ВОзвращает список болезней. Можно фильтр/искать

search, age, gender, parent, symptoms, sort_name, sort_by, rand, branches
GET /disease/?format=api&ordering=-name&page=39
HTTP 200 OK
Allow: GET, HEAD, OPTIONS
Content-Type: application/json
Vary: Accept

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                            "name": "лимфаденопатия"
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                            "name": "лимфоузел воспаление"
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                        {
                            "name": "лимфоузлы набухли"
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            },
            "code": "E43",
            "name": "Тяжелая белково-энергетическая недостаточность неуточненная",
            "icd_name": "Тяжелая белково-энергетическая недостаточность неуточненная",
            "gender": 0,
            "age_min": 0,
            "age_max": 100,
            "cause": [
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            "periodicity": 1,
            "slug": "e43_tyazhelaya_belkovo-energeticheskaya_nedostatochnost_neutochnennaya",
            "lead": "Нарушение здоровья, относящееся к группе недостаточность питания",
            "description": "Белково-энергетической недостаточностью называется патологическое состояние, которое развивается при недостаточном поступлении белка в организм вследствие неправильного (недостаточного) питания или усиленного распада в организме (в случае некоторых заболеваний) ",
            "etiology": "<p>Основные причины развития белково-энергетической недостаточности: </p>\r\n<ol>\r\n<li>Недостаточное поступление нутриентов. </li>\r\n<li>Недостаточное питание может быть следствием социально-экономических, религиозных факторов. Может быть вызвано ятрогенными причинами: госпитализация (необходимость соблюдения больничных диет), голодание в связи с обследованиями, диеты при различных заболеваниях, нерациональное искусственное питание. </li>\r\n<li>Причиной недостаточности питания могут стать психические заболевания, при которых извращается пищевое поведение: неврогенная анорексия, психозы. </li>\r\n<li>При гастроинтестинальной обструкции, дисфагии появляются механические препятствия для перорального приема пищи. </li>\r\n<li>Нарушения переваривания и/или всасывания нутриентов (синдромы мальдигестии и мальабсорбции). </li>\r\n<li>Нарушение переваривания и/или всасывания нутриентов отмечается при поступлении в организм их антагонистов при алкоголизме, отравлении лекарствами.  </li>\r\n<li>Дефекты транспорта питательных веществ.</li>\r\n<li>Недостаточность питания может развиваться при ускорении катаболических процессов у пациентов с онкологическими заболеваниями, инфекциями, гипертиреозом, сахарным диабетом. </li>\r\n<li>При нефротическом синдроме, ХОБЛ, кишечных свищах, экссудативной энтеропатии, плазморее при ожоговой болезни, десквамативных дерматитах наблюдаются повышенные потери нутриентов. </li>\r\n<li>Недостаточность питания может развиваться в периоды, когда потребность в нутриентах максимальная, а именно: во время беременности, лактации, в детском и подростковом возрасте, в период реконвалесценции после травм и острых инфекционных заболеваний, после операций. </li>\r\n</ol>",
            "pathogenesis": "<p>Начальная метаболическая реакция – уменьшение интенсивности обмена веществ. Для обеспечения энергией организм сначала использует жировую ткань. Однако позже, когда эти ткани истощаются, тело может использовать белки для получения энергии, в результате чего развивается отрицательный азотистый баланс. Затем внутренние органы и мышцы также начинают разрушаться, и их масса уменьшается. Наибольшая потеря массы у печени и кишечника, промежуточное положение занимают сердце и почки, и меньше всего теряет в весе нервная система. </p>\r\n<p>Прогрессирующая белково-энергетическая недостаточность приводит к нарушению функции органов. Уменьшение синтеза белков сыворотки крови в печени приводит к резкому снижению уровня циркулирующих белков. </p>\r\n<p>Снижаются сердечный выброс и сократительная способность миокарда. При тяжелой белково-энергетической недостаточности развиваются миофибриллярная атрофия и интерстициальный отек сердца. </p>\r\n<p>Слабость и атрофия дыхательных мышц приводит к нарушению респираторной функции. Характерны снижение жизненной емкости легких, частоты и минутного объема дыхания, нарушения мукоцилиарного клиренса. </p>\r\n<p>Поражение ЖКТ проявляется атрофией слизистой оболочки и потерей ворсинок тонкой кишки, приводящих к синдрому мальабсорбции. Развиваются панкреатическая и тонкокишечная дисахаридазная недостаточность. </p>",
            "diagnostics": "<p>Диагностика белково-энергетической недостаточности осуществляется на основании данных анамнеза, истории болезни пациента и результатов объективного обследования. Для окончательного подтверждения диагноза, а также определения вида и причин белково-энергетической недостаточности проводят лабораторные исследования (измерение уровня альбумина в плазме, количества лимфоцитов, а также реакция на кожные антигены). </p>",
            "treatment": "<p>При тяжелой белково-энергетической недостаточности проводится комплексная нутритивная поддержка с применением  энтерального и парентерального питания.              Оправданным видом энтерального питания является длительное энтеральное  питание через зонд, которое заключается в непрерывном медленном поступлении питательных веществ в желудочно-кишечный тракт (желудок, двенадцатиперстную кишку, тощую кишку - капельно, оптимально - с помощью инфузионного насоса). </p>\r\n<p>Основные лекарственные средства, применяемые при лечении тяжелой белково-энергетической недостаточности: </p>\r\n<p>Ферментные препараты – лекарственные средства, способствующие улучшению процесса пищеварения и включающие в свой состав пищеварительные ферменты (энзимы). </p>\r\n<p>Витамины жирорастворимые, водорастворимые – для коррекции дефицитных состояний </p>\r\n<p>Антибиотики – применяются различные группы антибиотиков, для предупреждения и лечения инфекций. </p>\r\n<p>Пробиотики – живые микроорганизмы, которые являются нормофлорой кишечного тракта человека. При БЭН у детей отмечаются дисбиотические процессы. Назначаются препараты пробиотики - содержащие лакто и бифидобактерии. </p>\r\n<p>Препараты железа –  применяют при БЭН для коррекции железодефицитного состояния. </p>\r\n<p>Препараты, восполняющие дефицит гормонов щитовидной железы, рекомендуются при гипотиреоидных состояниях различной этиологии.  </p>\r\n<p>Глюкокортикоиды оказывают выраженное противовоспалительное, противоаллергическое, противошоковое, антитоксическое действие. </p>\r\n<p>Иммунологические препараты, применяемые для заместительной и иммуномодулирующей терапии. Снижают риск развития инфекций при первичном и вторичном иммунодефиците. </p>\r\n<p>Плазмозамещающие препараты предназначены для коррекции выраженных нарушений белкового метаболизма (гипопротеинемии), восстановления коллоидно-онкотического давления, нарушенной гемодинамики. </p>\r\n<p>Растворы аминокислот – растворы специальные, питательные для парентерального питания. Растворы для инфузий, состоящие из электролитов и аминокислот, которые являются метаболическими аналогами или физиологическими веществами для образования белков. Сбалансированные по содержанию незаменимых и заменимых аминокислот. </p>\r\n<p>Жировые эмульсии – обеспечение организма незаменимыми жирными кислотами в составе парентерального питания. </p>\r\n<p>Раствор глюкозы – глюкоза участвует в различных процессах обмена веществ в организме, 5%, 10%, 20%. </p>",
            "prevention": "<p>Во всем мире самая важная стратегия профилактики белково-энергетической недостаточности состоит в том, чтобы снизить уровень бедности, улучшить знания о правильности питания и уровень оказания медицинской помощи. </p>\r\n<p>Кормление грудью ребенка в течение по крайней мере шести месяцев с момента рождения считается лучшим способом предотвращения недоедания в раннем детстве. </p>\r\n<p>У взрослых профилактика недоедания заключается в соблюдении качественного рациона, получении максимума витаминов и минералов с пищей.  </p>",
            "clinical_picture": "<p>При белково-энергетическойнедостаточности тяжелой степени наблюдается анорексия, общая вялость, снижение интереса к окружающему, отсутствие активных движений. Лицо страдальческое, старческое, щеки запавшие с атрофией комочков Биша, в терминальный период – безразличие. Резко нарушена терморегуляция, ребёнок быстро охлаждается.  </p>\r\n<p>Отставание в массе тела свыше 30%, отставание в длине тела составляет более 4 см, задержка психомоторного развития. Дыхание поверхностное, иногда могут отмечаться апноэ (отсутствие дыхания). Тоны сердца ослабленные, глухие, может наблюдаться тенденция к брадикардии (снижению ЧСС), снижению артериального давления. Живот увеличен в объёме вследствие вздутия, передняя брюшная стенка истончена, контурируются петли кишок, запоры чередуются с мыльно-известковыми испражнениями. Резко нарушена толерантность к пище, нарушены все виды обмена. У большинства больных отмечается рахит, анемия, явления дисбактериоза.  </p>\r\n<p>Терминальный период характеризуется триадой: гипотермией (температура тела 32–33° С), брадикардией (60–49 уд/мин), гипогликемией (снижением глюкозы в крови). </p>",
            "image": null,
            "image_alt": null,
            "standard_type": 3,
            "danger": 1,
            "published": 2,
            "parent": null,
            "block_rubric": 49,
            "standards": []
        },
        {
            "id": 13707,
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            "alternative_names": [],
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            },
            "code": "A21",
            "name": "Туляремия",
            "icd_name": "Туляремия",
            "gender": 0,
            "age_min": 0,
            "age_max": 100,
            "cause": [
                "4",
                "5",
                "6",
                "7"
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            "periodicity": 1,
            "slug": "a21_tulyaremiya",
            "lead": "Туляремия  — острая зоонозная бактериальная природно-очаговая инфекционная болезнь с разнообразными",
            "description": "<p>Характеризуется лихорадкой, интоксикацией, воспалительными изменениями в области входных ворот инфекции, регионарным лимфаденитом.</p>",
            "etiology": "<p>Возбудитель &mdash;грамотрицательная полиморфная (преимущественно кокковидная) неподвижная палочка, не образующая спор и капсул.</p>\r\n<p>Туляремия &mdash; классическая природно-очаговая болезнь, облигатный зооноз. Источником возбудителя инфекции служат около 150 видов животных, включая 105 видов млекопитающих, 25 видов птиц, несколько видов рыб, лягушек, других гидробионтов. На территории России основной резервуар и источник инфекции &mdash; грызуны (мышевидные, кролики, зайцы, водяные крысы, ондатры, хомяки и др.). Выделения и трупы павших животных содержат большое количество возбудителей, которые обсеменяют объекты окружающей среды, в том числе и водные, и длительно в них сохраняются. Между грызунами передача инфекции осуществляется алиментарным путём. Среди домашних животных резервуаром инфекции могут быть овцы, свиньи, крупный рогатый скот, лошади, но заражение людей чаще всего происходит в природных очагах при прямом и косвенном контакте с грызунами. Больной человек не может быть источником инфекции для окружающих.</p>\r\n<p>Переносчики инфекции, поддерживающие существование возбудителя в природных очагах, &mdash; кровососущие насекомые (иксодовые и гамазовые клещи, комары, слепни).</p>\r\n<p>В организм человека возбудитель может проникать через микротравмы кожного покрова и неповреждённую слизистую оболочку миндалин, ротоглотки, желудочно-кишечный тракт, дыхательных путей, глаз.</p>",
            "pathogenesis": "<p>F. tularensis проникает в организм человека через кожу (даже внешне не повреждённую) и слизистые оболочки глаз, дыхательных путей, миндалин и ЖКТ. При инфицировании через кожу или аэрогенным путём для развития болезни достаточно пятидесяти жизнеспособных микроорганизмов, а при алиментарном заражении &mdash; более 108 микробных клеток.</p>\r\n<p>В месте входных ворот инфекции происходит размножение возбудителя с развитием некротически-воспалительной реакции и первичного аффекта (кожная язва, проходящая стадии <a title=\"Перейти на страницу симптома Папулы\" href=\"/symptom/papuly/\">папулы</a>, везикулы и <a title=\"Перейти на страницу симптома Пустулы\" href=\"/symptom/pustuly/\">пустулы</a>; на миндалинах &mdash; некротическая ангина, в лёгких &mdash; очаговая некротическая пневмония, на конъюнктиве &mdash; конъюнктивит). Затем возбудитель проникает в регионарные лимфатические узлы, вызывая развитие специфического лимфаденита &mdash; первичного бубона. Здесь происходит частичная гибель бактерий, сопровождаемая выделением эндотоксина (ЛПС-комплекс), усиливающего местный воспалительный процесс и вызывающего развитие интоксикации при поступлении в кровь.</p>",
            "diagnostics": "<p>Диагностика туляремии основана на клинических, эпидемиологических и лабораторных данных.</p>\r\n<p>В общем анализе крови в начальном периоде обнаруживают нормоцитоз или небольшой лейкоцитоз, увеличение СОЭ. Периоду разгара болезни свойственна лейкопения с лимфо- или моноцитозом. Нейтрофильный лейкоцитоз отмечают только при нагноении бубонов.</p>\r\n<p>Для специфической диагностики туляремии применяют серологические и аллергические тесты, бактериологическое исследование и биологическую пробу.</p>",
            "treatment": "<p>Больных с подозрением на туляремию госпитализируют по клиническим показаниям. Окна в палатах должны быть закрыты сеткой, чтобы не допустить трансмиссивного пути распространения инфекции.</p>\r\n<p>В остром периоде больным необходимы постельный режим и полноценное питание, обогащённое витаминами. Большое значение имеет уход.</p>\r\n<p>Основные этиотропные препараты &mdash; аминогликозиды и тетрациклины (стандарт лечения).</p>\r\n<p>Патогенетическую терапию, включающую дезинтоксикацию, антигистаминные и противовоспалительные препараты (салицилаты), витамины и сердечно-сосудистые средства, проводят по показаниям.</p>",
            "prevention": "<p>Основа специфической профилактики &mdash; вакцинация лиц старше семи лет, пребывающих или работающих на территории, эндемичной по туляремии. Применяют живую сухую туляремийную вакцину.</p>\r\n<p>Неспецифическая профилактика предусматривает контроль за природными очагами туляремии, своевременное выявление эпизоотий среди диких животных, проведение дератизационных и дезинсекционных мероприятий.</p>\r\n<p>При водной вспышке запрещают употреблять некипячёную воду и купаться, а при заражении колодезной воды принимают меры к очистке колодца от трупов грызунов и проводят дезинфекцию воды.</p>\r\n<p>При угрозе трансмиссивного заражения рекомендуется применять репелленты, защитную одежду, ограничивается въезд непривитого населения на неблагополучные территории.</p>\r\n<p>Для профилактики промысловых заражений целесообразно использовать перчатки при снятии шкурок с убитых грызунов и дезинфицировать руки. Проводят мероприятия по дезинсекции и дезинфекции на складах хранения шкурок. Необходима тщательная термическая обработка мяса (например, заячьего) перед употреблением в пищу.</p>\r\n<p>При скирдовании сена и обмолоте хлеба употребляют очки-консервы и защитные маски.</p>\r\n<p>Среди населения районов, неблагополучных по туляремии, необходимо проводить систематическую разъяснительную и санитарно-просветительную работу.</p>\r\n<p>Лиц, контактировавших с больным, не изолируют, так как заболевшие не &nbsp;заразны. В жилье больного осуществляют дезинфекцию.</p>",
            "clinical_picture": "<p>Инкубационный период составляет от нескольких часов до 3 нед (в среднем 3&ndash;7 дней).</p>\r\n<p>По тяжести инфекционного процесса различают лёгкие, средней тяжести и тяжёлые формы туляремии.</p>\r\n<p>По длительности течения выделяют острую (до 3 мес), затяжную (до 6 мес), рецидивирующую формы туляремии и, кроме того, инаппарантную (бессимптомную, латентную) туляремию, которую обнаруживают преимущественно во время эпидемических вспышек при лабораторном исследовании.</p>\r\n<p>Туляремия протекает циклически. Выделяют следующие периоды заболевания: инкубационный, начальный, период разгара и выздоровления.</p>\r\n<p>Симптомы начального периода одинаковы при всех клинических формах. Типично острое начало: с озноба, лихорадки и симптомов интоксикации. Температура в течение нескольких часов поднимается до 38&ndash;40 &deg;С и выше. Одновременно возникают <a title=\"Перейти на страницу симптома Головная боль\" href=\"/symptom/golovnaya_bol/\">головная боль</a>, <a title=\"Перейти на страницу симптома Головокружение\" href=\"/symptom/golovokruzhenie/\">головокружение</a>, <a title=\"Перейти на страницу симптома Слабость\" href=\"/symptom/slabost/\">слабость</a>, разбитость, мышечные боли (особенно в поясничной области и икроножных мышцах), ухудшение аппетита, нарушения сна, повышенная <a title=\"Перейти на страницу симптома потливость\" href=\"/symptom/potlivost/\">потливость</a>. Возможны <a title=\"Перейти на страницу симптома Брадикардия\" href=\"/symptom/bradikardiya/\">брадикардия</a>, <a title=\"Перейти на страницу симптома Низкое давление\" href=\"/symptom/nizkoe_davlenie/\">гипотония</a>, гепатоспленомегалия.</p>\r\n<p>Продолжительность начального периода 2&ndash;3 дня. Позже возникают признаки, характерные для той или иной клинической формы, но общие симптомы для всех форм &mdash; <a title=\"Перейти на страницу симптома Высокая температура 38-42&deg; \" href=\"/symptom/vysokaya_temperatura_38-42/\">лихорадка</a>, характерный внешний вид больного и интоксикация.</p>\r\n<p>Продолжительность лихорадочного периода 2&ndash;3 нед (от 5&ndash;7 до 30 дней), но иногда, при рецидивирующем течении или присоединении осложнений, он может удлиняться до нескольких месяцев.&nbsp;</p>\r\n<p>Характерен внешний облик больных: лицо одутловато и гиперемировано, в тяжёлых случаях &mdash; синюшно-багрового цвета (особенно вокруг глаз, губ, мочек ушей). Нередко вокруг подбородка отмечают бледный треугольник, обнаруживают признаки конъюнктивита, инъекцию сосудов склер, точечные кровоизлияния на слизистой оболочке полости рта. Возможны носовые кровотечения. Больные эйфоричны.</p>\r\n<p>На кожных покровах с третьего дня болезни может возникать <a title=\"Перейти на страницу симптома Сыпь\" href=\"/symptom/syp/\">сыпь</a> эритематозного, папулёзного или петехиального характера, которая разрешается пластинчатым и(или) отрубевидным шелушением, пигментацией. У лиц пожилого возраста бывают узловатые эритемы.</p>\r\n<p>Осложнения чаще отмечаются при генерализованной форме туляремии. Возможно развитие инфекционно-токсического шока, менингита, менингоэнцефалита, перикардита, миокардиодистрофии, полиартрита, вегетативных неврозов, перитонита (вследствие нагноения и самопроизвольного вскрытия мезентериальных лимфатических узлов при абдоминальной форме), перфорации роговицы, бронхоэктазий, абсцесса и гангрены лёгких (при пневмонической форме). Течение любой формы может осложниться туляремийной пневмонией.</p>",
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}