Pub Date : 2024-07-23DOI: 10.30629/0023-2149-2024-102-4-309-314
T. I. Avdeeva, A. V. Koloskov
The review presents a modern understanding of the pathophysiology and mechanisms leading to thrombocytopenia, as well as emerging treatment methods for.
这篇综述介绍了导致血小板减少的病理生理学和机制的现代认识，以及新出现的治疗方法。
{"title":"Idiopathic thrombocytopenic purpura","authors":"T. I. Avdeeva, A. V. Koloskov","doi":"10.30629/0023-2149-2024-102-4-309-314","DOIUrl":"https://doi.org/10.30629/0023-2149-2024-102-4-309-314","url":null,"abstract":"The review presents a modern understanding of the pathophysiology and mechanisms leading to thrombocytopenia, as well as emerging treatment methods for.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"133 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141811388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-23DOI: 10.30629/0023-2149-2024-102-4-285-290
I. N. Bokarev
The article provides information on historical issues — the discovery of blood clotting factors, anticoagulant and thrombolytic therapy, on modern understanding, diagnosis and treatment of arterial and venous thrombosis, atherothrombosis, venous thromboembolism, intravascular microthrombosis syndrome, hemophilias and immunothrombosis. Assumptions about the development of atherosclerosis are presented.
{"title":"Bloodcoagulation. Modern state","authors":"I. N. Bokarev","doi":"10.30629/0023-2149-2024-102-4-285-290","DOIUrl":"https://doi.org/10.30629/0023-2149-2024-102-4-285-290","url":null,"abstract":"The article provides information on historical issues — the discovery of blood clotting factors, anticoagulant and thrombolytic therapy, on modern understanding, diagnosis and treatment of arterial and venous thrombosis, atherothrombosis, venous thromboembolism, intravascular microthrombosis syndrome, hemophilias and immunothrombosis. Assumptions about the development of atherosclerosis are presented.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"69 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141813001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-23DOI: 10.30629/0023-2149-2024-102-4-315-322
B. S. Sukovatykh, N. V. Bolomatov, D. V. Sidorov, M. B. Sukovatykh
The article provides a systematic review of data from domestic and international literature on the issue of hemorrhagic complications that can occur during emergency endovascular interventions. It provides a generalized classifi cation of these complications and highlights the frequency of major and minor hemorrhages in diff erent locations, depending on their underlying cause. Various factors, causes, and mechanisms related to the development of hemorrhaging are discussed, including those associated with surgical access, vessel dissection, rupture, anticoagulation, anti-platelet therapy, and thrombolysis. Methods for preventing and treating these complications following endovascular procedures are also described in detail.
{"title":"Hemorrhagic complications of emergency endovascular interventions","authors":"B. S. Sukovatykh, N. V. Bolomatov, D. V. Sidorov, M. B. Sukovatykh","doi":"10.30629/0023-2149-2024-102-4-315-322","DOIUrl":"https://doi.org/10.30629/0023-2149-2024-102-4-315-322","url":null,"abstract":"The article provides a systematic review of data from domestic and international literature on the issue of hemorrhagic complications that can occur during emergency endovascular interventions. It provides a generalized classifi cation of these complications and highlights the frequency of major and minor hemorrhages in diff erent locations, depending on their underlying cause. Various factors, causes, and mechanisms related to the development of hemorrhaging are discussed, including those associated with surgical access, vessel dissection, rupture, anticoagulation, anti-platelet therapy, and thrombolysis. Methods for preventing and treating these complications following endovascular procedures are also described in detail.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"77 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141812813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-23DOI: 10.30629/0023-2149-2024-102-4-297-308
I. V. Mayev, S. Lyamina
The gut microbiome is of undeniable contribution to the functioning of numerous human organ systems, including higher nervous activity and behavioral reactions, and largely determines the activity of the immune system. To date, a large amount of knowledge has been accumulated about the importance of the composition, diversity and functional properties of the gut microbiota both for maintaining the human body in a state of health and for the development of pathology. Changes in the human organism are inevitably accompanied by changes in species composition and microbiome diversity. Certain patterns of changes in the human gut microbiome throughout life, as well as changes in its functional activity under the infl uence of external factors and food preferences. This research is based on search results in databases and electronic libraries PubMed (MEDLINE), Embase, Cochrane Library, Google Scholar, eLibrary in the period from 2012 to 2023. The review is devoted to the analysis of gut microbiome as a marker and predictor of chronic socially signifi cant non-communicable diseases, as well as an integral component of health gain in the context of a personalized approach of modern therapeutic strategies.
{"title":"Gut microbiome: new diagnostic and treatment options","authors":"I. V. Mayev, S. Lyamina","doi":"10.30629/0023-2149-2024-102-4-297-308","DOIUrl":"https://doi.org/10.30629/0023-2149-2024-102-4-297-308","url":null,"abstract":"The gut microbiome is of undeniable contribution to the functioning of numerous human organ systems, including higher nervous activity and behavioral reactions, and largely determines the activity of the immune system. To date, a large amount of knowledge has been accumulated about the importance of the composition, diversity and functional properties of the gut microbiota both for maintaining the human body in a state of health and for the development of pathology. Changes in the human organism are inevitably accompanied by changes in species composition and microbiome diversity. Certain patterns of changes in the human gut microbiome throughout life, as well as changes in its functional activity under the infl uence of external factors and food preferences. This research is based on search results in databases and electronic libraries PubMed (MEDLINE), Embase, Cochrane Library, Google Scholar, eLibrary in the period from 2012 to 2023. The review is devoted to the analysis of gut microbiome as a marker and predictor of chronic socially signifi cant non-communicable diseases, as well as an integral component of health gain in the context of a personalized approach of modern therapeutic strategies. ","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"90 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141812594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-23DOI: 10.30629/0023-2149-2024-102-4-291-296
M. A. Telegina, Zhanna Evgen'evna Belaya
Thyrotoxicosis most often occurs due to autoimmune diseases of the thyroid gland or a multi-nodular toxic goiter, but it can also be caused by TSH-secreting pituitary adenomas. In the presence of these adenomas, the levels of circulating free T3 and T4 increase in the absence of suppression, even with elevated TSH levels. Incorrect interpretation of results from studies that only measure TSH can lead to erroneous diagnoses and management strategies for patients, including unnecessary surgery or radioactive iodine therapy. This can contribute to the growth of pituitary tumors. Various tests have been used to try to diagnose them, but none have proven to be eff ective. Only laboratory tests in combination with MRI of the pituitary can accurately diagnose and prescribe treatment. When choosing a treatment for TSH-producing pituitary adenomas, preference is given to the surgical method of transsphenoidal adenomectomy. If surgery is not possible or eff ective, the method used to normalize TSH levels is to prescribe somatostatin analogs. In some cases, it is possible to use somatostatin analog therapy before neurosurgery. In exceptional circumstances, radiation therapy may be used, as with other types of adenomas.
甲亢最常见的原因是甲状腺自身免疫性疾病或多结节毒性甲状腺肿，但也可能是分泌促甲状腺激素的垂体腺瘤引起的。在这些腺瘤存在的情况下，即使促甲状腺激素水平升高，循环游离 T3 和 T4 水平也会在没有抑制的情况下升高。对仅测量促甲状腺激素的研究结果进行不正确的解释会导致错误的诊断和患者管理策略，包括不必要的手术或放射性碘治疗。这可能会导致垂体瘤的生长。已有多种检测方法被用于诊断垂体瘤，但没有一种方法被证明是有效的。只有结合脑垂体核磁共振成像进行实验室检查，才能准确诊断和治疗。在选择治疗产生促甲状腺激素的垂体腺瘤的方法时，优先考虑经蝶窦腺瘤切除术这种手术方法。如果无法进行手术或手术效果不佳，则使用体生长抑素类似物来使促甲状腺激素水平恢复正常。在某些情况下，可以在神经外科手术前使用体生长抑素类似物疗法。在特殊情况下，可以像治疗其他类型的腺瘤一样使用放射治疗。
{"title":"Rare forms of thyrotoxicosis: thyrotropin-secreting pituitary adenomas","authors":"M. A. Telegina, Zhanna Evgen'evna Belaya","doi":"10.30629/0023-2149-2024-102-4-291-296","DOIUrl":"https://doi.org/10.30629/0023-2149-2024-102-4-291-296","url":null,"abstract":"Thyrotoxicosis most often occurs due to autoimmune diseases of the thyroid gland or a multi-nodular toxic goiter, but it can also be caused by TSH-secreting pituitary adenomas. In the presence of these adenomas, the levels of circulating free T3 and T4 increase in the absence of suppression, even with elevated TSH levels. Incorrect interpretation of results from studies that only measure TSH can lead to erroneous diagnoses and management strategies for patients, including unnecessary surgery or radioactive iodine therapy. This can contribute to the growth of pituitary tumors. Various tests have been used to try to diagnose them, but none have proven to be eff ective. Only laboratory tests in combination with MRI of the pituitary can accurately diagnose and prescribe treatment. When choosing a treatment for TSH-producing pituitary adenomas, preference is given to the surgical method of transsphenoidal adenomectomy. If surgery is not possible or eff ective, the method used to normalize TSH levels is to prescribe somatostatin analogs. In some cases, it is possible to use somatostatin analog therapy before neurosurgery. In exceptional circumstances, radiation therapy may be used, as with other types of adenomas.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141813013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-09DOI: 10.30629/0023-2149-2024-102-2-133-138
A. G. Vaganov, M. S. Nochnoy, D. A. Lisitsky, A. V. Gavrilenko
Cases of occlusive lesions of the arteries of the lower leg occupy a special place in the treatment of critical lower limb ischemia. In this regard, performing open reconstructive interventions is unpromising. A new era in the treatment of occlusions of the arteries of the lower leg has become endovascular surgery. However, due to extensive occlusive lesions of the arteries of the lower leg, direct endovascular revascularization is often impossible. Currently, vascular surgeons adhere to the angiosome principle, according to which the goal of balloon angioplasty is to restore blood supply to the artery supplying the angiosome with purulent-trophic changes. In the clinical example provided, the universality of the angiosome theory is questioned, and clinical success achieved due to the discovery of collateral blood fl ow is demonstrated. The patient underwent surgery with the use of an original hybrid operation technique with the installation of a port system followed by active therapeutic-diagnostic measures on an outpatient basis for 30 days. As a result of the treatment, epithelialization of the trophic defect and cessation of critical ischemic phenomena were noted.
{"title":"First experience of distal hybrid surgery on lower limb arteries with port-system installation","authors":"A. G. Vaganov, M. S. Nochnoy, D. A. Lisitsky, A. V. Gavrilenko","doi":"10.30629/0023-2149-2024-102-2-133-138","DOIUrl":"https://doi.org/10.30629/0023-2149-2024-102-2-133-138","url":null,"abstract":" Cases of occlusive lesions of the arteries of the lower leg occupy a special place in the treatment of critical lower limb ischemia. In this regard, performing open reconstructive interventions is unpromising. A new era in the treatment of occlusions of the arteries of the lower leg has become endovascular surgery. However, due to extensive occlusive lesions of the arteries of the lower leg, direct endovascular revascularization is often impossible. Currently, vascular surgeons adhere to the angiosome principle, according to which the goal of balloon angioplasty is to restore blood supply to the artery supplying the angiosome with purulent-trophic changes. In the clinical example provided, the universality of the angiosome theory is questioned, and clinical success achieved due to the discovery of collateral blood fl ow is demonstrated. The patient underwent surgery with the use of an original hybrid operation technique with the installation of a port system followed by active therapeutic-diagnostic measures on an outpatient basis for 30 days. As a result of the treatment, epithelialization of the trophic defect and cessation of critical ischemic phenomena were noted.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":" 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140995473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-09DOI: 10.30629/0023-2149-2024-102-2-152-162
L. A. Shpagina, O. Kotova, I. Shpagin, G. V. Kuznetsova, E. Loktin, A. Rukavitsyna, S. Karmanovskaya, L. Panacheva, E. Anikina
Justification. Knowledge of the differences in response to therapy between phenotypes of exacerbations of chronic obstructive pulmonary disease (COPD) is necessary to improve treatment outcomes. Objective: to determine the most effective additional pharmacological methods for virus-associated exacerbations of COPD. Material and methods. The study included patients hospitalized with exacerbations of COPD with viral (n = 60) and viral-bacterial (n = 60) infections, and a comparison group with exacerbations of COPD with bacterial infection (n = 60). The diagnosis of COPD was based on spirometric criteria, viral infection — according to the results of PCR-RV of sputum for RNA of respiratory viruses. Treatment was carried out in real clinical practice. The groups were comparable in the use of systemic glucocorticoids, short-acting bronchodilators. Dyspnea was assessed using the TDI index (primary endpoint), lung function (spirometry, diffusion capacity for carbon monoxide), exercise tolerance (6-minute walk test), length of hospital stay (secondary endpoints). The сorrelations were determined with the use of Cox proportional hazards model. Results. In the groups with virus-associated and viral-bacterial exacerbations, unlike bacterial exacerbations, the following types of treatment were associated with achieving TDI +1 (odds ratio — OR, 95 % confidence interval — CI): fixed triple combination (OR 2.69; 95 % CI 1.48–4.90; p = 0.010 and OR 2.74; 95 % CI 1.29–3.80; p = 0.031), inhalation of 3 % sodium chloride solution (OR 3.64; 95 % CI 1.45–5.42; p = 0.001 and OR 3.23; 95 % CI 2.15–5.43; p = 0.042), antiviral drugs (OR 2.91; 95 % CI 1.15–3.62; p = 0.009 and OR 2.76; 95 % CI 1.31–3.90; p = 0.008). As a result of treatment, an increase in DLco/Va, SpO2 after a 6-minute walk, and a decrease in the length of hospital stay were observed. Conclusion. Detection of virus-associated infections is a promising marker for determining indications for prescribing long-acting anticholinergic drugs and beta-adrenomimetics, inhaled corticosteroids, inhalations of hypertonic sodium chloride solution, and antiviral drugs for exacerbations of COPD.
理由。有必要了解慢性阻塞性肺疾病（COPD）加重表型之间对治疗反应的差异，以改善治疗效果。 目的：确定治疗病毒相关慢性阻塞性肺疾病加重的最有效的附加药物治疗方法。 材料和方法。研究对象包括慢性阻塞性肺疾病加重期病毒感染（n = 60）和病毒细菌感染（n = 60）住院患者，以及慢性阻塞性肺疾病加重期细菌感染对比组（n = 60）。慢性阻塞性肺病的诊断依据是肺活量测定标准，病毒感染的诊断依据是痰中呼吸道病毒 RNA 的 PCR-RV 检测结果。治疗在真实的临床实践中进行。两组在使用全身性糖皮质激素和短效支气管扩张剂方面具有可比性。呼吸困难通过 TDI 指数（主要终点）、肺功能（肺活量测定、一氧化碳弥散能力）、运动耐量（6 分钟步行测试）和住院时间（次要终点）进行评估。利用考克斯比例危险模型确定了相关性。 结果显示在病毒相关性和病毒细菌性病情恶化组中，与细菌性病情恶化不同，以下治疗类型与达到 TDI +1 相关（几率比 - OR，95 % 置信区间 - CI）：固定三联疗法（OR 2.69; 95 % CI 1.48-4.90; p = 0.010 和 OR 2.74; 95 % CI 1.29-3.80; p = 0.031），吸入 3 % 氯化钠溶液（OR 3.64; 95 % CI 1.45-5.42; p = 0.001 和 OR 3.23; 95 % CI 2.15-5.43;p = 0.042）、抗病毒药物（OR 2.91; 95 % CI 1.15-3.62; p = 0.009 和 OR 2.76; 95 % CI 1.31-3.90; p = 0.008）。经过治疗后，DLco/Va、6 分钟步行后的 SpO2 均有所提高，住院时间也有所缩短。 结论检测与病毒有关的感染是一个很有前景的指标，可用于确定慢性阻塞性肺疾病加重期的长效抗胆碱能药物和β-拟肾上腺素药物、吸入皮质类固醇、吸入高渗氯化钠溶液和抗病毒药物的处方适应症。
{"title":"Assessment of pharmacotherapy efficacy for the treatment of exacerbations of chronic obstructive pulmonary disease associated with viral infection","authors":"L. A. Shpagina, O. Kotova, I. Shpagin, G. V. Kuznetsova, E. Loktin, A. Rukavitsyna, S. Karmanovskaya, L. Panacheva, E. Anikina","doi":"10.30629/0023-2149-2024-102-2-152-162","DOIUrl":"https://doi.org/10.30629/0023-2149-2024-102-2-152-162","url":null,"abstract":" Justification. Knowledge of the differences in response to therapy between phenotypes of exacerbations of chronic obstructive pulmonary disease (COPD) is necessary to improve treatment outcomes. Objective: to determine the most effective additional pharmacological methods for virus-associated exacerbations of COPD. Material and methods. The study included patients hospitalized with exacerbations of COPD with viral (n = 60) and viral-bacterial (n = 60) infections, and a comparison group with exacerbations of COPD with bacterial infection (n = 60). The diagnosis of COPD was based on spirometric criteria, viral infection — according to the results of PCR-RV of sputum for RNA of respiratory viruses. Treatment was carried out in real clinical practice. The groups were comparable in the use of systemic glucocorticoids, short-acting bronchodilators. Dyspnea was assessed using the TDI index (primary endpoint), lung function (spirometry, diffusion capacity for carbon monoxide), exercise tolerance (6-minute walk test), length of hospital stay (secondary endpoints). The сorrelations were determined with the use of Cox proportional hazards model. Results. In the groups with virus-associated and viral-bacterial exacerbations, unlike bacterial exacerbations, the following types of treatment were associated with achieving TDI +1 (odds ratio — OR, 95 % confidence interval — CI): fixed triple combination (OR 2.69; 95 % CI 1.48–4.90; p = 0.010 and OR 2.74; 95 % CI 1.29–3.80; p = 0.031), inhalation of 3 % sodium chloride solution (OR 3.64; 95 % CI 1.45–5.42; p = 0.001 and OR 3.23; 95 % CI 2.15–5.43; p = 0.042), antiviral drugs (OR 2.91; 95 % CI 1.15–3.62; p = 0.009 and OR 2.76; 95 % CI 1.31–3.90; p = 0.008). As a result of treatment, an increase in DLco/Va, SpO2 after a 6-minute walk, and a decrease in the length of hospital stay were observed. Conclusion. Detection of virus-associated infections is a promising marker for determining indications for prescribing long-acting anticholinergic drugs and beta-adrenomimetics, inhaled corticosteroids, inhalations of hypertonic sodium chloride solution, and antiviral drugs for exacerbations of COPD.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":" 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140995827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-09DOI: 10.30629/0023-2149-2024-102-2-139-146
E. Yaroslavskaya, V. Garanina, N. Е. Shirokov, D. Krinochkin, N. A. Osokina, I. O. Korovina, A. V. Migacheva, A. D. Sapozhnikova, T. I. Petelina
Aim: to study the dynamics of clinical and echocardiographic parameters in patients with cardiovascular diseases (CVD) at 3, 12, and 26 months after COVID-19 pneumonia. Material and methods. The dynamics of clinical and echocardiographic parameters were studied in 130 patients with CVD at 3, 12, and 26 months after COVID-19 pneumonia (57 ± 8 years old, 46.9 % males). Results. Between the 1st and 2nd visits, body mass index (BMI) increased (30.6 ± 5.1 kg/m2 vs. 31.4 ± 5.4 kg/m2, p < 0.001), the number of patients with obesity of grades 2 –3 increased (14.6 % vs. 23.1 %, p < 0.001). Early diastolic septal mitral annular velocity decreased from the 2nd to the 3rd visit (7.0 [6.0; 8.0] cm/s vs. 6.0 [5.0; 8.0] cm/s, p = 0.023), as did the maximum diastolic lateral tricuspid annular velocity (12.0 [11.0; 14.0] cm/s vs. 8.0 [6.0; 9.0] cm/s, p < 0.001). Between the 2nd and 3rd visits, the average global longitudinal strain of the left ventricle increased ( –19.3 ± 2.6 % vs. –19.8 ± 2.2 %, p = 0.034), the frequency of detecting its reduced values decreased (34.9 % vs. 17.4 %, p = 0.003). Conclusion. In the long term after COVID-19 pneumonia, patients with CVD show an increase in BMI accompanied by worsening of diastolic ventricular function parameters without signifi cant progression in the frequency and severity of CVD.
{"title":"Dynamics of clinical and echocardiographic parameters of patients with cardiovascular diseases 3, 12 and 26 months after COVID-19 pneumonia","authors":"E. Yaroslavskaya, V. Garanina, N. Е. Shirokov, D. Krinochkin, N. A. Osokina, I. O. Korovina, A. V. Migacheva, A. D. Sapozhnikova, T. I. Petelina","doi":"10.30629/0023-2149-2024-102-2-139-146","DOIUrl":"https://doi.org/10.30629/0023-2149-2024-102-2-139-146","url":null,"abstract":" Aim: to study the dynamics of clinical and echocardiographic parameters in patients with cardiovascular diseases (CVD) at 3, 12, and 26 months after COVID-19 pneumonia. Material and methods. The dynamics of clinical and echocardiographic parameters were studied in 130 patients with CVD at 3, 12, and 26 months after COVID-19 pneumonia (57 ± 8 years old, 46.9 % males). Results. Between the 1st and 2nd visits, body mass index (BMI) increased (30.6 ± 5.1 kg/m2 vs. 31.4 ± 5.4 kg/m2, p < 0.001), the number of patients with obesity of grades 2 –3 increased (14.6 % vs. 23.1 %, p < 0.001). Early diastolic septal mitral annular velocity decreased from the 2nd to the 3rd visit (7.0 [6.0; 8.0] cm/s vs. 6.0 [5.0; 8.0] cm/s, p = 0.023), as did the maximum diastolic lateral tricuspid annular velocity (12.0 [11.0; 14.0] cm/s vs. 8.0 [6.0; 9.0] cm/s, p < 0.001). Between the 2nd and 3rd visits, the average global longitudinal strain of the left ventricle increased ( –19.3 ± 2.6 % vs. –19.8 ± 2.2 %, p = 0.034), the frequency of detecting its reduced values decreased (34.9 % vs. 17.4 %, p = 0.003). Conclusion. In the long term after COVID-19 pneumonia, patients with CVD show an increase in BMI accompanied by worsening of diastolic ventricular function parameters without signifi cant progression in the frequency and severity of CVD.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":" 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140994877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-09DOI: 10.30629/0023-2149-2024-102-2-183-187
P. E. Krynyukov, V. G. Abashin, I. I. Velichko
Data on the first aviation and aeronautical units of the Russian Imperial Army in the First World War are presented. Biographical information about the first air medical offi cers of these military units is given.
{"title":"Aviation and medicine. Doctors of the aviation units of the Russian Im- perial Army in the First World War","authors":"P. E. Krynyukov, V. G. Abashin, I. I. Velichko","doi":"10.30629/0023-2149-2024-102-2-183-187","DOIUrl":"https://doi.org/10.30629/0023-2149-2024-102-2-183-187","url":null,"abstract":" Data on the first aviation and aeronautical units of the Russian Imperial Army in the First World War are presented. Biographical information about the first air medical offi cers of these military units is given.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":" 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140996778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-09DOI: 10.30629/0023-2149-2024-102-2-147-151
A. E. Zaitsev, O. N. Asanov, E. Z. Sandalov, A. V. Zaitseva
Chronic wounds are a common surgical pathology. Some types of laser radiation allow for eff ective debridement of wounds and stimulation of healing processes. High-intensity erbium laser can comprehensively aff ect tissues in all phases of the wound process, leading to accelerated healing of chronic wounds. The aim of the study was to evaluate the eff ectiveness of using high-intensity erbium laser for treating patients with chronic wounds of various origins compared to traditional treatment. Material and methods: An analysis of the treatment of 144 patients with chronic wounds was conducted in two groups. In the 1st group (n = 71), a high-intensity erbium laser and dressings with water-soluble ointments were used. In the 2nd group (n = 73), standard surgical treatment with similar dressings was performed. Results were evaluated using visual assessment of wound defects, planimetry, bacteriological and cytological studies, assessment of procedure tolerability, and pain intensity before and after treatment. Results: рatients in the 1st group showed signs of healing signifi cantly earlier and more frequently achieved complete epithelialization of wounds. Laser treatment contributed to more effective decontamination of wound defects, and signs of tissue regeneration were more frequently observed in cytological images. Patients tolerated erbium laser treatment better than surgical treatment, although pain intensity after treatment did not differ between groups. Conclusion: The study confi rmed the effectiveness of using high-intensity erbium laser for treating chronic wounds. This method can be recommended for use in surgical practice alongside other technical and pharmacological tools.
{"title":"Clinical experience of using a high-intensity erbium laser for the treatment of chronic wounds","authors":"A. E. Zaitsev, O. N. Asanov, E. Z. Sandalov, A. V. Zaitseva","doi":"10.30629/0023-2149-2024-102-2-147-151","DOIUrl":"https://doi.org/10.30629/0023-2149-2024-102-2-147-151","url":null,"abstract":" Chronic wounds are a common surgical pathology. Some types of laser radiation allow for eff ective debridement of wounds and stimulation of healing processes. High-intensity erbium laser can comprehensively aff ect tissues in all phases of the wound process, leading to accelerated healing of chronic wounds. The aim of the study was to evaluate the eff ectiveness of using high-intensity erbium laser for treating patients with chronic wounds of various origins compared to traditional treatment. Material and methods: An analysis of the treatment of 144 patients with chronic wounds was conducted in two groups. In the 1st group (n = 71), a high-intensity erbium laser and dressings with water-soluble ointments were used. In the 2nd group (n = 73), standard surgical treatment with similar dressings was performed. Results were evaluated using visual assessment of wound defects, planimetry, bacteriological and cytological studies, assessment of procedure tolerability, and pain intensity before and after treatment. Results: рatients in the 1st group showed signs of healing signifi cantly earlier and more frequently achieved complete epithelialization of wounds. Laser treatment contributed to more effective decontamination of wound defects, and signs of tissue regeneration were more frequently observed in cytological images. Patients tolerated erbium laser treatment better than surgical treatment, although pain intensity after treatment did not differ between groups. Conclusion: The study confi rmed the effectiveness of using high-intensity erbium laser for treating chronic wounds. This method can be recommended for use in surgical practice alongside other technical and pharmacological tools.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":" 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140996911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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