The review, based on modern literature data and the results of many years of research conducted by the authors, highlights the problem of comorbidity (multimorbidity) in children with bronchial asthma (BA). There is a grouping of concomitant diseases in children with asthma depending on the type of comorbidity (causal, complicated, unspecified, reverse). Based on epidemiological data, observational and cohort studies, systematic reviews and meta-analyses, information on the frequency of BA in children with various comorbid diseases and comorbid diseases in children with BA was summarized. Scientific, theoretical and practical significance of comorbidity in BA, diagnostic and treatment programs in pediatric patients suffering from BA and comorbid diseases are substantiated.
Nutritional deficiency is quite common in patients with acute stroke. Trophic failure correlates with an increased hospital stay, readmissions, and the incidence of developmental complications and mortality. The nutritional deficiency identification is necessary both in the early and in the long-term period of the disease. The clinical review describes the leading diagnostic methods of assessing nutritional status in patients with acute stroke. The comparative characteristics of the applied rating scales and tests are presented. The somatometric, laboratory, and instrumental indicators of malnutrition, as well as the complex use of diagnostic methods and screening tests, are discussed.
Evaluation of the nutritional status at an early stage of hospitalization in patients with acute cerebrovascular insufficiency (CVA) is important for providing timely nutritional support. According to the Russian clinical guidelines for nutritional support of patients with stroke, the NRS‑2002 scale is essential to assessment the nutritional status. However, due to the obesity, about 30 % of patients do not entered into the general category of patients with CVA to get the standard examination.Aim. To analyze the NRS‑2002 scale effectiveness in patients with acute cerebrovascular accident, taking into account the somatic and visceral protein pools.Materials and methods. In the case of the prospective study the 140 patients with CVA were hospitalized in the primary vascular department of the City Clinical Hospital n. a. V. V. Vinogradov (Moscow, Russia), and were screened by the simplified malnutrition scoring system and the NRS‑2002 scale.Results. The research reveals: A low risk of malnutrition in 34,3 % of all cases and 72,7 % in patients under 70 years; the high BMI – Me‑26,6 (24,2–30,8) kg/m²; the protein deficiency in 140 (25.7 %) of patients with normal somatic protein pool and in 66 (28.8 %) of patients under 70 years.Conclusions. Detecting the risk of malnutrition with the NRS‑2002 scale in the early stage after hospitalization is not always informative due to the overweight and the age less than 70 years. The visceral protein pool analysis should be performed in all patients, independently of the NRS‑2002 scale and the somatic protein pool results.
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