Pub Date : 2023-03-30DOI: 10.33978/2307-3586-2023-19-1-18-24
I. Barykina, E. Popova, A. Salasyuk, V. Lutova, A. A. Vachugova
Gestational diabetes mellitus is characterized by an increased risk of fetal macrosomia and obstetric complications during childbirth, as well as the development of type 2 diabetes in the mother after pregnancy. Timely diagnosis and treatment of hyperglycemia during pregnancy reduces adverse pregnancy outcomes. The first step towards tight glucose control during pregnancy is self-monitoring of glycemia. Aim: to evaluate the effectiveness of regular glycemic control using a Satellite express glucometer calibrated on capillary whole blood in patients with gestational diabetes mellitus (GDM) in outpatient practice. Material and methods. The 96-week prospective observational non-interventional study included 150 patients with GDM. In women with confirmed GDM, blood glucose was measured using a satellite express glucometer. At each visit, further tactics for the treatment of GDM were determined based on the results of glycemia (data from the self-monitoring diary). Until the 34th week of pregnancy, an endocrinologist was consulted with a frequency of 1 time in 2 weeks in the form of a medical appointment and telephone contact. After 34 weeks of pregnancy, consultation of an endocrinologist with a frequency of 1 time per week. 6–12 weeks after delivery, an oral glucose tolerance test and consultation with an endocrinologist were performed to assess the degree of carbohydrate metabolism disorder. Results. The participation of 138 (92%) patients in the study ended in childbirth, 12 (8%) patients dropped out of the study ahead of schedule. Spontaneous abortions were noted in patients who performed self-monitoring of glycemia 0–1 times a day, independent births were more often observed in patients who performed self-monitoring 3–4 times a day, and these patients also had more stable glycemic indices. 9 patients out of 138 gave birth to children weighing 4000 g or more. The weight of the rest of the children at birth did not exceed 3500 g. Conclusion. A well-controlled course of GDM, adequate self-monitoring and dynamic observation of women allows delivery to be carried out within the generally accepted terms without worsening its outcomes.
{"title":"The Influence of Self-Control on the Course and Outcomes of Gestational Diabetes Mellitus","authors":"I. Barykina, E. Popova, A. Salasyuk, V. Lutova, A. A. Vachugova","doi":"10.33978/2307-3586-2023-19-1-18-24","DOIUrl":"https://doi.org/10.33978/2307-3586-2023-19-1-18-24","url":null,"abstract":"Gestational diabetes mellitus is characterized by an increased risk of fetal macrosomia and obstetric complications during childbirth, as well as the development of type 2 diabetes in the mother after pregnancy. Timely diagnosis and treatment of hyperglycemia during pregnancy reduces adverse pregnancy outcomes. The first step towards tight glucose control during pregnancy is self-monitoring of glycemia. Aim: to evaluate the effectiveness of regular glycemic control using a Satellite express glucometer calibrated on capillary whole blood in patients with gestational diabetes mellitus (GDM) in outpatient practice. Material and methods. The 96-week prospective observational non-interventional study included 150 patients with GDM. In women with confirmed GDM, blood glucose was measured using a satellite express glucometer. At each visit, further tactics for the treatment of GDM were determined based on the results of glycemia (data from the self-monitoring diary). Until the 34th week of pregnancy, an endocrinologist was consulted with a frequency of 1 time in 2 weeks in the form of a medical appointment and telephone contact. After 34 weeks of pregnancy, consultation of an endocrinologist with a frequency of 1 time per week. 6–12 weeks after delivery, an oral glucose tolerance test and consultation with an endocrinologist were performed to assess the degree of carbohydrate metabolism disorder. Results. The participation of 138 (92%) patients in the study ended in childbirth, 12 (8%) patients dropped out of the study ahead of schedule. Spontaneous abortions were noted in patients who performed self-monitoring of glycemia 0–1 times a day, independent births were more often observed in patients who performed self-monitoring 3–4 times a day, and these patients also had more stable glycemic indices. 9 patients out of 138 gave birth to children weighing 4000 g or more. The weight of the rest of the children at birth did not exceed 3500 g. Conclusion. A well-controlled course of GDM, adequate self-monitoring and dynamic observation of women allows delivery to be carried out within the generally accepted terms without worsening its outcomes.","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87734784","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 : 2023-03-30DOI: 10.33978/2307-3586-2023-19-5-6-13
A. Ageykin, D. Usenko, A. Gorelov, V. L. Melnikov, K.A. Zvonova
The results of numerous randomized clinical trials indicate the relationship of a new coronavirus infection (NCI) with the development of acute myocardial injury (AMI). Of great importance in the defeat of the heart belongs to the change in the cytokine and chemokine status, which determines the inflammatory potential. The aim of this work was a comprehensive assessment of clinical and laboratory indicators of the state of the heart in a new coronavirus infection and the determination of immunopathogenetic mechanisms of myocardial damage. 180 patients hospitalized with a diagnosis of «coronavirus infection COVID-19, virus identified (U07.1), moderate form» were examined. Risk factors, levels of cytokines and chemokines (IFN-α, IL-6, IL-17, MIP-1b), markers of cardiac damage/dysfunction (troponin I and FAFA, NTproBNP), and antimyocardial IgG antibodies were assessed. Statistical processing was carried out using the Microsoft Office package (Microsoft Excel), as well as the statistical package STATISTICA 9.0. The Shapiro-Wilk W test was used to check the normality of the distribution. Differences were considered significant at p ≤ 0.05, unreliable at p ≥ 0.05. It has been established that in the acute period, 45% of patients have an increase in troponin I values. They also have significantly higher levels of IL-6, IL-17 and MIP-1b against the background of inhibition of IFN-α production. In the acute period, a third of patients have antimyocardial antibodies, which are detected significantly more often and in higher titers in patients with AMI. The presence of a direct correlation between the level of antimyocardial antibodies and an increase in the amount of CRP, MIP-1b and IL-17 was established. The most significant risk factors for the development of myocardial damage in NCI are the presence of a burdened history of cardiovascular diseases, an increased body mass index, and diabetes mellitus. Thus, high levels of CRP, MIP-1b IL-17, antimyocardial antibodies, with a continuing deficiency without a tendency to restore the level of IFN-α, in the presence of the above risk factors, are diagnostically significant markers of AMI in patients with moderate NCI.
{"title":"Diagnostic Markers of Heart Damage in Patients with a Moderate Form of New Coronavirus Infection","authors":"A. Ageykin, D. Usenko, A. Gorelov, V. L. Melnikov, K.A. Zvonova","doi":"10.33978/2307-3586-2023-19-5-6-13","DOIUrl":"https://doi.org/10.33978/2307-3586-2023-19-5-6-13","url":null,"abstract":"The results of numerous randomized clinical trials indicate the relationship of a new coronavirus infection (NCI) with the development of acute myocardial injury (AMI). Of great importance in the defeat of the heart belongs to the change in the cytokine and chemokine status, which determines the inflammatory potential. The aim of this work was a comprehensive assessment of clinical and laboratory indicators of the state of the heart in a new coronavirus infection and the determination of immunopathogenetic mechanisms of myocardial damage. 180 patients hospitalized with a diagnosis of «coronavirus infection COVID-19, virus identified (U07.1), moderate form» were examined. Risk factors, levels of cytokines and chemokines (IFN-α, IL-6, IL-17, MIP-1b), markers of cardiac damage/dysfunction (troponin I and FAFA, NTproBNP), and antimyocardial IgG antibodies were assessed. Statistical processing was carried out using the Microsoft Office package (Microsoft Excel), as well as the statistical package STATISTICA 9.0. The Shapiro-Wilk W test was used to check the normality of the distribution. Differences were considered significant at p ≤ 0.05, unreliable at p ≥ 0.05. It has been established that in the acute period, 45% of patients have an increase in troponin I values. They also have significantly higher levels of IL-6, IL-17 and MIP-1b against the background of inhibition of IFN-α production. In the acute period, a third of patients have antimyocardial antibodies, which are detected significantly more often and in higher titers in patients with AMI. The presence of a direct correlation between the level of antimyocardial antibodies and an increase in the amount of CRP, MIP-1b and IL-17 was established. The most significant risk factors for the development of myocardial damage in NCI are the presence of a burdened history of cardiovascular diseases, an increased body mass index, and diabetes mellitus. Thus, high levels of CRP, MIP-1b IL-17, antimyocardial antibodies, with a continuing deficiency without a tendency to restore the level of IFN-α, in the presence of the above risk factors, are diagnostically significant markers of AMI in patients with moderate NCI.","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84898064","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 : 2023-03-30DOI: 10.33978/2307-3586-2023-19-1-32-38
E. Ivannikova, E. Dudinskaya
To date, sulfonylurea derivatives occupy a leading position in the structure of diabetes mellitus therapy. The article discusses the effectiveness and safety of the use of sulfonylurea derivatives in order to compensate for carbohydrate metabolism, including in comparison with other classes of hypoglycemic drugs. Special emphasis is placed on cardiovascular safety.
{"title":"Gliclazide MV: Proven Efficacy and Safety","authors":"E. Ivannikova, E. Dudinskaya","doi":"10.33978/2307-3586-2023-19-1-32-38","DOIUrl":"https://doi.org/10.33978/2307-3586-2023-19-1-32-38","url":null,"abstract":"To date, sulfonylurea derivatives occupy a leading position in the structure of diabetes mellitus therapy. The article discusses the effectiveness and safety of the use of sulfonylurea derivatives in order to compensate for carbohydrate metabolism, including in comparison with other classes of hypoglycemic drugs. Special emphasis is placed on cardiovascular safety.","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"207 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73030875","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 : 2023-03-30DOI: 10.33978/2307-3586-2023-19-1-6-16
A. Tiselko, M. Yarmolinskaya
Diabetes mellitus (DM) remains a disease that determines the high frequency of obstetric and perinatal complications. Achieving the physiological values of glycemia as the main condition for the successful course and outcomes of pregnancy in women with diabetes remains a difficult task to date. To improve the quality of treatment of patients with DM 1 type, the method of basic bolus insulin therapy has been used for more than 30 years. Therefore, the emergence of new effective and safe insulins is extremely important for improving pregnancy outcomes in patients with diabetes. Insulin degludec is an analogue of basal insulin of the new generation with improved pharmacokinetic and pharmacodynamics profiles compared to analogues of basal insulins of the previous generation, however, there was insufficient data on its use during pregnancy. This article presents the results of an open international randomized controlled study of EXPECT no less effective use of insulin degludec during pregnancy, which took place in 14 countries in 56 research centers, 8 of them in Russia. Of the 225 women with DM 1 type who participated in the study, 67 were from Russia. The EXPECT study compared the efficacy and safety of insulin degludec with insulin detemir (both in combination with insulin aspart) in pregnant women with DM 1 type. Insulin detemir was chosen as a comparison drug, since it is the first basal insulin analog approved for use during pregnancy and most often recommended as a first-line drug when choosing long-acting insulin for the treatment of diabetes in pregnant women. Material and methods. The study included women over the age of 18 with DM 1 type, whose gestation period ranged from 8 (+0 days) to 13 (+6 days) weeks and who were just planning a pregnancy. The study participants (1:1) were randomized using an interactive Internet system for the use of insulin degludec at a dose of 100 U/ml once a day or insulin detemir at a dose of 100 U/ml once or twice a day, while both drugs were taken in combination with insulin aspart at a dose of 100 U/ml. Pregnant women received the study drug at randomization, throughout the entire period of pregnancy and up to 28 days after delivery (the end of the study). Women who were not pregnant at the time of randomization started taking the study drug before conception. The primary endpoint is the last scheduled measurement of glycated hemoglobin (HbA1c) before childbirth (a field of at least 0.4% efficiency for degludec compared to detemir). Secondary endpoints are efficacy, safety for the mother, and pregnancy outcomes. The primary endpoint was evaluated in all randomized women who were pregnant during the study. Safety – for all participants who were pregnant during the study and received at least one dose of the study drug. This study is registered on the website ClinicalTrials.gov numbered NCT03377699 and currently completed. Results. From November 22, 2017 to November 8, 2019, out of 296 screened women, 225 were
{"title":"Proven Efficacy and Safety of Insulin Degludec in the Treatment of Type 1 Diabetes in Pregnant Women","authors":"A. Tiselko, M. Yarmolinskaya","doi":"10.33978/2307-3586-2023-19-1-6-16","DOIUrl":"https://doi.org/10.33978/2307-3586-2023-19-1-6-16","url":null,"abstract":"Diabetes mellitus (DM) remains a disease that determines the high frequency of obstetric and perinatal complications. Achieving the physiological values of glycemia as the main condition for the successful course and outcomes of pregnancy in women with diabetes remains a difficult task to date. To improve the quality of treatment of patients with DM 1 type, the method of basic bolus insulin therapy has been used for more than 30 years. Therefore, the emergence of new effective and safe insulins is extremely important for improving pregnancy outcomes in patients with diabetes. Insulin degludec is an analogue of basal insulin of the new generation with improved pharmacokinetic and pharmacodynamics profiles compared to analogues of basal insulins of the previous generation, however, there was insufficient data on its use during pregnancy. This article presents the results of an open international randomized controlled study of EXPECT no less effective use of insulin degludec during pregnancy, which took place in 14 countries in 56 research centers, 8 of them in Russia. Of the 225 women with DM 1 type who participated in the study, 67 were from Russia. The EXPECT study compared the efficacy and safety of insulin degludec with insulin detemir (both in combination with insulin aspart) in pregnant women with DM 1 type. Insulin detemir was chosen as a comparison drug, since it is the first basal insulin analog approved for use during pregnancy and most often recommended as a first-line drug when choosing long-acting insulin for the treatment of diabetes in pregnant women. Material and methods. The study included women over the age of 18 with DM 1 type, whose gestation period ranged from 8 (+0 days) to 13 (+6 days) weeks and who were just planning a pregnancy. The study participants (1:1) were randomized using an interactive Internet system for the use of insulin degludec at a dose of 100 U/ml once a day or insulin detemir at a dose of 100 U/ml once or twice a day, while both drugs were taken in combination with insulin aspart at a dose of 100 U/ml. Pregnant women received the study drug at randomization, throughout the entire period of pregnancy and up to 28 days after delivery (the end of the study). Women who were not pregnant at the time of randomization started taking the study drug before conception. The primary endpoint is the last scheduled measurement of glycated hemoglobin (HbA1c) before childbirth (a field of at least 0.4% efficiency for degludec compared to detemir). Secondary endpoints are efficacy, safety for the mother, and pregnancy outcomes. The primary endpoint was evaluated in all randomized women who were pregnant during the study. Safety – for all participants who were pregnant during the study and received at least one dose of the study drug. This study is registered on the website ClinicalTrials.gov numbered NCT03377699 and currently completed. Results. From November 22, 2017 to November 8, 2019, out of 296 screened women, 225 were ","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"65 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86880128","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 : 2023-03-30DOI: 10.33978/2307-3586-2023-19-5-14-22
M. Gordeeva, I. Serdiukova, A. Krasichkov, E. Parmon
Inflammatory changes in the myocardium create the prerequisites for the electrical instability of the myocardium, which can affect the ECG. It is promising to study relatively new electrocardiographic patterns: fragmentation of QRS (FQRS) and premature ventricular beats (FPVB) and early repolarization pattern (ERP) to improve the screening of patients with suspected myocarditis. Aim. To study FQRS, FPVB and ERP in patients with inflammatory changes in the myocardium. Material and methods. The study included 46 patients (78.3% male, 21.7% women) with suspected myocarditis. Age: median 47.5, quartile 37; 56.5. In all patients, the anamnesis, results of ECG, echocardiography, cardiac magnetic resonance imaging and endomyocardial biopsy were analyzed. Results. The patients were divided into three groups: the 1st – 20 patients with inflammatory and fibrotic changes in the myocardium, the 2nd – 20 patients with myocardial fibrosis without inflammatory, the 3rd – 6 patients without structural changes in the myocardium. FQRS in the 1st group was detected in 35% of the examined, in the 2nd – in 25%, in the 3rd – not registered. FPVB in the 1st group was determined in 55% of the examined, in the 2nd – in 30%, in the 3rd – in 33.3%. ERP in the 1st group was registered in 30% of the examined, in the 2nd group it was not detected, in the 3rd group – in 16.7%. FPVB and ERP were informative for the detection of inflammation (sensitivity – 57.9 and 85% respectively, specificity – 69.2 and 53.8% respectively). For the detection of fibrosis, FPVB proved to be the most informative (sensitivity – 80.0%, specificity – 59.1%). Conclusions. FQRS, FPVB, and ERP are significant ECG-markers for detecting both inflammatory changes in the myocardium and fibrosis. The use of these ECG-markers in routine clinical practice may have an impact on further management of patients with suspected myocarditis.
{"title":"Analysis of Fragmentation QRS Complex and Early Repolarization Pattern in Patients with Myocardial Inflammatory Changes","authors":"M. Gordeeva, I. Serdiukova, A. Krasichkov, E. Parmon","doi":"10.33978/2307-3586-2023-19-5-14-22","DOIUrl":"https://doi.org/10.33978/2307-3586-2023-19-5-14-22","url":null,"abstract":"Inflammatory changes in the myocardium create the prerequisites for the electrical instability of the myocardium, which can affect the ECG. It is promising to study relatively new electrocardiographic patterns: fragmentation of QRS (FQRS) and premature ventricular beats (FPVB) and early repolarization pattern (ERP) to improve the screening of patients with suspected myocarditis. Aim. To study FQRS, FPVB and ERP in patients with inflammatory changes in the myocardium. Material and methods. The study included 46 patients (78.3% male, 21.7% women) with suspected myocarditis. Age: median 47.5, quartile 37; 56.5. In all patients, the anamnesis, results of ECG, echocardiography, cardiac magnetic resonance imaging and endomyocardial biopsy were analyzed. Results. The patients were divided into three groups: the 1st – 20 patients with inflammatory and fibrotic changes in the myocardium, the 2nd – 20 patients with myocardial fibrosis without inflammatory, the 3rd – 6 patients without structural changes in the myocardium. FQRS in the 1st group was detected in 35% of the examined, in the 2nd – in 25%, in the 3rd – not registered. FPVB in the 1st group was determined in 55% of the examined, in the 2nd – in 30%, in the 3rd – in 33.3%. ERP in the 1st group was registered in 30% of the examined, in the 2nd group it was not detected, in the 3rd group – in 16.7%. FPVB and ERP were informative for the detection of inflammation (sensitivity – 57.9 and 85% respectively, specificity – 69.2 and 53.8% respectively). For the detection of fibrosis, FPVB proved to be the most informative (sensitivity – 80.0%, specificity – 59.1%). Conclusions. FQRS, FPVB, and ERP are significant ECG-markers for detecting both inflammatory changes in the myocardium and fibrosis. The use of these ECG-markers in routine clinical practice may have an impact on further management of patients with suspected myocarditis.","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75280967","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 : 2023-03-30DOI: 10.33978/2307-3586-2023-19-1-40-47
O. A. Shavlovskaya, I. A. Bokova
B vitamins deserve special attention because they take an active part in the regulation of almost all systems activity, have a neurotropic effect. Among all B vitamins, the most actively used are B1 (thiamine), B6 (pyridoxine), B12 (cobalamin), which are prescribed both in monotherapy and in combination, intramuscularly or orally. Other B vitamins are rarely used alone, only in combination with other vitamins or biologically active supplements (dietary supplements). Thiamine is responsible for the metabolism of nerve tissues, the production of acetylcholine, which participates in carbohydrate metabolism and related energy, fat, protein, water-salt metabolism, has a regulating effect on trophism and the activity of the nervous system. Different forms of vitamin B1 (thiamine disulfide, thiamine hydrochloride, benfotiamine) have an analgesic effect, exhibit an antitumor effect. Pyridoxine exhibits an antioxidant effect, its phosphorylated form (pyridoxal phosphate) participates in the decarboxylation of amino acids, in the formation of physiologically active amines (adrenaline, serotonin, dopamine, tyramine). Polyneuropathy (PNP) of various genesis (diabetic, alcoholic, dysmetabolic) is a target for pyridoxine. Cobalamin is required as a co-factor of the cytosolic methionine synthase reaction and the mitochondrial methymalonyl-CoA mutase reaction. Vitamin B12 deficiency can be manifested by disorders in the hematopoiesis system, PNP, cognitive disorders. Other B vitamins are actively involved in metabolic processes: B2 (riboflavin) is used by the body to metabolize fats, proteins and carbohydrates into glucose for energy, participates in redox processes, the production of red blood cells, B3 (niacin) participates in the processes of anabolism and catabolism, B4 (choline) is necessary for the synthesis of acetylcholine, betaine and phospholipids, B5 (pantothenate) necessary for the synthesis of co-enzyme A, with a deficiency of which severe damage to the basal ganglia region develops, accompanied by progressive cognitive and motor disorders, B7 (biotin), B8 (inositol), B9 (folic acid), B10 (paraaminobenzoic acid) are necessary for normal body functioning. With a combined deficiency of vitamins B1, B2, B6 and B12, there is an increased risk of depression. In the treatment of diseases associated with B vitamins deficiency, a complex of vitamins should be prescribed to enhance the effect.
{"title":"Vitamins B Effectiveness in Different Nosological Forms","authors":"O. A. Shavlovskaya, I. A. Bokova","doi":"10.33978/2307-3586-2023-19-1-40-47","DOIUrl":"https://doi.org/10.33978/2307-3586-2023-19-1-40-47","url":null,"abstract":"B vitamins deserve special attention because they take an active part in the regulation of almost all systems activity, have a neurotropic effect. Among all B vitamins, the most actively used are B1 (thiamine), B6 (pyridoxine), B12 (cobalamin), which are prescribed both in monotherapy and in combination, intramuscularly or orally. Other B vitamins are rarely used alone, only in combination with other vitamins or biologically active supplements (dietary supplements). Thiamine is responsible for the metabolism of nerve tissues, the production of acetylcholine, which participates in carbohydrate metabolism and related energy, fat, protein, water-salt metabolism, has a regulating effect on trophism and the activity of the nervous system. Different forms of vitamin B1 (thiamine disulfide, thiamine hydrochloride, benfotiamine) have an analgesic effect, exhibit an antitumor effect. Pyridoxine exhibits an antioxidant effect, its phosphorylated form (pyridoxal phosphate) participates in the decarboxylation of amino acids, in the formation of physiologically active amines (adrenaline, serotonin, dopamine, tyramine). Polyneuropathy (PNP) of various genesis (diabetic, alcoholic, dysmetabolic) is a target for pyridoxine. Cobalamin is required as a co-factor of the cytosolic methionine synthase reaction and the mitochondrial methymalonyl-CoA mutase reaction. Vitamin B12 deficiency can be manifested by disorders in the hematopoiesis system, PNP, cognitive disorders. Other B vitamins are actively involved in metabolic processes: B2 (riboflavin) is used by the body to metabolize fats, proteins and carbohydrates into glucose for energy, participates in redox processes, the production of red blood cells, B3 (niacin) participates in the processes of anabolism and catabolism, B4 (choline) is necessary for the synthesis of acetylcholine, betaine and phospholipids, B5 (pantothenate) necessary for the synthesis of co-enzyme A, with a deficiency of which severe damage to the basal ganglia region develops, accompanied by progressive cognitive and motor disorders, B7 (biotin), B8 (inositol), B9 (folic acid), B10 (paraaminobenzoic acid) are necessary for normal body functioning. With a combined deficiency of vitamins B1, B2, B6 and B12, there is an increased risk of depression. In the treatment of diseases associated with B vitamins deficiency, a complex of vitamins should be prescribed to enhance the effect.","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87641249","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 : 2022-08-31DOI: 10.33978/2307-3586-2022-18-22-94-99
E. Valitova, M.V. Chebotaryova, O. Berezina, D. Bordin
The article summarizes the data of international and Russian recommendations for the treatment and diagnosis of one of the most common diseases of the XXI century – gastroesophageal reflux disease (GERD), provides indications for the use of instrumental methods and refined criteria for the diagnosis of GERD, describes the principles of treatment, including the refractory form of GERD. Special emphasis is placed on the importance of esophageal manometry and reflux monitoring before antireflux surgery. Indications for antireflux operations are listed
{"title":"Diagnosis and Treatment of Gastroesophageal Reflux Disease: Analysis of Current Recommendations","authors":"E. Valitova, M.V. Chebotaryova, O. Berezina, D. Bordin","doi":"10.33978/2307-3586-2022-18-22-94-99","DOIUrl":"https://doi.org/10.33978/2307-3586-2022-18-22-94-99","url":null,"abstract":"The article summarizes the data of international and Russian recommendations for the treatment and diagnosis of one of the most common diseases of the XXI century – gastroesophageal reflux disease (GERD), provides indications for the use of instrumental methods and refined criteria for the diagnosis of GERD, describes the principles of treatment, including the refractory form of GERD. Special emphasis is placed on the importance of esophageal manometry and reflux monitoring before antireflux surgery. Indications for antireflux operations are listed","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73609411","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 : 2022-08-31DOI: 10.33978/2307-3586-2022-18-22-20-24
A. Shabunin, S. Smetanina, P. Drozdov, O. N. Levina, E. Nurmukhametova, D. A. Makeev, O. S. Zhuravel, D. A. Solomatin
Aim – to evaluate the results of applying a multidisciplinary approach to the treatment of patients with liver cirrhosis in the outcome of chronic viral hepatitis. Material and methods. From July 2018 to September 2021, 94 orthotopic liver transplants (OTLT) from a posthumous donor were performed at the surgical clinic of the Botkin Hospital. Of 94 recipients, 48 (51.1%) indicated for surgery as liver cirrhosis as a result of chronic viral hepatitis C (CVHC), in 8 (8.5%) cirrhosis as a result of chronic viral hepatitis B (CVHB). In the case of cirrhosis as a result of CVHB, the presence of viral replication was a contraindication for transplantation; patients with its presence at the stage of placing on the waiting list were sent to an infectious disease specialist to receive antiviral therapy (AVT). Prevention of recurrence of CVHB in the graft consisted of intraoperative, as well as early and late postoperative administration of 400–800 IU of immunoglobulin against hepatitis B. Among liver transplant recipients with liver cirrhosis in the outcome of CVHC, less than half (43.75%) did not have HCV RNA against the background of passed or the OEM received by the time of the operation. The rest of the patients had contraindications to AVT, and HCV eradication was performed after transplantation. Results. The average follow-up period for hepatic transplant recipients with liver cirrhosis as a result of CVHB was 12.28 ± 4.11 (7–23) months. Satisfactory graft function against the background of constant antiviral therapy was observed in all patients. No deaths were recorded. The average follow-up time for patients with cirrhosis of the liver in the outcome of chronic hepatitis C after OTTP was 21.67 ± 4.85 (1–38) months. Antiviral therapy was prescribed to 24 patients 2.7 ± 0.34 (2–4) months after surgery. Three patients did not receive AVT after surgery due to their low adherence to treatment. Satisfactory graft function was observed in all patients, confident virological response against the background of AVT – in 17 patients (70.8%). 7 patients (29.2%) are currently undergoing antiviral therapy. Of the three patients who did not receive AVT in the postoperative period of their own free will, 1 patient (33.3%) developed graft cirrhosis and death from decompensation of liver failure at 23 months after transplantation. Conclusion. The use of a multidisciplinary approach in the treatment of patients with liver cirrhosis as a result of chronic viral hepatitis allows achieving a confident virological response, radically curing liver cirrhosis, thereby preventing associated complications, improving the quality of life of patients and restoring their ability to work.
{"title":"Results of the Application of a Multidisciplinary Approach in the Treatment of Patients with Liver Cirrhosis as a Result of Chronic Viral Hepatitis","authors":"A. Shabunin, S. Smetanina, P. Drozdov, O. N. Levina, E. Nurmukhametova, D. A. Makeev, O. S. Zhuravel, D. A. Solomatin","doi":"10.33978/2307-3586-2022-18-22-20-24","DOIUrl":"https://doi.org/10.33978/2307-3586-2022-18-22-20-24","url":null,"abstract":"Aim – to evaluate the results of applying a multidisciplinary approach to the treatment of patients with liver cirrhosis in the outcome of chronic viral hepatitis. Material and methods. From July 2018 to September 2021, 94 orthotopic liver transplants (OTLT) from a posthumous donor were performed at the surgical clinic of the Botkin Hospital. Of 94 recipients, 48 (51.1%) indicated for surgery as liver cirrhosis as a result of chronic viral hepatitis C (CVHC), in 8 (8.5%) cirrhosis as a result of chronic viral hepatitis B (CVHB). In the case of cirrhosis as a result of CVHB, the presence of viral replication was a contraindication for transplantation; patients with its presence at the stage of placing on the waiting list were sent to an infectious disease specialist to receive antiviral therapy (AVT). Prevention of recurrence of CVHB in the graft consisted of intraoperative, as well as early and late postoperative administration of 400–800 IU of immunoglobulin against hepatitis B. Among liver transplant recipients with liver cirrhosis in the outcome of CVHC, less than half (43.75%) did not have HCV RNA against the background of passed or the OEM received by the time of the operation. The rest of the patients had contraindications to AVT, and HCV eradication was performed after transplantation. Results. The average follow-up period for hepatic transplant recipients with liver cirrhosis as a result of CVHB was 12.28 ± 4.11 (7–23) months. Satisfactory graft function against the background of constant antiviral therapy was observed in all patients. No deaths were recorded. The average follow-up time for patients with cirrhosis of the liver in the outcome of chronic hepatitis C after OTTP was 21.67 ± 4.85 (1–38) months. Antiviral therapy was prescribed to 24 patients 2.7 ± 0.34 (2–4) months after surgery. Three patients did not receive AVT after surgery due to their low adherence to treatment. Satisfactory graft function was observed in all patients, confident virological response against the background of AVT – in 17 patients (70.8%). 7 patients (29.2%) are currently undergoing antiviral therapy. Of the three patients who did not receive AVT in the postoperative period of their own free will, 1 patient (33.3%) developed graft cirrhosis and death from decompensation of liver failure at 23 months after transplantation. Conclusion. The use of a multidisciplinary approach in the treatment of patients with liver cirrhosis as a result of chronic viral hepatitis allows achieving a confident virological response, radically curing liver cirrhosis, thereby preventing associated complications, improving the quality of life of patients and restoring their ability to work.","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"101 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83920776","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 : 2022-08-31DOI: 10.33978/2307-3586-2022-18-22-72-84
D. Bordin, M. Livzan
The analysis of the most important changes and the translation into Russian of the provisions of the Maastricht VI Consensus published in August 2022 are presented. The main provisions of the consensus are based on the results of scientific research and are primarily practical. They take into account regional peculiarities, local data on the resistance of Helicobacter pylori to antibiotics, and public health opportunities. Monitoring of the actual clinical practice of H. pylori diagnosis and treatment becomes a necessary part of the implementation of the recommendations of Maastricht VI
{"title":"The Consensus Maastricht VI Is Published: What's New?","authors":"D. Bordin, M. Livzan","doi":"10.33978/2307-3586-2022-18-22-72-84","DOIUrl":"https://doi.org/10.33978/2307-3586-2022-18-22-72-84","url":null,"abstract":"The analysis of the most important changes and the translation into Russian of the provisions of the Maastricht VI Consensus published in August 2022 are presented. The main provisions of the consensus are based on the results of scientific research and are primarily practical. They take into account regional peculiarities, local data on the resistance of Helicobacter pylori to antibiotics, and public health opportunities. Monitoring of the actual clinical practice of H. pylori diagnosis and treatment becomes a necessary part of the implementation of the recommendations of Maastricht VI","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"150 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76412117","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 : 2022-08-31DOI: 10.33978/2307-3586-2022-18-22-14-18
K. G. Absandze, E. Vinnitskaya, Y. Sandler, T. Khaimenova, D.S. Filina, K.G. Sаliyev
Ursodeoxycholic acid (UDCA) is a first-line drug for the treatment of all patients with primary biliary cholangitis (PBC). The biochemical response to UDCA therapy is recommended to be evaluated 12 months after the start of treatment to determine the patient's response to therapy. In clinical practice, patients who do not respond sufficiently to therapy with UDCA drugs are often observed. It is known that an incomplete response ultimately correlates with the progression of the disease. The article presents the results of our own research, which studied the factors leading to an incomplete response of patients to UDCA therapy. Analysis of possible causes of incomplete response allowed us to identify two groups of factors associated with a suboptimal response to treatment of UDCA, which were conditionally divided into modifiable and unmodifiable. Significant prognostic factors of insufficient/incomplete response to therapy were identified, as well as categories of "difficult" patients with unmodifiable incomplete response factors. The results obtained make it possible to personalize approaches to the therapy of patients with PBC, reduce the risks of their incomplete response and optimize treatment
{"title":"Primary Biliary Cholangitis and Incomplete Response to Ursodeoxycholic Acid Therapy: Who is Guilty and What to Do?","authors":"K. G. Absandze, E. Vinnitskaya, Y. Sandler, T. Khaimenova, D.S. Filina, K.G. Sаliyev","doi":"10.33978/2307-3586-2022-18-22-14-18","DOIUrl":"https://doi.org/10.33978/2307-3586-2022-18-22-14-18","url":null,"abstract":"Ursodeoxycholic acid (UDCA) is a first-line drug for the treatment of all patients with primary biliary cholangitis (PBC). The biochemical response to UDCA therapy is recommended to be evaluated 12 months after the start of treatment to determine the patient's response to therapy. In clinical practice, patients who do not respond sufficiently to therapy with UDCA drugs are often observed. It is known that an incomplete response ultimately correlates with the progression of the disease. The article presents the results of our own research, which studied the factors leading to an incomplete response of patients to UDCA therapy. Analysis of possible causes of incomplete response allowed us to identify two groups of factors associated with a suboptimal response to treatment of UDCA, which were conditionally divided into modifiable and unmodifiable. Significant prognostic factors of insufficient/incomplete response to therapy were identified, as well as categories of \"difficult\" patients with unmodifiable incomplete response factors. The results obtained make it possible to personalize approaches to the therapy of patients with PBC, reduce the risks of their incomplete response and optimize treatment","PeriodicalId":11400,"journal":{"name":"Effective Pharmacotherapy","volume":"98 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73018443","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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