This article presents the experience of successful use of the drug dupilumab in a patient with severe atopic dermatitis and bronchial asthma. The effectiveness of biological therapy with dupilumab 300 mg subcutaneously for 52 weeks of T-2 associated diseases, including a combination of severe atopic dermatitis and bronchial asthma, uncontrolled course based on the case history of patient Ts., born in 2006 with the diagnosis "Main: atopic dermatitis, common form, severe course. Concomitant diagnosis: bronchial asthma, persistent course, uncontrolled, moderate severity". Dynamic monitoring of the total blood count with the calculation of the absolute number of eosinophils in peripheral blood was performed. The study showed high efficacy and safety of biological therapy with dupilumab 300 mg subcutaneously every 2 weeks for 52 weeks with a combination of severe atopic dermatitis and bronchial asthma, uncontrolled course in patient Ts (Born in 2006). The examination of the ALEX2 allergochip made it possible to establish the molecular components of the primary causal allergens, predict the course of an allergic disease, and carry out successful elimination measures against food allergens, preserving the maximum set of nutrients in the patient's diet. Dupilumab therapy in severe atopic dermatitis and uncontrolled bronchial asthma leads to clinically significant improvement in the course of diseases, control of disease symptoms. Atopic dermatitis shows a decrease in itching of the skin, normalization of sleep, improvement of quality of life. With bronchial asthma, a reduction in exacerbations, normalization of respiratory function indicators, complete control of the disease has been achieved. The targeted biological drug dupilumab has a targeted effect on the key links in the pathogenesis of atopic dermatitis and bronchial asthma and reduces the burden of severe diseases. Therefore, the use of dupilumab in atopic dermatitis and bronchial asthma contributes to achieving disease control and improving the patient's quality of life.
Within the framework of the 2030 Agenda for Sustainable Development, goals were formulated, including those targeting to improve quality of life of people all around the world. The task was formulated to ensure universal coverage of health services. In 2019, the United Nations General Assembly noted that at least half of world's population have no access to basic health services. The study developed methodology to carry out comprehensive comparative analysis of values of individual public health indicators and amount of population payments for medications to confirm possibility of applying these indicators to monitor public health, including possibility of international comparisons. The study demonstrated inverse relationship between share of citizens' funds to pay for medications, index of universal health coverage and life expectancy. The stable direct relationship between such indicators as overall mortality rate from non-communicable diseases and likelihood of dying at the age of 30-70 years from any of cardiovascular diseases, cancer, diabetes or chronic respiratory diseases.
Introduction. Twenty-five years ago, on May 29, 1997, a new specialty «Transfusiology» appeared in the nomenclature of medical and pharmacological specialties, which was due to the dictates of time. By this time, blood transfusion was used in patients with various diseases in the vast majority of medical institutions. As a result of the approval of regulatory legal acts, the basis for giving the discipline an independent status was created.Aim – to analyze the formation of the specialty «Transfusiology» in Russia.Main findings. To conduct historical-genetic research, a set of methods was used, including research and generalization of experience, methods of monographic description and modeling, and a group of analytical methods. The sources of information were regulatory legal acts. The documents, consistently developed over two and a half decades, made it possible to formulate the duties, rights and responsibilities of a transfusiologist, as well as solve the issues of certification and postgraduate education, developed qualification characteristics, and instructions for assigning the highest, first and second qualification categories in transfusiology. Priority was given to surgeons and therapists who had the opportunity to obtain a qualification category in the specialty «Transfusiology» corresponding to their previous specialty. In 1998 the position of chief freelance transfusiology specialist was introduced. Currently, blood transfusion is offered in 38 out of 49 medical care profiles.
The analysis of disability indicators allows to draw conclusions about both level of medical care and quality of therapeutic measures and about level of social economic development of society as a whole. Furthermore, disability is a complex problem including social, economic, medical and other components.The study is devoted to analysis of official statistical data by set of such methods as exploration and generalization of experience, analytical and statistical techniques, monographic description.The study established decreasing of total number of the disabled in the Russian Federation in 2015-2020 in absolute values with simultaneous increasing of both absolute value and share of disabled children. The analysis of the number of the disabled in the Federal Okrugs of the Russian Federation permitted to conclude about retained general trends specific to the Russian Federation. In the structure of disability among individuals recognized as disabled for the first time, share of individuals with the disability group I increased. In individuals recognized as disabled for the first time, the most common diseases are malignant neoplasms (Chapter II) and diseases of cardiovascular system (Chapter IX). Among main persistent functional disorders in individuals recognized as disabled (both for the first time and repeatedly), first rank positions are occupied by conditions encoded in the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, in Chapter III (dysfunction of the blood system and immune system), Chapter XIII (violation of neuromuscular, skeletal and movement-related functions), Chapter IX (violation of functions of cardiovascular system).
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