Pub Date : 2023-12-13DOI: 10.30629/0023-2149-2023-101-11-590-596
I. A. Merkushev, V. G. Abashin
This article presents new information about Petr Frantsevich Lesgaft, a scientist, anatomist, and physician who founded the development of functional anatomy and a scientifi cally based system of physical education in our country.
{"title":"P.F. Lesgaft as the founder of the development of functional anatomy","authors":"I. A. Merkushev, V. G. Abashin","doi":"10.30629/0023-2149-2023-101-11-590-596","DOIUrl":"https://doi.org/10.30629/0023-2149-2023-101-11-590-596","url":null,"abstract":"This article presents new information about Petr Frantsevich Lesgaft, a scientist, anatomist, and physician who founded the development of functional anatomy and a scientifi cally based system of physical education in our country. ","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"226 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139006122","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 : 2023-12-13DOI: 10.30629/0023-2149-2023-101-11-549-555
S. O. Lependin, M. B. Patsenko, S. E. Surigina, N. V. Morozova, V. Steklov
Due to the wide spread in the population and high risk of complications, atrial fibrillation is an important nosology, and doctors of both outpatient and hospital departments should be prepared for its early detection and diagnosis. The absence of specific symptoms and clear causes of onset, as well as the many associated clinical conditions, mean that knowledge of atrial fibrillation, especially its debut — the first diagnosed atrial fibrillation — is particularly necessary for general practitioners. This article analyzes literature on first diagnosed atrial fibrillation, focusing on the peculiarities of the disease’s course, diagnosis, choice of tactics, and treatment. The article introduces readers to information from modern publicly available publications on this topic, providing an overview of the key stages in the historical development of medicine in this area. Based on literary sources, existing problems of underestimating the danger of the disease, lack of unified approaches to patient management, and key definitions and concepts are revealed today.
{"title":"Features of diagnosis and treatment of newly diagnosed atrial fibrillation","authors":"S. O. Lependin, M. B. Patsenko, S. E. Surigina, N. V. Morozova, V. Steklov","doi":"10.30629/0023-2149-2023-101-11-549-555","DOIUrl":"https://doi.org/10.30629/0023-2149-2023-101-11-549-555","url":null,"abstract":"Due to the wide spread in the population and high risk of complications, atrial fibrillation is an important nosology, and doctors of both outpatient and hospital departments should be prepared for its early detection and diagnosis. The absence of specific symptoms and clear causes of onset, as well as the many associated clinical conditions, mean that knowledge of atrial fibrillation, especially its debut — the first diagnosed atrial fibrillation — is particularly necessary for general practitioners. This article analyzes literature on first diagnosed atrial fibrillation, focusing on the peculiarities of the disease’s course, diagnosis, choice of tactics, and treatment. The article introduces readers to information from modern publicly available publications on this topic, providing an overview of the key stages in the historical development of medicine in this area. Based on literary sources, existing problems of underestimating the danger of the disease, lack of unified approaches to patient management, and key definitions and concepts are revealed today.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"55 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139003700","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 : 2023-12-13DOI: 10.30629/0023-2149-2023-101-11-538-548
E. A. Zakharyan, E. V. Cherniy
According to a significant amount of scientific research, it is known that the deterioration of public health and the tendency towards certain types of disease cannot be explained only by conventional factors. It has been proven that a patient’s attitude towards their disease determines their response to the pathology and their adaptation to their new condition. The aim of this work is to analyze research, views, and beliefs of doctors and psychologists on the influence of a patient’s perception of their own illness and their attitude towards it on the course of the disease. This review presents an analysis of numerous scientific works aimed at identifying types of attitudes towards disease that are characteristic of various nosological forms, both mental and somatic. As a result of the literature analysis, a set of conditions and factors that determine the nature and intensity of the influence of attitudes towards disease on its course and outcome were identified. These include the volume and nature of information about a specific disease, which is understood by the patient according to their intellectual and psychological readiness to perceive and interpret it; the way in which a doctor provides information about the course of the disease, possible outcomes, and planned treatment methods; age and gender; the nature and severity of the disease itself, as well as the mental health of patients.
{"title":"Patient attitude towards disease as a predictor of its course and outcome","authors":"E. A. Zakharyan, E. V. Cherniy","doi":"10.30629/0023-2149-2023-101-11-538-548","DOIUrl":"https://doi.org/10.30629/0023-2149-2023-101-11-538-548","url":null,"abstract":"According to a significant amount of scientific research, it is known that the deterioration of public health and the tendency towards certain types of disease cannot be explained only by conventional factors. It has been proven that a patient’s attitude towards their disease determines their response to the pathology and their adaptation to their new condition. The aim of this work is to analyze research, views, and beliefs of doctors and psychologists on the influence of a patient’s perception of their own illness and their attitude towards it on the course of the disease. This review presents an analysis of numerous scientific works aimed at identifying types of attitudes towards disease that are characteristic of various nosological forms, both mental and somatic. As a result of the literature analysis, a set of conditions and factors that determine the nature and intensity of the influence of attitudes towards disease on its course and outcome were identified. These include the volume and nature of information about a specific disease, which is understood by the patient according to their intellectual and psychological readiness to perceive and interpret it; the way in which a doctor provides information about the course of the disease, possible outcomes, and planned treatment methods; age and gender; the nature and severity of the disease itself, as well as the mental health of patients.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"15 S1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139004908","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 : 2023-12-13DOI: 10.30629/0023-2149-2023-101-11-566-568
G. R. Urunova
The study of the influence of inhalation psychoactive substances (PAS) on the respiratory system is an important issue, given the speed and trend of the spread of various inhalation devices. Hookah is a device for smoking tobacco, the essence of which is the passage of tobacco smoke through a container with water or other liquids (milk, alcohol). The study was conducted among students of the Northern (Arctic) Federal University named after M.V. Lomonosov (SAFU), and the population permanently residing in the city of Arkhangelsk. The study was conducted from 2020 to 2022. The aim of this article is to compare the indicators of external respiration in individuals using PAS in different ways. Material and methods. External respiration was assessed by spirometry. Spirometry is a fairly simple, non-invasive and informative method for measuring airflows and volumes. The article presents an analysis of spirometry data from 155 people. Group I included individuals not using tobacco products, Group II included cigarette smokers only, and Group III included individuals using tobacco with a hookah. Results. Volume indicators (FVC, FEV1) in Group I were significantly higher than in representatives of Groups II and III (p > 0.01); Also, in Group I, speed indicators were significantly higher. A significant decrease in the FEV indicator was found in Group III compared to Group II (p > 0.01). Also, members of Groups II and III had a significant decrease in speed indicators compared to Group I.
{"title":"Features of external respiration in individuals using various methods of psychoactive substance consumption","authors":"G. R. Urunova","doi":"10.30629/0023-2149-2023-101-11-566-568","DOIUrl":"https://doi.org/10.30629/0023-2149-2023-101-11-566-568","url":null,"abstract":"The study of the influence of inhalation psychoactive substances (PAS) on the respiratory system is an important issue, given the speed and trend of the spread of various inhalation devices. Hookah is a device for smoking tobacco, the essence of which is the passage of tobacco smoke through a container with water or other liquids (milk, alcohol). The study was conducted among students of the Northern (Arctic) Federal University named after M.V. Lomonosov (SAFU), and the population permanently residing in the city of Arkhangelsk. The study was conducted from 2020 to 2022. The aim of this article is to compare the indicators of external respiration in individuals using PAS in different ways. Material and methods. External respiration was assessed by spirometry. Spirometry is a fairly simple, non-invasive and informative method for measuring airflows and volumes. The article presents an analysis of spirometry data from 155 people. Group I included individuals not using tobacco products, Group II included cigarette smokers only, and Group III included individuals using tobacco with a hookah. Results. Volume indicators (FVC, FEV1) in Group I were significantly higher than in representatives of Groups II and III (p > 0.01); Also, in Group I, speed indicators were significantly higher. A significant decrease in the FEV indicator was found in Group III compared to Group II (p > 0.01). Also, members of Groups II and III had a significant decrease in speed indicators compared to Group I.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"251 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139005931","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 : 2023-12-12DOI: 10.30629/0023-2149-2023-101-11-521-524
I. N. Bokarev, A. P. Melnikov, S. I. Burykh
Thrombin activatable fi brinolysis inhibitor (TAFI) is one of the key proteins of fi brinolysis and infl ammation systems. Based on literature data, information is presented on the biological eff ects of TAFI, the mechanisms of its activation, gene polymorphism that determines the duration of its action and activity. Nosological forms are listed, where TAFI is important in the pathogenesis of the development of diseases, its role in experimental and laboratory studies, and the possibility of pharmacological infl uence on the activity of this protein.
{"title":"TAFI phenomenon and its clinical significance","authors":"I. N. Bokarev, A. P. Melnikov, S. I. Burykh","doi":"10.30629/0023-2149-2023-101-11-521-524","DOIUrl":"https://doi.org/10.30629/0023-2149-2023-101-11-521-524","url":null,"abstract":"Thrombin activatable fi brinolysis inhibitor (TAFI) is one of the key proteins of fi brinolysis and infl ammation systems. Based on literature data, information is presented on the biological eff ects of TAFI, the mechanisms of its activation, gene polymorphism that determines the duration of its action and activity. Nosological forms are listed, where TAFI is important in the pathogenesis of the development of diseases, its role in experimental and laboratory studies, and the possibility of pharmacological infl uence on the activity of this protein.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"46 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139007037","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 : 2023-12-12DOI: 10.30629/0023-2149-2023-101-11-525-530
M. S. Annayev, K. Stegniy, B. Geltser, R. Goncharuk, A. M. Morozova, E. V. Maslyantsev
Primary hyperaldosteronism (PHA) is the most common cause of secondary arterial hypertension among endocrine disorders. Given that patients with this pathology are at a higher risk of developing fatal and non-fatal cardiovascular events, early diagnosis and timely treatment are of great importance. Currently, the two main forms of PHA are aldosterone-producing adenoma and bilateral adrenal hyperplasia, which are treated with laparoscopic adrenalectomy or pharmacotherapy with mineralocorticoid receptor antagonists. Although most patients experience restoration of their functional and metabolic status after surgical intervention, some may develop postoperative adrenal insuffi ciency, which requires long-term hormone replacement therapy. This review examines the options for organ-preserving surgeries, such as partial adrenalectomy and selective embolization of the adrenal artery.
{"title":"Primary hyperaldosteronism: the choice in favor of conservative surgery","authors":"M. S. Annayev, K. Stegniy, B. Geltser, R. Goncharuk, A. M. Morozova, E. V. Maslyantsev","doi":"10.30629/0023-2149-2023-101-11-525-530","DOIUrl":"https://doi.org/10.30629/0023-2149-2023-101-11-525-530","url":null,"abstract":"Primary hyperaldosteronism (PHA) is the most common cause of secondary arterial hypertension among endocrine disorders. Given that patients with this pathology are at a higher risk of developing fatal and non-fatal cardiovascular events, early diagnosis and timely treatment are of great importance. Currently, the two main forms of PHA are aldosterone-producing adenoma and bilateral adrenal hyperplasia, which are treated with laparoscopic adrenalectomy or pharmacotherapy with mineralocorticoid receptor antagonists. Although most patients experience restoration of their functional and metabolic status after surgical intervention, some may develop postoperative adrenal insuffi ciency, which requires long-term hormone replacement therapy. This review examines the options for organ-preserving surgeries, such as partial adrenalectomy and selective embolization of the adrenal artery.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139010192","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 : 2023-07-21DOI: 10.30629/0023-2149-2023-101-6-308-314
N. Stuklov, M. S. Kovalchuk, A. Gurkina, N. D. Kislyу
The high prevalence of iron deficiency (ID) in women and its important negative impact on the health care system is beyond doubt. The presence of severe problems of a systemic nature requires the development of special state programs to combat ID. The development of such programs is impossible without conducting epidemiological studies in each specific country. The purpose of this work is to determine the frequency and severity of ID in terms of serum ferritin (SF) in primary outpatients, depending on gender and age. The study was conducted in 15 large cities of Russia, in total, 1737 primary patients were included, of which 97 were males and 1640 were females. When studying the parameters of SF in general groups, its values are significantly lower in females, and average 40 ± 99 μg/l, while 61% of this cohort of patients have SF less than 30 μg/l, and 70% live in conditions of SF below target values, which requires the development of preventive programs to combat ID among female patients. Between the ages of 16 and 49, almost all females live in conditions of absolute ID, and it is probably in this group that the above activities should be carried out. On the contrary, as regards male patients, judging by the data obtained, a mandatory determination of SF is required to make a decision on conducting ferrotherapy.
{"title":"Epidemiology of iron deficiency in Russia: serum ferritin values depending on sex and age","authors":"N. Stuklov, M. S. Kovalchuk, A. Gurkina, N. D. Kislyу","doi":"10.30629/0023-2149-2023-101-6-308-314","DOIUrl":"https://doi.org/10.30629/0023-2149-2023-101-6-308-314","url":null,"abstract":"The high prevalence of iron deficiency (ID) in women and its important negative impact on the health care system is beyond doubt. The presence of severe problems of a systemic nature requires the development of special state programs to combat ID. The development of such programs is impossible without conducting epidemiological studies in each specific country. The purpose of this work is to determine the frequency and severity of ID in terms of serum ferritin (SF) in primary outpatients, depending on gender and age. The study was conducted in 15 large cities of Russia, in total, 1737 primary patients were included, of which 97 were males and 1640 were females. When studying the parameters of SF in general groups, its values are significantly lower in females, and average 40 ± 99 μg/l, while 61% of this cohort of patients have SF less than 30 μg/l, and 70% live in conditions of SF below target values, which requires the development of preventive programs to combat ID among female patients. Between the ages of 16 and 49, almost all females live in conditions of absolute ID, and it is probably in this group that the above activities should be carried out. On the contrary, as regards male patients, judging by the data obtained, a mandatory determination of SF is required to make a decision on conducting ferrotherapy.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78231331","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 : 2023-07-21DOI: 10.30629/0023-2149-2023-101-6-293-300
N. A. Samorodskaya, L. N. Eliseeva
Research objective. Evaluation of the influence of 6-month antihypertensive therapy with drugs of different classes on hemodynamic parameters of the circulatory system in patients with comorbid hypertension and rheumatoid arthritis. Materials and methods. Patients who met age criteria (58.6 ± 6.4 years), duration of hypertension (11.2 ± 1.6 years), onset (aged 45–64 years), and duration (7.2 ± 2.1 years) of rheumatoid arthritis were divided into groups: Group I (136 men, 141 women) — 277 patients with stage II hypertension; Group II (28 men, 114 women) — 142 patients with stage II hypertension and rheumatoid arthritis (in clinical-laboratory remission); Group III (20 men, 92 women) — 112 patients with stage II hypertension and rheumatoid arthritis (in clinical-laboratory exacerbation). Antihypertensive monotherapy was prescribed by polyclinic doctors: nebivolol, lisinopril, losartan, amlodipine, indapamide, and a combination of lisinopril and indapamide. Observation was carried out for 6 months. Results. The influence of antihypertensive therapy (6 months) on hemodynamic parameters of the circulatory system in patients of groups I and II was presented by positive dynamics of morphometric and speed parameters, while in group III patients the indicators were less significant and more distant. Conclusion. The presence of rheumatoid arthritis introduces additional changes in the dynamics of hemodynamic effects of prescribed antihypertensive therapy and is determined by the degree of disease activity and adequacy of basic anti-inflammatory therapy.
{"title":"Hemodynamic effects of antihypertensive therapy in patients with hypertension and rheumatoid arthritis comorbidity","authors":"N. A. Samorodskaya, L. N. Eliseeva","doi":"10.30629/0023-2149-2023-101-6-293-300","DOIUrl":"https://doi.org/10.30629/0023-2149-2023-101-6-293-300","url":null,"abstract":"Research objective. Evaluation of the influence of 6-month antihypertensive therapy with drugs of different classes on hemodynamic parameters of the circulatory system in patients with comorbid hypertension and rheumatoid arthritis. Materials and methods. Patients who met age criteria (58.6 ± 6.4 years), duration of hypertension (11.2 ± 1.6 years), onset (aged 45–64 years), and duration (7.2 ± 2.1 years) of rheumatoid arthritis were divided into groups: Group I (136 men, 141 women) — 277 patients with stage II hypertension; Group II (28 men, 114 women) — 142 patients with stage II hypertension and rheumatoid arthritis (in clinical-laboratory remission); Group III (20 men, 92 women) — 112 patients with stage II hypertension and rheumatoid arthritis (in clinical-laboratory exacerbation). Antihypertensive monotherapy was prescribed by polyclinic doctors: nebivolol, lisinopril, losartan, amlodipine, indapamide, and a combination of lisinopril and indapamide. Observation was carried out for 6 months. Results. The influence of antihypertensive therapy (6 months) on hemodynamic parameters of the circulatory system in patients of groups I and II was presented by positive dynamics of morphometric and speed parameters, while in group III patients the indicators were less significant and more distant. Conclusion. The presence of rheumatoid arthritis introduces additional changes in the dynamics of hemodynamic effects of prescribed antihypertensive therapy and is determined by the degree of disease activity and adequacy of basic anti-inflammatory therapy.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74019578","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 : 2023-07-21DOI: 10.30629/0023-2149-2023-101-6-301-307
A. L. Lomonosov, A. Golubev, M. Kukanova, A. A. Khomenchuk, A. H. Khushakov, G. D. Lomonosov
There are many variants of acute external hemorrhoids (AEH), with varying degrees of its development. The purpose of the study is to study the features of diagnosis and treatment of outpatient patients with AEH in the form of ovoid (AEH–FO). Material and methods. A solid sample, a retrospective sequential study of the data of 97 outpatient patients with AEH–FO. AEH–FO of the first degree (AEH–FO 1) was detected in 57,7% of patients, the node was more often elastic, blue in color, AEH–FO of the second degree (AEH–FO 2) in 42,3% of patients, wound necrosis on the node, the discharge of blood from it. In 32,7% of patients treated on average after 4 days, the average pain on the visual pain scale (VPS) was 6 points. Conservative treatment was carried out in all patients with AEH–FO with the appointment of MOFF (90% diosmin and 10% hesparin flavides. When bleeding from the node, tranexam, psyllium, lactulose, macrogol were prescribed for constipation. Analgesia was performed depending on the intensity of the pain. Only 3,1% of patients were operated on before 2018. Conclusions. The treatment of patients with AEH–FO was effective. In the average treatment period of 14 days, all patients recovered and were able to work.
{"title":"Diagnosis and treatment of external hemorrhoids on an outpatient basis","authors":"A. L. Lomonosov, A. Golubev, M. Kukanova, A. A. Khomenchuk, A. H. Khushakov, G. D. Lomonosov","doi":"10.30629/0023-2149-2023-101-6-301-307","DOIUrl":"https://doi.org/10.30629/0023-2149-2023-101-6-301-307","url":null,"abstract":"There are many variants of acute external hemorrhoids (AEH), with varying degrees of its development. The purpose of the study is to study the features of diagnosis and treatment of outpatient patients with AEH in the form of ovoid (AEH–FO). Material and methods. A solid sample, a retrospective sequential study of the data of 97 outpatient patients with AEH–FO. AEH–FO of the first degree (AEH–FO 1) was detected in 57,7% of patients, the node was more often elastic, blue in color, AEH–FO of the second degree (AEH–FO 2) in 42,3% of patients, wound necrosis on the node, the discharge of blood from it. In 32,7% of patients treated on average after 4 days, the average pain on the visual pain scale (VPS) was 6 points. Conservative treatment was carried out in all patients with AEH–FO with the appointment of MOFF (90% diosmin and 10% hesparin flavides. When bleeding from the node, tranexam, psyllium, lactulose, macrogol were prescribed for constipation. Analgesia was performed depending on the intensity of the pain. Only 3,1% of patients were operated on before 2018. Conclusions. The treatment of patients with AEH–FO was effective. In the average treatment period of 14 days, all patients recovered and were able to work.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"281 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86387261","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 : 2023-07-21DOI: 10.30629/0023-2149-2023-101-6-286-292
N. Gulyaev, A. Adamov, I. M. Akhmetshin, A. A. Prokhorchik, V. I. Baksheev
Currently, due to the increase in life expectancy in the human population, the relevance of the problem of sarcopenia and chronic somatic pathology, including chronic heart failure (CHF), is increasing. At the same time, there are no clear recommendations for managing patients with a combination of CHF and sarcopenia. In addition, the impact of sarcopenia in combination with CHF on kidney filtration function remains poorly understood. The aim of the study was to evaluate the dynamics of muscle mass and strength, kidney filtration function in patients with sarcopenia and CHF in a longitudinal study involving 53 male patients with a mean age of 75.2 ± 7.3 years. The first (main) group (n = 24) consisted of patients with CHF and sarcopenia, while the second comparison group (n = 29) included patients with CHF without sarcopenia. The results showed that patients in the main group had a more pronounced decrease in muscle mass and strength over time, glomerular filtration rate (GFR), calculated using CKD-EPI formulas, based on cystatin C (CKD-EPICysC) and cystatin-creatinine (CKD-EPICysC+Cr) levels. In the comparison group, a more significant decrease in GFR, calculated using creatinine, was observed. It is emphasized that for more accurate determination of GFR in patients with CHF and accompanying sarcopenia, it is advisable to use the CKD-EPICysC formula. Future controlled randomized studies will determine the possibility of including this recommendation in appropriate protocols for managing elderly patients.
{"title":"Dynamic assessment of the filtration function of the kidneys and indicators of muscle mass in patients with sarcopenia and chronic heart failure","authors":"N. Gulyaev, A. Adamov, I. M. Akhmetshin, A. A. Prokhorchik, V. I. Baksheev","doi":"10.30629/0023-2149-2023-101-6-286-292","DOIUrl":"https://doi.org/10.30629/0023-2149-2023-101-6-286-292","url":null,"abstract":"Currently, due to the increase in life expectancy in the human population, the relevance of the problem of sarcopenia and chronic somatic pathology, including chronic heart failure (CHF), is increasing. At the same time, there are no clear recommendations for managing patients with a combination of CHF and sarcopenia. In addition, the impact of sarcopenia in combination with CHF on kidney filtration function remains poorly understood. The aim of the study was to evaluate the dynamics of muscle mass and strength, kidney filtration function in patients with sarcopenia and CHF in a longitudinal study involving 53 male patients with a mean age of 75.2 ± 7.3 years. The first (main) group (n = 24) consisted of patients with CHF and sarcopenia, while the second comparison group (n = 29) included patients with CHF without sarcopenia. The results showed that patients in the main group had a more pronounced decrease in muscle mass and strength over time, glomerular filtration rate (GFR), calculated using CKD-EPI formulas, based on cystatin C (CKD-EPICysC) and cystatin-creatinine (CKD-EPICysC+Cr) levels. In the comparison group, a more significant decrease in GFR, calculated using creatinine, was observed. It is emphasized that for more accurate determination of GFR in patients with CHF and accompanying sarcopenia, it is advisable to use the CKD-EPICysC formula. Future controlled randomized studies will determine the possibility of including this recommendation in appropriate protocols for managing elderly patients.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"330 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73860379","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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