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Biological bases of survival in blocked Leningrad (to the 80th anniversary of the liberation of Leningrad from the nazi blockade) 被封锁的列宁格勒的生物生存基础(纪念列宁格勒摆脱纳粹封锁 80 周年)
Pub Date : 2024-04-12 DOI: 10.30629/0023-2149-2024-102-1-5-11
V. B. Simonenkо
Prerequisites for the survival of residents of besieged Leningrad: genetically determined human resilience, physiological psycho-emotional stress, nonspecifi c stress adaptation. A description of the trophological and energy status of the body is given in conditions of a significant decrease in the functions of all organs and systems due to atrophy of internal organs during starvation under blockade conditions. 
被围困列宁格勒居民生存的先决条件:由基因决定的人类复原力、生理心理情感压力、非特异性压力适应。在封锁条件下,由于饥饿导致内脏器官萎缩,所有器官和系统的功能都显著下降。
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引用次数: 0
The possibilities of cytoreductive operations in recurrent abdominal pain syndrome in cancer patients, occurring under the mask of acute pancreatitis 在急性胰腺炎掩盖下,对癌症患者复发性腹痛综合征进行细胞剥脱手术的可能性
Pub Date : 2024-02-22 DOI: 10.30629/0023-2149-2023-101-12-657-661
А. А. Baulin, L. A. Averyanova, V. A. Baulin, O. Baulina
Among the diseases of urgent pathology, the leading place belongs to acute pancreatitis, which is inferior to such nosologies as acute appendicitis and acute cholecystitis. Moreover, the lion’s share is occupied by light forms, which make up 85%. The aim of the work is to demonstrate a clinical case of recurrent abdominal syndrome occurring under the mask of acute pancreatitis in a patient with oncopathology identified using a diagnostic algorithm used in outpatient practice. Material and methods. Patient F., 60 years old, repeatedly sought medical help in a network of polyclinics and hospitals providing emergency specialized medical care with recurrent abdominal syndrome. Results and discussion. Against the background of conservative treatment, the patient had a short-term positive dynamics characteristic of a mild form of acute pancreatitis. After taking the patient to the dispensary and conducting an in-depth diagnostic examination according to the algorithm developed by our group of researchers, cancer of the stomach stump T2N0M0 was detected. Conclusion. Patients with recurrent abdominal pain syndrome need dispensary observation on an outpatient basis to identify other pathology occurring under the guise of acute pancreatitis and to conduct adequate treatment.
在紧急病理疾病中,急性胰腺炎居首位,比急性阑尾炎和急性胆囊炎等病名逊色。此外,轻型胰腺炎占了绝大部分,达 85%。本文旨在展示一例在急性胰腺炎掩盖下发生的复发性腹部综合征的临床病例,该病例是通过门诊实践中使用的诊断算法确定的肿瘤病理患者。材料和方法患者 F.,60 岁,因反复腹部综合征多次到提供急诊专科医疗服务的综合诊所和医院网络求医。结果与讨论。在保守治疗的背景下,患者出现了轻度急性胰腺炎的短期阳性反应。在将患者送往医务室并根据我们研究小组制定的算法进行深入诊断检查后,发现胃残端癌 T2N0M0。结论复发性腹痛综合征患者需要在门诊进行观察,以确定在急性胰腺炎伪装下发生的其他病变,并进行适当治疗。
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引用次数: 0
Morphometric variants of remodeling and diastolic function of the left ventricle in late postmenopausal patients with vitamin D deficiency 维生素 D 缺乏症绝经后晚期患者左心室重塑和舒张功能的形态学变异
Pub Date : 2024-02-22 DOI: 10.30629/0023-2149-2023-101-12-623-629
M. Shambatov, N. V. Izmozherova, A. A. Popov, I. Grishina, A. A. Vikhareva, A. V. Ryabinina
Aim. To reveal the features of the structural-geometric remodeling of the left chambers of the heart, the diastolic function of the left ventricle and to assess the presence of calcification of the valvular structures of the heart in late postmenopausal women with different levels of vitamin D. Material and methods. The cross-sectional study included 123 postmenopausal women. A standard transthoracic echocardiography was performed with an assessment of morphometric variants of remodeling of the left chambers of the heart and its diastolic function according to the transmitral flow. The significance of differences was assessed using the Mann–Whitney test, χ2 Pearson. Differences and correlations were considered significant at p < 0.05. Results. The median concentration of 25(OH)D in the sample was 20.51 ng/ml (15.8÷26.73). Adequate serum concentration of 25(OH)D was observed in 23 (19%) patients (group 1), in 100 (81%) cases vitamin D deficiency was detected (group 2). In group 1 — 7 (31%) patients had normal geometry (NG) of the left ventricle (LV), LV concentric remodeling (CR) was diagnosed in 1 (4%) case, LV concentric hypertrophy (CH) was diagnosed in 3 (13%) cases, and LV eccentric hypertrophy (EH) was detected in 12 (52%) cases. In Group 2, LV NG was diagnosed in 27 (27%) cases, LV CR was detected in 8 (8%) cases, LV CH was detected in 31 (31%) cases, and LV EH was verified in 34 (34%) cases, the differences are insignificant (p = 0.24). Patients of group 2 showed a statistically significant increase in the volume of the right atrium (RA) and thickness of the posterior wall of the left ventricle (TZSLV). In group 1, in 11 (50%) cases, rigid-type diastolic dysfunction (DD) was detected, and in 11 (50%) cases, a pseudo-normal type of DD was detected. In group 2, pseudonormal myocardial DD was detected in 26 (26%) patients, 74 (74%) patients had rigid-type DD, differences between groups were significant (p < 0.001). Calcifications were found in the annulus fibrosus in 16 (70%) cases in group 1 and in 88 (88%) patients in group 2, the differences were significant (p = 0.04). Conclusion. In the study, data were obtained indicating a significant contribution of vitamin D deficiency to changes in the geometry of the left chambers of the heart, diastolic function of the left ventricle, and calcification of valvular structures.
目的揭示不同维生素 D 水平的绝经后晚期妇女的心脏左腔结构几何重塑特征、左心室舒张功能,并评估心脏瓣膜结构是否存在钙化。这项横断面研究包括 123 名绝经后妇女。进行了标准的经胸超声心动图检查,并根据透射流量评估了心脏左腔重塑的形态变异及其舒张功能。采用 Mann-Whitney 检验和 χ2 Pearson 检验评估差异的显著性。P<0.05为差异和相关性显著。结果样本中 25(OH)D 的中位浓度为 20.51 纳克/毫升(15.8÷26.73)。在 23 名(19%)患者(第 1 组)中观察到 25(OH)D 血清浓度充足,在 100 名(81%)患者(第 2 组)中检测到维生素 D 缺乏。在第 1 组中,7 例(31%)患者的左心室几何形状正常(NG),1 例(4%)患者被诊断出左心室同心重塑(CR),3 例(13%)患者被诊断出左心室同心肥厚(CH),12 例(52%)患者被检测出左心室偏心肥厚(EH)。在第 2 组中,27 例(27%)确诊为左心室 NG,8 例(8%)检测到左心室 CR,31 例(31%)检测到左心室 CH,34 例(34%)验证了左心室 EH,差异不显著(P = 0.24)。第 2 组患者的右心房容积(RA)和左心室后壁厚度(TZSLV)均有统计学意义的显著增加。在第 1 组中,11 例(50%)患者发现了僵硬型舒张功能障碍(DD),11 例(50%)患者发现了假性正常型舒张功能障碍。在第二组中,26 例(26%)患者发现假性正常心肌舒张功能障碍,74 例(74%)患者为僵硬型舒张功能障碍,组间差异显著(P < 0.001)。第一组 16 例(70%)和第二组 88 例(88%)患者的纤维环中发现钙化,差异有显著性(P = 0.04)。结论本研究获得的数据表明,维生素 D 缺乏对心脏左腔几何形状、左心室舒张功能和瓣膜结构钙化的变化有显著影响。
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引用次数: 0
Vladimir Ivanovich Steklov (on his 60th birthday) 弗拉基米尔-伊万诺维奇-斯特克洛夫(60 岁生日)
Pub Date : 2024-02-22 DOI: 10.30629/0023-2149-2023-101-12-682-682
A. Editorial
.
.
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引用次数: 0
Structure of cardiac rhythm disorders in patients with obesity and associated with it dyslipidemia as an arrhythmogenic factor 肥胖症患者心律失常的结构以及与之相关的作为心律失常诱因的血脂异常
Pub Date : 2024-02-22 DOI: 10.30629/0023-2149-2023-101-12-630-636
E. I. Panova, E. P. Morozova
Obesity is a global public health problem in the twenty-first century. The most adverse it’s effects are associated with visceral type, with accumulation of epicardial fat, showing high metabolic activity, dysfunction and important role in the development of lipotoxic cardiomyopathy linked with significant morphological and functional myocardial changes, accompanying by high risk of heart rhythm disorders. The aim of the study: to identify structure (frequency and character) of cardiac arrhythmias in men of employable age with visceral obesity, to establish the relationship of arrhythmias with features of the blood lipid spectrum of these patients. Material and methods. 98 men with abdominal obesity and 46 overweight patients were examined. The control group consisted of 40 healthy patients with normal body weight. All the patients were undergone ECG monitoring, echocardiography and analysis of serum lipid levels. Results. The presence of obesity is statistically significantly associated with the risk of supraventricular couplets, frequent ventricular extrasystoles, sinus arrhythmia and atrial fibrillation. The increase in the severity of obesity was accompanied by a tendency to a greater frequency of arrhythmias: in obesity of I degree, the frequency of atrial fibrillation was 12.3%, II–III degree — 21.2%, p = 0.25; frequent ventricular extrasystoles with similar degrees of obesity — 13.8% and 21.1%, respectively. Atrial fibrillation was significantly more often detected against the background of lipid disorders, mainly with a decrease in HDLP. Conclusion. The main type of heart rhythm disturbance in patients with obesity are supraventricular arrhythmias, mainly atrial fibrillation, the frequency of which increases in proportion to the increase in the patient's body weight. Abdominal obesity leads to an increase in ventricular ectopic activity. Dyslipidemia is the one of risk factors for arrhythmias in these patients.
肥胖症是二十一世纪的一个全球性公共卫生问题。肥胖症最不利的影响与内脏型肥胖有关,心外膜脂肪堆积,表现出高代谢活性、功能障碍,并在脂肪毒性心肌病的发展中起重要作用,与心肌形态和功能的显著变化有关,同时伴有心律失常的高风险。研究目的:确定内脏肥胖的适龄男性心律失常的结构(频率和特征),确定心律失常与这些患者血脂谱特征的关系。材料和方法研究对象包括 98 名腹部肥胖男性和 46 名超重患者。对照组由 40 名体重正常的健康患者组成。所有患者均接受了心电图监测、超声心动图检查和血清脂质水平分析。结果显示据统计,肥胖与室上性偶联症、频发室性期外收缩、窦性心律失常和心房颤动的风险明显相关。肥胖程度越严重,心律失常的发生率越高:Ⅰ度肥胖的心房颤动发生率为 12.3%,Ⅱ-Ⅲ度肥胖的心房颤动发生率为 21.2%,P = 0.25;类似肥胖程度的频发室性期外收缩发生率分别为 13.8%和 21.1%。在血脂紊乱的背景下,心房颤动的检出率明显更高,这主要与 HDLP 的下降有关。结论肥胖症患者心律紊乱的主要类型是室上性心律失常,主要是心房颤动,其发生频率与患者体重的增加成正比。腹部肥胖会导致心室异位活动增加。血脂异常是这些患者发生心律失常的危险因素之一。
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引用次数: 0
Treatment of heart rhythm disturbances associated with SARS-CoV-2 infection with anti-inflammatory drugs 用消炎药治疗与 SARS-CoV-2 感染有关的心律紊乱
Pub Date : 2024-02-22 DOI: 10.30629/0023-2149-2023-101-12-665-674
Z. Sukmarova, E. Zotkin
Publications regarding cardiac arrhythmias associated with the new coronavirus infection (COVID-19) focus primarily on the high prevalence and symptoms of this complication. We have not found any studies on the specific treatment of arrhythmias associated with SARS-CoV2, since a standard therapeutic approach is probably implied. This observation describes a series of cases of various cardiac arrhythmias that occurred against the background of acute COVID-19 and were treated with anti-inflammatory, but not antiarrhythmic drugs. The cases are united by the occurrence of acute SARS-CoV-2 infection, the connection of relapses with inflammation symptoms, as well as the effectiveness of therapy with the main classes of anti-inflammatory drugs. A narrative review of the literature provides the rationale for the inflammatory theory of arrhythmias and sets the stage for discussion about how to integrate differentially anti-inflammatory drugs into the treatment regimen of such patients.
有关与新型冠状病毒感染(COVID-19)相关的心律失常的文献主要集中在这种并发症的高发病率和症状上。我们没有发现任何关于治疗与 SARS-CoV2 相关的心律失常的具体研究,因为这可能意味着一种标准的治疗方法。本文描述了一系列在急性 COVID-19 背景下出现的各种心律失常病例,这些病例接受了抗炎治疗,但没有接受抗心律失常药物治疗。这些病例的共同点是发生急性 SARS-CoV-2 感染,复发与炎症症状有关,以及主要抗炎药物的治疗效果。文献综述为心律失常的炎症理论提供了依据,并为讨论如何将不同的抗炎药物纳入此类患者的治疗方案奠定了基础。
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引用次数: 0
Russian officers and military doctors in the Paraguayan Army 巴拉圭军队中的俄罗斯军官和军医
Pub Date : 2024-02-22 DOI: 10.30629/0023-2149-2023-101-12-675-678
P. E. Krynyukov, V. G. Abashin
The information about the participation of Russian officers and military doctors in the Chaka War of 1932–1935 between Paraguay and Bolivia is presented. The biographical information of military doctors who emigrated from Russia after the Civil War is given. Their merit was the creation of the medical service of the army, which ensured the victory of Paraguay in the war.
介绍了俄罗斯军官和军医参加 1932-1935 年巴拉圭和玻利维亚之间恰卡战争的情况。介绍了内战后从俄罗斯移居国外的军医的履历。他们的功绩是创建了军队医疗服务机构,确保了巴拉圭在战争中的胜利。
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引用次数: 0
Current aspects of the pathogenesis and prevention of preeclampsia 子痫前期的发病机制和预防现状
Pub Date : 2024-02-22 DOI: 10.30629/0023-2149-2023-101-12-651-656
Yu. V. Shkurenko, A. D. Ibatov, S. Y. Trofimova
One of the most dangerous complications of pregnancy is preeclampsia. For effective prevention of preeclampsia, it is necessary to understand its mechanisms of development clearly. The analysis of modern patterns of preeclampsia cause and development are reviewed in this article. There are also the evidences of more effective strategies of prevention preeclampsia in our review, which have proven themselves most of all. The generalized endothelial mother’s disfunction is in the base of preeclampsia pathogenesis and caused by placental factors, genetical susceptibility and the lack of arterial invasion in trophoblast’s cell hereupon it increases the oxidative stress and inflammatory process, leading to complications of mother and fetus. More accurate understanding of preeclampsia mechanisms allows us to correct the adverse of lifestyle of patients and highlight those who are in the group of PE risk and need the prophylaxis to be prescribed. Nowadays, acetylsalicylic acid is a commonly accepted therapeutic medication and reliably effective (optimal dose from 75 to 162 mg). It is prescribed as the prevention from 11th to 14th week.
子痫前期是最危险的妊娠并发症之一。为了有效预防子痫前期,有必要清楚地了解其发病机制。本文对子痫前期病因和发展的现代模式进行了分析。在我们的综述中,还有更有效的子痫前期预防策略的证据,这些策略已被证明是最有效的。胎盘因素、遗传易感性和滋养层细胞缺乏动脉侵袭是子痫前期发病机制的基础,母亲内皮功能的普遍失调会增加氧化应激和炎症过程,从而导致母亲和胎儿的并发症。更准确地了解子痫前期的发病机制,可以帮助我们纠正患者的不良生活方式,突出那些属于子痫前期高危人群、需要进行预防性治疗的患者。如今,乙酰水杨酸是一种普遍接受的治疗药物,而且疗效可靠(最佳剂量为 75 至 162 毫克)。在第 11 到 14 周期间,该药物可作为预防用药。
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引用次数: 0
On the impact of the COVID-19 pandemic on the incidence of community-acquired pneumonia on the example of the region of the European North of Russia 以俄罗斯欧洲北部地区为例,论 COVID-19 大流行对社区获得性肺炎发病率的影响
Pub Date : 2024-02-22 DOI: 10.30629/0023-2149-2023-101-12-643-650
T. A. Karapetyan, N. V. Dorshakova, I. V. Peshkova
Rationale. During the COVID-19 pandemic, there was a sharp increase in the incidence of community-acquired pneumonia (CAP) in Russia and the Republic of Karelia (RK). Given the high significance of the problem, it is necessary to clarify the causes of the current epidemiological situation. The purpose of the work: to assess the incidence of CAP, not associated with COVID-19, in the adult population of the Republic of Karelia aged 18 years older in 2011–2019 in the administrative-territorial divisions of the republic, a comparison of its existing and projected levels in 2020–2021. Material and method. A retrospective observational epidemiological study was conducted based on the analysis of statistical data of the Republican Medical Information and Analytical Center of the Ministry of Health of the RK on the incidence of CAP, not associated with COVID-19, in the population aged 18 years and older in 2011–2021. Relative values, indicators of the dynamic series are used. To differentiate the administrative-territorial divisions of the RK by incidence in 2011–2019 the method of k-means cluster analysis was applied. To build a forecast for the incidence of CAP, not associated with COVID-19, for 2020–2021 used additive regression model for time series. Results. Among the districts, 3 clusters were identified for the incidence of non-coronavirus CAP in 2011–2019 with the worst epidemiological situation in Olonetsky. The actual incidence exceeded the predicted one in 2020 in 11 and in 2021 in 9 territories of the region, which confirms the impact of the pandemic on the incidence. Conclusion. There are territories in the republic with a “traditionally” high incidence of CAP, and the COVID-19 pandemic has made a significant contribution to its increase.
理由在 COVID-19 大流行期间,俄罗斯和卡累利阿共和国(RK)的社区获得性肺炎(CAP)发病率急剧上升。鉴于这一问题的严重性,有必要澄清造成当前流行病状况的原因。这项工作的目的是:评估 2011-2019 年卡累利阿共和国各行政区 18 岁以上成年人口中与 COVID-19 无关的 CAP 发病率,并对其现有水平和 2020-2021 年的预测水平进行比较。材料和方法。在分析卡累利阿共和国卫生部共和国医疗信息与分析中心统计数据的基础上,对 2011-2021 年卡累利阿共和国 18 岁及以上人口中与 COVID-19 无关的 CAP 发病率进行了回顾性流行病学观察研究。使用的是动态系列指标的相对值。为了根据 2011-2019 年的发病率对克罗埃西亚行政区划进行区分,采用了 k-means 聚类分析方法。为预测 2020-2021 年与 COVID-19 无关的 CAP 发病率,使用了时间序列加法回归模型。结果。在各地区中,确定了 2011-2019 年非冠状病毒 CAP 发病率的 3 个聚类,其中流行病情况最严重的是奥洛涅茨基。2020 年该地区有 11 个地区的实际发病率超过了预测值,2021 年有 9 个地区的实际发病率超过了预测值,这证实了大流行病对发病率的影响。结论共和国有些地区 "传统上 "CAP发病率较高,COVID-19大流行病对其发病率的上升起到了重要作用。
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引用次数: 0
A case of death in a patient with Marfan syndrome after re-infection with SARS-CoV-2 一例马凡氏综合征患者再次感染 SARS-CoV-2 后死亡的病例
Pub Date : 2024-02-22 DOI: 10.30629/0023-2149-2023-101-12-662-664
O. V. Alpidovskaya
The COVID-19 pandemic caused by the SARS-CoV-2 coronavirus has shown a wide range of manifestations, including cardiovascular. A clinical description of left ventricular aneurysm rupture in a 33-year-old patient after infection with SARS-CoV-2 is presented.
由 SARS-CoV-2 冠状病毒引起的 COVID-19 大流行显示出包括心血管在内的多种表现。本文介绍了一名 33 岁患者感染 SARS-CoV-2 后左心室动脉瘤破裂的临床描述。
{"title":"A case of death in a patient with Marfan syndrome after re-infection with SARS-CoV-2","authors":"O. V. Alpidovskaya","doi":"10.30629/0023-2149-2023-101-12-662-664","DOIUrl":"https://doi.org/10.30629/0023-2149-2023-101-12-662-664","url":null,"abstract":"The COVID-19 pandemic caused by the SARS-CoV-2 coronavirus has shown a wide range of manifestations, including cardiovascular. A clinical description of left ventricular aneurysm rupture in a 33-year-old patient after infection with SARS-CoV-2 is presented.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"34 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140440402","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}
引用次数: 0
期刊
Clinical Medicine (Russian Journal)
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