Pub Date : 2024-05-09DOI: 10.30629/0023-2149-2024-102-2-172-177
S. Yakushin
The existing inertia of clinical thinking in establishing a diagnosis, even in the presence of instrumental and valid diagnostic criteria, does not always allow for a reconsideration of the diagnosis given to the patient, especially several years ago. Existing clinical recommendations for certain nosological forms, which currently play a decisive role in diagnostics, treatment, and quality assessment of medical services, may not be fully applicable to all patients with a specifi c disease. As an illustration of the above, a clinical example of a patient diagnosed with “bronchial asthma” about 15 years ago without diagnostic criteria for this condition is provided. Three years ago, on a hospitalization described in the article, a chest computed tomography scan revealed typical signs of diff use pulmonary pneumonia. However, this did not allow for a change in the stereotypical diagnostic view and the correct diagnosis and appropriate treatment, including in a specialized pulmonology department. As a result, the disease progressed with the development of complications in the form of severe respiratory and heart failure. Only a reassessment of clinical symptoms, including inspiratory crackles, chest CT scan (diffuse opacity reduction resembling ground glass), and restrictive abnormalities in external respiration function without obstructive components, allowed for a reevaluation of the diagnosis and the prescription of pathogenetic therapy with glucocorticoids in combination with treatment for respiratory and heart failure, leading to rapid clinical improvement.
{"title":"Clinical thinking and instrumental diagnostics in the late stage of hypersensitive pneumonitis","authors":"S. Yakushin","doi":"10.30629/0023-2149-2024-102-2-172-177","DOIUrl":"https://doi.org/10.30629/0023-2149-2024-102-2-172-177","url":null,"abstract":" The existing inertia of clinical thinking in establishing a diagnosis, even in the presence of instrumental and valid diagnostic criteria, does not always allow for a reconsideration of the diagnosis given to the patient, especially several years ago. Existing clinical recommendations for certain nosological forms, which currently play a decisive role in diagnostics, treatment, and quality assessment of medical services, may not be fully applicable to all patients with a specifi c disease. As an illustration of the above, a clinical example of a patient diagnosed with “bronchial asthma” about 15 years ago without diagnostic criteria for this condition is provided. Three years ago, on a hospitalization described in the article, a chest computed tomography scan revealed typical signs of diff use pulmonary pneumonia. However, this did not allow for a change in the stereotypical diagnostic view and the correct diagnosis and appropriate treatment, including in a specialized pulmonology department. As a result, the disease progressed with the development of complications in the form of severe respiratory and heart failure. Only a reassessment of clinical symptoms, including inspiratory crackles, chest CT scan (diffuse opacity reduction resembling ground glass), and restrictive abnormalities in external respiration function without obstructive components, allowed for a reevaluation of the diagnosis and the prescription of pathogenetic therapy with glucocorticoids in combination with treatment for respiratory and heart failure, leading to rapid clinical improvement.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":" 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141128966","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: 10.30629/0023-2149-2024-102-2-125-132
A. Vlasov, Sh.-Ah. S. Al-Kubaisi, T. I. Vlasova, N. Myshkina, K. M. Sinyavina, E. A. Khozina, O. D. Khudaiberenova, M. Khachaturov
Acute pancreatitis remains one of the most dangerous pathologies in the structure of emergency abdominal surgery. This is due to many reasons, including an increase in the frequency of destructive forms of the disease, high mortality, and frequent unfavorable outcomes. The aim of this study was to investigate a number of leading components of homeostasis in patients with acute pancreatitis of varying severity. A retrospective study was conducted on 50 patients with acute pancreatitis of diff erent severity levels who were hospitalized at the Republican Clinical Hospital named after S.V. Katkovа (Saransk, Russia). The patients were divided into groups: the fi rst group (control, n = 30) consisted of patients with mild acute pancreatitis, and the second group (main, n = 20) consisted of patients with severe acute pancreatitis. The study evaluated the endogenous intoxication syndrome, the activity of lipid peroxidation and phospholipase systems, microcirculation status, liver function, and the activity of the coagulation-lytic blood system. The results showed that in the early stages of acute pancreatitis, several pathological processes were observed: the development of endotoxemia syndrome, activation of lipid peroxidation and phospholipase systems, microcirculation disorders, changes in the coagulation and fibrinolytic links of the hemostasis system, and liver function suppression. The severity of these disorders was associated with the severity of the pathology. In cases of mild severity, the changes in the parameters studied were reversible, while in severe cases they were stable and oftenirreversible. The presence of toxemia, oxidative stress, dysmicrocirculation, and hemostatic disorders should be considered as risk factors for disease progression and complications.
{"title":"Dishomeostatic phenomena in acute pancreatitis of variable severity","authors":"A. Vlasov, Sh.-Ah. S. Al-Kubaisi, T. I. Vlasova, N. Myshkina, K. M. Sinyavina, E. A. Khozina, O. D. Khudaiberenova, M. Khachaturov","doi":"10.30629/0023-2149-2024-102-2-125-132","DOIUrl":"https://doi.org/10.30629/0023-2149-2024-102-2-125-132","url":null,"abstract":" Acute pancreatitis remains one of the most dangerous pathologies in the structure of emergency abdominal surgery. This is due to many reasons, including an increase in the frequency of destructive forms of the disease, high mortality, and frequent unfavorable outcomes. The aim of this study was to investigate a number of leading components of homeostasis in patients with acute pancreatitis of varying severity. A retrospective study was conducted on 50 patients with acute pancreatitis of diff erent severity levels who were hospitalized at the Republican Clinical Hospital named after S.V. Katkovа (Saransk, Russia). The patients were divided into groups: the fi rst group (control, n = 30) consisted of patients with mild acute pancreatitis, and the second group (main, n = 20) consisted of patients with severe acute pancreatitis. The study evaluated the endogenous intoxication syndrome, the activity of lipid peroxidation and phospholipase systems, microcirculation status, liver function, and the activity of the coagulation-lytic blood system. The results showed that in the early stages of acute pancreatitis, several pathological processes were observed: the development of endotoxemia syndrome, activation of lipid peroxidation and phospholipase systems, microcirculation disorders, changes in the coagulation and fibrinolytic links of the hemostasis system, and liver function suppression. The severity of these disorders was associated with the severity of the pathology. In cases of mild severity, the changes in the parameters studied were reversible, while in severe cases they were stable and oftenirreversible. The presence of toxemia, oxidative stress, dysmicrocirculation, and hemostatic disorders should be considered as risk factors for disease progression and complications.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":" 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140997085","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: 10.30629/0023-2149-2024-102-2-178-182
V. E. Fedorchenko, D. R. Ivchenko, K. N. Nikolayev, N. V. Rodina
The treatment of gunshot thoracoabdominal injuries is a relevant issue in modern medicine. The high mortality rate, reaching 28.6 %, indicates the need to improve existing diagnostic and treatment approaches in providing medical care to such injured individuals during evacuation stages. The presented clinical case demonstrates the effectiveness of applying a staged approach to providing medical care for thoracoabdominal trauma.
{"title":"Surgical tactics for thoracoabdominal injury","authors":"V. E. Fedorchenko, D. R. Ivchenko, K. N. Nikolayev, N. V. Rodina","doi":"10.30629/0023-2149-2024-102-2-178-182","DOIUrl":"https://doi.org/10.30629/0023-2149-2024-102-2-178-182","url":null,"abstract":" The treatment of gunshot thoracoabdominal injuries is a relevant issue in modern medicine. The high mortality rate, reaching 28.6 %, indicates the need to improve existing diagnostic and treatment approaches in providing medical care to such injured individuals during evacuation stages. The presented clinical case demonstrates the effectiveness of applying a staged approach to providing medical care for thoracoabdominal trauma.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":" 36","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140997825","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: 10.30629/0023-2149-2024-102-2-188-192
I. A. Merkushev, V. G. Abashin
The article presents new information about Pyotr Frantsevich Lesgaft — a pedagogue and mentor, a follower of the traditions of his favorite teachers and professors of the Imperial Medico-Surgical Academy, his contribution to the development of the system of pedagogical upbringing and education of children in Russia.
{"title":"Doctor, teacher and mentor — Peter Frantsevich Lesgaft","authors":"I. A. Merkushev, V. G. Abashin","doi":"10.30629/0023-2149-2024-102-2-188-192","DOIUrl":"https://doi.org/10.30629/0023-2149-2024-102-2-188-192","url":null,"abstract":" The article presents new information about Pyotr Frantsevich Lesgaft — a pedagogue and mentor, a follower of the traditions of his favorite teachers and professors of the Imperial Medico-Surgical Academy, his contribution to the development of the system of pedagogical upbringing and education of children in Russia.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":" 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140995123","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: 10.30629/0023-2149-2024-102-2-163-171
R. M. Fayzullina, R. Gafurova, E. A. Bogomolovа
Aim: to evaluate the eff ectiveness and satisfaction of patients with bronchial asthma (BA) using the remote monitoring software product “ASTMATEST”. Materials and methods. A specialized website “ASTMATEST” — ww.asthmatest.ru was developed for conducting remote and timely telemonitoring of the health status of patients with verifi ed BA. An open prospective comparative study was conducted at the pediatric department of the City Children’s Clinical Hospital in Ufa from November 2022 till April 2023. The study included 2 groups of patients, similar in age and demographic indicators: the main group consisted of 38 (57.8 %) children whose parents agreed to use the information system of the website “ASTMATEST” in combination with its traditional methods, the control group included 34 (43.2 %) children whose parents refused to use the software product due to various reasons. The effectiveness of remote monitoring was analyzed by comparing the morning and evening peak flow meter readings, symptom control report data. Satisfaction with the work and use of the remote monitoring technology of the website “ASTMATEST” by patients with BA and their parents was assessed through a sociological survey using questionnaires. Results. In the main study group, the proportion of patients with severe BA decreased to 18.42 % due to an increase in the proportion of patients with mild (up to 34.21 %) and moderate (47.37 %) severity of BA. In the control group, the proportion of patients with mild BA decreased to 40.74 %, due to an increase in the proportion of patients with moderate (up to 44.44 %) and severe (14.82 %) severity. Conclusion. During the survey of patients in the main group using a specially designed questionnaire, it was found that the majority of patients and their parents/legal representatives are willing to continue using the developed software product to assess the level of disease control and adherence to doctor’s recommendations and prescriptions.
{"title":"Remote monitoring of the course of bronchial asthma in children","authors":"R. M. Fayzullina, R. Gafurova, E. A. Bogomolovа","doi":"10.30629/0023-2149-2024-102-2-163-171","DOIUrl":"https://doi.org/10.30629/0023-2149-2024-102-2-163-171","url":null,"abstract":" Aim: to evaluate the eff ectiveness and satisfaction of patients with bronchial asthma (BA) using the remote monitoring software product “ASTMATEST”. Materials and methods. A specialized website “ASTMATEST” — ww.asthmatest.ru was developed for conducting remote and timely telemonitoring of the health status of patients with verifi ed BA. An open prospective comparative study was conducted at the pediatric department of the City Children’s Clinical Hospital in Ufa from November 2022 till April 2023. The study included 2 groups of patients, similar in age and demographic indicators: the main group consisted of 38 (57.8 %) children whose parents agreed to use the information system of the website “ASTMATEST” in combination with its traditional methods, the control group included 34 (43.2 %) children whose parents refused to use the software product due to various reasons. The effectiveness of remote monitoring was analyzed by comparing the morning and evening peak flow meter readings, symptom control report data. Satisfaction with the work and use of the remote monitoring technology of the website “ASTMATEST” by patients with BA and their parents was assessed through a sociological survey using questionnaires. Results. In the main study group, the proportion of patients with severe BA decreased to 18.42 % due to an increase in the proportion of patients with mild (up to 34.21 %) and moderate (47.37 %) severity of BA. In the control group, the proportion of patients with mild BA decreased to 40.74 %, due to an increase in the proportion of patients with moderate (up to 44.44 %) and severe (14.82 %) severity. Conclusion. During the survey of patients in the main group using a specially designed questionnaire, it was found that the majority of patients and their parents/legal representatives are willing to continue using the developed software product to assess the level of disease control and adherence to doctor’s recommendations and prescriptions.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":" 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140994727","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 : 2024-05-08DOI: 10.30629/0023-2149-2024-102-2-118-124
V. Y. Brodsky
The aim of the review is to draw attention to the multifaceted biological action of medications, especially their infl uence on direct intercellular interactions. The data are summarized on the fact that common medications such as dopamine, glutamic acid, melatonin, phenylephrine-containing agents can, depending on the stimulated receptors, both organize and disorganize intercellular connections. The action can be predicted considering information on agonism or antagonism of receptor eff ects on intracellular calcium or cAMP. Information is provided on the possibility of mitigating unwanted eff ects. The data on the prospects of using gangliosides in therapy are summarized.
{"title":"Drugs as organizers of cell populations","authors":"V. Y. Brodsky","doi":"10.30629/0023-2149-2024-102-2-118-124","DOIUrl":"https://doi.org/10.30629/0023-2149-2024-102-2-118-124","url":null,"abstract":" The aim of the review is to draw attention to the multifaceted biological action of medications, especially their infl uence on direct intercellular interactions. The data are summarized on the fact that common medications such as dopamine, glutamic acid, melatonin, phenylephrine-containing agents can, depending on the stimulated receptors, both organize and disorganize intercellular connections. The action can be predicted considering information on agonism or antagonism of receptor eff ects on intracellular calcium or cAMP. Information is provided on the possibility of mitigating unwanted eff ects. The data on the prospects of using gangliosides in therapy are summarized.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":" 34","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140999637","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 : 2024-05-08DOI: 10.30629/0023-2149-2024-102-2-109-117
V. V. Krylov, M. Ragimov, I. V. Misnikova
The increasing number of patients with diabetes in the structure of comorbid cardiothoracic patients necessitates a more detailed study of the pathophysiological mechanisms of the modifying infl uence of diabetes, taking into account new scientific data. This allows for a more systematic view of processes that were previously the prerogative of specialists. Content. A modern perspective on the pathophysiological mechanisms of diabetes on cardiac structures is presented, with a description of the two most signifi cant pathological syndromes — diabetic cardiomyopathy and changes in the morphological structure of the atrioventricular valve leafl ets. The expansion of the endocrinologist’s role in the examination and treatment of cardiothoracic patients is justifi ed. Conclusion. A systemic approach to the problem of diabetes in cardiothoracic surgery, incorporating a multidisciplinary approach and active involvement of endocrinologists at all stages of the treatment process, will improve treatment outcomes for cardiothoracic patients and reduce their postoperative recovery times.
{"title":"Pathophysiological aspects of morphological changes in the structure of atrioventricular valves leafl ets in diabetes mellitus","authors":"V. V. Krylov, M. Ragimov, I. V. Misnikova","doi":"10.30629/0023-2149-2024-102-2-109-117","DOIUrl":"https://doi.org/10.30629/0023-2149-2024-102-2-109-117","url":null,"abstract":" The increasing number of patients with diabetes in the structure of comorbid cardiothoracic patients necessitates a more detailed study of the pathophysiological mechanisms of the modifying infl uence of diabetes, taking into account new scientific data. This allows for a more systematic view of processes that were previously the prerogative of specialists. Content. A modern perspective on the pathophysiological mechanisms of diabetes on cardiac structures is presented, with a description of the two most signifi cant pathological syndromes — diabetic cardiomyopathy and changes in the morphological structure of the atrioventricular valve leafl ets. The expansion of the endocrinologist’s role in the examination and treatment of cardiothoracic patients is justifi ed. Conclusion. A systemic approach to the problem of diabetes in cardiothoracic surgery, incorporating a multidisciplinary approach and active involvement of endocrinologists at all stages of the treatment process, will improve treatment outcomes for cardiothoracic patients and reduce their postoperative recovery times.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":" 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140998289","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 : 2024-05-07DOI: 10.30629/0023-2149-2024-102-2-101-108
E. S. Drachuk, A. A. Gubanova, I. Haidbayev, V. N. Burmistrova, K. A. Andreyanova, Yu. A. Hertek, V. E. Tuchina, S. V. Kuzmina, O. V. Kulikova, A. R. Borodina, A. A. Petrakov, S. M. Om, V, V. Babyuk
Modern medicine has a high demand for new drugs for the prevention and treatment of cytomegalovirus (CMV) infection. This review discusses maribavir — an oral antiviral drug with selective multimodal anti-CMV activity for the treatment of adults and children with post-transplant CMV infection resistant to traditional anti-CMV therapy. Despite numerous clinical trials of maribavir, the results of its effi cacy are ambiguous. Alongside successful studies indicating high effi cacy of the drug under review, there are data from statistically unsuccessful studies. The aim of this review is to examine the mechanism of its action on cytomegalovirus infection, viral sensitivity and cross-resistance mechanisms, as well as to summarize the results of clinical trials of the drug.
{"title":"Efficacy of the drug maribavir according to clinical studies","authors":"E. S. Drachuk, A. A. Gubanova, I. Haidbayev, V. N. Burmistrova, K. A. Andreyanova, Yu. A. Hertek, V. E. Tuchina, S. V. Kuzmina, O. V. Kulikova, A. R. Borodina, A. A. Petrakov, S. M. Om, V, V. Babyuk","doi":"10.30629/0023-2149-2024-102-2-101-108","DOIUrl":"https://doi.org/10.30629/0023-2149-2024-102-2-101-108","url":null,"abstract":" Modern medicine has a high demand for new drugs for the prevention and treatment of cytomegalovirus (CMV) infection. This review discusses maribavir — an oral antiviral drug with selective multimodal anti-CMV activity for the treatment of adults and children with post-transplant CMV infection resistant to traditional anti-CMV therapy. Despite numerous clinical trials of maribavir, the results of its effi cacy are ambiguous. Alongside successful studies indicating high effi cacy of the drug under review, there are data from statistically unsuccessful studies. The aim of this review is to examine the mechanism of its action on cytomegalovirus infection, viral sensitivity and cross-resistance mechanisms, as well as to summarize the results of clinical trials of the drug.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"49 S246","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141003409","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 : 2024-04-15DOI: 10.30629/0023-2149-2024-102-1-48-56
R. R. Karimov, E. Y. Salakheeva, D. A. Budanova, O. N. Antyufeeva, O. V. Bochkarnikova, E. Privalova, Y. Belenkov, I. Ilgisonis
Research objective. To evaluate the levels of CRP, cardio-specific markers, lipids, structural-functional (SF) state of vessels, and their interrelations in patients with lymphoproliterative diseases (LPD) before polychemotherapy (PCT).Materials and methods. The study included patients with newly diagnosed LPD (n = 30), including 16 men (53.3%) and 14 women (46.7%). All patients were divided into two groups: group 1 (n = 15) — patients with low/intermediate cardiovascular toxicity (CVT) risk; group 2 (n = 15) — patients with high/very high CVT risk. CVT risk stratification was performed with the use of specialized scales according to the current European clinical guidelines for cardio-oncology 2022. All patients included in the study underwent standard laboratory and instrumental examinations. Specific laboratory research involved assessing the levels of C-reactive protein (CRP), troponin I (TnI), N-terminal pro-brain natriuretic peptide (NT-proBNP), and lipid profile. The SF state of vessels was evaluated non-invasively using photoplethysmography (PPG) (Angioscan-01 device, Russia) and computerized videocapillaroscopy (CVC) of the periungual area (Capillaroscan-01 device, Russia).Results. According to the results of PPG and CVC, the occlusion index (OI) in group 2 was significantly lower and amounted to 1.2 [1; 1.3] compared to 1.7 [1.45; 2.1] in group 1 (p < 0.001); capillary density after reactive hyperemia (CDRH) was also significantly lower in group 2 compared to group 1 — 43 [35.5; 45] and 54 [43; 58] cap/mm², respectively (p = 0.033). According to the obtained results, there were no statistically significant diff erences in the levels of CRP, TnI, and NT-proBNP between patients in both groups; the indicators were within the reference values. A moderate inverse statistically signifi cant correlation was found between the level of CRP and the percentage of perfused capillaries (PPC) (rs = –0.545; p = 0.02) and the percentage of capillary recovery (PCR) (r = –0.446; p = 0.013).Conclusion. Patients with LPD have endothelial dysfunction before PCT, primarily due to the presence of cardiovascular risk factors (age, body mass index), and concomitant cardiovascular diseases. At the same time, the SF state of vessels initially does not depend on the stage and course of LPD, lipid levels, and TnI.
{"title":"Study of the initial vasculotoxic risk in patients with lymphoproliferative diseases before the start of polychemotherapy","authors":"R. R. Karimov, E. Y. Salakheeva, D. A. Budanova, O. N. Antyufeeva, O. V. Bochkarnikova, E. Privalova, Y. Belenkov, I. Ilgisonis","doi":"10.30629/0023-2149-2024-102-1-48-56","DOIUrl":"https://doi.org/10.30629/0023-2149-2024-102-1-48-56","url":null,"abstract":"Research objective. To evaluate the levels of CRP, cardio-specific markers, lipids, structural-functional (SF) state of vessels, and their interrelations in patients with lymphoproliterative diseases (LPD) before polychemotherapy (PCT).Materials and methods. The study included patients with newly diagnosed LPD (n = 30), including 16 men (53.3%) and 14 women (46.7%). All patients were divided into two groups: group 1 (n = 15) — patients with low/intermediate cardiovascular toxicity (CVT) risk; group 2 (n = 15) — patients with high/very high CVT risk. CVT risk stratification was performed with the use of specialized scales according to the current European clinical guidelines for cardio-oncology 2022. All patients included in the study underwent standard laboratory and instrumental examinations. Specific laboratory research involved assessing the levels of C-reactive protein (CRP), troponin I (TnI), N-terminal pro-brain natriuretic peptide (NT-proBNP), and lipid profile. The SF state of vessels was evaluated non-invasively using photoplethysmography (PPG) (Angioscan-01 device, Russia) and computerized videocapillaroscopy (CVC) of the periungual area (Capillaroscan-01 device, Russia).Results. According to the results of PPG and CVC, the occlusion index (OI) in group 2 was significantly lower and amounted to 1.2 [1; 1.3] compared to 1.7 [1.45; 2.1] in group 1 (p < 0.001); capillary density after reactive hyperemia (CDRH) was also significantly lower in group 2 compared to group 1 — 43 [35.5; 45] and 54 [43; 58] cap/mm², respectively (p = 0.033). According to the obtained results, there were no statistically significant diff erences in the levels of CRP, TnI, and NT-proBNP between patients in both groups; the indicators were within the reference values. A moderate inverse statistically signifi cant correlation was found between the level of CRP and the percentage of perfused capillaries (PPC) (rs = –0.545; p = 0.02) and the percentage of capillary recovery (PCR) (r = –0.446; p = 0.013).Conclusion. Patients with LPD have endothelial dysfunction before PCT, primarily due to the presence of cardiovascular risk factors (age, body mass index), and concomitant cardiovascular diseases. At the same time, the SF state of vessels initially does not depend on the stage and course of LPD, lipid levels, and TnI.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"329 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140703693","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 : 2024-04-15DOI: 10.30629/0023-2149-2024-102-1-69-79
Y. Lutokhina, O. V. Blagova, D. Ainetdinova, N. Sarkisova, E. A. Kogan, V. Rameev
{"title":"AL-amyloidosis after coronavirus infection with acute atypical heart injury","authors":"Y. Lutokhina, O. V. Blagova, D. Ainetdinova, N. Sarkisova, E. A. Kogan, V. Rameev","doi":"10.30629/0023-2149-2024-102-1-69-79","DOIUrl":"https://doi.org/10.30629/0023-2149-2024-102-1-69-79","url":null,"abstract":"","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"2 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140702587","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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