Pub Date : 2023-07-30DOI: 10.26442/20751753.2023.5.202247
D. Abramov, A. P. Zubarev, Valeriy M. Afanasiev, A. Smolkina, E. Karimova
Perforated duodenal ulcer is a common pathology with fairly high postoperative mortality, especially in late diagnosis. In some cases, timely diagnosis of a perforative ulcer may be difficult and the results of the survey may be contradictory. The classical triad of clinical signs of perforative ulcers is not always observed in patients, sometimes the clinical picture is so unclear that the final diagnosis can only be made intraoperative. The article presents an analysis of the clinical case of difficult diagnosis and treatment of perforative duodenal ulcer in a patient in an acute period of ischemic stroke. In addition, the patient had severe concomitant somatic pathology with a high risk of systemic thromboembolism and at the same time a high risk of bleeding.
{"title":"Perforative duodenal ulcer in a patient in the acute period of ischemic stroke. Case report","authors":"D. Abramov, A. P. Zubarev, Valeriy M. Afanasiev, A. Smolkina, E. Karimova","doi":"10.26442/20751753.2023.5.202247","DOIUrl":"https://doi.org/10.26442/20751753.2023.5.202247","url":null,"abstract":"Perforated duodenal ulcer is a common pathology with fairly high postoperative mortality, especially in late diagnosis. In some cases, timely diagnosis of a perforative ulcer may be difficult and the results of the survey may be contradictory. The classical triad of clinical signs of perforative ulcers is not always observed in patients, sometimes the clinical picture is so unclear that the final diagnosis can only be made intraoperative. The article presents an analysis of the clinical case of difficult diagnosis and treatment of perforative duodenal ulcer in a patient in an acute period of ischemic stroke. In addition, the patient had severe concomitant somatic pathology with a high risk of systemic thromboembolism and at the same time a high risk of bleeding.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47699421","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 : 2023-07-30DOI: 10.26442/20751753.2023.5.202250
O. Golovenko, A. O. Golovenko
Aim. To study the opinions of gastroenterologists about drugs affecting the intestinal microflora. Materials and methods. A qualitative survey was conducted in focus groups to study the patterns of prescribing drugs that regulate intestinal microflora in chronic gastrointestinal diseases. The survey included only outpatient gastroenterologists who managed patients with irritable bowel syndrome, an uncomplicated diverticular disease with clinical manifestations and excessive bacterial growth in the small intestine for at least 3 years. Results. Physicians perceive the non-absorbable antibiotic rifaximin alpha as the drug of choice for treating these diseases; they are aware of its low bioavailability and suitability for repeated use. However, with severe clinical symptoms, some doctors tend to use systemic antibiotics before infectious or inflammatory complications are confirmed. It is due to the erroneous perception of systemic antibiotics as obviously more effective drugs than non-absorbable antibiotics. When choosing a drug, it is essential to consider the risk of antibiotic-associated diarrhea, adverse changes in the microflora, and the patient's comorbidities. Conclusion. Surveyed gastroenterologists consider rifaximin alfa (Alfa Normix) the most suitable drug that helps in routine practice achieve the desired result with a minimum risk of adverse events. Many study participants are skeptical about the effect of probiotics due to the lack of evidence but emphasize their safety and the request for probiotics from patients. Not all doctors are aware of metabiotics. Prebiotics and dietary fibers are perceived as agents that affect both the intestinal microflora and the stool frequency. Some healthcare professionals are concerned about prebiotics and probiotics registered as dietary supplements, which can cause patient misunderstandings. Identified opinions about such agents can be used in training gastroenterologists and developing clinical guidelines.
{"title":"Opinions of gastroenterologists about intestinal microbiota modulating agents: results of the survey in focus groups","authors":"O. Golovenko, A. O. Golovenko","doi":"10.26442/20751753.2023.5.202250","DOIUrl":"https://doi.org/10.26442/20751753.2023.5.202250","url":null,"abstract":"Aim. To study the opinions of gastroenterologists about drugs affecting the intestinal microflora. \u0000Materials and methods. A qualitative survey was conducted in focus groups to study the patterns of prescribing drugs that regulate intestinal microflora in chronic gastrointestinal diseases. The survey included only outpatient gastroenterologists who managed patients with irritable bowel syndrome, an uncomplicated diverticular disease with clinical manifestations and excessive bacterial growth in the small intestine for at least 3 years. \u0000Results. Physicians perceive the non-absorbable antibiotic rifaximin alpha as the drug of choice for treating these diseases; they are aware of its low bioavailability and suitability for repeated use. However, with severe clinical symptoms, some doctors tend to use systemic antibiotics before infectious or inflammatory complications are confirmed. It is due to the erroneous perception of systemic antibiotics as obviously more effective drugs than non-absorbable antibiotics. When choosing a drug, it is essential to consider the risk of antibiotic-associated diarrhea, adverse changes in the microflora, and the patient's comorbidities. \u0000Conclusion. Surveyed gastroenterologists consider rifaximin alfa (Alfa Normix) the most suitable drug that helps in routine practice achieve the desired result with a minimum risk of adverse events. Many study participants are skeptical about the effect of probiotics due to the lack of evidence but emphasize their safety and the request for probiotics from patients. Not all doctors are aware of metabiotics. Prebiotics and dietary fibers are perceived as agents that affect both the intestinal microflora and the stool frequency. Some healthcare professionals are concerned about prebiotics and probiotics registered as dietary supplements, which can cause patient misunderstandings. Identified opinions about such agents can be used in training gastroenterologists and developing clinical guidelines.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46383048","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 : 2023-07-30DOI: 10.26442/20751753.2023.5.202253
Mariia A. Livzan, O. V. Korpacheva, Galiia R. Bikbavova, A. E. Romanyuk
Nausea and vomiting are among the most common complaints in outpatient clinics and hospitals, while they are associated with poor quality of life. Their causes are diverse, and pathogenetic mechanisms are multifactorial. In the presented article, the pathophysiology of nausea and vomiting is examined in detail, an algorithm of sequential actions is proposed, which is based on the following stages: finding out what the patient means by nausea and vomiting; determining whether these symptoms are acute or chronic; thorough detailing of complaints; detailed collection of anamnesis; careful physical examination. The indicated sequence of actions of the doctor during the initial treatment of the patient forms the basis for a differential diagnosis and determines further examination. Special attention is paid to the treatment of nausea and vomiting, the place of dopamine receptor blockers in the relief of these painful symptoms is discussed. The search for literature containing information on relevant studies was conducted in PubMed and Google Scholar systems according to the words: nausea, vomiting, postoperative vomiting, gastroparesis, dopamine receptor blockers, domperidone.
{"title":"Nausea and vomiting in the practice of a therapist and gastroenterologist: A review","authors":"Mariia A. Livzan, O. V. Korpacheva, Galiia R. Bikbavova, A. E. Romanyuk","doi":"10.26442/20751753.2023.5.202253","DOIUrl":"https://doi.org/10.26442/20751753.2023.5.202253","url":null,"abstract":"Nausea and vomiting are among the most common complaints in outpatient clinics and hospitals, while they are associated with poor quality of life. Their causes are diverse, and pathogenetic mechanisms are multifactorial. In the presented article, the pathophysiology of nausea and vomiting is examined in detail, an algorithm of sequential actions is proposed, which is based on the following stages: finding out what the patient means by nausea and vomiting; determining whether these symptoms are acute or chronic; thorough detailing of complaints; detailed collection of anamnesis; careful physical examination. The indicated sequence of actions of the doctor during the initial treatment of the patient forms the basis for a differential diagnosis and determines further examination. Special attention is paid to the treatment of nausea and vomiting, the place of dopamine receptor blockers in the relief of these painful symptoms is discussed. The search for literature containing information on relevant studies was conducted in PubMed and Google Scholar systems according to the words: nausea, vomiting, postoperative vomiting, gastroparesis, dopamine receptor blockers, domperidone.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43862841","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 : 2023-07-30DOI: 10.26442/20751753.2023.5.202289
N. Bakulina, S. Tikhonov, Anastasia Yu. Efremova, Vakhtang V. Mirtskhulava
Epidemiological, endoscopic and pathophysiological studies confirm the relationship between obesity and gastroesophageal reflux disease (GERD) and is characterized by a more severe course, has clinical and pathophysiological features. In the treatment of GERD, it is necessary to use an individualized integrated approach, which consists in the combined use of diet therapy, lifestyle changes and drug therapy. The basis of pharmacotherapy for GERD are proton-pump inhibitors that positively affect the quality of life and long-term prognosis. At the same time, pharmacodynamic and pharmacokinetic features determine the advantage of the rabeprazole molecule in obese patients, including the minimal risk of drug-drug interactions.
{"title":"Features of GERD therapy in obese patients: A review","authors":"N. Bakulina, S. Tikhonov, Anastasia Yu. Efremova, Vakhtang V. Mirtskhulava","doi":"10.26442/20751753.2023.5.202289","DOIUrl":"https://doi.org/10.26442/20751753.2023.5.202289","url":null,"abstract":"Epidemiological, endoscopic and pathophysiological studies confirm the relationship between obesity and gastroesophageal reflux disease (GERD) and is characterized by a more severe course, has clinical and pathophysiological features. In the treatment of GERD, it is necessary to use an individualized integrated approach, which consists in the combined use of diet therapy, lifestyle changes and drug therapy. The basis of pharmacotherapy for GERD are proton-pump inhibitors that positively affect the quality of life and long-term prognosis. At the same time, pharmacodynamic and pharmacokinetic features determine the advantage of the rabeprazole molecule in obese patients, including the minimal risk of drug-drug interactions.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46588005","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 : 2023-07-30DOI: 10.26442/20751753.2023.5.202294
O. D. Ostroumova, A. I. Kochetkov, S. V. Batyukina, Sergey V. Cheremushkin
Prevention of thromboembolic complications is the main goal in patients with atrial fibrillation. Anticoagulant therapy is used as prophylaxis, and direct oral anticoagulants are preferred. However, this therapy is associated with a risk of bleeding, among which gastrointestinal bleeding takes a leading place. Proton pump inhibitors are now widely used as prophylaxis for upper gastrointestinal bleedings, but when used long-term, may be associated with a number of adverse drug reactions, including an increased risk of adverse cardiovascular events. Long-term use of these drugs may suppress the action of antiplatelet drugs, disrupt the function of the vascular endothelium, and at the same time cause hypomagnesemia, iron deficiency, vitamin D and K deficiency. At the same time, monotherapy with proton pump inhibitors does not protect against the risk of bleeding from the lower gastrointestinal tract. Thus, as an effective gastro- and enteroprotection, it is necessary to prescribe drugs that protect the gastrointestinal tract throughout its entire length. Such a drug is rebamipide, which has a complex protective effect on the gastrointestinal tract, protecting the mucous membrane at all its levels (pre-, post-epithelial and directly epithelial level), and ensures the restoration of tight contacts in the epithelium of the intestinal tube throughout its entire length. It should be noted that the current consensus documents of the leading experts on the problem of decreasing the risk of gastrointestinal bleedings during direct oral anticoagulant treatment recommend the use of rebamipide for the entire duration of therapy.
{"title":"Gastroprotective therapy in patients with atrial fibrillation receiving anticoagulant therapy: A review","authors":"O. D. Ostroumova, A. I. Kochetkov, S. V. Batyukina, Sergey V. Cheremushkin","doi":"10.26442/20751753.2023.5.202294","DOIUrl":"https://doi.org/10.26442/20751753.2023.5.202294","url":null,"abstract":"Prevention of thromboembolic complications is the main goal in patients with atrial fibrillation. Anticoagulant therapy is used as prophylaxis, and direct oral anticoagulants are preferred. However, this therapy is associated with a risk of bleeding, among which gastrointestinal bleeding takes a leading place. Proton pump inhibitors are now widely used as prophylaxis for upper gastrointestinal bleedings, but when used long-term, may be associated with a number of adverse drug reactions, including an increased risk of adverse cardiovascular events. Long-term use of these drugs may suppress the action of antiplatelet drugs, disrupt the function of the vascular endothelium, and at the same time cause hypomagnesemia, iron deficiency, vitamin D and K deficiency. At the same time, monotherapy with proton pump inhibitors does not protect against the risk of bleeding from the lower gastrointestinal tract. Thus, as an effective gastro- and enteroprotection, it is necessary to prescribe drugs that protect the gastrointestinal tract throughout its entire length. Such a drug is rebamipide, which has a complex protective effect on the gastrointestinal tract, protecting the mucous membrane at all its levels (pre-, post-epithelial and directly epithelial level), and ensures the restoration of tight contacts in the epithelium of the intestinal tube throughout its entire length. It should be noted that the current consensus documents of the leading experts on the problem of decreasing the risk of gastrointestinal bleedings during direct oral anticoagulant treatment recommend the use of rebamipide for the entire duration of therapy.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46854977","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 : 2023-07-30DOI: 10.26442/20751753.2023.5.202221
E. M. Ledeneva, A. Vertkin, Iuliia V. Sediakina, S. S. Kurdjieva, M. Shamuilova
Over the last 10 years, the incidence of chronic pancreatitis (CP) has increased 4 times and nowadays is about 27.450 cases per 100 000 adults. In the outpatient gastroenterologist practice, patients with CP account for about 3545%, in the hospital gastroenterology department up to 2045%. CP criteria according to imaging methods fibrosis, duct dilatation and deformation, calcifications in the pancreatic parenchyma or its atrophy are formed at a late stage of the disease. Simultaneously, diagnosis at the early stage with potentially reversible changes remains difficult, due to the lack of clear instrumental and laboratory findings confirming minimal changes in the pancreas. However, some methods in combination with a detailed history taking, risk factors identification in comparison with the clinical features are of interest for the early diagnosis of chronic pancreatitis.
{"title":"Chronic pancreatitis: prospects for early detection: A review","authors":"E. M. Ledeneva, A. Vertkin, Iuliia V. Sediakina, S. S. Kurdjieva, M. Shamuilova","doi":"10.26442/20751753.2023.5.202221","DOIUrl":"https://doi.org/10.26442/20751753.2023.5.202221","url":null,"abstract":"Over the last 10 years, the incidence of chronic pancreatitis (CP) has increased 4 times and nowadays is about 27.450 cases per 100 000 adults. In the outpatient gastroenterologist practice, patients with CP account for about 3545%, in the hospital gastroenterology department up to 2045%. CP criteria according to imaging methods fibrosis, duct dilatation and deformation, calcifications in the pancreatic parenchyma or its atrophy are formed at a late stage of the disease. Simultaneously, diagnosis at the early stage with potentially reversible changes remains difficult, due to the lack of clear instrumental and laboratory findings confirming minimal changes in the pancreas. However, some methods in combination with a detailed history taking, risk factors identification in comparison with the clinical features are of interest for the early diagnosis of chronic pancreatitis.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47074646","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 : 2023-07-30DOI: 10.26442/20751753.2023.5.202217
O.Yu. Gasieva, I. Khatkov, A. Vertkin
Aim. To reveal and evaluate predictors of infectious complications in the postoperative period after pancreatoduodenectomy. Materials and methods. An analysis was made of 790 articles that dealt with the subject of complications after pancreatoduodenectomy. Results. Seventy five articles met the inclusion criteria. Studies with small samples (less than 20 patients) were not considered. Based on the multifactorial nature of the problem of preventing infectious complications in the postoperative period, the results of the review are divided into several sections. PBD is highly effective in obstructive jaundice syndrome at the preoperative stage, but is associated with the risk of bile infection and complications in the postoperative period. These circumstances should be taken into account when determining the indications for PBD, choosing the method of decompression, in cases where stenting is used, attention should also be paid to the choice of material. Bacteriobilia is an independent predictor of surgical site infections (SSI) after PDR. Conclusion. Changing the approach to antibiotic prophylaxis based on the antibiotic sensitivity of the microflora can lead to a decrease in the incidence of SSI, a reduction in the duration of hospitalization, the number of complications associated with long-term antibiotic therapy, a decrease in the rate of spread of antibiotic resistance and a decrease in the financial costs of the institution for a completed case of medical care.
{"title":"Peculiarities of antibiotic therapy after pancreaticoduodenectomy","authors":"O.Yu. Gasieva, I. Khatkov, A. Vertkin","doi":"10.26442/20751753.2023.5.202217","DOIUrl":"https://doi.org/10.26442/20751753.2023.5.202217","url":null,"abstract":"Aim. To reveal and evaluate predictors of infectious complications in the postoperative period after pancreatoduodenectomy. \u0000Materials and methods. An analysis was made of 790 articles that dealt with the subject of complications after pancreatoduodenectomy. \u0000Results. Seventy five articles met the inclusion criteria. Studies with small samples (less than 20 patients) were not considered. Based on the multifactorial nature of the problem of preventing infectious complications in the postoperative period, the results of the review are divided into several sections. PBD is highly effective in obstructive jaundice syndrome at the preoperative stage, but is associated with the risk of bile infection and complications in the postoperative period. These circumstances should be taken into account when determining the indications for PBD, choosing the method of decompression, in cases where stenting is used, attention should also be paid to the choice of material. Bacteriobilia is an independent predictor of surgical site infections (SSI) after PDR. \u0000Conclusion. Changing the approach to antibiotic prophylaxis based on the antibiotic sensitivity of the microflora can lead to a decrease in the incidence of SSI, a reduction in the duration of hospitalization, the number of complications associated with long-term antibiotic therapy, a decrease in the rate of spread of antibiotic resistance and a decrease in the financial costs of the institution for a completed case of medical care.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42593195","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 : 2023-07-30DOI: 10.26442/20751753.2023.5.202155
I. Maev, D. N. Andreev, Y. Kucheryavyy
Aim. To systematize data on the prevalence of non-alcoholic fatty liver disease (NAFLD) in the adult population of Russia. Materials and methods. The studies were searched in the MEDLINE/PubMed and RSCI electronic databases from January 2000 to December 2022 (inclusive). The search included relevant publications in peer-reviewed periodicals in English or Russian; publications with data from cross-sectional/epidemiological studies assessing the prevalence of NAFLD in the Russian population; studies on adult patients with NAFLD; publications with detailed descriptive statistics that allow using the data in the meta-analysis. Results. The final analysis included 5 studies involving 96.680 subjects. The overall prevalence of NAFLD in the five adult studies analyzed was 27.562% (95% confidence interval CI 19.05636.979). The analysis used a random effect model, as there was significant heterogeneity between the results in both groups (I2=99.87%; p0.0001). In the studies enrolling patients before 2015, the overall prevalence of NAFLD was 22.409% (95% CI 11.55035.615), whereas, in studies that enrolled patients after 2015, it was 35.874% (95% CI 28.09444.046). When analyzing multicenter studies only, the overall prevalence of NAFLD was 31.975% (95% CI 24.67039.755). Conclusion. This meta-analysis demonstrated that NAFLD is a widespread chronic liver disease in the adult population of Russia, affecting approximately one in four country residents. For a more accurate objectification of the epidemiological structure of NAFLD in Russia, further multicenter studies of unified design are required.
的目标。目的:对俄罗斯成人非酒精性脂肪性肝病(NAFLD)患病率数据进行系统化分析。材料和方法。在2000年1月至2022年12月(含)的MEDLINE/PubMed和RSCI电子数据库中检索这些研究。检索包括同行评议期刊上的相关出版物，英文或俄文;来自评估俄罗斯人群NAFLD患病率的横断面/流行病学研究数据的出版物;成人NAFLD患者的研究;具有详细描述性统计的出版物，允许在元分析中使用数据。结果。最终分析纳入5项研究，涉及96680名受试者。在分析的5项成人研究中，NAFLD的总患病率为27.562%(95%可信区间CI 19.05636.979)。分析采用随机效应模型，两组结果存在显著异质性(I2=99.87%;p0.0001)。在2015年之前纳入患者的研究中，NAFLD的总体患病率为22.409% (95% CI 11.55035.615)，而在2015年之后纳入患者的研究中，NAFLD的总体患病率为35.874% (95% CI 28.09444.046)。当仅分析多中心研究时，NAFLD的总患病率为31.975% (95% CI 24.67039.755)。结论。这项荟萃分析表明，NAFLD是俄罗斯成年人中广泛存在的一种慢性肝病，影响了大约四分之一的国家居民。为了更准确地客观了解俄罗斯NAFLD的流行病学结构，需要进一步进行统一设计的多中心研究。
{"title":"Prevalence of non-alcoholic fat disease liver in Russian Federation: meta-analysis","authors":"I. Maev, D. N. Andreev, Y. Kucheryavyy","doi":"10.26442/20751753.2023.5.202155","DOIUrl":"https://doi.org/10.26442/20751753.2023.5.202155","url":null,"abstract":"Aim. To systematize data on the prevalence of non-alcoholic fatty liver disease (NAFLD) in the adult population of Russia. \u0000Materials and methods. The studies were searched in the MEDLINE/PubMed and RSCI electronic databases from January 2000 to December 2022 (inclusive). The search included relevant publications in peer-reviewed periodicals in English or Russian; publications with data from cross-sectional/epidemiological studies assessing the prevalence of NAFLD in the Russian population; studies on adult patients with NAFLD; publications with detailed descriptive statistics that allow using the data in the meta-analysis. \u0000Results. The final analysis included 5 studies involving 96.680 subjects. The overall prevalence of NAFLD in the five adult studies analyzed was 27.562% (95% confidence interval CI 19.05636.979). The analysis used a random effect model, as there was significant heterogeneity between the results in both groups (I2=99.87%; p0.0001). In the studies enrolling patients before 2015, the overall prevalence of NAFLD was 22.409% (95% CI 11.55035.615), whereas, in studies that enrolled patients after 2015, it was 35.874% (95% CI 28.09444.046). When analyzing multicenter studies only, the overall prevalence of NAFLD was 31.975% (95% CI 24.67039.755). \u0000Conclusion. This meta-analysis demonstrated that NAFLD is a widespread chronic liver disease in the adult population of Russia, affecting approximately one in four country residents. For a more accurate objectification of the epidemiological structure of NAFLD in Russia, further multicenter studies of unified design are required.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42832745","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 : 2023-07-30DOI: 10.26442/20751753.2023.5.202251
Y. Shumskaya, D. A. Akhmedzyanova, M. Mnatsakanyan
Background. To stratify the risk in patients with COVID-19, it is important to understand the parameters that predispose to a severe course. Following risk factors were described: age over 60 years, overweight, male gender, chronic diseases: hypertension, diabetes mellitus. Low liver density on computed tomography (CT) is also considered as a potential risk factor. Aim. To evaluation whether low liver density can be used as a predictor of severe COVID-19. Materials and methods. Retrospective single-center cohort study. Patients with COVID-19 treated in a hospital setting, who underwent two CT scans of the thoracic organs in dynamics, were included. The patients were divided into groups according to the severity of the course (groups of moderate course, severe course and lethal outcome). Relation of the investigated factors was estimated using regression analysis. Results. 99 patients were enrolled; 3 comparison groups were formed (moderate-severe course n=37, severe course n=52, lethal outcome n=8). All groups significantly differed in C-reactive protein levels. According to multivariate regression analysis, COVID-19 severity was influenced by the liver to spleen density ratio as measured by CT scan on admission [odds ratio 12.18 (95% confidence interval 1.6789.07); p=0.008]. Conclusion. Reduced liver density on CT scan in a patient with COVID-19 may be a predictor of severe course of novel coronavirus infection.
{"title":"Decreased liver density as a potential predictor of severe COVID-19: a retrospective cohort study","authors":"Y. Shumskaya, D. A. Akhmedzyanova, M. Mnatsakanyan","doi":"10.26442/20751753.2023.5.202251","DOIUrl":"https://doi.org/10.26442/20751753.2023.5.202251","url":null,"abstract":"Background. To stratify the risk in patients with COVID-19, it is important to understand the parameters that predispose to a severe course. Following risk factors were described: age over 60 years, overweight, male gender, chronic diseases: hypertension, diabetes mellitus. Low liver density on computed tomography (CT) is also considered as a potential risk factor. \u0000Aim. To evaluation whether low liver density can be used as a predictor of severe COVID-19. \u0000Materials and methods. Retrospective single-center cohort study. Patients with COVID-19 treated in a hospital setting, who underwent two CT scans of the thoracic organs in dynamics, were included. The patients were divided into groups according to the severity of the course (groups of moderate course, severe course and lethal outcome). Relation of the investigated factors was estimated using regression analysis. \u0000Results. 99 patients were enrolled; 3 comparison groups were formed (moderate-severe course n=37, severe course n=52, lethal outcome n=8). All groups significantly differed in C-reactive protein levels. According to multivariate regression analysis, COVID-19 severity was influenced by the liver to spleen density ratio as measured by CT scan on admission [odds ratio 12.18 (95% confidence interval 1.6789.07); p=0.008]. \u0000Conclusion. Reduced liver density on CT scan in a patient with COVID-19 may be a predictor of severe course of novel coronavirus infection.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43928203","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 : 2023-07-30DOI: 10.26442/20751753.2023.5.202272
D. Teplyuk, Aliya A. Kaisina, Shabnam Ibragimova, Af A Bestavashvili, I. O. Tinkova, E. Pashkova, J. Kaibullayeva, A. Nersesov, C. Pavlov
Non-alcoholic fatty liver disease (NAFLD) is now a major risk factor for death among patients with liver disease. Currently, drugs that primarily affect surrogate markers of NAFLD are available. However, none of these drugs showed a significant effect on the course of steatohepatitis and fibrogenesis. The search for the most relevant lifestyle modification programs is still a priority in comprehensive treatment. A clinical case of follow-up of a comorbid patient is presented. Despite comprehensive treatment, disease regression was not achieved. NAFLD therapy remains a relevant issue. Finding new ways to affect the NAFLD course and individualize treatment approaches is necessary.
{"title":"Non-alcoholic fatty liver disease: from understanding risk factors to finding optimal treatment regimens: A review","authors":"D. Teplyuk, Aliya A. Kaisina, Shabnam Ibragimova, Af A Bestavashvili, I. O. Tinkova, E. Pashkova, J. Kaibullayeva, A. Nersesov, C. Pavlov","doi":"10.26442/20751753.2023.5.202272","DOIUrl":"https://doi.org/10.26442/20751753.2023.5.202272","url":null,"abstract":"Non-alcoholic fatty liver disease (NAFLD) is now a major risk factor for death among patients with liver disease. Currently, drugs that primarily affect surrogate markers of NAFLD are available. However, none of these drugs showed a significant effect on the course of steatohepatitis and fibrogenesis. The search for the most relevant lifestyle modification programs is still a priority in comprehensive treatment. A clinical case of follow-up of a comorbid patient is presented. Despite comprehensive treatment, disease regression was not achieved. NAFLD therapy remains a relevant issue. Finding new ways to affect the NAFLD course and individualize treatment approaches is necessary.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43688628","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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