The assessment of physicians' and senior medical students’ knowledge in the field of communityacquired pneumonia: preliminary results of the KNOCAP-II project (2017-2019)

Внебольничная пневмония (ВП) относится к одной из самых актуальных проблем современной медицины. На сегодняшний день ВП занимает 4 место в структуре смертности (после сердечно-сосудистых, цереброваскулярных заболеваний и злокачественных новообразований) и 1 место среди всех смертей от инфекционных заболеваний. Цель – оценка уровня знаний врачей терапевтического профиля и студентов старших курсов медицинских вузов в вопросах ведения пациентов с ВП. В рамках многоцентрового исследования KNOCAP (полное название проекта – «The assessment of physician and students’ knowledge of community-acquired pneumonia basics») представлены результаты анонимного проспективного опроса по оценке знаний и предпочтений врачей терапевтического профиля и студентов старших медицинских курсов в вопросах ведения пациентов с ВП. По итогам первого периода проекта (2017-2019 гг.) получены и проанализированы результаты анкетирования 588 врачей терапевтического профиля и 394 студентов-медиков из 17 центров России, Украины и Кыргызстана. За основу взят метод анонимного анкетирования, для чего была разработана оригинальная анкета на основании актуальных клинических рекомендаций. Наибольшие сложности вызвали следующие вопросы: сроки проведения повторного рентгенологического исследования при положительной динамике лечения, выбор основного диагностического признака при ведении пациента с ВП, указать типовые ошибки фармакотерапии ВП и выбор стартовой антимикробной терапии у пациентов с факторами риска и без них. В целом исследование показало значимое несоответствие знаний в вопросах ведения пациентов с ВП актуальным клиническим рекомендациям 2010 г. и проектом новых клинических рекомендаций 2018-2019 гг. В настоящее время существует необходимость в повышении уровня знаний и совершенствовании профессиональной деятельности врачей терапевтического профиля и студентов старших медицинских курсов, так как проведенный многоцентровой срез знаний и предпочтений специалистов во многих вопросах выявил их недостаточный уровень для корректного ведения пациентов с ВП. Community-acquired pneumonia (CAP) is one of the most relevant problems of modern medicine. Today, CAP takes 4th place in the structure of mortality (after cardiovascular, cerebrovascular diseases and malignant neoplasms) and 1st place among all deaths from infectious diseases. The aim of the study is to assess the level of general physician’ and senior medical students’ basic knowledge in CAP treatment. The article represents the results of anonymous prospective surveys within the framework of the second stage of KNOCAP multi-centered research project (full name of the project «The assessment of physician’ and students’ knowledge of community-acquired pneumonia basics») aimed at accessing the knowledge and preferences of doctors and students on the fundamental issues in diagnosis and treatment of community-acquired pneumonia. The survey conducted in 2017-2019 involved 588 physicians and 394 students from seventeen Russian, Kyrgyzstan and Ukrainian centers. The method of anonymous questioning was used in this study, for which an original questionnaire was developed on the basis of current clinical recommendations. The following fundamental questions caused the greatest difficulties in the respondents: terms for a repeated X-ray examination in positive dynamics of CAP treatment, the choice of main diagnostic criteria of CAP, the choice of the typical mistakes of CAP treatment, the choice of the initial antimicrobial therapy. In general, the respondents’ knowledge in CAP patients’ management deviates significantly from the current clinical guidelines, as of 2010, and from the new clinical guidelines draft, 2018-2019. Currently, there is a need to increase the level of knowledge and improve the professional activities of therapists and senior medical students, as a multicenter section of the knowledge and preferences of specialists in many issues revealed their insufficient level for the correct management of patients with CAP

This familiar diagnosis of “rhinitis”

The article highlights that rhinitis is the most common disease, it is divided into 3 main phenotypes: infectious (IR), allergic (AR) and non-infectious non-allergic (NAR). There are also combined forms. IR is a viral disease. Its clinical picture is described, the frequent failure of patients to consult a doctor for this disease is noted, which contributes to the development of complications and its chronization. The authors described the characteristic features of the AR clinic with “oral Allergy syndrome“. It is noted that NAR is a heterogeneous disease, which is divided into at least 6 subphenotypes: drug, taste, hormonal, atrophic, idiopathic and rhinitis of older people. The authors analyze the reasons for their occurrence. There is also a professional form of rhinitis. All these phenotypes are United by the symptom of difficult nasal breathing, which also occurs in chronic rhinosinusitis and “empty nose“ syndrome. Other causes of nasal breathing disorders are also mentioned. In the treatment of patients with almost any of the rhinitis phenotypes, the main ones are irrigation-elimination therapy and the appointment of topical decongestants (TD). An important role is played by avoiding the causes that activate the course of rhinitis, and educating the population to properly organize the individual treatment process. Topical vasoconstrictor drugs are the leading topical remedies that eliminate nasal breathing difficulties. They are sold in our country in the usual access and if used incorrectly can cause the development of medical rhinitis and many serious consequences. The methods of correct administration of the drug in the form of drops and spray, as well as its age-related dosages, are disclosed. © 2020, Remedium Group Ltd. All rights reserved

The value of herbal medicine in the treatment of acute tonsillopharyngitis of non-streptococcal genesis

The purpose of the study. To establish the effectiveness of symptom reduction and preventive action of the herbal drug Tonsilgon N (HD) as monotherapy for exacerbations of chronic tonsillitis/pharyngitis in adult patients. Material and methods. The study included 60 adult male and female patients aged 18 to 60 years with an established diagnosis of acute tonsillopharyngitis. In total, each patient underwent 5 visits. Visit 1-enrollment in the study and beginning of HD mono-therapy, Visit 2-on Day 7, Visit 3-on Day 14 and completion of HD monotherapy, Visit 4-on Day 60 and Visit 5-on Day 180. The diagnosis of the disease and the examination of the patient was carried out on the basis of anamnesis, general clinical and ENT examination, palpation of regional lymph nodes. The severity of the clinical signs was evaluated on the basis of the symptom score. The general condition of the patient was also evaluated using a visual analogue scale (VAS) and the number of exacerba-tions of tonsillopharyngitis during the observation period. Results. The number of exacerbations of chronic tonsillitis and episodes of ATP for 6 months after the end of treatment decreased 4.8 times compared to the previous period. During the course of treatment (14 days), complaints of patients with ATP (general health and/or fatigue, pain when swallowing, headache, cough, burning sensation, a lump in the throat, hoarseness, pain and dry-ness in the throat, difficulty swallowing) had a pronounced tendency to regression. Improvement was also noted on examination and clinical evaluation. According to the results of the analysis of the evaluation of general condition according to the VAS (according to the standard technique in cm), there was a significant improvement both during the treatment period by 2.2 times, and during the observation period (180 days) from the period of Visit 2 to Visit 4 by 31.3 times. Conclusion. The use of HD as monotherapy for non-streptococcal ATP has shown its high efficiency. The possibility of using Ton-silgon N was shown as a prophylactic agent that reduces the number of exacerbations of inflammatory diseases in the pharynx during the period after the treatment course. © 2020, Media Sphera Publishing Group. All rights reserved

The Effect of Contact Angle on Dynamics of Dry Spots Spreading in a Horizontal Layer of Liquid at Local Heating

The effect of equilibrium contact angle on dynamics of dry spot spreading at disruption of a horizontal water layer heated locally from the substrate was studied using the high-speed Schlieren technique. Different methods of working surface processing were applied; this allowed variations of the equilibrium contact angle from 27±6° to 74±9° without a change in thermal properties of the system. It is found out that substrate wettability significantly affects the propagation velocity of dry spot and its final size. It is also found out that the velocity of contact line propagation is higher in the areas of substrate with a higher temperature

Impedance properties and microwave magnetic field dependence of surface resistance of YBaCuO

The microwave magnetic field IIw dependence of the surface resistance Rs for a YBa₂Cu₃O-δ ceramic and thin film has been studied in 8 mm wave band. It is shown that for the film one of mechanisms consistent with the obtained dependence Rs(Hw) may be microwave-induced flux motion. For the ceramic specimen, the above dependence is in agreement with the model of Sridhar for the nonlinear high-frequency response of a planer superconductor in a current-induced critical state and with Gurevich's theory of the nonlinear dynamics of vortices in high-Jc overdamped Josephson contacts. An approach was applied which allows us to perform measurements without preliminary patterning of the samples

Russia, the US and the Missile Technology Control Regime

SIGLEAvailable from British Library Document Supply Centre-DSC:0680.400(317) / BLDSC - British Library Document Supply CentreGBUnited Kingdo

The phase composition, morphology and compressibility of graphene-zirconia composite nanostructured powder

Nanostructured composite particles of nano- and submicron sizes were synthesized by a combination of sol-gel and sonochemical techniques. Their graphene content was 0.8-0.9 wt%. These layered particles consisted of graphene sheets in which zirconia nanocrystals were discretely incorporated. The synthesized powders were characterized using XRD, TEM, HRTEM, diffusion aerosol spectrometry and elemental analysis. A comparison of the compressibility modulus, limit values of linear section deformation and compressibility factor shows that the compressibility of the composite is difficult to achieve compared to that of pure zirconia, apparently, due to the low elasticity of graphene sheets. This journal is © The Royal Society of Chemistry

Selbstresistenz in Polyketid-Antibiotika-Produzenten Schlussbericht

Available from TIB Hannover: DtF QN1(76,52) / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEBundesministerium fuer Bildung, Wissenschaft, Forschung und Technologie, Bonn (Germany)DEGerman