vegetables and fruits without excess, do not abuse animal protein, you don’t need to eat a lot of it either, otherwise everything will turn from good to bad, because it will go into excess fats and carbohydrates, it will be processed, the body cannot convert everything into proteins, this oxidative stress begins to grow in us, because our own antioxidant system cannot cope, what does this lead to, well, for example, when we have accumulated a lot of fatty tissue. we develop such a phenomenon as insulin resistance, this is when insulin cannot work, when the body does not reacts to insulin, yes, to its desire to conduct glucose into the cell, then there is also a lot of glucose in the blood, well, because it does not work, yes, it cannot get into the cells, then, firstly , glucose toxicity develops, because glucose itself becomes an oxidant, can you imagine? the most important substance for us

turns into such evil, poisons us, in fact, at the same moment the body in this situation switches to fats, begins to oxidize fats, and at the same time many free forms of these oxygens, active forms, are formed, again, oxidative stress is growing, that is , in such a situation, when all this begins to develop, one vicious circle after another , overflowing each other, forming new ones, it is very difficult to break out of this, therefore. it all began, as a rule, with a complex: smoking, lack of sleep, alcohol, eating fast food, abusing food in general, even good food, this is always, if a person does not get enough sleep to stay alert and work, what does he do, he eats, he drinks, he drinks not only healthy drinks in water, maybe not healthy ones energy drinks, it's all sugar, and it would seem that there are wonderful antioxidants in them, but they will work in this situation as oxidants.

do you know what it's like? imagine a person who stands and watches who will win, that's the side he takes, so if there are more oxidants, then even positive antioxidant molecules become oxidants, or vice versa, if a person does not take care of his body, yes, then here is what is called, write a complaint about yourself, as comrade said, so, are you accepted? today you start a new life, i have a boy, he sings better than robertina loretti, they didn't even listen to him , who didn't, what does it mean, you don't take the guy just because he doesn't know the notes, and excuse me, i don't understand you, the soloist's place is free, go sing, you saw what a guy, good, simple, he's gone crazy, it's impossible to sleep, what... this is a podcast

about deception of substances, we are talking about antioxidants, with you olesya nosova from ukhra pavlova. we also have this misconception that all antioxidants are somewhere from the outside, that if you don't eat something antioxidant, then everything is lost. i say, you know what? even testosterone is an antioxidant and in general it promotes, stimulates the synthesis of anti-inflammatory substances, they are usually antioxidant, so everything in our body is arranged quite wisely, and if you don't try to break it and take care of it, then the system will cope on its own, well, there are nuances, let's imagine a person from the traffic police, here he is standing at his post, regulating, and there some traffic light stopped working.

there are a lot of gases around him, like these exhaust gases, and naturally the level of oxidative stress in his body will be very high, and here, perhaps, it is difficult to do without some kind of positive external influence, it would be even better, of course, to remove it from there, if there were such an opportunity, or to use some means that would protect his body, or if a person smokes and smokes a lot, i'm not even talking about the fact that when a person abuses, although it seems safe to me... there are no doses of nicotine at all, but the more a person smokes, the more harm, and here the level of oxidative stress increases very much, well, so uncontrollably, i would say, moreover, not so long ago i read in komsomolskaya pravda that the consequences of smoking when completely stopped end completely after 30 years, well yes, there is also other information that if you quit smoking after 40 years, then you will never ... listeners, as quickly as possible get rid

of this habit once and for all, and those who did not start, did not even look in this direction, so let's return to our antioxidants, we have there are very, very many such stereotypes that if you take some one substance, then the system of this oxidative stress will change for the better, for example, i often come across the fact that people take the amino acid ellergenin, they do it with the consciousness that with the help of this amino acid the synthesis of h2o, oxidoside, which has a positive effect on the vascular wall, will increase. it must be said that this is based on this, on this vascular reflex , and such a burning issue of male sexual functions is based, right? therefore, if

a person will not have sufficient synthesis of no, then he will not have normal this very function of the rectum. and many men take elergenin in order to. improve this function, here again everything is not so simple, because if a person is obese, he abuses alcohol, smokes and so on, then that same no, we said, but can rise to the level, to the side of evil, yes, go over and turn from a positive antioxidant to another, interaction with this superoxide, turn into pyroxynitrite, pyroxynitrite - this is an ominous substance, and what about erectile function? it will not be, because the sinitrit pie also causes relaxation of the wall, but much less, and what's more, after this the vessels cannot come into tone, that is, there is such a danger, therefore, when it seems to you that taking an allergen will change the whole situation, as a rule, no, what's more,

it can even worsen it, what's more, if a person is obese, then this very insulin resistance it blocks the full synthesis of nitric oxide and ... again , it is pointless to try to increase it with an allergen but, we need to fight obesity and as effectively and efficiently as possible without putting it off, because the rectal function is an indicator of what is wrong with your heart vessels, just in this organ, this is the most indicative, yes, this is the most indicative, at many cardiologists' congresses several years ago, so it was then completely mainstream, it was written and rectal.

we ask men about this, no, we ask because this is a very clear indicator of general health, the state of a person, therefore, when we try to somehow like this, with one click to change such a complex system as oxidative reduction, it doesn't work like that, there is always something more important, something of priority, which caused the violation of these functions, the system is so complex that it is always on... because in essence it turns out that we want to deceive the system, we do not fight obesity, we think that it is a cosmetic defect, that this is something that, in fact, we ourselves must decide whether we are fat or we are not fat and we try to solve this problem in a roundabout way, the body does not

it works, but the body doesn't let us, it doesn't let us cheat, and in general i always tell patients, my dears, you don't have a second body, you can't open the closet and get it from there. you want to grow up and assert yourself urgently, but it's better at the expense of other things, well, okay, let's say we condemned smoking, and so on, but alcohol, after all, many people say that wine is full of antioxidants, it's very useful,

and also, as they say, will cure everything, or this again, and there is resseratrol, this name is often called, and so they say, doctor, well, look, italians, french and so on, georgians, all of them are long-lived, and i always say that in relation to, and the brain, any amount of alcohol, it always has an inflammatory effect, yes, we have a lot. but in general there are no extra ones, yes, alcohol has an anti-inflammatory effect on the periphery, if in small quantities, but well, i understand everything perfectly, and you will not let me deceive anyone, we live longer, but so far no one can stop the progression of neurodegenerative diseases, alzheimer's and other diseases, senile yes. it is just progressively marching across our land, and of course, the reason is not that everyone

uses, there are people who have never used and have encountered dementia, but they used some other harmful, yes , there were some harmful habits in their life, or nature turns us off, there is such a theory of aging that we have lived long enough, well, here we will resist, as in all the others we will not give in without a fight. using the antioxidant effect, we work actively, hormone replacement therapy, which, by the way, it has such a significant effect the whole world is racking its brains over neurodegenerative diseases, but our area of ​​responsibility, no one has canceled it, if we eat incorrectly, are incredibly stressed, including going to bed at midnight, we will not be physically active, by the way, physical activity is one of the best... means of fighting oxidants, that is, working muscle mass is,

among other things, the synthesis of antioxidants burning negative, we can compare good active muscle mass with such furnaces, where a lot of harmful stuff is burned, that's why if a person eats right, doesn't smoke, but is hypodynamic, then he very much reduces his antioxidant activity of his system, oxidant only because he is hypodynamic, he literally turns off such a huge system instead of helping the body to preserve itself. well, by the way, it's interesting, here zukhra, you say that it is very difficult to help yourself with these roundabout ways, antioxidants, because you never know when they will go over to the dark side, and if you help build up muscle mass with the help of, say, protein shakes, that will work, well, and protein shakes. thing, in my opinion, they are very different, there are completely, well, inappropriate, and

there are quite good ones, and we use them as functional nutrition, when a person has certain difficulties, he cannot eat naturally, or he is in a state when he is cold, he has recovered from something, well, there are a lot of different situations, then yes, you can, but why don't we eat a variety of foods, correctly, and so on, look, let's say, one of the most wonderful... and antioxidants - selenium, there is a lot of it in seafood, selenium helps to convert certain oxidants into a completely harmless form, there are some, it's not that it's a very aggressive form, but still peroxide, hydrogen peroxide h2o2 - this is not the most useful substance in our body, you don't even need to take it additionally, it is produced perfectly, yes, in your own body, so for all this to pass into a safe form, water and co2, selenium is needed, then it will be the glutathione system works well, but it

won't function without selenium, or here's your favorite sodd, don't confuse it with soda, yes sod, superoxide dismutase, we have three types of it, and it would seem that in order for such a mitochondrial, such an important component of it to form, manganese or zinc and copper are needed, zuhra. so tell me what of this should be taken, nothing for now i'll start, i'm confused, no, nothing should be taken, i 'm trying to bring it to the point that all these substances are in food, well, you just need to eat not fast food, good meat, poultry, fish, eggs, cottage cheese, plant fiber should be eaten, and we always talk to you, we constantly talk about this, seasonality, do not forget about seasonality, well, no need. eat strawberries in february, no need, and no need for blueberries, the golden rule of dietetics,

diversity, i have a patient who ate the same thing for several years, he tried to restore his liver, and he ate good products, but i do not know what kind of character, willpower, some kind of titanic the core of a person is inside, so that for 3 years there are only two products, liver, i will not say, well, it is logical, to restore the liver, you need to eat liver, no, this is according to the principle of homeopathy, like, like, no, you know, by the way, the liver is wonderful. cottage cheese restores, because there is a lot of methionine, and methionine is one of the amino acids that helps restore liver tissue, but the diet should be varied, then the body will receive absolutely all the substances, and copper, and zinc and everything you want, so i also prepared, i here i have prepared a list of products

that contain a lot of antioxidants, i am reading it out, dark chocolate, zukhra sherifovna, what do you have against it? dark chocolate, only regarding its quantity, i am confused by the quantity of dark chocolate, because again it will seem to a person that 5 g is absolutely nothing, you need to eat more, as much as is necessary for health, yes, it is all for health, for example, eat one orange and that's it, you have received your daily dose of vitamin c, one of the best antioxidants, and what else do you have in your table, so artichokes, yeah, i to be honest, when i saw it. well, it’s not our food, but on the other hand, there are a lot of such passionate gardeners now, and people who want to grow not only potatoes, but something interesting have gone into gardening, so it seems to me that you can also start with arteshoke somehow , that’s normal, well, it’s good for variety, not bad, it’s your favorite

sauerkraut, it’s just an elixir of youth, you’ll get antioxidants there. and short-chain fatty acids, your intestines will be healthy, and the microbiome will be good, and there will be a sea of ​​antioxidants, here are goji berries, by the way, also here and why is it such and such, here is such and such a hedenistic story and delights, and something that we have after all zuhra, you yourself know perfectly well that people like to be treated with something so exotic, yes goji berries are also such an exotic thing. if this, as they say, does not lead to a person walking around the transmur countries for 3 years and wearing out three pairs of iron, then please, raspberries are on this wonderful list, yes they are tasty and healthy, and blackberries, oh my god, this is also cabbage, yes, and red cabbage, just like that, it has a very, very large amount

of antioxidants, and the way red cabbage is prepared... its availability of antioxidants, that's true, here it's also probably important to say that these red vegetables and fruits contain vitamins of group a, a powerful antioxidant, and by the way, the substance that also helps us create such a... barrier immunity, which is also very important, yes, so as not to overload the immune system, and also lycapin, in addition to the vitamin group, olicapin, is also a powerful antioxidant, it saves our eyes, and for the prostate gland of the male population it is absolutely significant, it is difficult to overestimate, a significant substance, so yes, yeah, that completes my list,

spinach, spinach is of course a super vegetable, i adore it, it is important to say here, then again, and if our listeners find out that spinach is one of such excellent sources of antioxidants, then those who have high levels of uric acid, it is better not to eat spinach, because that it greatly increases the level of this uric acid, it can provoke a relapse of gout, if a person already has it, well, or start to form this history on spinach too - you don’t need to lean too much, and does cabbage have any negative properties, well, maybe someone shouldn’t eat it, say, when a person has a tendency to flatulence, or yes, yes, or there are some inflammatory bowel diseases, then this gas formation, yes, it will contribute to pain syndrome, therefore, cabbage has only these are the features, but most

people can use it boiled, for example, then it provokes less of any. such negative processes, it is perceived much easier, in a boiled state, as we just said, for example, vitamin c becomes more accessible, with you olesya nosova from ukhrapavlov, this is a podcast deception of substances, we are talking about antioxidants, well, in fact , from program to program i am once again convinced how cleverly and cunningly nature has conceived everything, in fact the main thing for us is to go with the flow. the main thing for us is not to invent anything of our own,

that's it - in fact, in order for us to live well, to live as long as possible, we need to do the same thing, so that this doesn't happen... we condemn ourselves to the fact that we, having gone through all the circles of hell, having spent a lot of money, because dietary supplements are such a story, very, very expensive, especially now, a pig in a poke, there may be something completely different from what is stated, therefore this is one of the now widespread liver diseases, this is toxic hepatitis against the background of unbridled intake, uncontrolled intake of various dietary supplements, but still we need to give a report on the fact that we do need some dietary supplements, but first of all we are talking about omega-3. omega-3, now briefly about omega-3 - this is what we do not produce, it is vital, it has a name essential, in other words, it is not produced, it is very necessary, yes,

here omega-3, among other things, helps in the fight against oxidants, when we begin to use fats or in general, when we have, well, let's say, a replacement of some molecules of fat, yes in the cell membrane to others, this happens. with the help of oxidants, they destroy one, then it must be replaced, sometimes this process is uncontrolled, especially in people with various metabolic disorders, polyunsaturated acids, here omega-3, first of all, they are different, omega-6 there will not help us here, but omega-3 will help a lot, it helps to control this process, but even earlier and more effectively vitamin e is introduced into this, also one of the most powerful antioxidants, so if one is lacking, yes, the other helps. and if not enough yes this is lipid peroxidation - this is a very formidable story, just what pushes a person to heart disease, we have not mentioned something else, we

have not mentioned water, yes, it is really difficult to overestimate, because if a person does not drink water, he will drink anything except energy drinks, yes, carbonated these sweet non-alcoholic drinks, tea and coffee, tea and coffee also have antioxidant properties, yes, there are substances there, especially green tea, but here is the most important thing quantity, because green tea, black tea, and coffee in excess, this is again the risk of increasing the level of uric acid, so if you drink a cup or two of tea or coffee, this is a solid benefit, and not with food, everything else should be represented by water, yeah, water, in addition to simply filling the vascular bed of the cell, it also reduces this acidity simply by its volume, normalizing the ph, i want to say, drink water, well, by the way, surprisingly, young people do not have a problem with water, young people

drink water, and the older generation, but they just not accustomed, yes, but with children, when we ran outside, our childhood, yes it was outside, there were pumps there, and we drank water from there, now i don’t see parents giving their children water. they give them juices, give them compote, something else like that, but no, well, anyway, in terms of water, there is some kind of awareness, you can feel it right away, well, of course, of course, not everywhere, well, but it would seem that what’s easier than drinking normal, good, tasty water, especially since we, our country, are not in a shortage of drinking water water, by the way, yes, it is, it is a treasure, it is such a blessing, we are not inclined to appreciate it, in fact we should appreciate it. the fact that we have a lot of water, a lot of tasty, good drinking water, in principle, water in the body also solves a lot of problems, along with not being

fat, eating right and so on, you need to drink water, these are the numerous, let's say, proposals regarding the preparation of water, yes, its production of some kind. so i hope our advice will serve someone well. this was a podcast deception of substances, with you was olesya nosova, editor-in-chief of komsomolskaya pravda , endocrinologist zukhra pavlova.

hello, this is the badden baden podcast and i am its host, konstantin severinov. today we will talk about antibiotics and we will talk with sergei vasilyevich tsarenko, chief resuscitator of the ministry of health of the russian federation. sergei, what are antibiotics? well, is that something? in life, antibius, well, that's terrible, we are also alive, i thought that antibiotics are a medicine, no, well, that 's absolutely right, yes, well, there are just two types animal world, prokaryotes and eokaryotes, we , thank god, are eokaryotes, that is, with a nucleus, and those that are without a nucleus, bacteria, the nucleus is what is inside us, this is our essence inside the cell, this is what is inside the cell, when without a nucleus, these are prokaryotes, bacteria,

antibiotics are against them, although in general there are antibiotics, tumors, but mainly these are antibacterial, who produces them, chemists did this, where do these substances come from? well, for starters, actually, they were found in nature, this is a way of coexistence of bacteria with each other, some bacteria produce antibiotics to drive other bacteria out of their habitats, the fight for uh food, for a place to live, etc., and what does this have to do with medicine. we also have microbes, on us, inside us, and we also have antibiotics inside us, well, our bacteria also produce them, but strictly speaking, the most powerful antibiotics, of course, our bacteria do not produce, which live in us, basically these antibiotics are produced by bacteria living in the soil, accordingly they are found there, after that there are two options to modify them partially chemically, well, the third way is to create

an antibiotic artificially, similar to the one that was found in nature, and these are some factories, microbiological industry or chemical factory that makes this substance, this is some kind of molecule, but it is a molecule, yes, you are a resuscitator, you encounter antibiotics in your medical work, this is generally one of the main points of attention, as a resuscitator, because without antibiotics with... modern resuscitation will die, we we use antibiotics in several situations: the first is the prophylactic administration of an antibiotic, for example, a patient goes for a planned surgical operation, this is accompanied by a skin incision before the surgical intervention, therefore , preoperative prophylaxis with antibiotics exists as a reasonable measure to reduce potential, but this is specifically in hospitals, that is, antibiotics, as i understand it, are not taken prophylactically at home, no,

this concerns a specific surgical intervention, and this antibiotic it is administered half an hour before the operation with the expectation that it will only act for the duration of the surgical intervention, this is a single administration, this is a single or, in extreme cases, a double administration during the operation , it is repeated again if the operation is long, and if the antibiotic does not work, then what, and if one antibiotic does not work, then some kind of inflammatory purulent problems arise, then the antibiotic is changed, and if in ... bacteria, this means that bacteria have multiple resistance to different groups of antibacterial drugs, therefore this is such a selection, as i said, it is of course not so blind, they just prescribed one, threw out another, it is selected based on the results of certain

bacteriological studies, but... this topic was already heard before the pandemic, the idea of ​​a pharmaceutical company that develops antibiotics, which is engaged in the search for an antibiotic, for example, a new one among soil microorganisms, for example, or creates this antibiotic chemically, it spends significant efforts on the initial stage of searching or creating this molecule. the next step is for the company to test this antibiotic for effectiveness, for its...

this takes quite a lot of time and money, since modern options for bringing the drug to market, they carry... a lot of restrictions, this is very reasonable, since this is a way to protect the patient from some unwanted side effects, everything must be studied in sufficient detail, and the moment when the company has finally gone through this thorny path, a lot of money has been spent, the antibiotic is released into wide clinical practice, unfortunately, bacteria that live much longer than you and me, longer, longer, yes in time, i mean in evolution.

look at bacteria, they reproduce very quickly and in the process of reproduction , random mutations occur that create a field for potential resistance of one or two or several bacterial cells to a new. antibiotic, that is, they bypass, they bypass this option, well, for example, an antibiotic cannot penetrate a cell, there is such a special penicillin-binding protein, for example, in a cell, it must drag this antibiotic into the cage, here it took this protein, it turned out to be defective, from the point of view

of evolution it is a very valuable thing for bacteria, because the antibiotic stops working, i find it strange about the economy, but if you have people who can die, if you have tried four antibiotics and nothing works, then that's the end, but after all, on... probably, it is obvious, it is obvious that there is a very great interest among end consumers, families, yes, among all of us in the community, for antibiotics to work, what does the economy have to do with it at all, and you understand, as a doctor, i am generally not interested in the economy i treat it as a kind of substance of a lower gradation, forgive me for such harshness, because the patient's need is more important than money, but we are forced to take into account the fact that these antibiotics must appear on the market. so the company that brings it to the market must spend this money, and accordingly, when the antibiotic stops functioning after 2-3 years, it turns out that the money is thrown away, well, not to the wind, but in any case it is not very profitable,

compared to the fact that, for example, the company took and released a drug that lowers blood pressure, that's what you 're talking about, you know, it sounds terrible, not all antibiotics have stopped working, if all antibiotics stopped working after 2-3 years, then you... would be left without tools, but they probably work or we are all gradually left without tools, in fact, the problems during the covid pandemic and the high mortality rate on ventilator therapy were connected precisely with this, that there were not enough antibiotics, which it was possible to replace the quantity, in the sense that there weren’t enough of them, they ran out of a sufficient quantity of effective antibiotics, that is, look earlier... well, i don’t know, 5-7 years ago, new antibacterial drugs came to the market so quickly that the outdated, ineffective ones, you could just put them aside, i always had as a renema specialist, well, that’s what we called a shoulder

of four or five antibiotics of different potential groups, which could be replaced if during the treatment the patient’s bacteria developed resistance to a specific b just understand they become resistant. in these conditions there is always a possibility, unfortunately, this is a biological law, that some bacterial cell will show resistance, wants to live, and will produce offspring that will be resistant to this antibiotic, another question. that if the patient is not very seriously ill, then he begins to recover, he has enough strength to cope with the infection, well, relatively speaking, on his own, and there is no need to change the antibiotic, but in cases of severe patients, complex, well, the

same covid patients, and they were on the art of ventilation of the lungs due to severe viral lung damage, they had an intubation tube through which bacteria entered from the external environment and we could not... teach them from the art of ventilation of the lungs, because they did not have enough reserves of their own, so during the treatment he recovered, but at the same time the lung damage was still high enough that i could wean him from the... the art of ventilation of the lungs, accordingly, he developed a new wave of bacterial infection, these are these waves, they eventually overwhelmed and the person died. hello, my dears, this is the most plot-driven musical detective show "rodnya". what do you think is hidden behind our screen, who is boris's close star relative, that it is yuri nikolaev, boyarsky, but...

we are watching the podcast banden baden, i am its

host, konstantin severinov. we are talking about antibiotic-resistant bacteria with sergei vasilyevich tsarenko, chief resuscitator of the ministry of health of the russian federation. this is what you are describing, it feels like the game over is about to happen will end, yes, if there are no new ones, that is, little by little all the bacteria in the scenario that you describe should become resistant. insofar as we use antibiotics, you use. so that he does not die, the same story, we are moving towards it, actually, now and...

this is just in the style of this science fiction

novel: we need to learn to live with microorganisms that attack us, but they kill us, you understand? look, actually the pseudomonas aeruginosa that you mentioned is not at all interested in leaving for morgue together with the patient, she would also live and live, you understand, therefore, from the fact that she took and killed the patient and she was buried in the cold ground, this is not good for her, this is also evolutionarily wrong for her, that's why ... since a microorganism can be alive, but at the same time not emit pathogenicity factors that kill the human macroorganism, then a theoretically achievable story. in general, it is not fantasy, when a conditional pseudomonas aeruginosa gets along with a patient, they exist perfectly, he lives with it, walks safely, she is with him, well, we have this skin bacterium on the surface, and in the lungs, as far as i understand, it is usually there, that is, in principle, we always have it, but in this sense we already

coexist with it, so somehow we need to understand why at one moment it gets out of control and we begin to strangle it with antibiotics, at this moment it is somehow indomitable ... the planet produces even more powerful means of attack, as a result, everyone dies together, and she is the patient, well, that is , this is my personal relationship with my personal microbes, when they treat me they become resistant, or i also transmit them to everyone else, and you also transmit them to everyone else, because firstly, well, you don’t know, you cough, you grab something with your hands, then this one can take some, that is, antibiotic resistance is contagious, in the sense that bacteria , in fact, have learned to interact with each other in such a way that in a number of cases they simply transmit their ability to be resistant to antibiotics to each other, there is such a structure in bacterial cell, called a plasmid, well , it's like a small trailer, this trailer is where the gene resistance lives, this

trailer is new year's gifts, yes, this new year's gift can be transmitted from pseudomonas aeruginosa, for example, to klepsiele or some other microbe. completely different, actually, well, klepsieva with pseudomonas aeruginosa is further than, i don't know, human races, that is, it is far from each other, nevertheless, they exchanged the trailer, all-domuna became this blue spider resistant to antibiotics, although it was not a question, but how did you say that when a serious patient comes to you, you, well, i don’t want to say, i hope that it’s not at random, but you take the first antibiotics, try. then how do you know what to take from the four antibiotics that you have in your arsenal? there are several points here, the first point, of course, is ideal, i must get the bacterium that actually causes uh from a specific patient, so i get the bacterium,

i examine it in a certain way bacteriological laboratory and testing for sensitivity to antibiotics, so i tested. i realized that these, so at this time he is lying in your intensive care unit, he should lie down for some time, but you understand and the essence of the explanation that for some time he may not be there, he is severe, he is severe, he is getting worse, and there is such a rule, the later you prescribe effective antibiotics, the worse the results, well, it is also obvious that the bacteria did not get in the first time, only on the fourth time, yes, this is a much worse chance, therefore, unfortunately in this zone uncertainty has to be dealt with and... well , and then, well, i would say, excuse me, common sense kicks in, common sense says that a patient admitted, for example, from home with bacterial pneumonia, that most likely there is pneumocystis, with a high probability this pneumocystis is sensitive to some specific antibiotics, and i prescribe these antibiotics because i don’t have

time to wait, it’s not for nothing that he came to me in intensive care, he’s already so bad that he already needs to be treated in the intensive care unit, he expects... that according to the results of my colleagues who study these subjects there, i don’t know, among the population, what are these microbiologists, this is some kind of microbiological service that looks at who has what , who has what, and in specific regions there is a different picture, sensitivity to antibiotics, accordingly, these people come directly, no one has ever approached me with an offer to donate microbes, or it’s just that when we take some tests in the laboratory they are still sent for this. tests are given, well, this one, again, this patient was admitted, yes, i am from him, before that how to prescribe antibiotics, i got some biological medium from it, or he spat macrotoy into a petri dish, or the patient was so severe that i had to insert an intubation tube, and i took this macrotoy out of there with a special device, a barchoscope, before i started treating

with antibiotics, i still sowed