RESUMEN
The development of telemedicine and the provision of medical care using remote technologies requires appropriate competencies and skills from medical specialists, the formation of which is an important task of adapting educational systems to modern challenges and responding to requests from both medical staff and patients. Based on the analysis of foreign scientific publications, the paper considers the assessment of the need to train medical workers in remote work with patients and the prospects for the introduction of telemedicine consultations into everyday professional practice. It is concluded that having more knowledge about which aspects of medicine are best combined with telemedicine, it is important to train future medical professionals in the use of these technologies and the provision of these types of medical care. Doctors should not only be trained in the use of telemedicine, but also learn how to do it professionally, safely and on the basis of evidence.
Asunto(s)
Médicos , Telemedicina , Humanos , Personal de Salud , Internacionalidad , Derivación y ConsultaRESUMEN
The authors evaluated the clinical efficacy and safety of the antiviral and immunomodulatory drug Isoprinosine (inosine pranobex, Teva Pharmaceutical Industries, Ltd) in the treatment of bronchopulmonary diseases in children. One hundred and fifty-two children with acute respiratory diseases and an exacerbation of recurrent respiratory diseases were followed up. The use of Isoprinosine in their combined treatment showed both positive clinical changes and a better immunogram.
Asunto(s)
Adyuvantes Inmunológicos/uso terapéutico , Exposición a Riesgos Ambientales/efectos adversos , Enfermedades Ambientales/tratamiento farmacológico , Inmunomodulación/inmunología , Inosina Pranobex/uso terapéutico , Enfermedades Respiratorias/tratamiento farmacológico , Adolescente , Niño , Preescolar , Enfermedades Ambientales/epidemiología , Enfermedades Ambientales/inmunología , Estudios de Seguimiento , Humanos , Inmunomodulación/efectos de los fármacos , Morbilidad/tendencias , Enfermedades Respiratorias/epidemiología , Enfermedades Respiratorias/inmunología , Federación de Rusia/epidemiologíaRESUMEN
A total of 3497 preschool children residing in the towns having with different man-made burden were examined. The study showed that most children referred to Health Groups 2 and 3. In the town with higher environmental pollution there were a larger proportion of children with dysfunctions of different organs and systems and higher incidence of diseases, including respiratory allergoses, etc.
Asunto(s)
Contaminación Ambiental , Morbilidad , Factores de Edad , Niño , Preescolar , Humanos , Factores de Riesgo , Siberia , Población UrbanaRESUMEN
Feasibility of measuring functional reserve of the myocardium under functional loads simulated by extracorporeal circulation was tried in 36 patients with diffuse purulent peritonitis on filtration detoxication. Altogether 49 sessions of hemofiltration and filtration exchange plasmapheresis were performed controlled by tetrapolar rheography. It is demonstrated that persistent decline of systolic and cardiac output, an increase of central blood volume and occurrence of a pathological impedance wave in response to pre- and postload on the myocardium during extracorporeal detoxication may serve an indication of a subclinical myocardial failure. Detection of a reduced myocardial reserve suggests restriction of hemodilution in plasmapheresis and infusion therapy or lasix administration in postfiltration period.
Asunto(s)
Hemofiltración , Contracción Miocárdica/fisiología , Peritonitis/fisiopatología , Plasmaféresis , Cardiografía de Impedancia , Terapia Combinada , Insuficiencia Cardíaca/diagnóstico , Insuficiencia Cardíaca/etiología , Insuficiencia Cardíaca/terapia , Hemodinámica/fisiología , Humanos , Peritonitis/complicaciones , Peritonitis/terapiaRESUMEN
Hemofiltration was for the first time used in multiple-modality treatment of 26 patients with peritonitis in the terminal phase with symptoms of organic and multi-organ insufficiency. Indications to and contraindications against this treatment modality were developed, as was the optimal scheme of hemofiltration in peritonitis patients. This method was found the most effective in patients with symptoms of multi-organ insufficiency (respiratory distress syndrome, nephropathy, hypodynamic syndrome, toxic and hypotoxic edema of the brain). Inclusion of this method into the complex of therapeutic measures has helped prolong the intensive care of peritonitis patients in the terminal phase in the majority of cases. Fourteen patients died, the death rate has made up 53.8 percent.
Asunto(s)
Hemofiltración/métodos , Insuficiencia Multiorgánica/terapia , Peritonitis/terapia , Toxemia/terapia , Adolescente , Adulto , Femenino , Humanos , Masculino , Insuficiencia Multiorgánica/etiología , Peritonitis/complicaciones , Cuidado Terminal , Toxemia/etiologíaRESUMEN
An experience of using discrete exchange plasmapheresis (DEP), filtration exchange plasmapheresis (FEP), hemofiltration (HF) and plasmafiltration (PF) in combination with ultraviolet (UV) irradiation of autoblood has been reviewed in 92 patients with pyogenic peritonitis. It has been shown that HF (PF) is an effective and pathogenetically grounded method of detoxication in patients with disseminated pyogenic peritonitis at a stage of polyorgan failure. FEP must be a method of choice during complex therapy at terminal phases of disseminated pyogenic peritonitis. The mechanisms of FEP therapeutic effect are based on elimination of a wide range of toxic substances, correction of severe metabolic disturbances, improvement of central and liver hemodynamics and, in combination with UV irradiation of autoblood, on bacteriocide and antihypoxic effect. The use of DEP is restricted to local pyogenic processes in the abdominal cavity.