Non-alcoholic fatty liver disease (NAFLD) went beyond the competence of a gastroenterologist and acquired the character of a multidisciplinary problem. NAFLD requires the attention of many professionals. A characteristic feature of NAFLD is the variety of concomitant diseases and pathological conditions with common pathophysiological mechanisms. This review summarizes and presents the data available in the modern literature on the association of NAFLD with cardiovascular diseases, type 2 diabetes mellitus, hypothyroidism, polycystic ovary syndrome, chronic kidney disease, colorectal cancer, obstructive sleep apnea, osteoporosis, psoriasis.
Первый Российский консенсус по количественной оценке приверженности к лечению: основные положения, алгоритмы и рекомендации -одобрен XII Национальным конгрессом терапевтов (Москва, 22-24 ноября 2017 г.).
Ключевые слова: приверженность к лечению, количественная оценка, рекомендации, российский кон-сенсусThe first Russian expert consensus on the quantitative evaluation of the treatment adherence: pivotal issues, algorithms and recommendations approved by the XII National Congress of physicians (Moscow, 22-24 November, 2017).
Омский государственный медицинский университет, Российская Федерация 2 Московский государственный медико-стоматологический университет им. А. И. Евдокимова, Российская Федерация 3 Национальный медицинский исследовательский центр профилактической медицины, Москва, Российская Федерация 4 Первый Московский государственный медицинский университет им. И. М. Сеченова (Сеченовский Университет), Российская Федерация 5 Семейный доктор, сеть медицинских клиник, Москва, Российская Федерация 6 Luxoft Professional, LLC в лице Люксофт Профешнл, Москва, Российская Федерация 7 Саратовский государственный медицинский университет им. В. И. Разумовского, Российская Федерация 8 Оренбургский государственный медицинский университет, Российская Федерация 9 Ростовский государственный медицинский университет, Ростов-на-Дону, Российская Федерация 10 Национальный медико-хирургический центр им.
In the review of the current literature urgent issues of treatment of patients with atrial fibrillation are analyzed, namely prevention of thrombosis and the use of anticoagulants therapy. The article describes the current possibilities of prevention thromboembolic complications in patients with atrial fibrillation at high risk. The fact of insufficient use of preventive antithrombotic therapy in patients with atrial fibrillation with high thrombotic risk is demonstrated, which is associated both with incomplete adherence of doctors to the implementation of clinical recommendations, and with low adherence of patients to receiving prescribed anticoagulants. The review of the literature discusses the difficulties of the use of oral anticoagulants, in particular direct action and their high financial burden, and anticoagulants indirect action and instability of their pharmacological effect. The article demonstrates the difficulties of warfarin therapy, such as insufficient adherence to treatment, genetic characteristics of the patient, alimentary and drug interactions. When discussing the issue of insufficient adherence, it is shown that the data on adherence to drug therapy are not homogeneous and do not fully take into account the influence of patient-dependent characteristics. The prospects of developing an individualized algorithm for choosing an anticoagulant for long-term administration for patients with atrial fibrillation from the position of a patient-oriented approach are separately discussed.
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