Improving the effectiveness of teaching problematic issues of rheumatology at the stage of postgraduate education by integrating immunological knowledge.[:]

Prof. A.P. Kuzmina, PHD O.M. Lazarenko

Dniprovskiy State Medical University

Clinical immunology is becoming an increasingly important area, in terms of its widespread use, in the teaching of rheumatology in cycles of thematic improvement. Purpose: development of a new diagnostic and therapeutic strategy for teaching rheumatological aspects based on the use of immunological knowledge. Rheumatologists are well aware of the simultaneous identification of antibodies to nuclear and cytoplasmic antigens, which contributes to the differential diagnosis of autoimmune pathology. The three versions of the quests we compiled had ambiguous answers from specialists who were well acquainted with clinical rheumatological pathology. 90% of physicians gave the correct, complete answer to the proposed first option (according to the WHO recommendations for the determination of molecular markers). The second variant of the task included activated forms of lymphocytes with phenotype CD69+, CD3+ HLA-DR+, CD19+ CD38+, CD8+ CD38+. Only 50% of physicians answered that such a test reflects the functional state of activated T- and B-lymphocytes and is recommended for monitoring the course of the disease. The next version of the quest was created taking into account the direct functions of receptor structures. Almost all physicians consider it unnecessary to assess minor subpopulations in patients with autoimmune diseases. When interpreting the results of the immunogram, a dissociation syndrome is established — a discrepancy between the direction of changes in the interrelated immunological parameters. The value of dissociation syndrome is that the latter may indicate latent immune defects. With the rapid expansion of new classes of drugs, clinical practice has changed dramatically, this is what drew the attention of rheumatologists to the fundamental knowledge of immunology and mechanisms of action of biological drugs. It should be noted that in many European countries, immunology courses have been developed specifically for rheumatology practice. Thus, the introduction of rheumatological aspects based on the use of immunological knowledge, especially at the stage of postgraduate education, which will contribute to professional development and the development of a full-fledged fully developed personality of the doctor.

Key words: rheumatology, immunological knowledge, postgraduate education, pedagogy.

https://dx.doi.org/10.15407/internalmed2021.02.040

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