Advisory activity of a doctor of general practitioner-family medicine: prognosis of chronic dermatosis under genotyping data and related problems of a comorbidity
Keywords:general practitioner-family medicine doctor, chronic dermatosis, dysplastic-dependent pathology, genotype, genes, primary health care level
Baskground. The role of the genetic predisposition of dysplastic-dependent pathology, in particular the predominant skin lesions in the form of chronic dermatosis, can not be considered to be studied. At the same time, it is extremely important to predict the occurrence and severity of the course of chronic dermatosis in the advisory activity of the general practitioner-family medicine doctor. The purpose of the study was to develop a counseling algorithm for assessing the genetically determined systemic damage of connective tissue in chronic dermatoses based on the study of diagnostic value and the predictive value of single nucleotide polymorphism of genes: SPINK-5, VDR, LCT and FDPS. Materials and methods. 48 patients with chronic dermatosis and 96 control group patients were examined, which used the data to determine the genotypes of VDR, LCT and FDPS. The determination of genotypes SPINK-5 was performed among 48 patients and 32 patients in the control group. The obtained data was used to create an advisory / screening algorithm for assessing the genetic predisposition of systemic connective tissue damage in chronic dermatosis and comorbid states. Results. The frequency was studied and prognostic coefficients were determined for various variants of single-nucleotide polymorphism SPINK-5, VDR, LCT and FDPS among patients with chronic dermatosis. The predictive value of individual variants of polymorphism was determined and the most prognostically unfavorable ones were found to be: the presence of homozygous variants of the VR gene of the VDR gene, the SS - gene of the LCT, the SS - gene of FDPS and the AA - of the gene SPINK - 5. An advisory (screening) algorithm for assessing the genetic predisposition of systemic connective tissue damage in chronic dermatosis has been worked out, the use of which can be initiated by the physician in the case of clinical manifestations, for example, lactase insufficiency. Conclusions. In order to provide counseling assistance to families and patients with chronic dermatoses at the primary level of medical care, substantiated industry newsletters, the use of which in practice eliminates the methodological uncertainty in the activities of the doctor GP-FM, improves the tools of interaction and intercourse with the higher levels of assistance, improving the formation process medical routes for such patients.
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