Consilium Medicum最新文献

{"title":"The difficult way in diagnostics of neurological manifestations of Sjogren's disease. Case report","authors":"M. Shchepankevich, L. Bogoderova, I.A. Veretelnikov, Elena V. Taneeva, D. S. Korobko","doi":"10.26442/20751753.2023.11.202460","DOIUrl":"https://doi.org/10.26442/20751753.2023.11.202460","url":null,"abstract":"Sjogren's disease is an immunoinflammatory rheumatic disease that is characterized by damage to the secreting epithelial glands with the development of parenchymal sialadenitis with xerostomia and keratoconjunctivitis sicca with hypolacrymia. Due to the high heterogeneity of clinical manifestations of this disease, diagnosis is difficult. This article presents a clinical case of a patient with a detailed description of the manifestation, course, and treatment of Sjogren's disease with a rare combination of extraglandular complications in the form of polymyositis and secondary polyneuropathy.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"12 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140263352","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}

{"title":"The role of timely rheumatoid arthritis treatment effectiveness control","authors":"Larisa M. Musaeva, Yulia A. Prokofeva, I. Menshikova, Aishat E. Rasulova","doi":"10.26442/20751753.2023.11.202606","DOIUrl":"https://doi.org/10.26442/20751753.2023.11.202606","url":null,"abstract":"Background. Regular assessment of rheumatoid arthritis (RA) activity is a key factor in therapy effectiveness improving. \u0000Aim. To prove that timely RA treatment control recommended by modern guidelines improves outcomes and reduce disability in real clinical practice. \u0000Materials and methods. Fourty patients with RA hospitalized at the University Clinical Hospital from January 2021 to January 2023 were included into a retrospective single-center study and divided into 2 groups. In the first group, RA activity was monitored after 3, 6, and 12 months, with therapy adjusted if necessary. In the second group, monitoring of RA activity was carried out after 12 months. The patients underwent clinical, laboratory and instrumental examinations (Tender Joint Count (TJC) and Swollen Joint Count (SJC), common blood test with differential white blood cell count, ESR, biochemical blood test, CRP, RF, ACCP, hands, feet and chest X-ray, ECG). RA activity was assessed using DAS28, CDAI, SDAI indices in both groups. \u0000Results. RA activity control after 12 months in patients of the first group regularly observed by a rheumatologist was better than in patients of the second group, who visited rheumatologist again only in 12 months. DAS28 decreased significantly, from 4.71±0.80 to 3.08±0.70 in the group with regular monitoring during the observation period. Remission or low activity was achieved by 75% of patients (5% remission and 70% low activity). Less dynamics was registered in patients of the second group: the initial DAS28 was 4.50±0.74, DAS28 after 12 months was 4.36±0.64, which corresponds to moderate activity. Low activity was achieved in 15% of patients, remission was not achieved in any patient. \u0000Conclusion. Strict adherence to the recommended terms for disease activity monitoring is necessary for successful RA treatment in real clinical practice.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"21 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140261137","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}

{"title":"Brain metastases as the first clinical manifestation of prostate cancer: a case report","authors":"N. A. Ognerubov, R. S. Sergeev, Dmitriy M. Mikhalev","doi":"10.26442/20751753.2023.11.202505","DOIUrl":"https://doi.org/10.26442/20751753.2023.11.202505","url":null,"abstract":"Background. Intracranial metastases, as the first clinical symptom of prostate cancer (PC), are extremely rare, with only anecdotal case reports in the literature. \u0000Aim. To present a case of multiple brain metastases (MCI) as the first clinical manifestation of PC with isolated facial nerve injury (FNI). \u0000Materials and methods. A 66-year-old patient with PC and multiple brain and bone metastases was observed. \u0000Results. The patient considered himself sick for 4 months when weakness in the left arm, headache, dizziness, facial asymmetry, staggering when walking, and memory loss appeared. He received non-surgical treatment prescribed by a neurologist. A clinical examination revealed a neurological deficit in the form of FN central palsy of grade 3 according to the House-Brackmann score. Magnetic resonance imaging of the brain showed masses in the right insular, left temporal lobes, and left cerebellar hemisphere of 3.7×3.3×2.9, 1.1×0.8 and 0.5×0.6 cm, respectively, with marked perifocal edema. According to the magnetic resonance imaging of the pelvis in the right half of the prostate gland, a tumor of 2.2×1.0×2.7 cm and PI-RADS 5 score was detected, and a metastatic lesion of the left ilium was found. Bone scintigraphy showed metastases in the thoracic and lumbar spine. A core biopsy of the prostate was performed. Histological and immunohistochemical studies revealed acinar adenocarcinoma with a Gleason score of 6 (3+3) points. The level of total prostate-specific antigen was 8.6 ng/mL. A final diagnosis was made: stage IV prostate cancer, T2aN0M1c, with brain and bone metastases. Given the neurological symptoms, radiation therapy was performed on the brain with a total radiation dose of 30 Gy, followed by androgen deprivation and monochemotherapy with docetaxel and bisphosphonates. \u0000Conclusion. Multiple brain lesions as the first clinical manifestation of PC are extremely rare. An isolated lesion of FN with neurological deficit in the form of central palsy indicates an advanced metastatic process. The primary method of treatment is palliative radiation therapy with a total radiation dose of 30 Gy, followed by androgen deprivation and chemotherapy.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"36 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140261986","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}

{"title":"Chondroprotectors in complex treatment of non-specific back pain: effectiveness evaluation","authors":"Elena B. Kuznetsova, N. S. Kuznetsov","doi":"10.26442/20751753.2023.11.202482","DOIUrl":"https://doi.org/10.26442/20751753.2023.11.202482","url":null,"abstract":"Background. Degenerative and dystrophic spinal diseases and associated pain syndrome remain a leading problem for practical health. The symptom-modifying and structurally modifying effects of chondrobrotectors suggest that they may be effective in treating patients with lower back pain (LBP). \u0000Aim. Study of the efficacy of Ambene® Bio in complex therapy of patients with acute LBP associated with degenerative dystrophic spinal diseases. \u0000Materials and methods. The article analyzes the results of examination and treatment of 50 patients with dorsopatia and non-specific LBP, who received treatment in hospital in the neurological department of Saratov City Clinical Hospital №9 or outpatient on the basis of the clinic “Artromedcenter” Saratov. Patients are randomly sampled into two groups of 25 people: those who received (core group) and those who did not receive (comparison group) Ambene® Bio therapy. The groups were comparable by sex, age, and clinical manifestations of dorsopathy. Methods of non-parametric analysis have been applied to statistical processing of the study results. The analysis included computing the median (Me) and quartile scale (Q25–Q75 – 25th and 75th percentiles). \u0000Results. All patients participating in the study noted improvement and reduction of pain syndrome during the treatment. The results of a survey using 100-point VAS indicate that on the 20th day of therapy (visit 2) the lower back pain syndrome significantly decreased from 66.1±8.54 to 23.32±6.76 (p0.05). In the comparison group the VAS dynamics pain was positive, but not so pronounced: before treatment – 70.11±11.43, on the 20th day of therapy – 46.15±9.38. The sum of test points on the Watkins scale in the core group did not exceed 15 points during the study, while in the HS the total scale was close to the value of 24 points. \u0000Conslusion. The use of Ambene® Bio promotes a faster onset of the analgesic effect – on the 7th day of therapy, pain was practically relieved in 56% of patients in the core group. This made it possible to reduce the dose and shorten the duration of the NSAID course.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"28 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140262838","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}

{"title":"Non-pharmacological methods of treating chronic non-specific neck pain, possibilities of radiofrequency denervation: A review","authors":"Maksim I. Gaydash, Haider N.A. Akif, Mikhail G. Zonov","doi":"10.26442/20751753.2023.11.202485","DOIUrl":"https://doi.org/10.26442/20751753.2023.11.202485","url":null,"abstract":"Chronic non-specific neck pain (CNSNP), or cervicodynia, is a common pathology that significantly reduces the quality of life of patients. It is believed to be based on degenerative and dystrophic changes in the spine, as well as myofascial pain syndrome. Currently, a comprehensive approach is used in the treatment of CNSNP, including kinesitherapy, ergotherapy, manual therapy, and cognitive-behavioral therapy. In case of ineffectiveness of conservative patient management methods, radiofrequency denervation is used, which is an effective and safe procedure for reducing the severity of pain syndrome. The results of the use of radiofrequency denervation in CNSNP are discussed.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"51 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140260781","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}

{"title":"Advices for diagnostics of ankylosing spondylitis/axial spondyloarthritis: A review","authors":"Nikolay V. Bunchuk, A. Levshakova","doi":"10.26442/20751753.2023.11.202461","DOIUrl":"https://doi.org/10.26442/20751753.2023.11.202461","url":null,"abstract":"The article written by a rheumatologist and a radiologist who have long-term experience in diagnostics of ankylosing spondylitis (axial spondylitis), provides advices on rational recognition of these diseases. The first part of the article discusses adequate visualization of the sacroiliac joints and the need for thoughtful consideration of radiological and MRI signs of sacroiliitis, neither of which, taken alone, is pathognomonic. An optimal, from the authors' point of view, algorithm for conducting visualization studies of sacroilial joints is proposed. Numerous situations simulating sacroiliitis are analyzed.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"93 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140261517","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}

{"title":"Multimodal treatment of osteoarthritis: A review. III All-Russian Scientific and Practical Conference \"Musculoskeletal Pain in Rheumatic Diseases\". Review of the Symposium on September 22, 2023, Moscow, Russia","authors":"","doi":"10.26442/20751753.2023.11.202573","DOIUrl":"https://doi.org/10.26442/20751753.2023.11.202573","url":null,"abstract":"As part of the III All-Russian Scientific and Practical Conference \"Musculoskeletal Pain in Rheumatic Diseases,\" a symposium on multimodal therapy of osteoarthritis (OA) was held on September 22. Leading Russian experts discussed the results of modern fundamental and practical aspects of OA, analyzed the main world trends in pain control in such patients using drug and non-drug approaches, presented new data on the efficacy and safety of various classes of analgesics and chondroprotective agents, discussed the roles of disease-modifying anti-inflammatory therapy and medical rehabilitation. During the symposium, details of a new OA therapy are presented. The symposium was held with the support of OOO Viatris.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"132 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140078904","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}

{"title":"Clinical and laboratory evaluation of the effectiveness of the nootropic drug Actitropil (fonturacetam) in the treatment of asthenic syndrome","authors":"M. R. Bekuzarova, Amirkhan A. Kumakhov","doi":"10.26442/20751753.2023.11.202576","DOIUrl":"https://doi.org/10.26442/20751753.2023.11.202576","url":null,"abstract":"Background. Asthenia is one of the most common symptoms in the clinical practice of a doctor of any specialty. This is due to the high incidence of this pathology: in patients with chronic somatic diseases from 45% to 90%, with an acute pathological process – about 55%. There are no uniform standards for the treatment of asthenic disorder; however, the basis for the medical correction of this pathology is nootropic drugs. \u0000Aim. To study the clinical efficacy and safety of the nootropic drug Actitropil (fonturacetam) in patients with various types of asthenic disorder. \u0000Materials and methods. The observational clinical program included 50 patients (average age 43.22±14.60) with asthenic symptoms. Patients received Actitropil (fonturacetam) at a dose of 200 mg per day, divided into two doses. The duration of therapy was 30 days, the total duration of follow-up was 60 days. The effectiveness of treatment was evaluated before and after the course of therapy, as well as in the delayed period according to the scales of asthenia MFI-20, well-being, activity, mood SAN, anxiety and depression HADS (part 1), sleep quality Spiegel, quality of life EQoL-5D-3L. Patients' satisfaction with the treatment and tolerability of therapy were also assessed on 5-point scales; adverse events were recorded and the number of patients with good, satisfactory and unsatisfactory treatment results was calculated based on the subjective assessment of the subjects. Blood parameters analysis was used as laboratory assessment methods: erythrocytes, leukocytes, reticulocytes, platelets, hemoglobin, hematocrit, blood sedimentation rate, total protein, glucose, alanine aminotransferase, aspartate aminotransferase, prothrombin and thrombin time, prothrombin, international normalised ratio, activated partial thromboplastin time, fibrinogen. \u0000Results and conclusion. The results of the study showed high efficacy (98%) and safety of the use of Actitropil (absence of adverse events, low adverse events level during the course of treatment, no negative effect on liver function, blood coagulation and carbohydrate metabolism) in the treatment of various types of asthenic syndrome, including those associated with comorbid diseases. There is a significant therapeutic effect of Actitropil on concomitant symptoms of asthenia: anxiety, sleep status and quality of life. The antiasthenic effect of the drug does not differ depending on age and increases in the delayed period.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"3 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140260991","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}

{"title":"Changes in the electrical and viscoelastic parameters of erythrocytes in patients with manifestations of metabolic syndrome, COVID-19 convalescents, when exposed to citicoline in an in vitro experiment","authors":"M. Kruchinina, Andrei A. Gromov, Elina V. Kruchinina, Yulia A. Shishakina","doi":"10.26442/20751753.2023.11.202528","DOIUrl":"https://doi.org/10.26442/20751753.2023.11.202528","url":null,"abstract":"Aim. To study changes in the electrical and viscoelastic parameters of erythrocytes using the method of dielectrophoresis in patients with manifestations of the metabolic syndrome who underwent COVID-19, when exposed to the drug citicoline in an in vitro experiment to reduce the severity of microcirculatory disorders. \u0000Materials and methods. 31 men were examined with manifestations of metabolic syndrome (50.6±9.9 years), COVID-19 convalescences, within 8 to 12 months after the disease, the diagnosis was confirmed by PCR, ELISA. The electrical and viscoelastic parameters of erythrocytes were studied by dielectrophoresis twice: the initial levels of indicators were determined and after 30 minutes of exposure with after 30 minutes of exposure to a solution of the drug Ronocyte (oral solution with the active substance citicoline sodium – 104.50 mg., which is equivalent to 100.00 mg citicoline at a concentration of 0.01 µl per 0.3 µl of red blood cell suspension in 0.3M sucrose solution (pH 7.36). \u0000Results. Exposure of erythrocyte suspension of patients with Ronocyte solution led to change in the levels of electrical, viscoelastic parameters: an increase in the average cell diameter (p=0.0003), the proportion of discocytes (p=0.0004), the amplitude of cell deformation at high frequencies of the electric field (p=0.000002), cell capacity (p=0.000007), the velocity of erythrocytes to the electrodes (p=0.003), dipole moment (p=0.002), polarizability at 106 and 0.5×106 Hz (p=0.000019 and p=0.0015, respectively), relative polarizability (p0.05) and, conversely, to reduce summarized rigidity (p=0.000003), viscosity (p=0.000002), electrical conductivity (p0.000001), aggregation indices (p=0.00003), destruction at frequencies of 106 Hz (p=0.003), 0.5x106 Hz (p=0.00002), 0.1×106 Hz (p0.00001), polarizability at low frequencies of the electric field (p=0.02). Under the influence of the drug, the equilibrium frequency of erythrocytes shifted to the low-frequency range compared to the initial values (p0.0000001). The revealed changes indicate an increase in the surface charge of erythrocytes, their ability to deform, and cell resistance under the action of citicoline. \u0000Conclusion. For the first time, the effect of the drug with the active substance citicoline, improving the rheological properties of erythrocytes, was discovered. Preparations with the active substance - citicoline should be considered promising for conducting a full-fledged clinical study to study the reduction of circulatory disorders at the microcirculatory level in patients with manifestations of metabolic syndrome who have undergone COVID-19 coronavirus infection.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"47 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140262063","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}

{"title":"The choice of pathogenetic therapy for a patient with dorsalgia: A review","authors":"P. Kamchatnov, R. Cheremin, Liudmila A. Skipetrova, A. V. Chugunov, S. V. Prikazchikov","doi":"10.26442/20751753.2023.11.202285","DOIUrl":"https://doi.org/10.26442/20751753.2023.11.202285","url":null,"abstract":"Musculoskeletal pain syndromes are one of the common causes of temporary disability associated with a decrease in the quality of life of patients. Dorsalgia (DA) is the most common form of these syndromes. Currently, osteoarthritis of the facet joints has been replaced as one of the main mechanisms for the occurrence of DA. The article discusses the main causes of DA development, important inflammatory processes in its symptoms. The issues of treatment of patients with DA are discussed. Information about the efficacy and safety of the use of Nise® (nimesulide) is given.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"45 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140261796","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}