ°ΠΊΠΎΠ²ΠΊΠΈ Ρ Π½Π°Π½ΠΎΡΠ°Π·ΠΌΠ΅ΡΠ½ΡΠΌΠΈ ΡΠΎΡΠΎΠ°ΠΊΡΠΈΠ²Π½ΡΠΌΠΈ ΡΠ»Π΅ΠΌΠ΅Π½ΡΠ°ΠΌΠΈ, Π° ΡΠ°ΠΊΠΆΠ΅ ΠΏΡΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Ρ Π²ΠΎΠΏΡΠΎΡΡ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡΠΈ Π½ΠΎΠ²Π΅ΠΉΡΠ΅ΠΉ ΡΠΏΠ°ΠΊΠΎΠ²ΠΊΠΈ Π΄Π»Ρ ΠΏΠΎΡΡΠ΅Π±ΠΈΡΠ΅Π»Π΅ΠΉ
ΠΡΡΠΈ ΡΡΠΎΠ²Π΅ΡΡΠ΅Π½ΡΡΠ²ΠΎΠ²Π°Π½ΠΈΡ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ ΡΠΈΠ½Π°Π½ΡΠΎΠ²ΠΎ-Ρ ΠΎΠ·ΡΠΉΡΡΠ²Π΅Π½Π½ΠΎΠΉ Π΄Π΅ΡΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ Π²ΡΡΡΠ°Π²ΠΎΡΠ½ΠΎ-ΡΡΠΌΠ°ΡΠΎΡΠ½ΡΡ ΠΏΡΠ΅Π΄ΠΏΡΠΈΡΡΠΈΠΉ
Π Π΄Π°Π½ΡΠΉ ΡΡΠ°ΡΡΡ ΡΠΎΠ·Π³Π»ΡΠ½ΡΡΡ ΠΎΡΠ½ΠΎΠ²Π½Ρ ΡΠ΅ΠΎΡΠ΅ΡΠΈΡΠ½Ρ Π·Π°ΡΠ°Π΄ΠΈ Π²ΠΈΠ·Π½Π°ΡΠ΅Π½Π½Ρ ΠΏΠΎΠΊΠ°Π·Π½ΠΈΠΊΡΠ² ΡΡΠ½Π°Π½ΡΠΎΠ²ΠΎ-Π³ΠΎΡΠΏΠΎΠ΄Π°ΡΡΡΠΊΠΎΡ Π΄ΡΡΠ»ΡΠ½ΠΎΡΡΡ Π½Π΅Π²ΠΈΡΠΎΠ±Π½ΠΈΡΠΈΡ
ΠΏΡΠ΄ΠΏΡΠΈΡΠΌΡΡΠ², ΡΠΎΠ·ΡΠΎΠ±Π»Π΅Π½Ρ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΡΡ Π΄Π»Ρ ΠΏΠΎΠΊΡΠ°ΡΠ΅Π½Π½Ρ Π΅ΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΡΡΠ½Π°Π½ΡΠΎΠ²ΠΎ-Π³ΠΎΡΠΏΠΎΠ΄Π°ΡΡΡΠΊΠΎΡ Π΄ΡΡΠ»ΡΠ½ΠΎΡΡΡ ΠΏΡΠ΄ΠΏΡΠΈΡΠΌΡΡΠ², ΡΠΊΡ Π·Π°ΠΉΠΌΠ°ΡΡΡΡΡ Π²ΠΈΡΡΠ°Π²ΠΊΠΎΠ²ΠΎ-ΡΡΠΌΠ°ΡΠΊΠΎΠ²ΠΎΡ Π΄ΡΡΠ»ΡΠ½ΡΡΡΡ.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 ΡΡΠ°ΡΡΠ΅ ΡΠ°ΡΡΠΌΠΎΡΡΠ΅Π½Ρ ΡΠ΅ΠΎΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΎΡΠ½ΠΎΠ²Ρ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ ΡΠΈΠ½Π°Π½ΡΠΎΠ²ΠΎ-Ρ
ΠΎΠ·ΡΠΉΡΡΠ²Π΅Π½Π½ΠΎΠΉ Π΄Π΅ΡΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ Π½Π΅ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΡΡΠ²Π΅Π½Π½ΡΡ
ΠΏΡΠ΅Π΄ΠΏΡΠΈΡΡΠΈΠΉ, ΡΠ°Π·ΡΠ°Π±ΠΎΡΠ°Π½Ρ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΈ Π΄Π»Ρ ΡΠ»ΡΡΡΠ΅Π½ΠΈΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΡΠΈΠ½Π°Π½ΡΠΎΠ²ΠΎ-Ρ
ΠΎΠ·ΡΠΉΡΡΠ²Π΅Π½Π½ΠΎΠΉ Π΄Π΅ΡΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ ΠΏΡΠ΅Π΄ΠΏΡΠΈΡΡΠΈΠΉ, ΠΊΠΎΡΠΎΡΡΠ΅ Π·Π°Π½ΠΈΠΌΠ°ΡΡΡΡ Π²ΡΡΡΠ°Π²ΠΎΡΠ½ΠΎ-ΡΡΠΌΠ°ΡΠΎΡΠ½ΠΎΠΉ Π΄Π΅ΡΡΠ΅Π»ΡΠ½ΠΎΡΡΡΡ
Investigation of the Possibility of Immobilization of Mobile Forms of Arsenic in Technogenic Soils
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
The aim of the study β 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.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ β Π²ΡΡΡΠ½ΠΈΡΡ, ΠΊΠ°ΠΊ ΠΈ ΡΠ΅ΠΌ ΠΏΠΈΡΠ°Π΅ΡΡΡ ΠΌΠΎΠ»ΠΎΠ΄Π΅ΠΆΡ, Π° ΠΈΠΌΠ΅Π½Π½ΠΎ, ΡΡΡΠ΄Π΅Π½ΡΡ 2 ΠΊΡΡΡΠ° Π£ΡΠ°Π»ΡΡΠΊΠΎΠ³ΠΎ ΡΠ½Π΅ΡΠ³Π΅ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΈΠ½ΡΡΠΈΡΡΡΠ° Π£ΡΠ°Π»ΡΡΠΊΠΎΠ³ΠΎ ΡΠ΅Π΄Π΅ΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠ½ΠΈΠ²Π΅ΡΡΠΈΡΠ΅ΡΠ° (Π΄Π°Π»Π΅Π΅ β Π£ΡΠ°Π» ΠΠΠΠ Π£ΡΠ€Π£) ΠΈ ΠΏΡΠΎΠ²Π΅ΡΡΠΈ Π°Π½Π°Π»ΠΈΠ· ΠΏΠΎΠ»ΡΡΠ΅Π½Π½ΠΎΠΈΜ ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΠΈ Π΄Π»Ρ ΡΠΎΠ³ΠΎ, ΡΡΠΎΠ±Ρ ΡΡΠΎΡΠΌΡΠ»ΠΈΡΠΎΠ²Π°ΡΡ ΡΠ΅ΡΠΊΠΈΠ΅ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΈ ΠΏΠΎ ΠΊΠΎΡΡΠ΅ΠΊΡΠΈΠΈ ΡΠ°ΡΠΈΠΎΠ½Π°
The possibility of an effective alliance between practical health care and medical education for the 5th course studentsβ scientific research work performance during the practice
It is considering the questions of studentsβ research work organization at the medical university. The article describes the problems, which arise under the organization of the studentsβ research activities in medical university during their summer practice. It also reflects the studentsβ success in undertaking the case studies according to the needs of practical public health.Π ΡΡΠ°ΡΡΠ΅ ΠΎΡΠ²Π΅ΡΠ΅Π½Ρ Π²ΠΎΠΏΡΠΎΡΡ ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΈ Π½Π°ΡΡΠ½ΠΎ-ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°ΡΠ΅Π»ΡΡΠΊΠΎΠΉ Π΄Π΅ΡΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ ΡΡΡΠ΄Π΅Π½ΡΠΎΠ². ΠΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Ρ ΠΏΡΠΎΠ±Π»Π΅ΠΌΡ, ΠΊΠΎΡΠΎΡΡΠ΅ Π²ΠΎΠ·Π½ΠΈΠΊΠ°ΡΡ ΠΏΡΠΈ ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΈ Π½Π°ΡΡΠ½ΠΎ-ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°ΡΠ΅Π»ΡΡΠΊΠΎΠΉ ΡΠ°Π±ΠΎΡΡ ΡΡΡΠ΄Π΅Π½ΡΠΎΠ² Π² ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΌ Π²ΡΠ·Π΅ Π² ΠΏΠ΅ΡΠΈΠΎΠ΄ ΠΏΡΠΎΡ
ΠΎΠΆΠ΄Π΅Π½ΠΈΡ ΠΈΠΌΠΈ ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΡΡΠ²Π΅Π½Π½ΠΎΠΉ ΠΏΡΠ°ΠΊΡΠΈΠΊΠΈ, ΠΏΡΠΎΠ΄Π΅ΠΌΠΎΠ½ΡΡΡΠΈΡΠΎΠ²Π°Π½Ρ ΡΡΠΏΠ΅Ρ
ΠΈ ΡΡΡΠ΄Π΅Π½ΡΠΎΠ² Π² ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠΈ ΠΊΠΎΠ½ΠΊΡΠ΅ΡΠ½ΡΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ Π² ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²ΠΈΠΈ Ρ ΠΏΠΎΡΡΠ΅Π±Π½ΠΎΡΡΡΠΌΠΈ ΠΏΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π·Π΄ΡΠ°Π²ΠΎΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΡ
Π Π΅Π²ΠΌΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠ°Ρ ΠΎΠ½Π»Π°ΠΉΠ½-ΡΠΊΠΎΠ»Π° ΠΊΠ°ΠΊ Π°Π»ΡΡΠ΅ΡΠ½Π°ΡΠΈΠ²Π° ΡΡΠ°Π΄ΠΈΡΠΈΠΎΠ½Π½ΡΠΌ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°ΡΠ΅Π»ΡΠ½ΡΠΌ ΡΠ΅Ρ Π½ΠΎΠ»ΠΎΠ³ΠΈΡΠΌ Π΄Π»Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ²
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 doctorβs 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.ΠΠΎ Π²ΡΠ΅ΠΌΡ ΠΏΠ°Π½Π΄Π΅ΠΌΠΈΠΈ COVID-19 ΠΌΠ½ΠΎΠ³ΠΈΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΡ Ρ ΡΠ΅Π²ΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠΌΠΈ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡΠΌΠΈ ΠΎΡΡΠ°Π»ΠΈΡΡ Π±Π΅Π· ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ ΠΈ ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΉ ΠΏΠΎΠ΄Π΄Π΅ΡΠΆΠΊΠΈ, Π²ΠΌΠ΅ΡΡΠΈ Ρ ΡΠ΅ΠΌ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΠΉ ΡΡΠΎΠ²Π΅Π½Ρ ΡΠΈΡΡΠΎΠ²ΠΈΠ·Π°ΡΠΈΠΈ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ ΠΏΠ΅ΡΠ΅Π½Π΅ΡΡΠΈ ΠΎΠ±ΡΡΠ΅Π½ΠΈΠ΅ ΠΈ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠ΅ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΈ ΠΈΡ
ΡΠΎΠ΄ΡΡΠ²Π΅Π½Π½ΠΈΠΊΠΎΠ² Π² ΠΎΠ½Π»Π°ΠΉΠ½-ΡΠΎΡΠΌΠ°Ρ.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ β ΠΏΡΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°ΡΡ ΠΎΠΏΡΡ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ ΡΠ΅Π²ΠΌΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠΊΠΎΠ»Ρ Π² ΠΎΠ½Π»Π°ΠΉΠ½-ΡΠΎΡΠΌΠ°ΡΠ΅ ΠΊΠ°ΠΊ ΠΌΠ΅ΡΠΎΠ΄Π° ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΡ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ Π³ΡΠ°ΠΌΠΎΡΠ½ΠΎΡΡΠΈ Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΡ.ΠΠ°ΡΠΈΠ΅Π½ΡΡ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΡΠΏΠΎΠ»Π½Π΅Π½ΠΎ ΠΎΠ΄Π½ΠΎΠΌΠΎΠΌΠ΅Π½ΡΠ½ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΏΡΡΠ΅ΠΌ Π΄ΠΎΠ±ΡΠΎΠ²ΠΎΠ»ΡΠ½ΠΎΠ³ΠΎ Π°Π½ΠΎΠ½ΠΈΠΌΠ½ΠΎΠ³ΠΎ Π°Π½ΠΊΠ΅ΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ 157 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², Ρ ΡΠ΅Π½ΡΡΠ±ΡΡ 2020 Π³. ΠΏΠΎ Π½ΠΎΡΠ±ΡΡ 2021 Π³. ΠΏΡΠΈΠ½ΡΠ²ΡΠΈΡ
ΡΡΠ°ΡΡΠΈΠ΅ Π² ΠΎΠ½Π»Π°ΠΉΠ½-ΡΠΊΠΎΠ»Π΅ ΠΏΠΎ ΡΠ΅Π²ΠΌΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ, Π΄Π΅ΠΉΡΡΠ²ΡΡΡΠ΅ΠΉ Π½Π° Π±Π°Π·Π΅ Π¦Π΅Π½ΡΡΠ° ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅Π²ΠΌΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΠ Β«ΠΠΎΠ²Π°Ρ ΠΠΎΠ»ΡΠ½ΠΈΡΠ°Β» (ΠΠΊΠ°ΡΠ΅ΡΠΈΠ½Π±ΡΡΠ³). ΠΡΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΡ Π·Π°ΠΏΠΎΠ»Π½ΡΠ»ΠΈ ΠΎΠ½Π»Π°ΠΉΠ½-ΠΎΠΏΡΠΎΡΠ½ΠΈΠΊ, Π²ΠΊΠ»ΡΡΠ°Π²ΡΠΈΠΉ 15 Π²ΠΎΠΏΡΠΎΡΠΎΠ², ΠΊΠ°ΡΠ°Π²ΡΠΈΡ
ΡΡ Π²ΠΎΠ·ΡΠ°ΡΡΠ°, ΠΌΠ΅ΡΡΠ° ΠΆΠΈΡΠ΅Π»ΡΡΡΠ²Π°, ΠΌΠΎΡΠΈΠ²Π°ΡΠΈΠΈ ΡΠ»ΡΡΠ°ΡΠ΅Π»Π΅ΠΉ, ΠΈΡΡΠΎΡΠ½ΠΈΠΊΠΎΠ² ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΠΈ ΠΎ ΡΠΊΠΎΠ»Π΅, ΠΎΡΠ΅Π½ΠΊΠΈ ΡΠΎΡΠΌΡ ΠΈ ΡΠΎΠ΄Π΅ΡΠΆΠ°Π½ΠΈΡ Π»Π΅ΠΊΡΠΈΠΉ, ΠΊΠ°ΡΠ΅ΡΡΠ²Π° ΠΈ Π½ΠΎΠ²ΠΈΠ·Π½Ρ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Π½ΡΡ
ΡΠ²Π΅Π΄Π΅Π½ΠΈΠΉ, ΡΡΠ΅ΠΏΠ΅Π½ΠΈ Π΄ΠΎΠ²Π΅ΡΠΈΡ ΠΊ Π²ΡΠ°ΡΡ.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΈ ΠΎΠ±ΡΡΠΆΠ΄Π΅Π½ΠΈΠ΅. ΠΠ½Π°Π»ΠΈΠ· ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² Π°Π½ΠΊΠ΅ΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΏΡΠΎΠ΄Π΅ΠΌΠΎΠ½ΡΡΡΠΈΡΠΎΠ²Π°Π» Π·Π°ΠΈΠ½ΡΠ΅ΡΠ΅ΡΠΎΠ²Π°Π½Π½ΠΎΡΡΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π² ΠΏΠΎΠ»ΡΡΠ΅Π½ΠΈΠΈ ΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠΉ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΠΈ ΠΏΠΎ ΠΏΡΠΎΠ±Π»Π΅ΠΌΠ°ΠΌ ΡΠ΅Π²ΠΌΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ, ΠΏΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»ΡΠ½ΡΡ ΠΎΡΠ΅Π½ΠΊΡ ΡΠΎΡΠΌΠ°ΡΠ° ΠΈ ΡΠΎΠ΄Π΅ΡΠΆΠ°Π½ΠΈΡ ΠΎΠ½Π»Π°ΠΉΠ½ΡΠΊΠΎΠ»Ρ, Π΅Π΅ ΠΏΠΎΠ·ΠΈΡΠΈΠ²Π½ΡΡ ΡΠΎΠ»Ρ Π² ΡΠ°Π·ΡΡΡΠ½Π΅Π½ΠΈΠΈ ΡΡΡΠΈ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ ΠΈ ΡΠΎΠΏΡΡΡΡΠ²ΡΡΡΠΈΡ
ΠΏΡΠΎΠ±Π»Π΅ΠΌ.ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΠ½Π»Π°ΠΉΠ½-ΡΠΊΠΎΠ»Ρ Π΄Π»Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»ΡΡΡΡΡ Π°ΠΊΡΡΠ°Π»ΡΠ½ΡΠΌ ΠΈ ΠΏΠ΅ΡΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΡΠΌ Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½ΠΈΠ΅ΠΌ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠΈ
ΠΠ°ΡΠ΅ΡΡΠ²ΠΎ Π²Π΅Π΄Π΅Π½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΏΠΎΠ΄Π°Π³ΡΠΎΠΉ Π² ΡΠ΅Π°Π»ΡΠ½ΠΎΠΉ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠ°ΠΊΡΠΈΠΊΠ΅
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.ΠΠ°ΡΠ΅ΡΡΠ²ΠΎ Π²Π΅Π΄Π΅Π½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΏΠΎΠ΄Π°Π³ΡΠΎΠΉ Π² ΠΎΠ±ΡΠ΅ΡΠ΅ΡΠ°ΠΏΠ΅Π²ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠ°ΠΊΡΠΈΠΊΠ΅ ΠΎΡΡΠ°Π΅ΡΡΡ ΡΠ΅ΡΡΠ΅Π·Π½ΠΎΠΉ ΠΏΡΠΎΠ±Π»Π΅ΠΌΠΎΠΉ, Π½Π΅ΡΠΌΠΎΡΡΡ Π½Π° ΡΡΡΠ΅ΡΡΠ²ΡΡΡΠΈΠ΅ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΈ ΠΏΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΏΠΎΠ΄Π°Π³ΡΡ ΠΈ ΠΏΠΎΡΠ΅Π½ΡΠΈΠ°Π»ΡΠ½ΡΡ ΠΎΠ±ΡΠ°ΡΠΈΠΌΠΎΡΡΡ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ β ΠΎΡΠ΅Π½ΠΊΠ° ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠ³ΠΎ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ Π²Π΅Π΄Π΅Π½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΏΠΎΠ΄Π°Π³ΡΠΎΠΉ Π² ΡΠ΅Π°Π»ΡΠ½ΠΎΠΉ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠ°ΠΊΡΠΈΠΊΠ΅.ΠΠ°ΡΠΈΠ΅Π½ΡΡ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΠ° ΠΏΠ΅ΡΠ²ΠΎΠΌ ΡΡΠ°ΠΏΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ ΠΎΠΏΡΠΎΡ 97Π²ΡΠ°ΡΠ΅ΠΉ, ΡΠ°Π·Π΄Π΅Π»Π΅Π½Π½ΡΡ
ΠΏΠΎ ΡΠΏΠ΅ΡΠΈΠ°Π»ΡΠ½ΠΎΡΡΡΠΌ: ΡΠ΅Π²ΠΌΠ°ΡΠΎΠ»ΠΎΠ³ΠΎΠ², ΡΠ΅ΡΠ°ΠΏΠ΅Π²ΡΠΎΠ² ΠΈ Π΄ΡΡΠ³ΠΈΡ
ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΡΡΠΎΠ²; Π½Π° Π²ΡΠΎΡΠΎΠΌ ΡΡΠ°ΠΏΠ΅ β ΠΎΠΏΡΠΎΡ 64 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΏΠΎΠ΄Π°Π³ΡΠΎΠΉ, ΠΊΠΎΡΠΎΡΡΡ
Π½Π°Π±Π»ΡΠ΄Π°Π»ΠΈ Π²ΡΠ°ΡΠΈ ΡΠ°Π·Π½ΡΡ
ΡΠΏΠ΅ΡΠΈΠ°Π»ΡΠ½ΠΎΡΡΠ΅ΠΉ.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΈ ΠΎΠ±ΡΡΠΆΠ΄Π΅Π½ΠΈΠ΅. ΠΠ»Ρ ΠΊΡΠΏΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΎΡΡΡΠΎΠ³ΠΎ ΠΏΡΠΈΡΡΡΠΏΠ° ΠΏΠΎΠ΄Π°Π³ΡΡ Π²ΡΠ°ΡΠΈ ΡΠ°ΡΠ΅ Π²ΡΠ΅Π³ΠΎ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π»ΠΈ Π½Π΅ΡΡΠ΅ΡΠΎΠΈΠ΄Π½ΡΠ΅ ΠΏΡΠΎΡΠΈΠ²ΠΎΠ²ΠΎΡΠΏΠ°Π»ΠΈΡΠ΅Π»ΡΠ½ΡΠ΅ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΡ (ΠΠΠΠ), ΠΊΠΎΠ»Ρ
ΠΈΡΠΈΠ½, Π³Π»ΡΠΊΠΎΠΊΠΎΡΡΠΈΠΊΠΎΠΈΠ΄Ρ (ΠΠ), Π° ΡΠ°ΠΊΠΆΠ΅ Π°Π»Π»ΠΎΠΏΡΡΠΈΠ½ΠΎΠ». ΠΡΠΈ Π²Π΅Π΄Π΅Π½ΠΈΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΠΎΠ΄Π°Π³ΡΠΎΠΉ ΡΡΠ°Ρ-ΡΠ½ΠΈΠΆΠ°ΡΡΠΈΠ΅ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΡ Π½Π°Π·Π½Π°ΡΠ°Π»ΠΈ Π² ΠΎΡΠ½ΠΎΠ²Π½ΠΎΠΌ ΡΠ΅Π²ΠΌΠ°ΡΠΎΠ»ΠΎΠ³ΠΈ ΠΈ Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎ ΡΠ΅ΠΆΠ΅ β Π²ΡΠ°ΡΠΈ Π΄ΡΡΠ³ΠΈΡ
ΡΠΏΠ΅ΡΠΈΠ°Π»ΡΠ½ΠΎΡΡΠ΅ΠΉ. ΠΠ· ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ² ΡΠ°ΠΌΡΠΌ ΠΏΠΎΠΏΡΠ»ΡΡΠ½ΡΠΌ ΡΠ²Π»ΡΠ»ΡΡ Π°Π»Π»ΠΎΠΏΡΡΠΈΠ½ΠΎΠ» Π² ΠΌΠ°ΠΊΡΠΈΠΌΠ°Π»ΡΠ½ΠΎΠΉ Π΄ΠΎΠ·Π΅ 300 ΠΌΠ³/ΡΡΡ. Π’Π΅Π½Π΄Π΅Π½ΡΠΈΡ ΠΊ ΡΠΌΠ΅Π½ΡΡΠ΅Π½ΠΈΡ ΡΠΈΡΠ»Π° ΡΠΎΡΡΡΠΎΠ² ΠΎΡΠΌΠ΅ΡΠ°Π»Π°ΡΡ Ρ ΡΠ΅Ρ
Π±ΠΎΠ»ΡΠ½ΡΡ
, Π²Π΅Π΄Π΅Π½ΠΈΠ΅ ΠΊΠΎΡΠΎΡΡΡ
ΠΎΡΡΡΠ΅ΡΡΠ²Π»ΡΠ»ΠΎΡΡ Π² ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²ΠΈΠΈ Ρ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΡΠΌΠΈ EULAR. Π ΡΡΠΎΠΉ ΠΆΠ΅ Π³ΡΡΠΏΠΏΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π±ΡΠ» Π±ΠΎΠ»Π΅Π΅ Π½ΠΈΠ·ΠΊΠΈΠΉ ΡΡΠΎΠ²Π΅Π½Ρ ΠΌΠΎΡΠ΅Π²ΠΎΠΉ ΠΊΠΈΡΠ»ΠΎΡΡ (ΠΠ) ΠΈ Π±ΠΎΠ»Π΅Π΅ Π²ΡΡΠΎΠΊΠΈΠΉ ΡΡΠΎΠ²Π΅Π½Ρ ΠΏΡΠΈΠ²Π΅ΡΠΆΠ΅Π½Π½ΠΎΡΡΠΈ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ.ΠΡΠ΅ΠΈΠΌΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠ΅ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΠΠΠ ΠΏΡΠΈ ΡΠ΅Π΄ΠΊΠΎΠΌ Π½Π°Π·Π½Π°ΡΠ΅Π½ΠΈΠΈ ΠΊΠΎΠ»Ρ
ΠΈΡΠΈΠ½Π° ΠΈ ΠΠ, Π° ΡΠ°ΠΊΠΆΠ΅ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ Π°Π»Π»ΠΎΠΏΡΡΠΈΠ½ΠΎΠ»Π° Π΄Π»Ρ ΠΊΡΠΏΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΎΡΡΡΠΎΠ³ΠΎ ΠΏΡΠΈΡΡΡΠΏΠ° ΡΠΎΠ·Π΄Π°ΡΡ ΠΏΡΠ΅Π΄ΠΏΠΎΡΡΠ»ΠΊΠΈ Π΄Π»Ρ ΡΡΡΠ³ΡΠ±Π»Π΅Π½ΠΈΡ ΡΠ΅ΡΠ΅Π½ΠΈΡ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ ΠΈ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ ΠΊΠΎΠΌΠΏΠ»Π°Π΅Π½ΡΠ°. ΠΠ΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΡΡΡ Π΄ΠΎΠ·Ρ Π°Π»Π»ΠΎΠΏΡΡΠΈΠ½ΠΎΠ»Π° ΠΈ ΠΎΡΡΡΡΡΡΠ²ΠΈΠ΅ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π½Π°Π·Π½Π°ΡΠ΅Π½ΠΈΡ ΠΊΠΎΠ»Ρ
ΠΈΡΠΈΠ½Π° Π΄Π»Ρ Π»Π΅ΡΠ΅Π½ΠΈΡ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΠΎΠ΄Π°Π³ΡΡ ΡΠΏΠΎΡΠΎΠ±ΡΡΠ²ΡΡΡ ΠΏΡΠΎΠ³ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ ΠΈ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΎΡΡΡΡΡ
Π°ΡΠ°ΠΊ. Π‘Π»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΡΠΌ EULAR ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ Π΄ΠΎΡΡΠΈΡΡ ΡΠ΅Π»Π΅Π²ΠΎΠ³ΠΎ ΡΡΠΎΠ²Π½Ρ ΠΠ ΠΈ Π½Π΅ ΡΠΎΠ»ΡΠΊΠΎ ΠΏΡΠ΅Π΄ΠΎΡΠ²ΡΠ°ΡΠΈΡΡ, Π½ΠΎ ΠΈ Π΄ΠΎΠ±ΠΈΡΡΡΡ ΠΎΠ±ΡΠ°ΡΠ½ΠΎΠ³ΠΎ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΠ°ΠΊΠΈΡ
ΠΏΡΠΎΡΠ²Π»Π΅Π½ΠΈΠΉ ΠΏΠΎΠ΄Π°Π³ΡΡ, ΠΊΠ°ΠΊ ΡΠΎΡΡΡΡ.ΠΡΠ²ΠΎΠ΄Ρ. ΠΠ»Ρ ΡΠ°Π΄ΠΈΠΊΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠ»ΡΡΡΠ΅Π½ΠΈΡ ΡΠΈΡΡΠ°ΡΠΈΠΈ Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎ ΡΠ΅Π³ΡΠ»ΡΡΠ½ΠΎΠ΅ ΠΎΠ±ΡΡΠ΅Π½ΠΈΠ΅ Π²ΡΠ°ΡΠ΅ΠΉ Π²ΡΠ΅Ρ
ΡΠΏΠ΅ΡΠΈΠ°Π»ΡΠ½ΠΎΡΡΠ΅ΠΉ ΡΠ°ΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠΌΡ Π²Π΅Π΄Π΅Π½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΏΠΎΠ΄Π°Π³ΡΠΎΠΉ, ΠΎΡΠ½ΠΎΠ²Π°Π½Π½ΠΎΠΌΡ Π½Π° ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΡΡ
EULAR
Π€ΠΈΠ±ΡΠΎΠΌΠΈΠ°Π»Π³ΠΈΡ: ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠ°Ρ ΠΊΠ°ΡΡΠΈΠ½Π° ΠΈ Π²Π°ΡΠΈΠ°Π½ΡΡ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ
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.Π€ΠΈΠ±ΡΠΎΠΌΠΈΠ°Π»Π³ΠΈΡ (Π€Π) β ΡΠΎΡΡΠΎΡΠ½ΠΈΠ΅, Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΠ·ΡΡΡΠ΅Π΅ΡΡ ΡΠΈΠ½Π΄ΡΠΎΠΌΠΎΠΌ Π³Π΅Π½Π΅ΡΠ°Π»ΠΈΠ·ΠΎΠ²Π°Π½Π½ΠΎΠΉ Π±ΠΎΠ»ΠΈ, Π° ΡΠ°ΠΊΠΆΠ΅ Π½Π°Π»ΠΈΡΠΈΠ΅ΠΌ ΡΡΡΠ°Π»ΠΎΡΡΠΈ, ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΡ
Π½Π°ΡΡΡΠ΅Π½ΠΈΠΉ, Π°ΡΡΠ΅ΠΊΡΠΈΠ²Π½ΡΡ
ΠΈ ΠΌΠ½ΠΎΠΆΠ΅ΡΡΠ²Π΅Π½Π½ΡΡ
ΡΠΎΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠΈΠΌΠΏΡΠΎΠΌΠΎΠ². ΠΠΎΠ»Π΅Π²ΠΎΠΉ ΡΠΈΠ½Π΄ΡΠΎΠΌ ΠΌΠΎΠΆΠ΅Ρ ΠΈΠΌΠ΅ΡΡ Π½Π°ΡΠΈΠΎΠ½Π°Π»ΡΠ½ΡΠ΅, ΡΡΠ½ΠΈΡΠ΅ΡΠΊΠΈΠ΅, Π³Π΅Π½Π΄Π΅ΡΠ½ΡΠ΅ ΠΈ Π²ΠΎΠ·ΡΠ°ΡΡΠ½ΡΠ΅ ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠΈ.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ β ΠΎΡΠ΅Π½ΠΈΡΡ ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠΈ ΡΠ΅ΡΠ΅Π½ΠΈΡ Π€Π Π² ΠΊΡΡΠΏΠ½ΠΎΠΌ ΠΏΡΠΎΠΌΡΡΠ»Π΅Π½Π½ΠΎΠΌ ΡΠ΅Π½ΡΡΠ΅ Π ΠΎΡΡΠΈΠΉΡΠΊΠΎΠΉ Π€Π΅Π΄Π΅ΡΠ°ΡΠΈΠΈ ΠΈ ΠΏΡΠ΅Π΄ΡΡΠ°Π²ΠΈΡΡ Π΅Π΅ ΡΠ΅Π½ΠΎΡΠΈΠΏΠΈΡΠ΅ΡΠΊΠΈΠ΅ Π²Π°ΡΠΈΠ°Π½ΡΡ.ΠΠ°ΡΠΈΠ΅Π½ΡΡ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. Π ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π²ΠΊΠ»ΡΡΠ΅Π½ΠΎ 92 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° (8 ΠΌΡΠΆΡΠΈΠ½, 84 ΠΆΠ΅Π½ΡΠΈΠ½Ρ) Ρ Π€Π Π² Π²ΠΎΠ·ΡΠ°ΡΡΠ΅ ΠΎΡ 18 Π΄ΠΎ 86 Π»Π΅Ρ (ΡΡΠ΅Π΄Π½ΠΈΠΉ Π²ΠΎΠ·ΡΠ°ΡΡ 50,5 Π³ΠΎΠ΄Π°). ΠΠΈΠ°Π³Π½ΠΎΠ· ΡΡΡΠ°Π½Π°Π²Π»ΠΈΠ²Π°Π»ΠΈ ΡΠΎΠ³Π»Π°ΡΠ½ΠΎ ΠΊΡΠΈΡΠ΅ΡΠΈΡΠΌ ACR 2016 Π³. Π£ΡΠΈΡΡΠ²Π°Π»ΠΈ ΡΠ°ΠΊΠΆΠ΅ Π΄Π°Π½Π½ΡΠ΅ ΠΎ Π΄Π°Π²Π½ΠΎΡΡΠΈ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ, ΠΏΡΠΎΡΠ΅ΡΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠΉ Π·Π°Π½ΡΡΠΎΡΡΠΈ, Π½Π°Π»ΠΈΡΠΈΠΈ ΡΠΏΠΎΡΡΠΈΠ²Π½ΡΡ
Π½Π°Π³ΡΡΠ·ΠΎΠΊ, ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠΌΠΎΠΉ ΡΠ°Π½Π΅Π΅ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ, Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΠΎΡΡΠΈ Π±ΠΎΠ»ΠΈ, ΡΠΎΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠΈΠΌΠΏΡΠΎΠΌΠΎΠ² ΠΈΠ· Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΊΡΠΈΡΠ΅ΡΠΈΠ΅Π² ACR 2010 Π³. ΠΈ ΠΎΠ±ΡΠ΅ΠΉ ΠΎΡΠ΅Π½ΠΊΠ΅ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ Π·Π΄ΠΎΡΠΎΠ²ΡΡ Π±ΠΎΠ»ΡΠ½ΡΠΌ. ΠΡΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΡ Π·Π°ΠΏΠΎΠ»Π½ΡΠ»ΠΈ Π³ΠΎΡΠΏΠΈΡΠ°Π»ΡΠ½ΡΡ Π°Π½ΠΊΠ΅ΡΡ ΡΡΠ΅Π²ΠΎΠ³ΠΈ ΠΈ Π΄Π΅ΠΏΡΠ΅ΡΡΠΈΠΈ (HADS).Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΈ ΠΎΠ±ΡΡΠΆΠ΄Π΅Π½ΠΈΠ΅. ΠΠΎΠΊΠ°Π·Π°Π½ΠΎ, ΡΡΠΎ Π² ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΊΠ°ΡΡΠΈΠ½Π΅ Π€Π Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ Π·Π½Π°ΡΠΈΠΌΡΠΌΠΈ ΡΠΎΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠΌΠΈ ΡΠΈΠΌΠΏΡΠΎΠΌΠ°ΠΌΠΈ ΡΠ²Π»ΡΠ»ΠΈΡΡ ΠΌΡΡΠ΅ΡΠ½Π°Ρ Π±ΠΎΠ»Ρ ΠΈ ΠΌΡΡΠ΅ΡΠ½Π°Ρ ΡΠ»Π°Π±ΠΎΡΡΡ, ΠΏΡΠΎΡΠ²Π»Π΅Π½ΠΈΡ ΡΠΈΠ½Π΄ΡΠΎΠΌΠ° ΡΠ°Π·Π΄ΡΠ°ΠΆΠ΅Π½Π½ΠΎΠΉ ΠΊΠΈΡΠΊΠΈ ΠΈ ΡΡΡΠ°Π»ΠΎΡΡΡ, ΠΏΡΠΈΡΠ΅ΠΌ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΡΡΡ ΠΌΠ½ΠΎΠ³ΠΈΡ
ΡΠΈΠΌΠΏΡΠΎΠΌΠΎΠ² Ρ Π»ΠΈΡ ΡΡΠ°ΡΡΠ΅ 60 Π»Π΅Ρ Π±ΡΠ»Π° ΠΌΠ΅Π½ΡΡΠ΅ΠΉ, ΡΠ΅ΠΌ Ρ Π±ΠΎΠ»Π΅Π΅ ΠΌΠΎΠ»ΠΎΠ΄ΡΡ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ². ΠΠ΅Π½ΡΠΊΠΈΠΉ ΠΏΠΎΠ» Π²ΡΡΡΡΠΏΠ°Π» Π΄ΠΎΠΏΠΎΠ»Π½ΠΈΡΠ΅Π»ΡΠ½ΡΠΌ ΡΠ°ΠΊΡΠΎΡΠΎΠΌ ΡΠΈΡΠΊΠ° ΡΡΠΈΠ»Π΅Π½ΠΈΡ Π±ΠΎΠ»Π΅Π²ΡΡ
ΠΎΡΡΡΠ΅Π½ΠΈΠΉ ΠΈ ΠΊΠΎΠ³Π½ΠΈΡΠΈΠ²Π½ΡΡ
Π½Π°ΡΡΡΠ΅Π½ΠΈΠΉ. ΠΠ°Π»ΠΈΡΠΈΠ΅ ΡΠΎΠΏΡΡΡΡΠ²ΡΡΡΠ΅ΠΉ Π΄Π΅ΠΏΡΠ΅ΡΡΠΈΠΈ, Π²Π΅ΡΠΈΡΠΈΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ ΠΏΠΎ HADS, Π°ΡΡΠΎΡΠΈΠΈΡΠΎΠ²Π°Π»ΠΎΡΡ Ρ ΡΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΠΌ ΡΡ
ΡΠ΄ΡΠ΅Π½ΠΈΠ΅ΠΌ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΡΠΎΡΠ²Π»Π΅Π½ΠΈΠΉ Π€Π. Π ΡΠΎ ΠΆΠ΅ Π²ΡΠ΅ΠΌΡ ΠΏΡΠΎΡΠ΅ΠΊΡΠΈΠ²Π½ΡΠΌΠΈ ΡΠ°ΠΊΡΠΎΡΠ°ΠΌΠΈ Π² ΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠΈ ΡΡΠ΄Π° ΡΠΈΠΌΠΏΡΠΎΠΌΠΎΠ² Π€Π ΠΎΠΊΠ°Π·Π°Π»ΠΈΡΡ ΠΏΡΠΎΡΠ΅ΡΡΠΈΠΎΠ½Π°Π»ΡΠ½Π°Ρ Π΄Π΅ΡΡΠ΅Π»ΡΠ½ΠΎΡΡΡ ΠΈ Π·Π°Π½ΡΡΠΈΡ ΡΠΏΠΎΡΡΠΎΠΌ. ΠΡΠ΄Π²ΠΈΠ½ΡΡΠ° Π³ΠΈΠΏΠΎΡΠ΅Π·Π° ΠΎ Π½Π°Π»ΠΈΡΠΈΠΈ Π½Π΅ΡΠΊΠΎΠ»ΡΠΊΠΈΡ
ΡΠ΅Π½ΠΎΡΠΈΠΏΠΎΠ² Π€Π (ΡΡΠ΅Π²ΠΎΠΆΠ½ΡΠΉ, ΡΡΠ΅Π²ΠΎΠΆΠ½ΠΎ-Π΄Π΅ΠΏΡΠ΅ΡΡΠΈΠ²Π½ΡΠΉ, ΡΠ³ΠΎΡΠ΅Π½ΡΡΠΈΡΠ½ΡΠΉ ΠΈ ΡΠΎΡΡΠ΄ΠΈΡΡΡΠΉ).ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΡΠΎΠ΄Π΅ΠΌΠΎΠ½ΡΡΡΠΈΡΠΎΠ²Π°Π½Ρ ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠΈ ΡΠ΅ΡΠ΅Π½ΠΈΡ Π€Π Π² ΠΊΡΡΠΏΠ½ΠΎΠΌ ΠΏΡΠΎΠΌΡΡΠ»Π΅Π½Π½ΠΎΠΌ ΡΠ΅Π½ΡΡΠ΅ Π ΠΎΡΡΠΈΠΉΡΠΊΠΎΠΉ Π€Π΅Π΄Π΅ΡΠ°ΡΠΈΠΈ ΠΈ Π²ΡΠ΄Π΅Π»Π΅Π½Ρ ΡΠ°Π·Π»ΠΈΡΠ½ΡΠ΅ ΡΠ΅Π½ΠΎΡΠΈΠΏΡ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ, ΡΡΠΎ ΠΌΠΎΠΆΠ΅Ρ Π±ΡΡΡ ΠΏΠΎΠ»Π΅Π·Π½ΡΠΌ ΠΏΡΠΈ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΠΈ ΡΠ°ΠΊΡΠΈΠΊΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ²
Key aspects of the management of patient schools as telemedicine technology of modern healthcare
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.ΠΠ²Π΅Π΄Π΅Π½ΠΈΠ΅. ΠΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΡΡ Π·Π΄ΡΠ°Π²ΠΎΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΡ Π² 2020 Π³. ΡΠ²ΠΈΠ»Π°ΡΡ ΡΠ°Π±ΠΎΡΠ° Π² ΡΡΠ»ΠΎΠ²ΠΈΡΡ
ΠΌΠ°ΡΡΠΎΠ²ΠΎΠΉ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π΅ΠΌΠΎΡΡΠΈ COVID-19, ΠΎΠ³ΡΠ°Π½ΠΈΡΠ΅Π½Π½ΠΎΡΡΠΈ ΠΈ ΠΏΠ΅ΡΠ΅ΡΠ°ΡΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ ΠΊΠ°Π΄ΡΠΎΠ²ΡΡ
ΡΠ΅ΡΡΡΡΠΎΠ², ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠΌ ΡΠ΅Π³ΠΎ ΡΡΠ°Π»Π° Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½Π°Ρ ΠΈΠ½ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½Π½ΠΎΡΡΡ Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΡ ΠΏΠΎ ΡΠ°Π·Π»ΠΈΡΠ½ΡΠΌ Π°ΡΠΏΠ΅ΠΊΡΠ°ΠΌ Π·Π΄ΠΎΡΠΎΠ²ΡΡ. ΠΠ΄Π½ΠΈΠΌ ΠΈΠ· ΠΏΡΠ°Π²ΠΈΠ»ΡΠ½ΡΡ
ΡΠ΅ΡΠ΅Π½ΠΈΠΉ Π² ΡΡΠΈΡ
ΡΡΠ»ΠΎΠ²ΠΈΡΡ
ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΡ ΡΠΊΠΎΠ» Π΄Π»Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΠΊΠΎΡΠΎΡΡΠ΅ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΡΡ ΠΏΡΠΎΠ²Π΅ΡΡΠΈ ΠΎΠ΄Π½ΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠ΅ ΠΎΠ±ΡΡΠ΅Π½ΠΈΠ΅ ΠΈ Π΄ΠΎΠ½Π΅ΡΡΠΈ Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΡΡ ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΡ Π΄ΠΎ Π±ΠΎΠ»ΡΡΠΎΠ³ΠΎ ΡΠΈΡΠ»Π° Π»ΡΠ΄Π΅ΠΉ. ΠΠΏΠ΅ΡΠ²ΡΠ΅ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Ρ ΠΊΠ»ΡΡΠ΅Π²ΡΠ΅ Π°ΡΠΏΠ΅ΠΊΡΡ ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΈ ΡΠ΅Π»Π΅ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΡ
ΡΠΊΠΎΠ» Π΄Π»Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π² ΡΡΠ»ΠΎΠ²ΠΈΡΡ
ΠΏΠ°Π½Π΄Π΅ΠΌΠΈΠΈ Π½ΠΎΠ²ΠΎΠΉ ΠΊΠΎΡΠΎΠ½Π°Π²ΠΈΡΡΡΠ½ΠΎΠΉ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΈ. Π¦Π΅Π»ΡΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΎΡΠ΅Π½ΠΊΠ° ΡΠ΅Π»Π΅ΡΠΎΠΎΠ±ΡΠ°Π·Π½ΠΎΡΡΠΈ ΡΠ΅Π»Π΅ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΡ
ΡΠΊΠΎΠ» Π΄Π»Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΊΠ°ΠΊ ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΠΈ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠ³ΠΎ Π·Π΄ΡΠ°Π²ΠΎΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΡ. ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. Π Π°Π±ΠΎΡΠ° ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π° ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ ΠΎΠ΄Π½ΠΎΠΌΠΎΠΌΠ΅Π½ΡΠ½ΠΎΠ³ΠΎ ΠΏΠΎΠΏΠ΅ΡΠ΅ΡΠ½ΠΎΠ³ΠΎ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² Π°Π½ΠΊΠ΅ΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΡΠ»ΡΡΠ°ΡΠ΅Π»Π΅ΠΉ Π΄Π²ΡΡ
ΡΠΈΠΊΠ»ΠΎΠ² ΡΠΊΠΎΠ», ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ²ΡΠΈΡ
ΡΡ Π² ΠΎΠ½Π»Π°ΠΉΠ½-ΡΠ΅ΠΆΠΈΠΌΠ΅. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π ΡΠΈΠΊΠ»Π΅ ΡΠΊΠΎΠ» ΠΏΠΎ ΡΠ΅Π°Π±ΠΈΠ»ΠΈΡΠ°ΡΠΈΠΈ ΠΏΠΎΡΠ»Π΅ ΠΏΠ΅ΡΠ΅Π½Π΅ΡΡΠ½Π½ΠΎΠ³ΠΎ COVID-19 ΠΏΡΠΈΠ½ΡΠ»ΠΈ ΡΡΠ°ΡΡΠΈΠ΅ 1403 ΡΠ΅Π»ΠΎΠ²Π΅ΠΊΠ°, ΠΎΠ±ΡΠ°ΡΠ½Π°Ρ ΡΠ²ΡΠ·Ρ Π² Ρ
ΠΎΠ΄Π΅ ΠΎΠΏΡΠΎΡΠ½ΠΈΠΊΠ° Π½Π° ΠΎΡΠ½ΠΎΠ²Π΅ Google-ΠΏΠ»Π°ΡΡΠΎΡΠΌΡ ΠΏΠΎΠ»ΡΡΠ΅Π½Π° ΠΎΡ 171 ΡΠ»ΡΡΠ°ΡΠ΅Π»Ρ. Π§ΠΈΡΠ»Π΅Π½Π½ΠΎΡΡΡ ΡΡΠ°ΡΡΠ½ΠΈΠΊΠΎΠ² ΡΠΊΠΎΠ» ΠΏΠΎ ΡΠ΅Π²ΠΌΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 197 ΡΠ΅Π»ΠΎΠ²Π΅ΠΊ, ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ Π°Π½ΠΊΠ΅ΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΏΠΎΠ»ΡΡΠ΅Π½Ρ ΠΎΡ 36 ΡΠ΅ΡΠΏΠΎΠ½Π΄Π΅Π½ΡΠΎΠ². ΠΡΠ΄Π΅Π»Π΅Π½Ρ 10 ΠΊΠ»ΡΡΠ΅Π²ΡΡ
ΠΏΡΠΈΠ½ΡΠΈΠΏΠΎΠ² ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΈ ΠΎΠ½Π»Π°ΠΉΠ½-ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π½Π° ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΌ ΡΡΠ°ΠΏΠ΅: ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ Π΄ΠΈΡΡΠ°Π½ΡΠΈΠΎΠ½Π½ΡΡ
ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΠΉ, Π·Π°ΠΈΠ½ΡΠ΅ΡΠ΅ΡΠΎΠ²Π°Π½Π½ΠΎΡΡΡ ΡΡΠΊΠΎΠ²ΠΎΠ΄ΡΡΠ²Π° ΠΈ Π°Π΄ΠΌΠΈΠ½ΠΈΡΡΡΠ°ΡΠΈΠΈ Π»Π΅ΡΠ΅Π±Π½ΠΎΠ³ΠΎ ΡΡΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΡ, ΠΊΠΎΠΌΠ°Π½Π΄Π½ΡΠΉ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄, ΡΠ΅Ρ
Π½ΠΈΡΠ΅ΡΠΊΠΈΠ΅ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠΈ ΡΠ΅Π°Π»ΠΈΠ·Π°ΡΠΈΠΈ ΡΠΊΠΎΠ», Π°Π΄Π°ΠΏΡΠ°ΡΠΈΡ Π»Π΅ΠΊΡΠΈΠΎΠ½Π½ΠΎΠ³ΠΎ ΠΌΠ°ΡΠ΅ΡΠΈΠ°Π»Π° Π΄Π»Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΡΠΎΠ»Ρ ΠΏΡΠΎΡΠΈΠ»ΡΠ½ΠΎΠ³ΠΎ ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΡΡΠ° Π² ΠΏΡΠΎΡΠ΅ΡΡΠ΅ ΠΏΡΠΎΡΠ²Π΅ΡΠ΅Π½ΠΈΡ, ΡΡΠ°ΡΡΠΈΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΠΈΠ·ΠΌΠ΅ΡΠ΅Π½ΠΈΠ΅ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΠΈ ΡΠ²ΠΎΠ΅Π²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠ΅ Π²Π½Π΅ΡΠ΅Π½ΠΈΠ΅ ΠΊΠΎΡΡΠ΅ΠΊΡΠΈΠ², ΡΠ°Π·Π²ΠΈΡΠΈΠ΅ ΠΈ ΡΠΎΠ²Π΅ΡΡΠ΅Π½ΡΡΠ²ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°ΡΠ΅Π»ΡΠ½ΠΎΠΉ ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΠΈ Π΄Π»Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΠΆΠ΅Π»Π°Π½ΠΈΠ΅ ΡΠΎΡΡΡΠ΄Π½ΠΈΡΠ΅ΡΡΠ²Π° ΠΈ ΠΎΠ±ΠΌΠ΅Π½Π° ΠΎΠΏΡΡΠΎΠΌ. ΠΠ³ΡΠ°Π½ΠΈΡΠ΅Π½ΠΈΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ. Π ΡΠ°Π±ΠΎΡΠ΅ ΠΏΡΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Ρ Π΄Π²Π΅ ΡΠ°Π·Π½ΡΠ΅ ΠΏΠΎ ΡΠ°Π·ΠΌΠ΅ΡΡ ΠΈ ΠΎΡΠ½ΠΎΡΠΈΡΠ΅Π»ΡΠ½ΠΎ Π½Π΅Π±ΠΎΠ»ΡΡΠΈΠ΅ Π³ΡΡΠΏΠΏΡ ΡΠ»ΡΡΠ°ΡΠ΅Π»Π΅ΠΉ, ΠΊΠΎΡΠΎΡΡΠ΅ Π°Π½ΠΎΠ½ΠΈΠΌΠ½ΠΎ ΠΎΡΠ²Π΅ΡΠ°Π»ΠΈ Π½Π° ΡΡΠ°Π½Π΄Π°ΡΡΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΡΠ΅ Π²ΠΎΠΏΡΠΎΡΡ ΠΎ ΡΠ΅Π»Π΅ΡΠΎΠΎΠ±ΡΠ°Π·Π½ΠΎΡΡΠΈ ΠΈ ΠΊΠ°ΡΠ΅ΡΡΠ²Π΅ ΠΏΡΠΎΠ²Π΅Π΄ΡΠ½Π½ΠΎΠ³ΠΎ ΠΎΠ±ΡΡΠ΅Π½ΠΈΡ. ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΠΎΡΠ²Π»Π΅Π½ΠΈΠ΅ Π½ΠΎΠ²ΡΡ
Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠ΅ΠΉ, ΡΠ²ΡΠ·Π°Π½Π½ΡΡ
Ρ ΡΠ΅Π»Π΅ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΠΌ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΡ, Π²ΠΊΠ»ΡΡΠ°Ρ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°ΡΠ΅Π»ΡΠ½ΡΠ΅ ΠΌΠ΅ΡΠΎΠΏΡΠΈΡΡΠΈΡ Π΄Π»Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΠΎΡΠΊΡΡΠ²Π°ΡΡ Π½ΠΎΠ²ΡΠ΅ ΠΏΠ΅ΡΡΠΏΠ΅ΠΊΡΠΈΠ²Ρ Π΄Π»Ρ ΡΠ»ΡΡΡΠ΅Π½ΠΈΡ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ, Π½Π°ΠΏΡΠ°Π²Π»Π΅Π½Π½ΠΎΠΉ Π½Π° ΡΠΊΡΠ΅ΠΏΠ»Π΅Π½ΠΈΠ΅ Π·Π΄ΠΎΡΠΎΠ²ΡΡ ΠΈ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΡ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ