Saratov JOURNAL of Medical and Scientific Research

Norm and disease. Monomorbidity, comorbidity and methodology for their diagnostics

Year: 2018, volume 14 Issue: №2 Pages: 209-216
Heading: Internal Diseases Article type: Review
Authors: Kats Y.A., Parkhoniuk E.V., Skriptsova S.A.
Organization: Saratov State Medical University

The absence of a single classification and generally accepted terminology of comorbidity leads to a different understanding of the issues of diagnosis of comorbidity. Comorbidity is a complex system in which the patient is both an integral object and part of this system, which includes diseases complexes. As it is known, the success of solving diagnostic problems, especially in the presence of comorbidity ultimately determines the consistency and validity of the findings, and, consequently, the effectiveness of the diagnosis as a whole. Previously, we proposed an integrative method which, preserving the system approach and the method of comparison, suggests using the sum of data from genetic, constitutional, immunological, anthropological and other types of examination to obtain the most complete representation not only of the nature of the disease, but, first of all, the patient himself. Proceeding from the foregoing, the present review focuses not only on the features of compiling a "patient diagnosis" in the presence of comorbidity but also on the sequence in which the pathological conditions should be considered and reflected in the main diagnosis in the presence of several active processes.

1. Balashov LE. Life, death, immortality of man. M., 2005.
2. Arakelyan G. Mathematics and history of the golden section. M.: Logos, 2014; 404 p.
3. Shmigevskiy NV. The formula of perfection. Country of knowledge 2010; (4): 2-7
4. Mario Livio. cp — Chislo Вода. Zolotoe sechenie — formula mirozdaniya. Litres, 2015; 481 p.
5. Auffray С, Charron D, Hood L. Predictive, preventive, personalized and participatory medicine: back and the future. Gen-omMed2010;26;2(8):57
6. Kontseptsiya «4P-meditsiny» kak novyy vektor razvitiya zdravookhraneniya. Primorskaya meditsinskaya assotsiatsiya; Nauchno-prakticheskoe obshchestvo vrachey PMA 07.12.2016 11:53.
7. Beaudet A. Making genomic medicine a reality. Am J Hum Genet 1999; (64): 1-13
8. Baranov VS. The genetic passport is the base of individual and predictive medicine. SPb.: Izd-vo N-L, 2009; 528 p.
9. Hood L, Heath JR, Phelps ME, et al. Systems Biology and New Technologies Enable Predictive and Preventative Medicine. Science 2004; 306: 640-643
10. Weston AD, Hood L. Network Systems Biology for Drug Discovery. J Proteome Res 2004; (3): 179-198
11. Auffray C, Chaen Z, Hood L. Systems medicine: the future of medical genomicsand healthcare. Genome Med 2009; (1): 2
12. Bodrova ТА, Kostyushev DS, Antonova EN, et al. Introduction into PPPM: experience of the past and tomorrow's reality. Annals of the Russian Academy of Medical Sciences 2013; (1): 58-64
13. Kaminskiy IP, Ogorodova LM, Patrushev MV, et al. Medicine of the Future: Opportunities for Breakthrough through the Prism of Technology Forecast. Foresight-Russia 2013; 7 (1): 14-27
14. Bodrova Т, Golubnichaya О, Rose N, et al. Introduction into predictive preventive medicine: experience of the past and tomorrow's reality. In: Hereditary metabolic diseases with central nervous system lesion. SPb.: Chelovek i ego zdorov'e, 2012; p. 36-37
15. Gross J. Parallelpatologist kui differential diagnotilisest problemist Sisenaiguste klinikus. Noukogude Eesti Tervishoid 1963; 5: 18-20
16. Zaretskiy MM. Medical error: inevitable or not? Ther-apia 2009; 33 (1): 63-66
17. Bogmat LF, Shevchenko NS, Dem'yanenko MV. Comorbidity in rheumatic diseases in adolescents: Literature review and own data. Modern Pediatrics 2015; 2 (66): 56-61
18. Belousov YuV Comorbidity in the Digestive System Diseases in Children. Child's health 2012; 1 (36): 134-138
19. Belyalov Fl. Treatment of diseases in conditions of comorbidity. Moscow: GEOTAR-Media, 2016; 544 p.
20. Vertkin AL, Zayrat'yants OV, Vovk El. Final diagnosis. M.: GEOTAR-Media, 2008; 576 p.
21. Kolomoets MYu, Vashenyak 00. Comorbidity and poly-morbidity in therapeutic practice. Ukr Med Jour 2012; (5): 140-143
22. Feinstein AR. Pretherapeutic classification of comorbidity in chronic disease. Journal Chronic Disease 1970; 7 (23): 455-468
23. Tong B, Stevenson О Comorbidity of cardiovascular disease, diabetes and chronic kidney disease in Australian. Institute of Health and Welfare Canberra, 2007; 69 p.
24. Antropov YuF, Mollaeva NR. Comorbidity of gastro-enterological and endocrine pathology in children with affective disorders. In: Materialy XIV Kongressa detskikh gastroenterologov Rossii, 2007; p. 127-129.
25. Vertkin AL, Skotnikov AS. The role of chronic allergic inflammation in the pathogenesis of Bronchial Asthma and its rational pharmacotherapy in patients with polypathy. Treating physician 2009; (4): 61-67
26. Rasputina LV. Nonspecific pulmonary diseases and cardiovascular diseases comorbidity in medical practice. Ukr pulmonary jour 2011; (4): 25-27
27. Kalev OF, Kaleva NG. Polypathy in cardiology. In: Materialy Vseros. nauch.-prakt. konf., posvyashch. 75-ietiyu zasluzhennogo deyatelya nauki RF, prof. O. F. Kaleva / pod red. O.F. Kaleva. Chelyabinsk, 2013; p. 14-19
28. Holzer ВМ, Siebenhuener К, Ворр М, et al. Evidence-based design recommendations for prevalence studies on multimorbidity: improving comparability of estimates. Popul Health Metr 2017; 15(1): 9. DOI: 10.1186/s12963-017-0126-4
29. Caughey GE, Vitry Al, Gilbert AL, et al. Prevalence of comorbidity of chronic diseases in Australia. ВМС Public Health 2008; (8): 221
30. Sumin AN, Korok EV, Shcheglova AV, et al. Comorbidities in Patients with Ischemic Heart Disease: gender differences. Rational pharmacotherapy in cardiology 2017; 13 (5): 622-629. DOI: 10.20996/1819-6446-2017-13-5-622-629
31. Akimova NS, Persashvili DG, Martynovitch TV, et al. Cognitive abnormality and gray state at CHF as against Ischemic Heart Disease. Heart failure 2011; 12 (5): 282-285
32. Kraemer Н.С. Statistical issues in assessing comorbidity. Stat Med 1995; (14): 721-723
33. Rocca WA, Boyd CM, Grossardt BR, et al. Prevalence of multimorbidity in a geographically defined American population: patterns by age, sex, and race/ethnicity. Mayo Clin Proc 2014;89(10):336-49. DOI: 10.1016/j.mayocp.2014.07.010. 34. Komorbidnost'.Vikipediya.2011 .URL:'
35. Zayratyants OV, Kakturskiy LV. Formulation and comparison of clinical and pathoanatomical diagnoses: Handbook. Moscow: 000 «Meditsinskoe informatsion-noe agentstvo», 2008; 424 p.
36. Lazebnik LB. Aging and polymorbidity. Consillium Medicum 2005; 12: 53-57
37. Schofer I, von Leitner ЕС, Schon G, et al. Multimorbidity patterns in the elderly: a new approach of disease clustering identifies complex interrelations between chronic conditions. Public Library of Science (PLoS) One 2010 Dec 29; 5(12): e15941
38. Van den Akker M, Buntinx F, Roos S, et al.Comorbidity or multimorbidity: what's in a name? A review of the literature. Eur J Gen Pract1996; 2 (2): 65-70
39. Mudrov MYa. Izbrannye proizvedeniya. Moscow: Izd-vo AMN SSSR, 1949; 296 p
40. Nikolaev PN. Bright disease in the modern understanding of Kiev: Gosmedizdat USSR 1938; 147 p.
41. Shamarin PI. Some questions of the methodology of diagnosis: About epistemological analysis of diagnostic errors. Saratov: Privolzh. kn. izd-vo, 1969; 71 p.
42. Shamarin PI. Thinking of a clinicist about the medical profession. Saratov: Izd-vo Sarat. un-ta, 1974; 253 p.
43. Ardamatskiy NA. Introduction into General Therapy. Saratov: Izd-vo Sarat. un-ta, 1991; 301 p.
44. Kats YA. Diagnostics: Fundamentals of Theory and Practice. Saratov: Izd-vo Sarat. un-ta, 2012; 357 p.
45. Kats YA, Parkhonyuk EV, Skriptsova SA. Sclerotic disease, integrative diagnosis, chronic forms and treatment of diseases. Saratov Journal of Medical Scientific Research 2015; 11 (3): 268-274
46. Lazebnik LB, Vertkin AL, Konev YuV, et al. Aging: professional medical approach. Moscow: Eksmo, 2014; 320 p.

2018_2_209-216.pdf258.36 KB

No votes yet