Контроль аллергического ринита: современные инструменты оценкиТюфилин Д.С., Деев И.А., Кобякова О.С., Куликов Е.С., Табакаев Н.А., Винокурова Д.А., Кириллова Н.А. Сибирский государственный медицинский университет (СибГМУ) Россия, 634050, г. Томск, Московский тракт, 2 РЕЗЮМЕ Актуальность и цель. В настоящее время аллергический ринит (АР) является распространенным заболеванием, негативно влияющим на качество жизни пациентов и приводящем к развитию бронхиальной астмы, что определяет его высокое социально-ýкономическое бремя. Согласно общей концепции, одобренной Всемирной организацией здравоохранения, целью терапии АР, как и других аллергических состояний, является контроль над симптомами, что отражено в отечественных клинических рекомендациях. Тем не менее реализация данной цели на практике затруднительна из-за отсутствия международного стандартизированного валидизированного инструмента оценки контроля АР. В ýтой связи целью данного обзора является анализ результатов исследований, посвященных созданию таких инструментов, и проведение их сравнительного анализа.Материалы и методы. Для проведения обзора использовались базы данных Web of Science, Scopus и Российского индекса научного цитирования, библиотека PubMed. В качестве маркеров поиска были использованы такие ключевые слова, как allergic rhinitis control, AR control, AR questionnaire, включены публикации с 1991 г. (первая работа в данном направлении) по настоящее время (2018 г.). Всего было проанализировано 96 публикаций.Результаты. По результатам поиска все исследования были расположены в хронологическом порядке и описаны их основные результаты. Отдельно рассмотрены достоинства и недостатки опросников по качеству жизни пациентов с АР, использования инструментом из официальных клинических руководств, оценки контроля аллергического ринита при помощи визуальных аналоговых шкал, а также специализированных опросников по контролю АР.Заключение. Проведенный обзор позволяет сделать выводы не только о качестве предлагаемых сегодня инструментов, но и предложить наиболее репрезентативные опросники для определения уровня контроля аллергического ринита для использования в клинической практике.Ключевые слова: аллергические состояния, валидация, опросники по аллергическому риниту, оценка контроля, анкеты АР.Конфликт интересов. Авторы декларируют отсутствие явных и потенциальных конфликтов интересов, связанных с публикацией настоящей статьи.Источник финансирования. Авторы заявляют об отсутствии финансирования при проведении исследования.
Introduction. Clinical trials (CTs) are the footing foundation of evidence-based medicine. In Russia many aspects of CT implementation remain unexplored; one of them is the attitude of Russian society. Aims. This study aims to determine the knowledge and perception of CTs by potential participants. Analysis of the perception of CTs through the eyes of patients: CTs - is it a benefit or an unjustified risk? Materials. The primary method of research was a questionnaire. A total of 488 anonymous, voluntary surveys of patients from hospitals in Tomsk were studied. Results. More than half of the respondents heard about CTs, while the primary source of information was the media. The participants adequately assess the importance of conducting CTs to develop medicine and medical care for society. The primary goal of CTs is to determine the effectiveness and safety of drugs, and respondents regard their engagement as an opportunity to contribute to the development of science. The primary motivating factor in participating in CTs is receiving treatment for an incurable disease and observing conditions by a qualified doctor. The central negative aspect is the possibility of causing a risk to own health. The questionnaire demonstrated the need and importance of all points of informed consent. Several questions concerned the public attitude to researchers. According to patients, medical researchers arouse trust and confidence in altruistic motives during the CTs. Conclusion. This study revealed a low interest of Russians in participating in CTs, except for personal benefit. The behavior of the doctors, the ability to convey reliable information to the patient to adequately assess benefits and possible risks play an important role in deciding on the involvement of patients in the CTs. The results of this work will allow us to adapt the process of organizing CTs to the needs of patients in the local context.
Objective: this study aims to analyze the use of antiretroviral therapy and its efficacy in HIV-infected patients in 5 regions of Russian Federation.Materials and methods: the research protocol included a retrospective analysis of the regional Centers for the Prevention and Control of AIDS registers and medical records of patients. Inclusion criteria were a verified diagnosis of HIV infection. The first group included patients (n=1161) receiving antiretroviral therapy regimens at the latest by 01/01/2015, the second group included patients with no antiretroviral therapy before 01/01/2015 (n=1366). The groups were compared with each other by socio-demographic indicators and characteristics of HIV infection, including infection routes, stage of the disease and its natural course.Results: Group I showed a higher prevalence of patients with an undetectable viral load (60,7%) comparing to group II (p<0,05) where a low (70,9%) and high (8,5%) viral load was observed. There was a dynamic decrease in patients’ numbers with severe immunodeficiency by 12.6% and an increase in the average amount of CD4+ in group I.
Objectives. This work aims to provide retrospective analysis of socio-economic, demographic and clinical features of patients with HIV infection in 5 regions of Russian Federation with high prevalence of HIV infection (Krasnoyarsk, Tomsk, Irkutsk, Ulyanovsk Region, Samara Region). Materials and methods. A study was a part of the project «Natural and Clinical Course of HIV Infection in the Russian Federation». The protocol of study included a retrospective analysis of the regional Centers for the Prevention and Control of AIDS registers and medical records of patients. Inclusion criteria was a verified diagnosis of HIV infection. Diagnosis should be made by 01/01/2015 at the latest.Results. Demographic and socio-epidemiological parameters, clinical manifestations, immunological aspects and the status of antiretroviral therapy in the studied cohort were evaluated. The results of the analytical study allowed us to present a modern profile of the HIV-infected population.Discussion. The analysis showed the prevalence of socially adapted people of working age (30–39 years), the predominance of the parenteral route of HIV infection associated with intravenous drug use in men and the activation of the sexual route of HIV infection in a cohort of women, and other features of HIV epidemiology. Results of analytical work reflect the situation of HIV infection in the Russian Federation, justifying the need for further research in this area and implementing effective prevention strategies into practice.
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