Pub Date : 2023-11-05DOI: 10.26442/20751753.2023.6.202307
Janneta R. Tcherkassova, Sergei A. Tsurkan, Anna I. Prostyakova, Nikolai V. Suganov, Alexander M. Boroda, Albina I. Khamitova, Alexander P. Roytman
Aim. Demonstration the possibility of practical application of the highly sensitive tumor marker CA-62 in the initial diagnosis in asymptomatic patients with suspected cancer and/or the presence of pathological changes in instrumental studies, as well as describe the criteria for interpreting the results to help the doctor make a decision.
Materials and methods. The article used the results and conclusions of blind clinical trials conducted to detect early stages of breast cancer (BC), prostate cancer (PC), colorectal cancer (CRC) and non-small cell lung cancer using the CA-62 tumor marker and other tumor markers. Statistical analysis was performed using the MedCalc program (MedCalc Software Ltd, Belgium). Diagnostic efficiency was assessed in terms of sensitivity, specificity, test accuracy, PPV and NPV, ROC analysis. The significance level was taken as p0.001.
Results. The use of the standard cut-off value of 5000 U/ml of the CA-62 tumor marker makes it possible to achieve 97% sensitivity with 95% specificity in stage I BC. The combination of tumor markers CA-62 and CA 15-3 allows achieving 100% specificity in differentiation of BC and benign breast hyperplasia. The use of the CA-62 marker (6500 U/ml) in the gray zone of PSA 2.510 ng/ml improves the accuracy of detecting PC in biopsy from 35 to 93.1% with 90% sensitivity and 97% specificity. The use of a combination of tumor markers (CA-625000 U/ml, CYFRA 21-12.5 ng/ml and CEA5 ng/ml) will allow the doctor to improve the efficiency of differentiating lung cancer from chronic obstructive pulmonary disease. The combined use of markers (CEA3.5 ng/ml) and (CA-625000 U/ml) achieves 100% specificity with 97% sensitivity in detecting early stages of CRC.
Conclusion. The article shows the possibilities of using the CA-62 marker, as well as new algorithms for the detection and differentiation of early stages of BC, PC, non-small cell lung cancer and CRC and benign neoplasms using the CA-62 marker in primary diagnosis. The use of the CA-62 tumor marker or its combination with other diagnostic methods can be a useful strategy for a comprehensive assessment of the risk of malignant neoplasms and increasing the diagnostic sensitivity of detecting early stages of cancer.
{"title":"Practical application of the CA-62 tumor marker in the initial diagnosis of oncological disease of epithelial origin: assistance to the doctor in interpreting the results","authors":"Janneta R. Tcherkassova, Sergei A. Tsurkan, Anna I. Prostyakova, Nikolai V. Suganov, Alexander M. Boroda, Albina I. Khamitova, Alexander P. Roytman","doi":"10.26442/20751753.2023.6.202307","DOIUrl":"https://doi.org/10.26442/20751753.2023.6.202307","url":null,"abstract":"Aim. Demonstration the possibility of practical application of the highly sensitive tumor marker CA-62 in the initial diagnosis in asymptomatic patients with suspected cancer and/or the presence of pathological changes in instrumental studies, as well as describe the criteria for interpreting the results to help the doctor make a decision.
 Materials and methods. The article used the results and conclusions of blind clinical trials conducted to detect early stages of breast cancer (BC), prostate cancer (PC), colorectal cancer (CRC) and non-small cell lung cancer using the CA-62 tumor marker and other tumor markers. Statistical analysis was performed using the MedCalc program (MedCalc Software Ltd, Belgium). Diagnostic efficiency was assessed in terms of sensitivity, specificity, test accuracy, PPV and NPV, ROC analysis. The significance level was taken as p0.001.
 Results. The use of the standard cut-off value of 5000 U/ml of the CA-62 tumor marker makes it possible to achieve 97% sensitivity with 95% specificity in stage I BC. The combination of tumor markers CA-62 and CA 15-3 allows achieving 100% specificity in differentiation of BC and benign breast hyperplasia. The use of the CA-62 marker (6500 U/ml) in the gray zone of PSA 2.510 ng/ml improves the accuracy of detecting PC in biopsy from 35 to 93.1% with 90% sensitivity and 97% specificity. The use of a combination of tumor markers (CA-625000 U/ml, CYFRA 21-12.5 ng/ml and CEA5 ng/ml) will allow the doctor to improve the efficiency of differentiating lung cancer from chronic obstructive pulmonary disease. The combined use of markers (CEA3.5 ng/ml) and (CA-625000 U/ml) achieves 100% specificity with 97% sensitivity in detecting early stages of CRC.
 Conclusion. The article shows the possibilities of using the CA-62 marker, as well as new algorithms for the detection and differentiation of early stages of BC, PC, non-small cell lung cancer and CRC and benign neoplasms using the CA-62 marker in primary diagnosis. The use of the CA-62 tumor marker or its combination with other diagnostic methods can be a useful strategy for a comprehensive assessment of the risk of malignant neoplasms and increasing the diagnostic sensitivity of detecting early stages of cancer.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"4 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135724373","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 : 2023-11-05DOI: 10.26442/20751753.2023.6.202343
Natalia S. Zapariy, Olga I. Potapenko, Aleksandr V. Vyalov
Background. One of the major issues of disability is improving the medical rehabilitation system for patients and disabled people due to malignant neoplasms of the brain. It is important to study the patterns of disability to develop effective medical and social rehabilitation methods for disabled people.
Aim. To study the cumulative disability of the adult population due to malignant neoplasms of the brain in Moscow for 20162021 to develop measures for the prevention of morbidity and disability of this population, recommendations for improving comprehensive medical and social rehabilitation at all stages, and the provider of rehabilitation services.
Materials and methods. It was a continuous study. The study included patients aged 18 years and older, examined and re-examined at the Bureau of Medical and Social Expertise due to malignant brain neoplasms in Moscow for 20162021.
Results. Cumulative disability due to malignant neoplasms of the brain among the adult population of Moscow for 20162021 showed an increase in the total number of disabled people with a predominance of persons repeatedly recognized as disabled, the predominance of disabled people of working age with a tendency to rate increase, the predominance of malignant neoplasms of the brain (C71), frontal lobe (C71.1), and overlapping lesions of brain (C71.8); III disability category and males prevailed.
{"title":"Indicators of cumulative disability due to malignant neoplasms of the brain for 2016–2021","authors":"Natalia S. Zapariy, Olga I. Potapenko, Aleksandr V. Vyalov","doi":"10.26442/20751753.2023.6.202343","DOIUrl":"https://doi.org/10.26442/20751753.2023.6.202343","url":null,"abstract":"Background. One of the major issues of disability is improving the medical rehabilitation system for patients and disabled people due to malignant neoplasms of the brain. It is important to study the patterns of disability to develop effective medical and social rehabilitation methods for disabled people.
 Aim. To study the cumulative disability of the adult population due to malignant neoplasms of the brain in Moscow for 20162021 to develop measures for the prevention of morbidity and disability of this population, recommendations for improving comprehensive medical and social rehabilitation at all stages, and the provider of rehabilitation services.
 Materials and methods. It was a continuous study. The study included patients aged 18 years and older, examined and re-examined at the Bureau of Medical and Social Expertise due to malignant brain neoplasms in Moscow for 20162021.
 Results. Cumulative disability due to malignant neoplasms of the brain among the adult population of Moscow for 20162021 showed an increase in the total number of disabled people with a predominance of persons repeatedly recognized as disabled, the predominance of disabled people of working age with a tendency to rate increase, the predominance of malignant neoplasms of the brain (C71), frontal lobe (C71.1), and overlapping lesions of brain (C71.8); III disability category and males prevailed.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135724374","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 : 2023-11-05DOI: 10.26442/20751753.2023.6.202347
Igor V. Reshetov, Anastasia S. Fatyanova
The article reflects practical aspects of the introduction of a new professional standard of oncologist. These are segreagation of competences according to the new labor functions, admission to professional retraining in oncology of doctors of new specialties, preparation of a new educational standard, as well as new requirements for work experience in the main specialty for retraining.
{"title":"Importance of the reformed oncology education for today's specialists","authors":"Igor V. Reshetov, Anastasia S. Fatyanova","doi":"10.26442/20751753.2023.6.202347","DOIUrl":"https://doi.org/10.26442/20751753.2023.6.202347","url":null,"abstract":"The article reflects practical aspects of the introduction of a new professional standard of oncologist. These are segreagation of competences according to the new labor functions, admission to professional retraining in oncology of doctors of new specialties, preparation of a new educational standard, as well as new requirements for work experience in the main specialty for retraining.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"5 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135724369","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 : 2023-11-05DOI: 10.26442/20751753.2023.6.202335
Nikolai A. Ognerubov, Tatiana S. Antipova, Galina N. Abakumova
Background. Primary hyperparathyroidism is a common endocrinological disease caused mainly by parathyroid adenoma. The main treatment method is surgery (parathyroidectomy). Therefore, the exact determination of adenoma localization is crucial.
Aim. To evaluate the current possibilities of multimodal diagnosis of parathyroid adenomas.
Materials and methods. A retrospective analysis of 49 patients with primary hyperparathyroidism aged 24 to 82 (median 57.9 years) was performed. Modern radionuclide and hybrid technologies were used for topical diagnosis and metabolic assessment of parathyroid adenomas: scanning, single-photon emission computed tomography, single-photon emission computed tomography combined with computed tomography, positron emission tomography combined with computed tomography with 18F-deoxyglucose and 18F-choline. The diagnosis of primary hyperparathyroidism was confirmed by a biochemical blood test: the level of parathyroid hormone and ionized and total calcium.
Results. The study included 43 (87.8%) females and 6 (12.2%) males. The female/male ratio was 7.2:1. Most cases (78.1%) were the hypercalcemic type of primary hyperparathyroidism, and the normocalcemic type was diagnosed in 21.9% of patients. The mean parathyroid hormone level was 145.43 pg/mL, exceeding the reference values by 2.2 times. Parathyroid hormone concentration in patients with primary hyperparathyroidism was 156.38 pg/mL, and mean ionized and total blood calcium levels were 1.43 and 3.04 mmol/L, respectively. The asymptomatic type occurred in 76.7% of patients. The symptomatic type of hyperparathyroidism had 23.3%, manifested with nephrolithiasis, pancreatitis, and bone lesions. Parathyroid adenomas were more often located in the left lobe (42.9%). In 77.6% of patients with primary hyperparathyroidism, solitary adenomas were detected. Ectopia of the parathyroid glands was detected in 16.3% of patients, with intrathyroidal location in the left lobe being the most common. Rare locations include the anterior and posterior mediastinum and the esophageal wall.
Conclusion. Modern diagnostic multimodal options based on radionuclide and hybrid technologies are crucial in the personalized treatment of primary hyperparathyroidism.
{"title":"Parathyroid adenoma: multimodal diagnosis capabilities: A retrospective study","authors":"Nikolai A. Ognerubov, Tatiana S. Antipova, Galina N. Abakumova","doi":"10.26442/20751753.2023.6.202335","DOIUrl":"https://doi.org/10.26442/20751753.2023.6.202335","url":null,"abstract":"Background. Primary hyperparathyroidism is a common endocrinological disease caused mainly by parathyroid adenoma. The main treatment method is surgery (parathyroidectomy). Therefore, the exact determination of adenoma localization is crucial.
 Aim. To evaluate the current possibilities of multimodal diagnosis of parathyroid adenomas.
 Materials and methods. A retrospective analysis of 49 patients with primary hyperparathyroidism aged 24 to 82 (median 57.9 years) was performed. Modern radionuclide and hybrid technologies were used for topical diagnosis and metabolic assessment of parathyroid adenomas: scanning, single-photon emission computed tomography, single-photon emission computed tomography combined with computed tomography, positron emission tomography combined with computed tomography with 18F-deoxyglucose and 18F-choline. The diagnosis of primary hyperparathyroidism was confirmed by a biochemical blood test: the level of parathyroid hormone and ionized and total calcium.
 Results. The study included 43 (87.8%) females and 6 (12.2%) males. The female/male ratio was 7.2:1. Most cases (78.1%) were the hypercalcemic type of primary hyperparathyroidism, and the normocalcemic type was diagnosed in 21.9% of patients. The mean parathyroid hormone level was 145.43 pg/mL, exceeding the reference values by 2.2 times. Parathyroid hormone concentration in patients with primary hyperparathyroidism was 156.38 pg/mL, and mean ionized and total blood calcium levels were 1.43 and 3.04 mmol/L, respectively. The asymptomatic type occurred in 76.7% of patients. The symptomatic type of hyperparathyroidism had 23.3%, manifested with nephrolithiasis, pancreatitis, and bone lesions. Parathyroid adenomas were more often located in the left lobe (42.9%). In 77.6% of patients with primary hyperparathyroidism, solitary adenomas were detected. Ectopia of the parathyroid glands was detected in 16.3% of patients, with intrathyroidal location in the left lobe being the most common. Rare locations include the anterior and posterior mediastinum and the esophageal wall.
 Conclusion. Modern diagnostic multimodal options based on radionuclide and hybrid technologies are crucial in the personalized treatment of primary hyperparathyroidism.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"4 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135724371","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 : 2023-11-05DOI: 10.26442/20751753.2023.6.202322
Sergey A. Parts, Igor V. Reshetov, Evgeniya S. Kuzmina, Vsevolod N. Galkin
The main objective of the oncology patient routing system in the region is to ensure the accessibility and quality of outpatient oncology care. According to the regulatory documents of the Ministry of Health of Russia, the key role in the routing system is assigned to outpatient cancer care centers. We analyzed the regulatory requirements for the operation of the centers and proposed algorithms for their integration in the regions. Based on the developed algorithms, routing modeling and a rank assessment of the models were performed with a subsequent risk assessment and rationale for organizational measures to mitigate the risks.
{"title":"Organizational models of cancer patient routing at the regional level","authors":"Sergey A. Parts, Igor V. Reshetov, Evgeniya S. Kuzmina, Vsevolod N. Galkin","doi":"10.26442/20751753.2023.6.202322","DOIUrl":"https://doi.org/10.26442/20751753.2023.6.202322","url":null,"abstract":"The main objective of the oncology patient routing system in the region is to ensure the accessibility and quality of outpatient oncology care. According to the regulatory documents of the Ministry of Health of Russia, the key role in the routing system is assigned to outpatient cancer care centers. We analyzed the regulatory requirements for the operation of the centers and proposed algorithms for their integration in the regions. Based on the developed algorithms, routing modeling and a rank assessment of the models were performed with a subsequent risk assessment and rationale for organizational measures to mitigate the risks.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135724370","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 : 2023-11-05DOI: 10.26442/20751753.2023.6.202351
Igor E. Khatkov, Irina I. Andreyashkina, Kristina A. Anichkina, Alina V. Pasternak, Elizaveta S. Prokofieva, Roman D. Zaitsev, Ivan D. Trotsenko
Randomized clinical trials (RCTs) are the gold standard of evidence-based medicine. However, it is no less evident that real practice presents many new and important questions that are difficult to answer in the RCT. To what extent does the real patient meet the criteria for inclusion in the study? What are the efficacy and safety of the drug in comorbid and elderly patients? How deviations from the treatment regimen affect safety, etc. The introduction of innovative oncology approaches is disproportionately faster than in other fields. That is why a balanced analysis of the effects of innovation in real-world practice is relevant. Regulatory authorities are aware of this and demonstrate a willingness to consider and actively support real-world evidence research as part of drug applications, which is a powerful incentive for developing this area. The purpose of the article is to analyze the regulatory approaches in the United States and Europe to real-world studies when considering drug applications and to discuss the experience of organizing an observational study of the effectiveness of individual drugs for the treatment of oncological diseases in Moscow as a unique example of interaction between regulatory authorities and the expert community of oncologists.
{"title":"Observational studies as a tool for introducing innovative oncology approaches into clinical practice: A review","authors":"Igor E. Khatkov, Irina I. Andreyashkina, Kristina A. Anichkina, Alina V. Pasternak, Elizaveta S. Prokofieva, Roman D. Zaitsev, Ivan D. Trotsenko","doi":"10.26442/20751753.2023.6.202351","DOIUrl":"https://doi.org/10.26442/20751753.2023.6.202351","url":null,"abstract":"Randomized clinical trials (RCTs) are the gold standard of evidence-based medicine. However, it is no less evident that real practice presents many new and important questions that are difficult to answer in the RCT. To what extent does the real patient meet the criteria for inclusion in the study? What are the efficacy and safety of the drug in comorbid and elderly patients? How deviations from the treatment regimen affect safety, etc. The introduction of innovative oncology approaches is disproportionately faster than in other fields. That is why a balanced analysis of the effects of innovation in real-world practice is relevant. Regulatory authorities are aware of this and demonstrate a willingness to consider and actively support real-world evidence research as part of drug applications, which is a powerful incentive for developing this area. The purpose of the article is to analyze the regulatory approaches in the United States and Europe to real-world studies when considering drug applications and to discuss the experience of organizing an observational study of the effectiveness of individual drugs for the treatment of oncological diseases in Moscow as a unique example of interaction between regulatory authorities and the expert community of oncologists.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"5 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135724368","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 : 2023-11-05DOI: 10.26442/20751753.2023.6.202302
Aleksandra S. Polonskaia, Anna V. Michenko, Larisa S. Kruglova, Evgeniya A. Shatokhina, Andrey N. Lvov
Modern antitumor therapy includes novel targeted and immunotherapeutic options specifically targeting tumor targets. However, many of these targets are also expressed in the constantly proliferating epidermis of the skin, leading to derangement of proliferation and differentiation of keratinocytes, inflammatory responses, skin barrier dysfunction, inhibition of antimicrobial peptides' synthesis, and toxic skin reactions. The article presents an overview of current data on microbiome disorders associated with toxic skin reactions. The potential mechanisms of skin microbiome changes inducing the occurrence and persistence of rashes during anticancer therapy are addressed.
{"title":"Skin microbiome in cancer patients with pruritus and other skin toxic reactions related to anticancer therapy: A review","authors":"Aleksandra S. Polonskaia, Anna V. Michenko, Larisa S. Kruglova, Evgeniya A. Shatokhina, Andrey N. Lvov","doi":"10.26442/20751753.2023.6.202302","DOIUrl":"https://doi.org/10.26442/20751753.2023.6.202302","url":null,"abstract":"Modern antitumor therapy includes novel targeted and immunotherapeutic options specifically targeting tumor targets. However, many of these targets are also expressed in the constantly proliferating epidermis of the skin, leading to derangement of proliferation and differentiation of keratinocytes, inflammatory responses, skin barrier dysfunction, inhibition of antimicrobial peptides' synthesis, and toxic skin reactions. The article presents an overview of current data on microbiome disorders associated with toxic skin reactions. The potential mechanisms of skin microbiome changes inducing the occurrence and persistence of rashes during anticancer therapy are addressed.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"4 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135724372","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 : 2023-10-14DOI: 10.26442/20751753.2023.9.202395
Diana I. Abdulganieva, Ekaterina V. Dyakova, Era V. Ivanova, Nailya G. Shamsutdinova, Asiya R. Yangurazova, Nigina A. Nigmatullina, Ildar F. Fatkullin
Aim. Pregnancy worsens COVID-19 and has been listed by the US Food and Drug Administration as a high risk factor for complicating COVID-19. The severe course of a new coronavirus infection in some pregnant patients has created the prerequisites for the search for treatment methods that can reduce the likelihood of adverse outcomes. One of these therapy options is treatment with virus-neutralizing antibodies monoclonal antibodies. Experience with the use of monoclonal antibodies for the treatment of pregnant women is very limited, but in 2021 pregnancy was recognized as a high risk factor for the course of a new coronavirus infection, making it possible to use this group of drugs.
Materials and methods. We described the experience of COVID-19 monoclonal antibody therapy during pregnancy in the Republic of Tatarstan. A retrospective analysis of 18 case histories of pregnant patients with mild and moderate course of confirmed coronavirus infection, treated with monoclonal antibodies (casirivimab/imdevimab) from March 2022 to June 2022, was carried out on the basis of the Perinatal Center of the Republican Clinical Hospital, Kazan, Republic of Tatarstan.
Results. All patients tolerated the administration of casirivimab/imdevimab satisfactorily; no adverse drug reactions were identified. Subjective improvement was observed on the 3rd day of MCA treatment. Delivery through the natural birth canal was carried out on time in 11 women; by caesarean section on time in 5 patients. A follow-up study of children born to 18 patients who had COVID-19 was collected. The age of the children at the time of information collection ranged from 10 months 1 year 1 month. Currently, all children are healthy and developing according to their age.
Conclusion. In all pregnant patients with a new coronavirus infection with mild to moderate course, the administration of casirivimab/imdevimab was an effective method of treating the new coronavirus infection. The follow-up of children born from 18 patients was followed: the childrens condition was satisfactory, their development corresponded to their age.
{"title":"Monoclonal antibody therapy for COVID-19 during pregnancy","authors":"Diana I. Abdulganieva, Ekaterina V. Dyakova, Era V. Ivanova, Nailya G. Shamsutdinova, Asiya R. Yangurazova, Nigina A. Nigmatullina, Ildar F. Fatkullin","doi":"10.26442/20751753.2023.9.202395","DOIUrl":"https://doi.org/10.26442/20751753.2023.9.202395","url":null,"abstract":"Aim. Pregnancy worsens COVID-19 and has been listed by the US Food and Drug Administration as a high risk factor for complicating COVID-19. The severe course of a new coronavirus infection in some pregnant patients has created the prerequisites for the search for treatment methods that can reduce the likelihood of adverse outcomes. One of these therapy options is treatment with virus-neutralizing antibodies monoclonal antibodies. Experience with the use of monoclonal antibodies for the treatment of pregnant women is very limited, but in 2021 pregnancy was recognized as a high risk factor for the course of a new coronavirus infection, making it possible to use this group of drugs.
 Materials and methods. We described the experience of COVID-19 monoclonal antibody therapy during pregnancy in the Republic of Tatarstan. A retrospective analysis of 18 case histories of pregnant patients with mild and moderate course of confirmed coronavirus infection, treated with monoclonal antibodies (casirivimab/imdevimab) from March 2022 to June 2022, was carried out on the basis of the Perinatal Center of the Republican Clinical Hospital, Kazan, Republic of Tatarstan.
 Results. All patients tolerated the administration of casirivimab/imdevimab satisfactorily; no adverse drug reactions were identified. Subjective improvement was observed on the 3rd day of MCA treatment. Delivery through the natural birth canal was carried out on time in 11 women; by caesarean section on time in 5 patients. A follow-up study of children born to 18 patients who had COVID-19 was collected. The age of the children at the time of information collection ranged from 10 months 1 year 1 month. Currently, all children are healthy and developing according to their age.
 Conclusion. In all pregnant patients with a new coronavirus infection with mild to moderate course, the administration of casirivimab/imdevimab was an effective method of treating the new coronavirus infection. The follow-up of children born from 18 patients was followed: the childrens condition was satisfactory, their development corresponded to their age.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"87 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135803541","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 : 2023-10-14DOI: 10.26442/20751753.2023.9.202406
Andrey A. Zaytsev, Igor V. Leshchenko
The publication discusses modern antimicrobial therapy regimens in patients with exacerbation of chronic obstructive pain. Lung diseases from the perspective of the updated version of national recommendations. Indications for prescribing antibiotics, etiological exacerbation risk factors, risk factors for encountering microorganisms with antibiotic resistance mechanisms, selection algorithm antimicrobial drug.
{"title":"Modern concepts of antimicrobial therapy regimens for exacerbation of chronic obstructive pulmonary disease: A review","authors":"Andrey A. Zaytsev, Igor V. Leshchenko","doi":"10.26442/20751753.2023.9.202406","DOIUrl":"https://doi.org/10.26442/20751753.2023.9.202406","url":null,"abstract":"The publication discusses modern antimicrobial therapy regimens in patients with exacerbation of chronic obstructive pain. Lung diseases from the perspective of the updated version of national recommendations. Indications for prescribing antibiotics, etiological exacerbation risk factors, risk factors for encountering microorganisms with antibiotic resistance mechanisms, selection algorithm antimicrobial drug.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135803754","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 : 2023-10-14DOI: 10.26442/20751753.2023.9.202271
Vladimir Y. Mishin, Anastasiia V. Mishina, Dmitry A. Lezhnev, Aleksandr L. Sobkin, Ivan V. Shashenkov
Aim. To study the features of clinical manifestations and diagnosis of comorbidity of disseminated pulmonary tuberculosis, coronavirus, pneumocystis and pneumococcal pneumonia in patients with late stages of HIV infection with immunodeficiency.
Materials and methods. The prospective study included 120 newly identified patients with disseminated pulmonary tuberculosis with Mycobacterium tuberculosis, stage IVB of HIV infection, in the phase of progression and in the absence of antiretroviral therapy, aged 2953 years, who were randomized into 1A and 2A main groups and 1B and 2B comparison groups. Group 1A included 29 patients with comorbidity and pneumocystis pneumonia and group 2A 31 patients with comorbidity of disseminated pulmonary tuberculosis, coronovirus pneumococcal pneumonia, and group 1B and 2B comprised 29 and 31 similar patients, but without coronovirus pneumonia. To diagnose coronavirus pneumonia, PCR of SARS-CoV-2 RNA was used in smears from the nasopharynx and oropharynx, in sputum or in endotracheal aspirate. To detect Pneumocystis jirovecii, the causative agent of pneumocystis pneumonia, a microscopic examination of diagnostic material from the respiratory tract with RomanovskyGiemse and GrokottGmri coloration was carried out, and to detect Streptococcus pneumoniae, the causative agent of pneumococcal pneumonia, the diagnostic material was seeded on special nutrient media with determination of the drug resistance of the resulting culture to broad-spectrum antibiotics. Statistical data processing was carried out using the Microsoft Office Excel 2019 program with the calculation of the average in the group and the standard error of the average, confidence interval.
Results. The comorbidity of disseminated pulmonary tuberculosis, coronavirus, pneumocystis and pneumococcal pneumonia in patients in the late stages of HIV infection, in the phase of progression and in the absence of antiretroviral therapy was characterized by severe immunodeficiency, generalization of tuberculosis with multiple extrapulmonary lesions and severe pneumonia. This determines the similarity of clinical manifestations and respiratory symptoms, and also makes it difficult to visualize computed tomographic changes consisting of a complex simultaneous combination of four pathological syndromes: dissemination, pleural pathology, increased pulmonary pattern and adenopathy. Simultaneous layering of several pathologies with the same type of clinical manifestations and computed tomographic changes requires a comprehensive etiological diagnosis of specific diseases to prescribe timely comprehensive treatment and reduce the lethality of this heavy contingent of patients.
Conclusion. Patients with disseminated pulmonary tuberculosis and HIV infection who are registered in the office of tuberculosis care for HIV-infected in the tuberculosis dispensary represent a high risk group of COVID-19 infection and the development of coronavirus pneumonia, and with
{"title":"Features of clinical manifestations and diagnosis of comorbidity of disseminated pulmonary tuberculosis, coronavirus, pneumocystis and pneumococcal pneumonia in patients with late stages of HIV infection with immunodeficiency","authors":"Vladimir Y. Mishin, Anastasiia V. Mishina, Dmitry A. Lezhnev, Aleksandr L. Sobkin, Ivan V. Shashenkov","doi":"10.26442/20751753.2023.9.202271","DOIUrl":"https://doi.org/10.26442/20751753.2023.9.202271","url":null,"abstract":"Aim. To study the features of clinical manifestations and diagnosis of comorbidity of disseminated pulmonary tuberculosis, coronavirus, pneumocystis and pneumococcal pneumonia in patients with late stages of HIV infection with immunodeficiency.
 Materials and methods. The prospective study included 120 newly identified patients with disseminated pulmonary tuberculosis with Mycobacterium tuberculosis, stage IVB of HIV infection, in the phase of progression and in the absence of antiretroviral therapy, aged 2953 years, who were randomized into 1A and 2A main groups and 1B and 2B comparison groups. Group 1A included 29 patients with comorbidity and pneumocystis pneumonia and group 2A 31 patients with comorbidity of disseminated pulmonary tuberculosis, coronovirus pneumococcal pneumonia, and group 1B and 2B comprised 29 and 31 similar patients, but without coronovirus pneumonia. To diagnose coronavirus pneumonia, PCR of SARS-CoV-2 RNA was used in smears from the nasopharynx and oropharynx, in sputum or in endotracheal aspirate. To detect Pneumocystis jirovecii, the causative agent of pneumocystis pneumonia, a microscopic examination of diagnostic material from the respiratory tract with RomanovskyGiemse and GrokottGmri coloration was carried out, and to detect Streptococcus pneumoniae, the causative agent of pneumococcal pneumonia, the diagnostic material was seeded on special nutrient media with determination of the drug resistance of the resulting culture to broad-spectrum antibiotics. Statistical data processing was carried out using the Microsoft Office Excel 2019 program with the calculation of the average in the group and the standard error of the average, confidence interval.
 Results. The comorbidity of disseminated pulmonary tuberculosis, coronavirus, pneumocystis and pneumococcal pneumonia in patients in the late stages of HIV infection, in the phase of progression and in the absence of antiretroviral therapy was characterized by severe immunodeficiency, generalization of tuberculosis with multiple extrapulmonary lesions and severe pneumonia. This determines the similarity of clinical manifestations and respiratory symptoms, and also makes it difficult to visualize computed tomographic changes consisting of a complex simultaneous combination of four pathological syndromes: dissemination, pleural pathology, increased pulmonary pattern and adenopathy. Simultaneous layering of several pathologies with the same type of clinical manifestations and computed tomographic changes requires a comprehensive etiological diagnosis of specific diseases to prescribe timely comprehensive treatment and reduce the lethality of this heavy contingent of patients.
 Conclusion. Patients with disseminated pulmonary tuberculosis and HIV infection who are registered in the office of tuberculosis care for HIV-infected in the tuberculosis dispensary represent a high risk group of COVID-19 infection and the development of coronavirus pneumonia, and with ","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135803542","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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