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При возможности следует избегать применения кортикостероидов и рассмотреть возможность быстрого снижения дозы и рекомендуется перейти на будесонид . Это необходимо учесть с учетом риска обострения ХЗОК. Если пациент с ХОЗК находится в контакте с человеком с COVID-19 или у него развивается COVID-19, рекомендуется постепенно снизить дозу кортикостероидов, предпочтение отдается применению будесонида , но с учетом тяжести течения ХОЗК и риска развития обострения.
Specialists of the Laboratory of Epidemiological Research and Medical Informatics of the State Institution “Institute of Public Health named after A.I. O.M. Marzeeva NAMNU” researched the issues of health status, its subjective feeling, as well as behavior that contributes to health or is risky among people of all ages. Assessment by adolescents and young people of their own health, life satisfaction is important for the development of both preventive programs and directions for promoting health. At the same time, it is also important for the elderly and elderly to maintain an active lifestyle, maintain health, work (self-realization), and overcome the so-called biological determinism. It is reasonable to consider the social environment as an important determinant of health. In this regard, the question of optimizing the social environment arises, since in the absence of a comfortable social environment focused on human development, there are actually no constructive conditions for the formation of good health.
In 2021, in Ukraine, vaccination coverage rates for children under 1 year of age against such infections as tuberculosis, measles, whooping cough, diphtheria, poliomyelitis, hepatitis B, etc. ranged from 78% to 80.1% (with the required level >90 %), which is undoubtedly not enough to recognize the epidemic situation under control. In particular, this figure for 3 vaccinations against polio at the age of up to 1 year was 80.1%, 5 vaccinations at the age of 6 years received only 78.4% of children. At the same time, vaccination coverage rates varied widely across regions. In 12 regions, among children under 1 year old, they were <80% and ranged from 68.5% to 73.9%, and among children under 18 months. (4 vaccinations) - 66% to 73%. That is, almost 20-30% of children did not receive routine vaccination against poliomyelitis due to age in the above target groups, subject to vaccination according to the Immunization Schedule.
The first and mandatory step in the treatment of hypertension is lifestyle modification (LS), which is aimed at correcting the above risk factors, primarily modifiable ones. A big problem is the choice of the most optimal treatment for hypertension, which can slow down the progression of lesions of the heart, blood vessels, kidneys, brain and eyes. The vast majority of hypertensive patients who seek medical help require combination antihypertensive therapy. At the same time, the most appropriate at the present level is the use of fixed combinations of such drugs.
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