Пульс - медицинский центр 
Пульс - медицинский центр
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Именно переход на использование в Украине ИПВ для всех доз Календаря прививок должен быть ближайшей задачей по вакцинопрофилактике. Для этого можно использовать несколько механизмов, включая гуманитарную помощь, заключение планируемых прямых договоров с производителями вакцин исходя из потребностей необходимого состава вакцин согласно Календарю, в частности с учетом существования современных комбинированных вакцин с ИПВ, которые могут быть использованы и в более старшем возрасте. При отсутствии комбинированных вакцин с ИПВ можно использовать ИПВ в качестве моновакцины.
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.
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.
When transitioning to biological therapy, subcutaneous administration should be considered to limit patient contact with the healthcare facility. Selective switching from intravenous infliximab to subcutaneous anti-TNF is not recommended as it may increase the risk of relapse. If the patient is in contact with a COVID-19 person, withdrawal of anti-TNF therapy for 2 weeks should be considered.
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