Pub Date : 2023-07-17DOI: 10.26442/20751753.2023.2.202229
D. Korobko, Ivan Ie. Arkhipov, Anna I. Prokaeva, E. V. Tret'iakova
Siponimod (Kajendra) is a sphingosine-1-phosphate receptor modulator type 1 and 5 (S1P1,5), the first targeted agent for the treatment of patients with secondary progressive multiple sclerosis, both with and without exacerbations and/or activity according to magnetic resonance imaging. The drug was approved in Russia at the end of December 2020. The efficacy of siponimod was confirmed in EXPAND study, a large, randomized, double-blind phase III clinical study. This article presents three clinical cases of patients with secondary progressive multiple sclerosis from the practice of specialists of the Novosibirsk Center for Multiple Sclerosis and Other Autoimmune Diseases of the Nervous System with an analysis of patients selection for siponimod treatment and an assessment of the therapy effectiveness.
{"title":"The first cases of using targeted therapy for secondary progressive multiple sclerosis in Russia. Case report","authors":"D. Korobko, Ivan Ie. Arkhipov, Anna I. Prokaeva, E. V. Tret'iakova","doi":"10.26442/20751753.2023.2.202229","DOIUrl":"https://doi.org/10.26442/20751753.2023.2.202229","url":null,"abstract":"Siponimod (Kajendra) is a sphingosine-1-phosphate receptor modulator type 1 and 5 (S1P1,5), the first targeted agent for the treatment of patients with secondary progressive multiple sclerosis, both with and without exacerbations and/or activity according to magnetic resonance imaging. The drug was approved in Russia at the end of December 2020. The efficacy of siponimod was confirmed in EXPAND study, a large, randomized, double-blind phase III clinical study. This article presents three clinical cases of patients with secondary progressive multiple sclerosis from the practice of specialists of the Novosibirsk Center for Multiple Sclerosis and Other Autoimmune Diseases of the Nervous System with an analysis of patients selection for siponimod treatment and an assessment of the therapy effectiveness.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45436341","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 : 2023-07-13DOI: 10.26442/20751753.2023.10.202218
M. A. Khalikova, Dmitrij A. Tsaregorodtsev, M. Beraya, Alexey V. Sedov
Background. Class IC antiarrhythmic drugs (IC-AADs) are recommended as first-line therapy in treatment of lone paroxysmal atrial fibrillation (AF) along with catheter ablation of pulmonary veins. Despite previous attempts to identify predictors of IC-AADs` efficacy, the choice between IC-AADs agents is still most often carried out using empirical approach.Aim. To determine the predictors of IC-AADs ` efficacy in patients with paroxysmal AF in the absence of structural heart disease.Materials and methods. Seventy four patients (22 men, 52 women, average age 65 [57; 70] years) were treated with IC-AADs: 26 patients were prescribed lappaconitine hydrobromide (Al) (allapinin at a dosage of 75 mg/day or allaforte 50100 mg/day), 25 patients were prescribed propafenone (P) 450600 mg/day, 23 patients diethylaminopropionylethoxycarbonylaminophenothiazine hydrochloride (ethacizine, E) 150 mg/day. The average frequency of AF paroxysms was 2 [0.4; 6.25] per month. Patients were divided into 2 groups depending on the effect of AADs.Results. Over a 12 months follow-up IC-AADs therapy was effective in 28 (37.8%) patients (Eff+ group), in the remaining 46 (62.2%) patients AF recurrences or side effects demanding AADs withdrawal were registered (Eff-group). A DC value greater or equal to 5 ms predicted the effectiveness of IC-AADs therapy with 79% sensitivity and 77% specificity (OR 12, 95% CI 3.0749.5, p0.0001). In the Al group the deceleration capacity (DC) value greater or equal to 5.25 ms allowed predicting therapy effectiveness with 86% sensitivity and 100% specificity (OR 7, 95% CI 1.14; 43; p=0.002). In the E group, the DC index was characterized by high sensitivity (80%) and specificity (85%) for a threshold value of 5.9 ms. In case of DC above this value, the probability of E therapy efficacy increased by 22-times (OR 22, 95% CI 1.5; 314; p=0.009). In group P, the DC medians in the Eff+ and Eff- groups did not differ significantly (p=0.821). However, at low DC values (less than 4 ms) P turned out to be the most effective compared to other two IC-AADs: its effectiveness was 50%, which was significantly higher compared to E (0%) and Al (0%) (p=0.046).Conclusion. Estimation of the DC level before starting IC-AADs can make it easier to choose a specific drug from this group and improve treatment results: at DC above 5.2 ms, it is advisable to use Al, at DC6 ms Al or E, at DC less than 4 ms P.
{"title":"Predictors of class IC antiarrhythmic drugs efficacy in patients with paroxysmal form of atrial fibrillation","authors":"M. A. Khalikova, Dmitrij A. Tsaregorodtsev, M. Beraya, Alexey V. Sedov","doi":"10.26442/20751753.2023.10.202218","DOIUrl":"https://doi.org/10.26442/20751753.2023.10.202218","url":null,"abstract":"Background. Class IC antiarrhythmic drugs (IC-AADs) are recommended as first-line therapy in treatment of lone paroxysmal atrial fibrillation (AF) along with catheter ablation of pulmonary veins. Despite previous attempts to identify predictors of IC-AADs` efficacy, the choice between IC-AADs agents is still most often carried out using empirical approach.Aim. To determine the predictors of IC-AADs ` efficacy in patients with paroxysmal AF in the absence of structural heart disease.Materials and methods. Seventy four patients (22 men, 52 women, average age 65 [57; 70] years) were treated with IC-AADs: 26 patients were prescribed lappaconitine hydrobromide (Al) (allapinin at a dosage of 75 mg/day or allaforte 50100 mg/day), 25 patients were prescribed propafenone (P) 450600 mg/day, 23 patients diethylaminopropionylethoxycarbonylaminophenothiazine hydrochloride (ethacizine, E) 150 mg/day. The average frequency of AF paroxysms was 2 [0.4; 6.25] per month. Patients were divided into 2 groups depending on the effect of AADs.Results. Over a 12 months follow-up IC-AADs therapy was effective in 28 (37.8%) patients (Eff+ group), in the remaining 46 (62.2%) patients AF recurrences or side effects demanding AADs withdrawal were registered (Eff-group). A DC value greater or equal to 5 ms predicted the effectiveness of IC-AADs therapy with 79% sensitivity and 77% specificity (OR 12, 95% CI 3.0749.5, p0.0001). In the Al group the deceleration capacity (DC) value greater or equal to 5.25 ms allowed predicting therapy effectiveness with 86% sensitivity and 100% specificity (OR 7, 95% CI 1.14; 43; p=0.002). In the E group, the DC index was characterized by high sensitivity (80%) and specificity (85%) for a threshold value of 5.9 ms. In case of DC above this value, the probability of E therapy efficacy increased by 22-times (OR 22, 95% CI 1.5; 314; p=0.009). In group P, the DC medians in the Eff+ and Eff- groups did not differ significantly (p=0.821). However, at low DC values (less than 4 ms) P turned out to be the most effective compared to other two IC-AADs: its effectiveness was 50%, which was significantly higher compared to E (0%) and Al (0%) (p=0.046).Conclusion. Estimation of the DC level before starting IC-AADs can make it easier to choose a specific drug from this group and improve treatment results: at DC above 5.2 ms, it is advisable to use Al, at DC6 ms Al or E, at DC less than 4 ms P.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45910742","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 : 2023-06-07DOI: 10.26442/20751753.2023.3.202191
O. Savushkina, P. Astanin, M. Malashenko, Igor V. Pyhtin, Ekaterina R. Kuzmina, A. A. Zaitsev
Background. Gunshot injuries occupy one of the leading places in a number of injuries (combat injuries) that occur in military conflicts. Aim. To study the effect of gunshot wounds of the chest (penetrating and non-penetrating), as well as closed chest trauma on the respiratory function. Materials and methods. The study included 78 patients with a diagnosis of combined trauma, including a gunshot penetrating/non-penetrating wound of the chest or closed chest injuries. The median period from injury to the time of lung function tests was 17 [15; 22] days. Results. A prospective cross-sectional study was performed. All patients (100% males) underwent spirometry, body plethysmography, and diffusion test. The total sample was divided into two groups: group 1 (median age 27.5 [23.0; 36.0] years) 68 patients with gunshot penetrating chest wound, group 2 (median age 26.5 [20.0; 30.5] years) 10 patients with gunshot non-penetrating wound or closed chest trauma. In group 1, the medians of the vital capacity, forced vital capacity, inspiratory capacity, forced exhalation volume in 1 second, lung diffusion capacity (determined by the value of the carbon monoxide transfer-factor DLCO) and alveolar volume were reduced. In group 2, pulmonary ventilation parameters were within normal values while the median of DLCO was reduced. There were no statistically significant differences between the groups. Conclusion. Both gunshot penetrating wounds of the chest and gunshot non-penetrating wounds of the chest and closed chest injuries have a negative impact, including on the respiratory function, to a greater extent on lung diffusion capacity. It is necessary to create programs of drug correction and longer rehabilitation treatment of this category of patients.
{"title":"Functional disorders of the respiratory system in combat chest injury","authors":"O. Savushkina, P. Astanin, M. Malashenko, Igor V. Pyhtin, Ekaterina R. Kuzmina, A. A. Zaitsev","doi":"10.26442/20751753.2023.3.202191","DOIUrl":"https://doi.org/10.26442/20751753.2023.3.202191","url":null,"abstract":"Background. Gunshot injuries occupy one of the leading places in a number of injuries (combat injuries) that occur in military conflicts. \u0000Aim. To study the effect of gunshot wounds of the chest (penetrating and non-penetrating), as well as closed chest trauma on the respiratory function. \u0000Materials and methods. The study included 78 patients with a diagnosis of combined trauma, including a gunshot penetrating/non-penetrating wound of the chest or closed chest injuries. The median period from injury to the time of lung function tests was 17 [15; 22] days. \u0000Results. A prospective cross-sectional study was performed. All patients (100% males) underwent spirometry, body plethysmography, and diffusion test. The total sample was divided into two groups: group 1 (median age 27.5 [23.0; 36.0] years) 68 patients with gunshot penetrating chest wound, group 2 (median age 26.5 [20.0; 30.5] years) 10 patients with gunshot non-penetrating wound or closed chest trauma. In group 1, the medians of the vital capacity, forced vital capacity, inspiratory capacity, forced exhalation volume in 1 second, lung diffusion capacity (determined by the value of the carbon monoxide transfer-factor DLCO) and alveolar volume were reduced. In group 2, pulmonary ventilation parameters were within normal values while the median of DLCO was reduced. There were no statistically significant differences between the groups. \u0000Conclusion. Both gunshot penetrating wounds of the chest and gunshot non-penetrating wounds of the chest and closed chest injuries have a negative impact, including on the respiratory function, to a greater extent on lung diffusion capacity. It is necessary to create programs of drug correction and longer rehabilitation treatment of this category of patients.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48548106","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 : 2023-06-07DOI: 10.26442/20751753.2023.3.202143
E. Radtsig, Mikhail M. Polunin, A. D. Egina, Daria G. Bondareva
Various types of otitis are common in the pediatric population. The use of otoscopy techniques by primary care doctors (pediatricians, family, and general practitioners) has significantly expanded the diagnostic capabilities of the primary examination of the child. However, it requires many specialists to know the principles of patient management with various types of otitis media. The article addresses the principles of routing and drug therapy for patients with various types of otitis media. The focus is on ear drops (formulation, indications for using specific drugs, safety, and age-related aspects).
{"title":"Topical therapy of otitis media in children: A review","authors":"E. Radtsig, Mikhail M. Polunin, A. D. Egina, Daria G. Bondareva","doi":"10.26442/20751753.2023.3.202143","DOIUrl":"https://doi.org/10.26442/20751753.2023.3.202143","url":null,"abstract":"Various types of otitis are common in the pediatric population. The use of otoscopy techniques by primary care doctors (pediatricians, family, and general practitioners) has significantly expanded the diagnostic capabilities of the primary examination of the child. However, it requires many specialists to know the principles of patient management with various types of otitis media. The article addresses the principles of routing and drug therapy for patients with various types of otitis media. The focus is on ear drops (formulation, indications for using specific drugs, safety, and age-related aspects).","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44208837","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 : 2023-06-07DOI: 10.26442/20751753.2023.3.202096
Ju. E. Stepanova
Phoniatry is a branch of otorhinolaryngology and deals with issues related to the diagnosis, treatment and prevention of voice disorders. Violations of voice function, especially in persons of voice-speaking professions, worsen the quality of life, affect interpersonal relationships, create difficulties in communication, and in some cases lead to professional unfitness. It is known that about 6% of the population suffers from voice disorders, and laryngeal diseases are 56 times more common among specialists of voice-speaking professions. The invention of the laryngeal mirror became a landmark event in the emergence of laryngology, and subsequently phoniatry. The process of voice formation is provided by the voice apparatus, which consists of four departments and forms a single functional system. The vibrations of the vocal folds are a complex physiological process as a result of which sound appears. But this sound is not like the voice we hear. He acquires his unique timbre in the resonator department. It is possible to assess the state of voice function with the help of video endostroboscopy of the larynx and acoustic research methods. These diagnostic methods complement each other and create the most objective representation of the voice and its disorders.
{"title":"Fundamentals of phoniatry (lecture)","authors":"Ju. E. Stepanova","doi":"10.26442/20751753.2023.3.202096","DOIUrl":"https://doi.org/10.26442/20751753.2023.3.202096","url":null,"abstract":"Phoniatry is a branch of otorhinolaryngology and deals with issues related to the diagnosis, treatment and prevention of voice disorders. Violations of voice function, especially in persons of voice-speaking professions, worsen the quality of life, affect interpersonal relationships, create difficulties in communication, and in some cases lead to professional unfitness. It is known that about 6% of the population suffers from voice disorders, and laryngeal diseases are 56 times more common among specialists of voice-speaking professions. The invention of the laryngeal mirror became a landmark event in the emergence of laryngology, and subsequently phoniatry. The process of voice formation is provided by the voice apparatus, which consists of four departments and forms a single functional system. The vibrations of the vocal folds are a complex physiological process as a result of which sound appears. But this sound is not like the voice we hear. He acquires his unique timbre in the resonator department. It is possible to assess the state of voice function with the help of video endostroboscopy of the larynx and acoustic research methods. These diagnostic methods complement each other and create the most objective representation of the voice and its disorders.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44452976","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 : 2023-06-07DOI: 10.26442/20751753.2023.3.202166
Sergey V. Yakovlev, Leonid I. Dvoretskiy, Vladimir A. Petrov
The frequency of routine prescription of systemic antibacterial drugs in outpatient practice is still unreasonably high despite the desire to reduce them. Under the auspices of the Alliance of Clinical Chemotherapists and Microbiologists, the observational program RAPORT was conducted to assess the therapeutic potential (including bacterial complications preventing) of Raphamin in routine clinical practice in adults with acute respiratory viral infection (ARVI). The program included 14,033 patients aged 1897 years with ARVI who received an investigational drug (ID) as monotherapy (93%) or in combination with basic therapy (7%). The frequency of prophylactic prescribing antibacterial drugs was 0.6%. It was shown that fever duration was 2.311.38 days, and the duration of the disease 3.61.52 days. In 99.4% of patients, ID allowed to avoid the development of bacterial complications and prescription of antibacterial drugs. ID showed a stable therapeutic effect in patients who started treatment late, as well as in patients with a moderate course of ARVI, there was no delay in recovery. The results obtained a broad prospect for the use of ID in order to minimize the number of bacterial complications and the frequency of use of antibiotics in ARVI, which may reduce rate of resistance of topical pathogens in the future.
{"title":"Therapy of acute respiratory viral infections in adults in outpatient clinical practice: new opportunities for the prevention of bacterial complications (Results of the observational program RAPORT)","authors":"Sergey V. Yakovlev, Leonid I. Dvoretskiy, Vladimir A. Petrov","doi":"10.26442/20751753.2023.3.202166","DOIUrl":"https://doi.org/10.26442/20751753.2023.3.202166","url":null,"abstract":"The frequency of routine prescription of systemic antibacterial drugs in outpatient practice is still unreasonably high despite the desire to reduce them. Under the auspices of the Alliance of Clinical Chemotherapists and Microbiologists, the observational program RAPORT was conducted to assess the therapeutic potential (including bacterial complications preventing) of Raphamin in routine clinical practice in adults with acute respiratory viral infection (ARVI). The program included 14,033 patients aged 1897 years with ARVI who received an investigational drug (ID) as monotherapy (93%) or in combination with basic therapy (7%). The frequency of prophylactic prescribing antibacterial drugs was 0.6%. It was shown that fever duration was 2.311.38 days, and the duration of the disease 3.61.52 days. In 99.4% of patients, ID allowed to avoid the development of bacterial complications and prescription of antibacterial drugs. ID showed a stable therapeutic effect in patients who started treatment late, as well as in patients with a moderate course of ARVI, there was no delay in recovery. The results obtained a broad prospect for the use of ID in order to minimize the number of bacterial complications and the frequency of use of antibiotics in ARVI, which may reduce rate of resistance of topical pathogens in the future.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"60 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135404661","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 : 2023-06-07DOI: 10.26442/20751753.2023.3.202100
S. V. Lilenko, D. S. Luppov
Patients with acute vestibulopathy are among the most uneasy (in terms of severity of symptoms) and challenging (in terms of determining the level of damage). At the same time, the methods of traditional otoneurological examination often do not allow to reveal the cause of unexpected balance disorders. In order to determine the degree of vestibular function decompensation and develop the tactic for the urgent treatment, Saint Petersburg Research Institute of Ear, Throat, Nose and Speech uses both screening methods included in the Vestibular Passport and computerized vestibulometry techniques. Methods of oculomotor and postural reactions assessment are described in details using the example of case history. The high diagnostic significance of the results of instrumental vestibulometry using the Frenzel glasses, foam pad, computer electrooculography, video oculography and computer dynamic posturography is demonstrated. The therapeutic tactics of managing a patient with acute mixed vestibulopathy is shown.
{"title":"Acute mixed vestibulopathy. History case from the vestibulologist practice. Case report","authors":"S. V. Lilenko, D. S. Luppov","doi":"10.26442/20751753.2023.3.202100","DOIUrl":"https://doi.org/10.26442/20751753.2023.3.202100","url":null,"abstract":"Patients with acute vestibulopathy are among the most uneasy (in terms of severity of symptoms) and challenging (in terms of determining the level of damage). At the same time, the methods of traditional otoneurological examination often do not allow to reveal the cause of unexpected balance disorders. In order to determine the degree of vestibular function decompensation and develop the tactic for the urgent treatment, Saint Petersburg Research Institute of Ear, Throat, Nose and Speech uses both screening methods included in the Vestibular Passport and computerized vestibulometry techniques. Methods of oculomotor and postural reactions assessment are described in details using the example of case history. The high diagnostic significance of the results of instrumental vestibulometry using the Frenzel glasses, foam pad, computer electrooculography, video oculography and computer dynamic posturography is demonstrated. The therapeutic tactics of managing a patient with acute mixed vestibulopathy is shown.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49182238","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 : 2023-06-07DOI: 10.26442/20751753.2023.3.202173
Aleksandra G. Rosatkevich
Many convalescents of the new coronavirus infection caused by the SARS-CoV-2 virus, including mild and moderate severity, have frequent acute respiratory viral infections (ARVI) and other diseases of the ENT organs during the first 6 months after recovery. A well-known problem of COVID-19 is immune disorders due to the negative impact of the virus on the immune system, which is associated with various consequences described as a post-COVID syndrome. One of the manifestations of post-COVID syndrome is a decrease in infection resistance due to the immunodeficiency state. In particular, exacerbations of bacterial and viral ENT diseases, frequent ARVI, and exacerbation of herpes virus infection were reported. Moreover, the infections tend to be prolonged, cyclic, and often recurrent, significantly reducing patients' physical activity and quality of life. ARVI symptoms, accompanying the post-COVID syndrome, negatively affect the general condition of patients. Immunocorrection can interrupt the vicious circle of recurrent ARVI and restore impaired immunity after COVID-19. The immunomodulatory drug Galavit has a pathogenetic basis for use in the post-COVID period to restore the immune system. It was shown effective in preventing frequent recurrent ARVI and herpes virus infection in patients in the post-COVID period. The article shows the experience of using Galavit in coronavirus infection convalescents with frequent episodes of acute respiratory infections.
{"title":"Immunomodulating agent Galavit for the prevention of frequent acute respiratory viral infections after COVID-19: A review","authors":"Aleksandra G. Rosatkevich","doi":"10.26442/20751753.2023.3.202173","DOIUrl":"https://doi.org/10.26442/20751753.2023.3.202173","url":null,"abstract":"Many convalescents of the new coronavirus infection caused by the SARS-CoV-2 virus, including mild and moderate severity, have frequent acute respiratory viral infections (ARVI) and other diseases of the ENT organs during the first 6 months after recovery. A well-known problem of COVID-19 is immune disorders due to the negative impact of the virus on the immune system, which is associated with various consequences described as a post-COVID syndrome. One of the manifestations of post-COVID syndrome is a decrease in infection resistance due to the immunodeficiency state. In particular, exacerbations of bacterial and viral ENT diseases, frequent ARVI, and exacerbation of herpes virus infection were reported. Moreover, the infections tend to be prolonged, cyclic, and often recurrent, significantly reducing patients' physical activity and quality of life. ARVI symptoms, accompanying the post-COVID syndrome, negatively affect the general condition of patients. Immunocorrection can interrupt the vicious circle of recurrent ARVI and restore impaired immunity after COVID-19. The immunomodulatory drug Galavit has a pathogenetic basis for use in the post-COVID period to restore the immune system. It was shown effective in preventing frequent recurrent ARVI and herpes virus infection in patients in the post-COVID period. The article shows the experience of using Galavit in coronavirus infection convalescents with frequent episodes of acute respiratory infections.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41618638","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 : 2023-06-07DOI: 10.26442/20751753.2023.3.202093
E. Schelkanovtseva, O. Mironova, K. Solovev, E. A. Berestova, A. A. Balakhonov, I. Nagornov, V. Fomin, A. Panferov
Background. The identification of early predictors of poor outcomes of new coronavirus infection is necessary for optimizing patient management algorithms for hospitalized patients with COVID-19. Aim. To study the role of chitotriosidase activity as a marker of unfavorable outcomes in COVID-19 hospitalized patients. Materials and methods. The prospective observational single-center study included 347 patients with COVID-19 hospitalized in university clinic. In addition to the standard laboratory analysis (complete blood count, C-reactive protein, ferritin, creatinine, international normalized ratio, etc.) the blood serum chitotriosidase activity was determined at all the patients on admission. Primary endpoints were mortality from all causes and performing invasive ventilation (IV) and/or non-invasive ventilation (NIV). This study was approved by the Local Ethics Committee №12-21 (Clinical Trial Registry: NCT04752085). Results. A total of 347 patients were enrolled in this study (average age 66 years, females 182 52.5%), 30 patients (8.6%) died during the hospitalization, 39 (11.2%) performed IV or NIV. Along with age more than 65 (odds ratio OR 10.81, 95% confidence interval CI 2.6444.22) and Neutrophil-Lymphocyte Ratio higher than 7 (OR 15.89, 95% CI 3.0981.65) chitotriosidase activity higher than 170 ng/hr/ml (OR 4.23, 95% CI 1.4512.35) were independent predictors of mortality during hospitalization. Neutrophil-Lymphocyte Ratio higher than 5.6 (OR 11.22, 95% CI 2.3753,1) and сhitotriosidase activity higher than 151 ng/hr/ml (OR 3.17, 95% CI 1.317.67) have been evaluated as predictors of performing IV/NIV. Conclusion. Chitotriosidase level more than 151 nmol/h/mL could be considered as an early predictor of severity and poor prognosis in hospitalized patients with COVID-19.
{"title":"Сhitotriosidase activity in prediction of poor prognosis in COVID-19 hospitalized patients","authors":"E. Schelkanovtseva, O. Mironova, K. Solovev, E. A. Berestova, A. A. Balakhonov, I. Nagornov, V. Fomin, A. Panferov","doi":"10.26442/20751753.2023.3.202093","DOIUrl":"https://doi.org/10.26442/20751753.2023.3.202093","url":null,"abstract":"Background. The identification of early predictors of poor outcomes of new coronavirus infection is necessary for optimizing patient management algorithms for hospitalized patients with COVID-19. \u0000Aim. To study the role of chitotriosidase activity as a marker of unfavorable outcomes in COVID-19 hospitalized patients. \u0000Materials and methods. The prospective observational single-center study included 347 patients with COVID-19 hospitalized in university clinic. In addition to the standard laboratory analysis (complete blood count, C-reactive protein, ferritin, creatinine, international normalized ratio, etc.) the blood serum chitotriosidase activity was determined at all the patients on admission. Primary endpoints were mortality from all causes and performing invasive ventilation (IV) and/or non-invasive ventilation (NIV). This study was approved by the Local Ethics Committee №12-21 (Clinical Trial Registry: NCT04752085). \u0000Results. A total of 347 patients were enrolled in this study (average age 66 years, females 182 52.5%), 30 patients (8.6%) died during the hospitalization, 39 (11.2%) performed IV or NIV. Along with age more than 65 (odds ratio OR 10.81, 95% confidence interval CI 2.6444.22) and Neutrophil-Lymphocyte Ratio higher than 7 (OR 15.89, 95% CI 3.0981.65) chitotriosidase activity higher than 170 ng/hr/ml (OR 4.23, 95% CI 1.4512.35) were independent predictors of mortality during hospitalization. Neutrophil-Lymphocyte Ratio higher than 5.6 (OR 11.22, 95% CI 2.3753,1) and сhitotriosidase activity higher than 151 ng/hr/ml (OR 3.17, 95% CI 1.317.67) have been evaluated as predictors of performing IV/NIV. \u0000Conclusion. Chitotriosidase level more than 151 nmol/h/mL could be considered as an early predictor of severity and poor prognosis in hospitalized patients with COVID-19.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44393554","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 : 2023-06-07DOI: 10.26442/20751753.2023.3.202094
M. A. Lengina, Vadim М. Abdullin, Victoria V. Shapovalova, Violetta D. Frolova, Anna Yu. Kravchenko, Semyon V. Klepikov
Inflammatory diseases of the nose and paranasal sinuses provoked by fungal contamination have been on the rise over the past decades. The cause of infection, according to the literature, is more often accidental ingestion of filling material, fragments of teeth and small parts of the implant into the sinuses, followed by fungal contamination. Diagnosis of fungal sinusitis, as a rule, is not difficult, but if the use of modern technological capabilities of research and differential analysis is refused or ignored, the verification of the diagnosis may be erroneous and the routing of the patient will not be determined correctly. In the context of early diagnosis and timely treatment of inflammatory diseases of the nose and paranasal sinuses, of course, a brief historical overview reflecting the importance of the existing problem will be useful for doctors, and the given clinical example will largely help to avoid mistakes.
{"title":"Historical aspects of fungal sinusitis, topical issues of early diagnosis and medical care on clinical example: A review","authors":"M. A. Lengina, Vadim М. Abdullin, Victoria V. Shapovalova, Violetta D. Frolova, Anna Yu. Kravchenko, Semyon V. Klepikov","doi":"10.26442/20751753.2023.3.202094","DOIUrl":"https://doi.org/10.26442/20751753.2023.3.202094","url":null,"abstract":"Inflammatory diseases of the nose and paranasal sinuses provoked by fungal contamination have been on the rise over the past decades. The cause of infection, according to the literature, is more often accidental ingestion of filling material, fragments of teeth and small parts of the implant into the sinuses, followed by fungal contamination. Diagnosis of fungal sinusitis, as a rule, is not difficult, but if the use of modern technological capabilities of research and differential analysis is refused or ignored, the verification of the diagnosis may be erroneous and the routing of the patient will not be determined correctly. In the context of early diagnosis and timely treatment of inflammatory diseases of the nose and paranasal sinuses, of course, a brief historical overview reflecting the importance of the existing problem will be useful for doctors, and the given clinical example will largely help to avoid mistakes.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42050269","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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