Terapevt Arkh
-
The novel coronavirus infection COVID-19 (SARS-CoV-2) is now known to cause a variety of extrapulmonary complications, including cardiovascular, neurological and dermatological complications, many of which occur or last several weeks after infection. We present a clinical case of a patient who first developed symptoms of ankylosing spondylitis 2 weeks after recovering from COVID-19. The patient was prescribed therapy in accordance with international and Russian recommendations for the management of patients with ankylosing spondylitis with a positive effect in the form of absence arthritis, enthesitis and reducing the inflammatory back pain.
-
Recently, the importance of comorbid infections in rheumatology has increased significantly, which have a significant impact on morbidity and mortality, especially in immuno-inflammatory rheumatic diseases (IIRD). In this regard, vaccination is becoming increasingly important in the prevention of infections in these patients. ⋯ The role of the rheumatology team in solving the problems associated with immunization of patients with IIRD is emphasized, as well as the importance of joint decision-making taking into account the needs and preferences of patients. The issues concerning the use of vaccines against influenza, pneumococcal infection, hepatitis B.
-
The 2019 coronavirus disease (COVID-19) pandemic become a major challenge for humanity and a unique opportunity to get an idea of the real achievements of modern biology and medicine. In the course of the pandemic, a large number of new fundamental and medical issues have been revealed regarding the relationship between viral infection and many common chronic non-infectious diseases, among which immune-mediated rheumatic diseases (IMRD) occupy an important position. It is now well known that SARS-CoV-2 infection is accompanied by a wide range of extrapulmonary clinical and laboratory disorders, some of which are characteristic of IMRD and other autoimmune and autoinflammatory diseases in humans. ⋯ The COVID-19-associated hyperinflammatory syndrome was used as a reason for drug repurposing and off-label use of a wide range of anti-inflammatory drugs, which have been specially developed for the treatment of IMRD over the past 20 years. Common immunopathological mechanisms and approaches to pharmacotherapy in COVID-19 and IMRD determined the unique place of rheumatology among medical specialties contributing to combat the COVID-19 pandemic. The article provides the basic provisions of the International and National Association of Rheumatologists and the Association of Rheumatologists of Russia (ARR) recommendations for management of patients with IMRD during the COVID-19 pandemic.
-
The article is devoted to voluntary informed consent. It considers the historical issues of the formation of this concept in modern health care and medical science. The article highlights a historical role of the Nuremberg Code which was taken as the basis for the Universal Declaration of Human Rights, the World Medical Association (WMA) Code of Ethics, the Declaration on Bioethics and Human Rights, i.e. documents that defined the world order after the end of World War II.
-
To evaluate the cardiovascular risk (CVR) and analyze its relationship with detection of early carotid artery atherosclerotic lesion in patients with rheumatoid arthritis (RA). ⋯ RRS, mSCORE, ASSIGN, QRISK3 calculators equally predict atherosclerotic carotid artery damage in RA patients. The optimal ratio of specificity and sensitivity is shown for the mSCORE scale. Stratification of CVR in RA patients should include assessment of the carotid intima-media thickness. To identify CVR in RA patients, the most informative methods are mSCORE calculation and carotid intima-media thickness determination.