Pub Date : 2023-01-01DOI: 10.31550/1727-2378-2023-22-2-62-69
N. V. Sharova, D. V. Cherkashin, A. Sobolev, R. Makiev, S.A. Parcernjak, B.A. Jerdneev
Aim: To determine the values of peak inspiratory flow (PIP) for choosing an inhaler in patients with exacerbation of chronic obstructive pulmonary disease (COPD) and to evaluate the possibility of optimizing inhalation therapy considering PIP in real clinical practice. Design: Open cohort controlled prospective study. Materials and methods. 76 people were examined. Group 1 included 32 patients with COPD exacerbation, 18 of them were re-examined before discharge and completed a survey 3 months after discharge from the hospital. Group 2 consisted of 15 patients with stable COPD. Group 3 included 29 healthy individuals. PIF using various inhalers was studied using the In-Check DIALTM G16 Clement Clarke International Limited (Great Britain), fixing the level without resistance (R0) and 5 levels of resistance (R1–R5). Suboptimal PIF (sPIF) values were considered at R0 < 90, R1–R4 < 60, R5 < 30 l/min. Spirometry was performed on a Flowscreen II spirometer (Jaeger) with a flow-volume curve recording, calculation of generally accepted indicators, and on a PTS-14P-01 pressure-tachospirograph to determine the peak inspiratory rate. Statistical data processing was carried out using the Statistica v. 10. According to the Bonferroni principle, differences were considered significant at p < 0.005. Results. During exacerbation of COPD, a decrease in PIF from 120 to 40 l/min (p < 0.001 compared with the control) and the presence of sPIF in 5–75% of cases, depending on the type of inhalation device, were revealed (no sPIF was noted in the control). Most patients were free to use a nebulizer, a metered-dose aerosol inhaler (MAI), a liquid inhaler (Respimat) and a breathhaler upon admission to the hospital. Patients could not create the necessary inspiratory effort when using the ellipt in 47% of cases, turbuhaler — in 63%, nexthaler — in 75%, handihaler — in 31%. With proven positive clinical and functional dynamics during treatment (increase in FEV1 from 37% (28; 53) to 55% (37; 62), p < 0.004), the identified changes persisted by the time of discharge from the hospital and did not reach the values of PIF and sPIF, determined in stable COPD. Analysis of PIF and sPIF in patients in real clinical practice, depending on the drugs received, showed that by the time they were discharged from the hospital, half of the patients had sPIF, continued to use turbuhaler and handihaler inhalers, and were not able to create an adequate PIF for effective inhalation of drugs. A survey of patients 3 months after discharge from the hospital showed that patients with optimal PIF values, who used drugs with the help of PPI, Respimat and Breezhaler, did not have exacerbations within the indicated periods. Patients with CPIP who continued to use the combination of turbuhaler and handihaler had moderate exacerbations. Conclusion. Optimization of inhalation therapy based on PIP in patients with COPD exacerbation should include: 1) the possibility of choosing the optimal inhaler, consider
{"title":"Optimization of Inhalation Therapy Considering Peak Inspiratory Flow in Patients with Exacerbation of Chronic Obstructive Pulmonary Disease in Real Clinical Practice","authors":"N. V. Sharova, D. V. Cherkashin, A. Sobolev, R. Makiev, S.A. Parcernjak, B.A. Jerdneev","doi":"10.31550/1727-2378-2023-22-2-62-69","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-2-62-69","url":null,"abstract":"Aim: To determine the values of peak inspiratory flow (PIP) for choosing an inhaler in patients with exacerbation of chronic obstructive pulmonary disease (COPD) and to evaluate the possibility of optimizing inhalation therapy considering PIP in real clinical practice. Design: Open cohort controlled prospective study. Materials and methods. 76 people were examined. Group 1 included 32 patients with COPD exacerbation, 18 of them were re-examined before discharge and completed a survey 3 months after discharge from the hospital. Group 2 consisted of 15 patients with stable COPD. Group 3 included 29 healthy individuals. PIF using various inhalers was studied using the In-Check DIALTM G16 Clement Clarke International Limited (Great Britain), fixing the level without resistance (R0) and 5 levels of resistance (R1–R5). Suboptimal PIF (sPIF) values were considered at R0 < 90, R1–R4 < 60, R5 < 30 l/min. Spirometry was performed on a Flowscreen II spirometer (Jaeger) with a flow-volume curve recording, calculation of generally accepted indicators, and on a PTS-14P-01 pressure-tachospirograph to determine the peak inspiratory rate. Statistical data processing was carried out using the Statistica v. 10. According to the Bonferroni principle, differences were considered significant at p < 0.005. Results. During exacerbation of COPD, a decrease in PIF from 120 to 40 l/min (p < 0.001 compared with the control) and the presence of sPIF in 5–75% of cases, depending on the type of inhalation device, were revealed (no sPIF was noted in the control). Most patients were free to use a nebulizer, a metered-dose aerosol inhaler (MAI), a liquid inhaler (Respimat) and a breathhaler upon admission to the hospital. Patients could not create the necessary inspiratory effort when using the ellipt in 47% of cases, turbuhaler — in 63%, nexthaler — in 75%, handihaler — in 31%. With proven positive clinical and functional dynamics during treatment (increase in FEV1 from 37% (28; 53) to 55% (37; 62), p < 0.004), the identified changes persisted by the time of discharge from the hospital and did not reach the values of PIF and sPIF, determined in stable COPD. Analysis of PIF and sPIF in patients in real clinical practice, depending on the drugs received, showed that by the time they were discharged from the hospital, half of the patients had sPIF, continued to use turbuhaler and handihaler inhalers, and were not able to create an adequate PIF for effective inhalation of drugs. A survey of patients 3 months after discharge from the hospital showed that patients with optimal PIF values, who used drugs with the help of PPI, Respimat and Breezhaler, did not have exacerbations within the indicated periods. Patients with CPIP who continued to use the combination of turbuhaler and handihaler had moderate exacerbations. Conclusion. Optimization of inhalation therapy based on PIP in patients with COPD exacerbation should include: 1) the possibility of choosing the optimal inhaler, consider","PeriodicalId":11479,"journal":{"name":"Doctor.Ru","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76998787","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 : 2023-01-01DOI: 10.31550/1727-2378-2023-22-4-18-23
V. I. Alferova, S. Mustafina
Aim: To study the features of adiponectin, leptin, resistin, adipsin, interleukin 6, and tumor necrosis factor α levels in individuals with a metabolically healthy and unhealthy phenotype at different values of body weight according to the literature. Key points. The results of foreign and domestic studies of the levels of adipocytokines in metabolically healthy and unhealthy phenotypes in individuals with different body weights are presented. Adipokines such as adiponectin, leptin, resistin, adipsin, interleukin 6, and tumor necrosis factor α were analyzed. Data are given on the pathogenetic and clinical features of the production of these biologically active substances and their effect on metabolism. Conclusion. According to the literature, high levels of leptin, resistin, tumor necrosis factor α, interleukin 6 are associated with a metabolically unhealthy phenotype, and adiponectin, adipsin are associated with a metabolically healthy phenotype. Keywords: adipokines, metabolically healthy obesity, metabolically unhealthy obesity, adiponectin, leptin, resistin, adipsin, interleukin 6, tumor necrosis factor α.
{"title":"Adipocytokines Through the Prism of Human Metabolic Phenotypes","authors":"V. I. Alferova, S. Mustafina","doi":"10.31550/1727-2378-2023-22-4-18-23","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-4-18-23","url":null,"abstract":"Aim: To study the features of adiponectin, leptin, resistin, adipsin, interleukin 6, and tumor necrosis factor α levels in individuals with a metabolically healthy and unhealthy phenotype at different values of body weight according to the literature. Key points. The results of foreign and domestic studies of the levels of adipocytokines in metabolically healthy and unhealthy phenotypes in individuals with different body weights are presented. Adipokines such as adiponectin, leptin, resistin, adipsin, interleukin 6, and tumor necrosis factor α were analyzed. Data are given on the pathogenetic and clinical features of the production of these biologically active substances and their effect on metabolism. Conclusion. According to the literature, high levels of leptin, resistin, tumor necrosis factor α, interleukin 6 are associated with a metabolically unhealthy phenotype, and adiponectin, adipsin are associated with a metabolically healthy phenotype. Keywords: adipokines, metabolically healthy obesity, metabolically unhealthy obesity, adiponectin, leptin, resistin, adipsin, interleukin 6, tumor necrosis factor α.","PeriodicalId":11479,"journal":{"name":"Doctor.Ru","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75676342","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 : 2023-01-01DOI: 10.31550/1727-2378-2023-22-1-62-67
A. S. Anikeev, N. M. Startseva, V.M. Grabovsky, I. M. Ordiyants, L. Gazaryan, A. Savicheva
Objective of the Review: To summarize the proven prognostic and diagnostic criteria for gestational complications caused by a combination of gestational diabetes mellitus (GDM) and preeclampsia (PE). Key points. There is an analytical review of the modern paradigm of GDM and PE, their complications, as well as perinatal and long-term outcomes for mother and child. The data on clinical, anamnestic and laboratory risk factors of PE in GDM are systematized. A close relationship between the mechanisms of PE and GDM development — angiogenic imbalance and metabolic disorders in the placenta is described. Conclusion. GDM is recognized as an independent risk factor for the development of PE, and this risk is the greater the less GDM is compensated. Polycystic ovary syndrome and an increased body mass index as concomitant factors of metabolic disorders also increase the risk of developing PE. The supposed pathogenetic commonality of GDM and PE is the presence of oxidative stress and metaflammation, which increase insulin resistance and cause endothelial dysfunction. Keywords: preeclampsia, gestational diabetes mellitus, metabolism, risk factors, pathogenetic commonality.
{"title":"Features of Metabolism in Women with Preeclampsia Combined with Gestational Diabetes Mellitus","authors":"A. S. Anikeev, N. M. Startseva, V.M. Grabovsky, I. M. Ordiyants, L. Gazaryan, A. Savicheva","doi":"10.31550/1727-2378-2023-22-1-62-67","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-1-62-67","url":null,"abstract":"Objective of the Review: To summarize the proven prognostic and diagnostic criteria for gestational complications caused by a combination of gestational diabetes mellitus (GDM) and preeclampsia (PE). Key points. There is an analytical review of the modern paradigm of GDM and PE, their complications, as well as perinatal and long-term outcomes for mother and child. The data on clinical, anamnestic and laboratory risk factors of PE in GDM are systematized. A close relationship between the mechanisms of PE and GDM development — angiogenic imbalance and metabolic disorders in the placenta is described. Conclusion. GDM is recognized as an independent risk factor for the development of PE, and this risk is the greater the less GDM is compensated. Polycystic ovary syndrome and an increased body mass index as concomitant factors of metabolic disorders also increase the risk of developing PE. The supposed pathogenetic commonality of GDM and PE is the presence of oxidative stress and metaflammation, which increase insulin resistance and cause endothelial dysfunction. Keywords: preeclampsia, gestational diabetes mellitus, metabolism, risk factors, pathogenetic commonality.","PeriodicalId":11479,"journal":{"name":"Doctor.Ru","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74564622","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 : 2023-01-01DOI: 10.31550/1727-2378-2023-22-1-56-61
D. Medzhidova, E. Shifman, V. R. Abdullaev, M. Muslimov
Aim: To study the changes in the structural and functional parameters of blood erythrocytes in maternity women during cesarean section, depending on the method of management of the perioperative period (PP), at all its stages. Design: Comparative group retrospective and prospective study. Materials and methods. The study included patients (n = 81) who underwent a planned cesarean section under spinal anesthesia (SA). The control group consisted of 38 maternity hospitals, in which PP was conducted traditionally. In the main group, 43 maternity hospitals were conducted according to the accelerated recovery program: refusal of mechanical intestinal cleansing, glucose-containing drink 2 hours before surgery, antibiotic prophylaxis 1 hour before surgery (cefazolin 2 g intravenously). Blood sampling and examination of the structural and dynamic parameters of the erythrocyte membranes of the patients' blood were carried out at different stages of PP: before CA, after the development of CA, by the end of the operation; umbilical cord blood was also examined. Results. In the control group, the polarity of annular and total lipids, as well as the microviscosity of total lipids, did not significantly change at different stages of Cesarean section. By the end of the operation, the fluidity of annular lipids increased by 24% and the parameter of the efficiency of the transfer of excitation energy from tryptophan residues of erythrocyte membrane proteins by umbilical cord blood to pyrene ((F0–F)/F0) increased by 11%. In the main group, after the development of CA and by the end of the operation, the index (F0–F)/F0 in the membranes of red blood cells decreased by 10%; the fluidity of annular lipids increased to CA and by the end of the operation by 25%, after the development of CA — by 30% relative to the control group to CA. The dissociation constants of 1-anilinonaphthalene-8-sulfonate with plasma proteins and erythrocyte membranes in the control group up to CA differ significantly: Kd2 is 5.34 times greater than Kd1. The number of binding centers in erythrocytes is 12 times less than in plasma proteins. Conclusion. The concept of PUV, which promotes rapid recovery of the patient, can prevent the intensification of oxidative-inflammatory processes, which allows the development of new therapeutic methods to improve the rheological properties of blood in many clinical conditions. Keywords: perioperative period, accelerated recovery program, carbohydrate drink, caesarean section, conformational changes in proteins.
{"title":"Changes in RBC Profile in Mothers After Caesarean Section Depending on the Perioperative Management Method","authors":"D. Medzhidova, E. Shifman, V. R. Abdullaev, M. Muslimov","doi":"10.31550/1727-2378-2023-22-1-56-61","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-1-56-61","url":null,"abstract":"Aim: To study the changes in the structural and functional parameters of blood erythrocytes in maternity women during cesarean section, depending on the method of management of the perioperative period (PP), at all its stages. Design: Comparative group retrospective and prospective study. Materials and methods. The study included patients (n = 81) who underwent a planned cesarean section under spinal anesthesia (SA). The control group consisted of 38 maternity hospitals, in which PP was conducted traditionally. In the main group, 43 maternity hospitals were conducted according to the accelerated recovery program: refusal of mechanical intestinal cleansing, glucose-containing drink 2 hours before surgery, antibiotic prophylaxis 1 hour before surgery (cefazolin 2 g intravenously). Blood sampling and examination of the structural and dynamic parameters of the erythrocyte membranes of the patients' blood were carried out at different stages of PP: before CA, after the development of CA, by the end of the operation; umbilical cord blood was also examined. Results. In the control group, the polarity of annular and total lipids, as well as the microviscosity of total lipids, did not significantly change at different stages of Cesarean section. By the end of the operation, the fluidity of annular lipids increased by 24% and the parameter of the efficiency of the transfer of excitation energy from tryptophan residues of erythrocyte membrane proteins by umbilical cord blood to pyrene ((F0–F)/F0) increased by 11%. In the main group, after the development of CA and by the end of the operation, the index (F0–F)/F0 in the membranes of red blood cells decreased by 10%; the fluidity of annular lipids increased to CA and by the end of the operation by 25%, after the development of CA — by 30% relative to the control group to CA. The dissociation constants of 1-anilinonaphthalene-8-sulfonate with plasma proteins and erythrocyte membranes in the control group up to CA differ significantly: Kd2 is 5.34 times greater than Kd1. The number of binding centers in erythrocytes is 12 times less than in plasma proteins. Conclusion. The concept of PUV, which promotes rapid recovery of the patient, can prevent the intensification of oxidative-inflammatory processes, which allows the development of new therapeutic methods to improve the rheological properties of blood in many clinical conditions. Keywords: perioperative period, accelerated recovery program, carbohydrate drink, caesarean section, conformational changes in proteins.","PeriodicalId":11479,"journal":{"name":"Doctor.Ru","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77392928","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 : 2023-01-01DOI: 10.31550/1727-2378-2023-22-4-64-69
S. M. Voevoda, O. Rymar
Aim: to present the likely pathophysiological mechanisms of hyperprolactinemia development in patients with a new coronavirus infection, as well as to present the results of clinical studies available at the time of writing the review to assess the contribution of hyperprolactinemia to the severity of the coronavirus infection. Key points: hyperprolactinemia is considered as a negative factor contributing to a more severe course of coronavirus infection in different groups of patients. The more severe course of a covid infection is based on the development of inflammatory processes that increase with an increased level of prolactin in the blood. Conclusion. The authors of most research papers report that experimental, clinical trials and clinical studies are needed to confirm the inflammatory and/or anti-inflammatory role of prolactin in the setting of coronavirus infection. Keywords: prolactin, hyperprolactinemia, new coronavirus infection.
{"title":"Prolactin as a Factor Influencing the Course of a New Coronavirus Infection: a Literary Review","authors":"S. M. Voevoda, O. Rymar","doi":"10.31550/1727-2378-2023-22-4-64-69","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-4-64-69","url":null,"abstract":"Aim: to present the likely pathophysiological mechanisms of hyperprolactinemia development in patients with a new coronavirus infection, as well as to present the results of clinical studies available at the time of writing the review to assess the contribution of hyperprolactinemia to the severity of the coronavirus infection. Key points: hyperprolactinemia is considered as a negative factor contributing to a more severe course of coronavirus infection in different groups of patients. The more severe course of a covid infection is based on the development of inflammatory processes that increase with an increased level of prolactin in the blood. Conclusion. The authors of most research papers report that experimental, clinical trials and clinical studies are needed to confirm the inflammatory and/or anti-inflammatory role of prolactin in the setting of coronavirus infection. Keywords: prolactin, hyperprolactinemia, new coronavirus infection.","PeriodicalId":11479,"journal":{"name":"Doctor.Ru","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77462963","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 : 2023-01-01DOI: 10.31550/1727-2378-2023-22-1-16-20
O. P. Vinogradova, O. Artemova, O. V. Epifanova
Aim: Evaluation of immune response factors in the treatment of mild cervical neoplasia against the background of human papillomavirus in patients of childbearing age. Design: Prospective study. Materials and methods. The study included a survey of 210 patients of fertile age. Among them were 150 patients with human papillomavirus (HPV) and cervical intraepithelial neoplasia, established by histological examination. Patients underwent Pap test, extended colposcopy, determination of HPV type and viral load. Patients with suspected pathology of the cervical zone underwent multifocal biopsy of the cervix. When analyzing changes in the cervix zone, the levels of interferon-γ, interleukin-18, caspase 3 and 9 were evaluated. Results. Among patients with cervical neoplasia of the first degree, the concentration of caspase 3, caspase 9 and interferon-γ at the first stage of the examination was higher (p < 0.05) than the values in the control group (among conditionally healthy women without viral load), while interleukin-18 was significantly lower (p < 0.05). In subgroups I and II, after 3 and 12 months, the concentrations of the studied parameters significantly differed from those in the control group and values before treatment (p < 0.05), while, after 12 months, the values of caspase 3 and caspase 9 in the subgroup where therapy was carried out (subgroup II) were significantly lower than in subgroup I. Also, among the patients, there was a statistical difference in the values of the cytokine series, however, the level of interleukin-18 in subgroup II after 10 days and 12 months was significantly higher than in subgroup I. fluctuations in indicators made it possible to justify the use of immunocorrective therapy for the treatment of a mild neoplastic process of the cervical zone. Conclusion. The results of the study allow optimizing approaches to the treatment of women of childbearing age with mild cervical neoplasia on the background of HPV. Keywords: genotyping, caspase-3, caspase-9, apoptosis, cervical neoplasia, polymerase reaction, interleukin-18, tumor necrosis factor-α, viral load.
{"title":"Influence of Therapy of Cervical Neoplasias on Immunological and Apoptotic Parameters","authors":"O. P. Vinogradova, O. Artemova, O. V. Epifanova","doi":"10.31550/1727-2378-2023-22-1-16-20","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-1-16-20","url":null,"abstract":"Aim: Evaluation of immune response factors in the treatment of mild cervical neoplasia against the background of human papillomavirus in patients of childbearing age. Design: Prospective study. Materials and methods. The study included a survey of 210 patients of fertile age. Among them were 150 patients with human papillomavirus (HPV) and cervical intraepithelial neoplasia, established by histological examination. Patients underwent Pap test, extended colposcopy, determination of HPV type and viral load. Patients with suspected pathology of the cervical zone underwent multifocal biopsy of the cervix. When analyzing changes in the cervix zone, the levels of interferon-γ, interleukin-18, caspase 3 and 9 were evaluated. Results. Among patients with cervical neoplasia of the first degree, the concentration of caspase 3, caspase 9 and interferon-γ at the first stage of the examination was higher (p < 0.05) than the values in the control group (among conditionally healthy women without viral load), while interleukin-18 was significantly lower (p < 0.05). In subgroups I and II, after 3 and 12 months, the concentrations of the studied parameters significantly differed from those in the control group and values before treatment (p < 0.05), while, after 12 months, the values of caspase 3 and caspase 9 in the subgroup where therapy was carried out (subgroup II) were significantly lower than in subgroup I. Also, among the patients, there was a statistical difference in the values of the cytokine series, however, the level of interleukin-18 in subgroup II after 10 days and 12 months was significantly higher than in subgroup I. fluctuations in indicators made it possible to justify the use of immunocorrective therapy for the treatment of a mild neoplastic process of the cervical zone. Conclusion. The results of the study allow optimizing approaches to the treatment of women of childbearing age with mild cervical neoplasia on the background of HPV. Keywords: genotyping, caspase-3, caspase-9, apoptosis, cervical neoplasia, polymerase reaction, interleukin-18, tumor necrosis factor-α, viral load.","PeriodicalId":11479,"journal":{"name":"Doctor.Ru","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76875319","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 : 2023-01-01DOI: 10.31550/1727-2378-2023-22-1-21-27
O. Safronov, E. Kazachkova, E. Kazachkov, I. V. Safronova, G.N. Mshak-Manukyan, A.O. Safronov
Aim: Clinical and morphological evaluation of the effectiveness of the hysteroscopic metroplasty using the pulsed diode laser in case of the intrauterine septum. Design: Retrospective comparative study. Materials and methods. A comparative analysis of the effectiveness of the metroplasty, specific features of the course of the surgery, postoperative period, status of the endometrium and reproductive function was performed in 39 women (1st group) who underwent the surgery with the use of the pulsed diode laser and 19 patients (2nd group) who underwent bipolar electrosurgery. Results. When using the proposed method of metroplasty, the dissection of the intrauterine septum was statistically significantly more often optimal (82.05%) (p < 0.001). The morphological structure of the endometrium after metroplasty in patients of the 1st group significantly more often corresponded to the phase of the menstrual cycle (86.36%; p = 0.044) and was less often changed due to manifestations of perivascular fibrosis (12 (54.55%) of 22; p = 0.037). In most women of the 1st group, pregnancy ended in timely delivery — 15 (71.43%) out of 21 (p = 0.013). Conclusion. The proposed method of metroplasty is an effective and safe method of dissection of the intrauterine septum, which has a positive effect on reproductive function. Keywords: intrauterine septum, hysteroscopic metroplasty, reproductive function.
{"title":"Clinical and Morphological Evaluation of the Effectiveness of Ambulatory Hysteroscopic Metroplasty in Case of Intrauterine Septum","authors":"O. Safronov, E. Kazachkova, E. Kazachkov, I. V. Safronova, G.N. Mshak-Manukyan, A.O. Safronov","doi":"10.31550/1727-2378-2023-22-1-21-27","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-1-21-27","url":null,"abstract":"Aim: Clinical and morphological evaluation of the effectiveness of the hysteroscopic metroplasty using the pulsed diode laser in case of the intrauterine septum. Design: Retrospective comparative study. Materials and methods. A comparative analysis of the effectiveness of the metroplasty, specific features of the course of the surgery, postoperative period, status of the endometrium and reproductive function was performed in 39 women (1st group) who underwent the surgery with the use of the pulsed diode laser and 19 patients (2nd group) who underwent bipolar electrosurgery. Results. When using the proposed method of metroplasty, the dissection of the intrauterine septum was statistically significantly more often optimal (82.05%) (p < 0.001). The morphological structure of the endometrium after metroplasty in patients of the 1st group significantly more often corresponded to the phase of the menstrual cycle (86.36%; p = 0.044) and was less often changed due to manifestations of perivascular fibrosis (12 (54.55%) of 22; p = 0.037). In most women of the 1st group, pregnancy ended in timely delivery — 15 (71.43%) out of 21 (p = 0.013). Conclusion. The proposed method of metroplasty is an effective and safe method of dissection of the intrauterine septum, which has a positive effect on reproductive function. Keywords: intrauterine septum, hysteroscopic metroplasty, reproductive function.","PeriodicalId":11479,"journal":{"name":"Doctor.Ru","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80012184","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 : 2023-01-01DOI: 10.31550/1727-2378-2023-22-2-57-61
E. Vladimirova, E. Shmelev, N. Makaryants, A. S. Zaitseva, S. A. Kasimtseva, T. Smirnova
Aim: To identify the incidence and the characteristics of adverse reactions, to mitigate them, and to determine possible adjustments in antimicrobial therapy. Design: Observational retrospective long-term study. Materials and methods. We examined 125 patients with nontuberculous lung mycobacteriosis. 73.6% of cases had concomitant diseases. Results. The therapy for nontuberculous mycobacteriosis was prescribed in 115 patients, depending on drug susceptibility, and included at least 3 drug products. 31.3% of patients had adverse reactions; one third of these patients had allergic reactions. Hepatotoxic reactions were recorded in 16.5% of cases, cardiotoxic — in 12.2%, ototoxic — in 10.4%, optic neuritis was diagnosed in 5 % of cases. In 31.3% of cases, the therapy was adjusted, in 13.9% of cases, the therapy was reviewed and alternative treatment was offered. The complete antibacterial course was prescribed to 79 (68.7%) patients. Conclusion. The therapy for nontuberculous mycobacteriosis should be selected in inpatient settings with laboratory and functional monitoring. Keywords: nontuberculous lung mycobacteriosis, antimicrobial therapy, adverse reactions.
{"title":"Specificity of Therapy Selection for Patients with Nontuberculous Lung Mycobacteriosis","authors":"E. Vladimirova, E. Shmelev, N. Makaryants, A. S. Zaitseva, S. A. Kasimtseva, T. Smirnova","doi":"10.31550/1727-2378-2023-22-2-57-61","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-2-57-61","url":null,"abstract":"Aim: To identify the incidence and the characteristics of adverse reactions, to mitigate them, and to determine possible adjustments in antimicrobial therapy. Design: Observational retrospective long-term study. Materials and methods. We examined 125 patients with nontuberculous lung mycobacteriosis. 73.6% of cases had concomitant diseases. Results. The therapy for nontuberculous mycobacteriosis was prescribed in 115 patients, depending on drug susceptibility, and included at least 3 drug products. 31.3% of patients had adverse reactions; one third of these patients had allergic reactions. Hepatotoxic reactions were recorded in 16.5% of cases, cardiotoxic — in 12.2%, ototoxic — in 10.4%, optic neuritis was diagnosed in 5 % of cases. In 31.3% of cases, the therapy was adjusted, in 13.9% of cases, the therapy was reviewed and alternative treatment was offered. The complete antibacterial course was prescribed to 79 (68.7%) patients. Conclusion. The therapy for nontuberculous mycobacteriosis should be selected in inpatient settings with laboratory and functional monitoring. Keywords: nontuberculous lung mycobacteriosis, antimicrobial therapy, adverse reactions.","PeriodicalId":11479,"journal":{"name":"Doctor.Ru","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90947023","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 : 2023-01-01DOI: 10.31550/1727-2378-2023-22-3-32-39
N. Geppe, M. Velikoretskaya, I. Ozerskaya, T. Kozhevnikova, R. M. Faizullina, S. Shatalina, N.K. Ziskina, E.A. Siderko
Aim: To evaluate the effect of carbocysteine on cough and the level of secretory immunoglobulin A (sIgA) in saliva in children with acute respiratory viral infections (ARVI) and the presence of a correlation between the level of sIgA in saliva and the total cough index. Design: Multicentre observational study. Materials and methods. 156 children older than 2 years (4.4 ± 1.2 years) with ARVI were included in the study. All patients received carbocysteine at the age dosage. The total cough index and the concentration of sIgA in saliva were measured on days 1–2 and on days 7–10 from the onset of ARVI. Results. The total cough index significantly decreased in 98.7% of patients by the 7–10th day of illness. The level of sIgA in saliva was initially 26.49 (8.94; 56.51) μg/ml, in dynamics — 30.07 (8.52; 60.40) μg/ml (no significant differences were found). An increase in the level of sIgA in dynamics was noted in 43.6% of patients, and in the vast majority of them the increase was significant — 20% or more. A decrease in the concentration of sIgA in dynamics was noted in 55.8% of patients. A significant correlation was found between sIgA concentrations in saliva at the first and second visits (p < 0,001). There was no significant correlation between the total cough index and sIgA levels. Conclusion. A significant positive dynamic of cough was noted in patients with ARVI during treatment with carbocysteine. The concentration of sIgA in saliva varies within a wide range. A multidirectional change in the level of sIgA in saliva over time was noted in children with ARVI. Further study of the mechanisms of local mucosal immunity can help in the development of new approaches to the treatment and prevention of ARVI. Keywords: carbocysteine, secretory immunoglobulin A in saliva, acute respiratory viral infections in children, cough, mucosal immunity.
{"title":"Carbocysteine Influence on Cough Severity and Local Mucosal Immunity in Acute Respiratory Viral Infections in Children","authors":"N. Geppe, M. Velikoretskaya, I. Ozerskaya, T. Kozhevnikova, R. M. Faizullina, S. Shatalina, N.K. Ziskina, E.A. Siderko","doi":"10.31550/1727-2378-2023-22-3-32-39","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-3-32-39","url":null,"abstract":"Aim: To evaluate the effect of carbocysteine on cough and the level of secretory immunoglobulin A (sIgA) in saliva in children with acute respiratory viral infections (ARVI) and the presence of a correlation between the level of sIgA in saliva and the total cough index. Design: Multicentre observational study. Materials and methods. 156 children older than 2 years (4.4 ± 1.2 years) with ARVI were included in the study. All patients received carbocysteine at the age dosage. The total cough index and the concentration of sIgA in saliva were measured on days 1–2 and on days 7–10 from the onset of ARVI. Results. The total cough index significantly decreased in 98.7% of patients by the 7–10th day of illness. The level of sIgA in saliva was initially 26.49 (8.94; 56.51) μg/ml, in dynamics — 30.07 (8.52; 60.40) μg/ml (no significant differences were found). An increase in the level of sIgA in dynamics was noted in 43.6% of patients, and in the vast majority of them the increase was significant — 20% or more. A decrease in the concentration of sIgA in dynamics was noted in 55.8% of patients. A significant correlation was found between sIgA concentrations in saliva at the first and second visits (p < 0,001). There was no significant correlation between the total cough index and sIgA levels. Conclusion. A significant positive dynamic of cough was noted in patients with ARVI during treatment with carbocysteine. The concentration of sIgA in saliva varies within a wide range. A multidirectional change in the level of sIgA in saliva over time was noted in children with ARVI. Further study of the mechanisms of local mucosal immunity can help in the development of new approaches to the treatment and prevention of ARVI. Keywords: carbocysteine, secretory immunoglobulin A in saliva, acute respiratory viral infections in children, cough, mucosal immunity.","PeriodicalId":11479,"journal":{"name":"Doctor.Ru","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76781686","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 : 2023-01-01DOI: 10.31550/1727-2378-2023-22-3-56-60
M.A. Arustamyan, L. Avetisyan, A.О. Kotanyan, M.R. Ohanyan, M. Mardiyan, A. Chopikyan
Aim: To evaluate the psychological peculiarities of mothers of preterm and term birth infants, and their attitude to breastfeeding before and after childbirth. Design: Observational study. Materials and methods. The subjects of the research were a pregnant woman at 12-week gestation randomly selected from 5 maternity hospitals in Yerevan. 268 pregnant women were eligible for inclusion in this observational study and created a total group. After birth, mothers were divided into groups of full-term (n = 239) and premature (n = 29) babies. We analysed baseline demographics, health information of the mother, history of pregnancy and delivery, as well as health information of babies. We assessed the presence of depressive symptoms with a Beck Depression Inventory and situational and individual anxiety levels with the Spielberger State-Trait Anxiety Inventory. Results. Assessment of the psychological status demonstrated a high level of state anxiety: 26.7 ± 1.4 and 45.8 ± 1.5 points in mothers of full-term and premature babies, respectively; in mothers of premature babies, the value was significantly higher (р < 0.05). Personal anxiety was relatively inert, there were no significant differences between the groups (p > 0.05). Depressive symptoms were also more pronounced in preterm mothers (moderate depression) than in term birth mothers (mild mood disturbance): 22.5 ± 0.8 points vs. 11.4 ± 0.9 points (p < 0.01). The majority of women (68.3%) who had preterm delivery had a high level of state anxiety (р < 0.01 vs. mothers of full-term babies). Women who were ready to breastfeed longer after the baby is born had more marked signs of depression. In mothers full-term and premature babies, the attitude to breastfeeding before delivery demonstrated direct correlation with the level of depression on Beck depression inventory (r = 0.75, p = 0.02 and r = 0.68, p < 0.01, respectively). The degree of state anxiety in mothers of premature babies correlated with hospitalisation duration (r = 0.9, p = 0.008). Conclusions. Mothers of preterm infants need psychological care based on high level of situational anxiety and depressive symptoms. Breastfeeding is a good biological tool for improved interaction of the mother with her baby; it boosts psychological comfort and reduces anxiety and depression. Keywords: preterm birth, anxiety, depression, mother-infant interaction.
目的:探讨早产儿和足月儿母亲的心理特点及其对母乳喂养的态度。设计:观察性研究。材料和方法。研究对象是一名妊娠12周的孕妇，随机从埃里温的5家妇产医院中选择一名孕妇。268名孕妇符合纳入这项观察性研究的条件，并形成一个总组。出生后，母亲被分为足月婴儿(n = 239)和早产儿(n = 29)两组。我们分析了基线人口统计数据、母亲的健康信息、怀孕和分娩史以及婴儿的健康信息。我们用Beck抑郁量表评估抑郁症状的存在，用Spielberger状态-特质焦虑量表评估情境和个体焦虑水平。结果。心理状态评估显示，足月母亲和早产儿母亲的状态焦虑水平较高，分别为26.7±1.4分和45.8±1.5分;在早产儿母亲中，这一数值明显更高(p < 0.05)。个人焦虑相对惰性，组间差异无统计学意义(p > 0.05)。抑郁症状在早产母亲(中度抑郁)比足月母亲(轻度情绪障碍)更明显:22.5±0.8分比11.4±0.9分(p < 0.01)。大多数早产妇女(68.3%)有高水平的状态焦虑(与足月婴儿的母亲相比< 0.01)。在婴儿出生后准备更长时间母乳喂养的妇女有更明显的抑郁迹象。足月和早产儿母亲产前母乳喂养态度与贝克抑郁量表抑郁水平直接相关(r = 0.75, p = 0.02和r = 0.68, p < 0.01)。早产儿母亲的状态焦虑程度与住院时间相关(r = 0.9, p = 0.008)。结论。早产儿母亲需要基于高水平情境焦虑和抑郁症状的心理护理。母乳喂养是改善母亲与婴儿互动的良好生物工具;它能提高心理舒适度，减少焦虑和抑郁。关键词:早产，焦虑，抑郁，母婴互动。
{"title":"Psychological Features of Mothers of Premature and Full-term Babies","authors":"M.A. Arustamyan, L. Avetisyan, A.О. Kotanyan, M.R. Ohanyan, M. Mardiyan, A. Chopikyan","doi":"10.31550/1727-2378-2023-22-3-56-60","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-3-56-60","url":null,"abstract":"Aim: To evaluate the psychological peculiarities of mothers of preterm and term birth infants, and their attitude to breastfeeding before and after childbirth. Design: Observational study. Materials and methods. The subjects of the research were a pregnant woman at 12-week gestation randomly selected from 5 maternity hospitals in Yerevan. 268 pregnant women were eligible for inclusion in this observational study and created a total group. After birth, mothers were divided into groups of full-term (n = 239) and premature (n = 29) babies. We analysed baseline demographics, health information of the mother, history of pregnancy and delivery, as well as health information of babies. We assessed the presence of depressive symptoms with a Beck Depression Inventory and situational and individual anxiety levels with the Spielberger State-Trait Anxiety Inventory. Results. Assessment of the psychological status demonstrated a high level of state anxiety: 26.7 ± 1.4 and 45.8 ± 1.5 points in mothers of full-term and premature babies, respectively; in mothers of premature babies, the value was significantly higher (р < 0.05). Personal anxiety was relatively inert, there were no significant differences between the groups (p > 0.05). Depressive symptoms were also more pronounced in preterm mothers (moderate depression) than in term birth mothers (mild mood disturbance): 22.5 ± 0.8 points vs. 11.4 ± 0.9 points (p < 0.01). The majority of women (68.3%) who had preterm delivery had a high level of state anxiety (р < 0.01 vs. mothers of full-term babies). Women who were ready to breastfeed longer after the baby is born had more marked signs of depression. In mothers full-term and premature babies, the attitude to breastfeeding before delivery demonstrated direct correlation with the level of depression on Beck depression inventory (r = 0.75, p = 0.02 and r = 0.68, p < 0.01, respectively). The degree of state anxiety in mothers of premature babies correlated with hospitalisation duration (r = 0.9, p = 0.008). Conclusions. Mothers of preterm infants need psychological care based on high level of situational anxiety and depressive symptoms. Breastfeeding is a good biological tool for improved interaction of the mother with her baby; it boosts psychological comfort and reduces anxiety and depression. Keywords: preterm birth, anxiety, depression, mother-infant interaction.","PeriodicalId":11479,"journal":{"name":"Doctor.Ru","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75418897","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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