The paper presents algorithms for adult outpatient care of coronavirus disease 2019 (COVID-19) and its assumption.

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Regarding poor detection of bronchial asthma (BA) in outpatient facilities diagnostic values of main clinical and phenotypical BA signs were investigated to improve early diagnosis of the disease. To verify the diagnosis we elaborated a clinic variant of BA, assessed medical documents and questioned 96 patients. The correct diagnosis was found to be reached usually in some years after the appearance of the first BA symptoms (in average 12.49 ± 7.32 yrs) in spite of typical onset of the disease in all the cases: dry cough attacks in 82.2 %, asthma attacks in 6.3 %, dyspnoea in 46.9 %, and chest tightness while contacting with an allergen or an unspecific irritant (dynamic physical exercise, stress, cold air) in 7.3 % of the patients. Detailing of symptoms was performed and diagnostic value of every sign was determined. Discriminative coefficients were calculated for reliably high influencing signs; their informative values and probability of BA detection were defined. Subjective and objective causes of late BA diagnosis were retrospectively analyzed based on medical documentation and questioning 92 doctors of outpatient facilities.

Asthma control in clinical trials achieves 25 to 68 %; it is significantly lower in real-life clinical practice. This study was designed as a prospective open study for evaluating asthma control in 104 asthmatic adults in primary care settings of Omsk city. The efficacy of treatment has being assessed during 6 months using the validated Russian version of ACT questionnaire; score < 20 was considered as uncontrolled asthma, 20–24 as a good control, and 25 as the full control. The patients received budesonide (Benacort), beclomethasone dipropionate (Beclasone ECO Ease Breathe), budesonide/formoterol (Symbicort), or fluticasone (Flixotide) as the basic therapy; 4 patients were treated with symptomatic therapy alone. Asthma control improved by 3 to 8 points in average while using inhaled steroids and by 1.25 points under the symptomatic treatment. Severe asthma patients failed to reach the control. Improvement in asthma control was similar for all basic medications. Abilities to further improvement in asthma control are thought to improve quality of management of asthma patients in primary care settings.

Dermatomyositis is a progressive systemic disease clinically manifested by a muscle lesion with impaired motor function as well as skin rashes, often in the form of erythema. In some cases, dermatomyositis can be the onset of cancer. In this regard, the doctor is required to be highly alert and focused on detecting the tumor process in patients with progressive muscle weakness and characteristic skin manifestations of dermatomyositis. The article presents a clinical case of paraneoplastic dermatomyositis co‐existing with small cell lung cancer. The malignancy was diagnosed during cancer screening in a patient with classic manifestations of dermatomyositis. Improvement of clinical manifestations of dermatomyositis appeared with glucocorticosteroid therapy and surgical treatment, but the patient died, since small cell lung cancer has an aggressive clinical course with an unfavorable prognosis.