Пульс - медицинский центр 
Пульс - медицинский центр
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Таким образом, АГ была и остается очень важной медицинской и социальной проблемой, которая требует соответствующего внимания не только со стороны учреждений здравоохранения и медицинских работников, но и руководства Минздрава и государства. Только совместными усилиями представителей медицинской науки, здравоохранения и всего общественного общества можно достичь повышения эффективности борьбы с этим заболеванием.
Regardless of the period of the life cycle, it is necessary to increase self-esteem of health by optimizing the social environment, introducing the basics of a healthy lifestyle (in particular, various forms of self-realization, regular physical education and sports of optimal intensity, fitness, yoga, etc.). After all, inadequate self-assessment of one's own health can change a person's behavior in a negative direction, lead to the health of destructive or deviant forms of behavior.
The use of thiopurine (azathioprine and mercaptopurine) reduces the immune response to viruses, which is associated with an increased risk of opportunistic infections. There is limited evidence that they increase the risk of respiratory infections. The risks and benefits should be considered, but most patients can continue on a stable dose. In patients in stable remission, elderly patients and in the presence of concomitant pathology, it is recommended to stop taking thiopurine. During a pandemic, it is recommended to avoid starting thiopurine or increasing the dose, which will allow patients to avoid potential side effects. If the patient is in contact with a COVID-19 person, temporary withdrawal of thiopurine for 2 weeks should be considered. If a patient tests positive for SARS-CoV-2 and/or develops COVID-19, temporary discontinuation of thiopurine may be recommended until the patient clears the infection.
Treatment with corticosteroids (especially prednisolone ≥20 mg/day or equivalent) is associated with an increased risk of infection. However, it is unclear whether corticosteroid therapy is associated with an increased risk of developing COVID-19 or its complications. Data on budesonide, a topical corticosteroid with low systemic bioavailability, show that these drugs are associated with significantly fewer side effects compared to systemic corticosteroids and their side effects are close to placebo. If possible, corticosteroids should be avoided and a rapid dose reduction considered, and a switch to budesonide is recommended. This must be taken into account, taking into account the risk of exacerbation of CKD. If a patient with COPD is in contact with a person with COVID-19 or develops COVID-19, it is recommended to gradually reduce the dose of corticosteroids, the use of budesonide is preferred, but taking into account the severity of COPD and the risk of exacerbation.
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