Pub Date : 2023-01-01DOI: 10.31550/1727-2378-2023-22-2-15-20
N. T. Mirzoev, G. G. Kutelev, V. Ivanov, D. V. Cherkashin, K. Shulenin, R. Makiev
Aim: To study the correlation of laboratory and instrumental indicators with the severity of the COVID-19 and to assess the dynamics of changes of the lipid profile and the electrical axis of the heart of patients in the acute period of the disease and after recovery. Design: Retrospective observational study. Materials and Methods. A retrospective analysis of medical histories of 30 young patients (18–44 years) without cardiovascular diseases, who underwent two-stage treatment at the Military Medical Academy named after S.M. Kirov with diagnoses: «COVID-19, virus identified» (U07.1, ICD-10) and «Post COVID-19 condition» (U09.9, ICD-10) in the period from April to December 2021. Results. The study found that individuals after COVID-19 had an increase in total cholesterol concentrations (6.51 [5.62–6.79] mmol/l), lowdensity lipoprotein (3.89 [3.34–4.52] mmol/l) and very low-density lipoprotein (1.06 ± 0.72 mmol/l) as opposed to acute period of COVID-19, where the lipid spectrum remained within normal values. In addition, an electrocardiogram analysis showed dynamics of the alpha angle changed from 42 ± 11 to 25 ± 17 degrees of patients after the elimination of SARS-CoV-2, with the deviation of the electrical axis of the heart to the left was detected of the first time in 5 (17%) patients after COVID-19. Conclusion. Individuals after COVID-19, who have been identified for the first time as having dyslipidemia and deviation of the electrical axis of the heart to the left, as well as high levels of inflammation markers can be considered by candidates for high-tech imaging techniques to eliminate damage of the cardiovascular system. Keywords: novel coronavirus disease; SARS-CoV-2; electrocardiography; electrical axis of the heart; dyslipidemia; cardiovascular complications.
{"title":"Changes of the Electrical Axis of the Heart and Dyslipidemia as Possible Markers of Cardiovascular Damage in Patients after COVID-19","authors":"N. T. Mirzoev, G. G. Kutelev, V. Ivanov, D. V. Cherkashin, K. Shulenin, R. Makiev","doi":"10.31550/1727-2378-2023-22-2-15-20","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-2-15-20","url":null,"abstract":"Aim: To study the correlation of laboratory and instrumental indicators with the severity of the COVID-19 and to assess the dynamics of changes of the lipid profile and the electrical axis of the heart of patients in the acute period of the disease and after recovery. Design: Retrospective observational study. Materials and Methods. A retrospective analysis of medical histories of 30 young patients (18–44 years) without cardiovascular diseases, who underwent two-stage treatment at the Military Medical Academy named after S.M. Kirov with diagnoses: «COVID-19, virus identified» (U07.1, ICD-10) and «Post COVID-19 condition» (U09.9, ICD-10) in the period from April to December 2021. Results. The study found that individuals after COVID-19 had an increase in total cholesterol concentrations (6.51 [5.62–6.79] mmol/l), lowdensity lipoprotein (3.89 [3.34–4.52] mmol/l) and very low-density lipoprotein (1.06 ± 0.72 mmol/l) as opposed to acute period of COVID-19, where the lipid spectrum remained within normal values. In addition, an electrocardiogram analysis showed dynamics of the alpha angle changed from 42 ± 11 to 25 ± 17 degrees of patients after the elimination of SARS-CoV-2, with the deviation of the electrical axis of the heart to the left was detected of the first time in 5 (17%) patients after COVID-19. Conclusion. Individuals after COVID-19, who have been identified for the first time as having dyslipidemia and deviation of the electrical axis of the heart to the left, as well as high levels of inflammation markers can be considered by candidates for high-tech imaging techniques to eliminate damage of the cardiovascular system. Keywords: novel coronavirus disease; SARS-CoV-2; electrocardiography; electrical axis of the heart; dyslipidemia; cardiovascular complications.","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":"72595250","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: 10.31550/1727-2378-2023-22-4-59-63
A. Ametov, E. Pashkova, K. Amikishieva, V.R. Gadzhiev
Aim: To demonstrate a clinical case of a patient with diabetes mellitus secondary to chronic pancreatitis, who needs not only compensation for carbohydrate metabolism, but also correction of exocrine pancreatic insufficiency. Key points. The patient noted a significant improvement in well-being against the background of adequate hypoglycemic therapy (nighttime metformin, sodium-glucose co-transporter type 2 inhibitors and glucagon-like peptide-1 receptor agonist, basal insulin glargine) and enzyme-replacement therapy with pancreatin minimicrospheres at a dose of 50,000 IU on main meals and up to 25,000 ED at snacks. When evaluating the glycemic profile of continuous glucose monitoring showed stabilization of blood glucose at the target range. According to the results of laboratory tests, the patient showed not only normalization of carbohydrate metabolism, but also an initially reduced level of total protein, vitamins and minerals. Conclusion. Administration of drugs used to treat patients with type 2 diabetes mellitus for the management of patients with diabetes secondary to chronic pancreatitis is justified. At the same time, the addition of insulin is often necessary. For this group of patients, the enzyme replacement therapy of exocrine pancreatic insufficiency is as important for the correction of metabolic disorders as the usual hypoglycemic therapy. Keywords: pancreatogenic diabetes mellitus, chronic pancreatitis, exocrine pancreatic insufficiency.
{"title":"Diabetes Mellitus Secondary to Chronic Pancreatitis: Aspects of Clinical Course and Management","authors":"A. Ametov, E. Pashkova, K. Amikishieva, V.R. Gadzhiev","doi":"10.31550/1727-2378-2023-22-4-59-63","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-4-59-63","url":null,"abstract":"Aim: To demonstrate a clinical case of a patient with diabetes mellitus secondary to chronic pancreatitis, who needs not only compensation for carbohydrate metabolism, but also correction of exocrine pancreatic insufficiency. Key points. The patient noted a significant improvement in well-being against the background of adequate hypoglycemic therapy (nighttime metformin, sodium-glucose co-transporter type 2 inhibitors and glucagon-like peptide-1 receptor agonist, basal insulin glargine) and enzyme-replacement therapy with pancreatin minimicrospheres at a dose of 50,000 IU on main meals and up to 25,000 ED at snacks. When evaluating the glycemic profile of continuous glucose monitoring showed stabilization of blood glucose at the target range. According to the results of laboratory tests, the patient showed not only normalization of carbohydrate metabolism, but also an initially reduced level of total protein, vitamins and minerals. Conclusion. Administration of drugs used to treat patients with type 2 diabetes mellitus for the management of patients with diabetes secondary to chronic pancreatitis is justified. At the same time, the addition of insulin is often necessary. For this group of patients, the enzyme replacement therapy of exocrine pancreatic insufficiency is as important for the correction of metabolic disorders as the usual hypoglycemic therapy. Keywords: pancreatogenic diabetes mellitus, chronic pancreatitis, exocrine pancreatic insufficiency.","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":"76316334","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: 10.31550/1727-2378-2023-22-3-76-80
N. I. Zakharova, N. D. Odinaeva, A.S. Gryzunova, M. Shvedova
Aim: To assess the possibility of using Tanoshi nappies and pants for the prevention of diaper dermatitis, their safety and tolerability by newborns and babies under 2 years of age. Design. Prospective cohort study. Materials and methods. The study included 50 children with the weight 2 to 28 kg under 2 years of age without any signs of skin diseases, including nappy (pants) area. Proposed items were used for 14 days subject to timely change 4–7 times daily after bowel movement and during hygienic procedures 1–2 times daily. Skin was visually assessed by a children’s doctor on day 1, day 7, and day 14 of the study (M. Odio skin assessment tool). Results. On day 1, day 7, and day 14, all children had 0 points for their skin assessment of waist, buttocks, genitals, anal region, inguinal fold (M. Odio skin assessment tool). Assessment of the skin in the nappy and pants area after 14 days of use did not show any signs of dryness, irritation, oedema, and erosions from the contact with a nappy. Conclusion. All 50 newborns and babies under 2 years of age who used disposable Tanoshi nappies and pants in the real clinical practice over 2 weeks did not show any signs of diaper dermatitis. It proves that the nappies are safe and well tolerated by children under 2 years of age with proper skin care. Tanoshi nappies and pants can be recommended for children under 2 years of age who do not have any skin conditions and diseases. Keywords: diaper dermatitis, newborns, children under 2 years of age, nappies.
{"title":"Possible Use of Disposable Nappies for the Prevention of Diaper Dermatitis in Newborns and Babies Under 2 Years of Age","authors":"N. I. Zakharova, N. D. Odinaeva, A.S. Gryzunova, M. Shvedova","doi":"10.31550/1727-2378-2023-22-3-76-80","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-3-76-80","url":null,"abstract":"Aim: To assess the possibility of using Tanoshi nappies and pants for the prevention of diaper dermatitis, their safety and tolerability by newborns and babies under 2 years of age. Design. Prospective cohort study. Materials and methods. The study included 50 children with the weight 2 to 28 kg under 2 years of age without any signs of skin diseases, including nappy (pants) area. Proposed items were used for 14 days subject to timely change 4–7 times daily after bowel movement and during hygienic procedures 1–2 times daily. Skin was visually assessed by a children’s doctor on day 1, day 7, and day 14 of the study (M. Odio skin assessment tool). Results. On day 1, day 7, and day 14, all children had 0 points for their skin assessment of waist, buttocks, genitals, anal region, inguinal fold (M. Odio skin assessment tool). Assessment of the skin in the nappy and pants area after 14 days of use did not show any signs of dryness, irritation, oedema, and erosions from the contact with a nappy. Conclusion. All 50 newborns and babies under 2 years of age who used disposable Tanoshi nappies and pants in the real clinical practice over 2 weeks did not show any signs of diaper dermatitis. It proves that the nappies are safe and well tolerated by children under 2 years of age with proper skin care. Tanoshi nappies and pants can be recommended for children under 2 years of age who do not have any skin conditions and diseases. Keywords: diaper dermatitis, newborns, children under 2 years of age, nappies.","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":"89900975","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: 10.31550/1727-2378-2023-22-3-89-91
A. V. Aksenov, Е.А. Ivanovskaya
Aim: demonstration of a clinical case of the successful use of etanercept in a child with еnthesitis-аssociated аrthritis. Key points. Еnthesitis-аssociated аrthritis is one of the clinical variants of juvenile idiopathic arthritis. The initial therapy of еnthesitis-аssociated аrthritis includes nonsteroidal anti-inflammatory drugs (NSAIDs) and non-biological disease-modifying drugs, the ineffectiveness of which is an indication for the appointment of genetically engineered drugs, in particular, the inhibitor of tumor necrosis factor-α etanercept. Conclusion. Currently, for the treatment of еnthesitis-аssociated аrthritis, if the use of NSAIDs and non-biological disease-modifying drugs is ineffective, genetically engineered drugs should be prescribed, in particular etanercept, which allows to achieve drug remission. Keywords: еnthesitis-аssociated аrthritis, etanercept, children.
{"title":"Successful Use of Etanercept in a Child with Еnthesitis-Аssociated Аrthritis","authors":"A. V. Aksenov, Е.А. Ivanovskaya","doi":"10.31550/1727-2378-2023-22-3-89-91","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-3-89-91","url":null,"abstract":"Aim: demonstration of a clinical case of the successful use of etanercept in a child with еnthesitis-аssociated аrthritis. Key points. Еnthesitis-аssociated аrthritis is one of the clinical variants of juvenile idiopathic arthritis. The initial therapy of еnthesitis-аssociated аrthritis includes nonsteroidal anti-inflammatory drugs (NSAIDs) and non-biological disease-modifying drugs, the ineffectiveness of which is an indication for the appointment of genetically engineered drugs, in particular, the inhibitor of tumor necrosis factor-α etanercept. Conclusion. Currently, for the treatment of еnthesitis-аssociated аrthritis, if the use of NSAIDs and non-biological disease-modifying drugs is ineffective, genetically engineered drugs should be prescribed, in particular etanercept, which allows to achieve drug remission. Keywords: еnthesitis-аssociated аrthritis, etanercept, children.","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":"73560449","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: 10.31550/1727-2378-2023-22-1-33-39
V. Dolgushina, E. G. Syundyukova, V. Chulkov, K.A. Unigovskaya
Aim: Based on the study of the history, course of pregnancy and childbirth, to assess the risks of venous thromboembolic events among women with major obstetric syndromes. Design: Retrospective cohort study using the continuum sampling method. Materials and methods. 200 birth histories were analyzed: group 1 — 55 women with great obstetric syndromes, group 2 — 145 pregnant without them. The history of women, pregnancy outcomes were studied, and an analysis of the risks of venous thromboembolic complications was carried out. Results. Anamnestic risk factors for major obstetric syndromes were a family history aggravated by early thromboembolic events (RR = 3,13; 95% CI: 1,34–7,30), unemployed status (RR = 1,73; 95% CI: 1,32–2,65), preeclampsia in the past (RR = 23,46; 95% CI: 1,28–428,80), first pregnancy (RR = 1,63; 95% CI: 1,04–2,55), chronic arterial hypertension (RR = 8,45; 95% CI: 1,76–40,66). There was a significant increase in the risk of venous thromboembolic complications in patients of group 1 during pregnancy (1 (1–2) points; p < 0.001) and in the postpartum period (3 (1–4) points; p < 0.001). Conclusion. Prognostic markers of great obstetric syndromes were aggravated family and personal obstetric anamnesis, parity, low social status, chronic arterial hypertension. A significant increase in the risk of venous thromboembolic complications in pregnant women and puerperas with major obstetric syndromes was revealed. Keywords: great obstetric syndromes, preeclampsia, risk factors, venous thromboembolic complications.
{"title":"Risks of Venous Thromboembolic Events and the Great Obstetric Syndromes","authors":"V. Dolgushina, E. G. Syundyukova, V. Chulkov, K.A. Unigovskaya","doi":"10.31550/1727-2378-2023-22-1-33-39","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-1-33-39","url":null,"abstract":"Aim: Based on the study of the history, course of pregnancy and childbirth, to assess the risks of venous thromboembolic events among women with major obstetric syndromes. Design: Retrospective cohort study using the continuum sampling method. Materials and methods. 200 birth histories were analyzed: group 1 — 55 women with great obstetric syndromes, group 2 — 145 pregnant without them. The history of women, pregnancy outcomes were studied, and an analysis of the risks of venous thromboembolic complications was carried out. Results. Anamnestic risk factors for major obstetric syndromes were a family history aggravated by early thromboembolic events (RR = 3,13; 95% CI: 1,34–7,30), unemployed status (RR = 1,73; 95% CI: 1,32–2,65), preeclampsia in the past (RR = 23,46; 95% CI: 1,28–428,80), first pregnancy (RR = 1,63; 95% CI: 1,04–2,55), chronic arterial hypertension (RR = 8,45; 95% CI: 1,76–40,66). There was a significant increase in the risk of venous thromboembolic complications in patients of group 1 during pregnancy (1 (1–2) points; p < 0.001) and in the postpartum period (3 (1–4) points; p < 0.001). Conclusion. Prognostic markers of great obstetric syndromes were aggravated family and personal obstetric anamnesis, parity, low social status, chronic arterial hypertension. A significant increase in the risk of venous thromboembolic complications in pregnant women and puerperas with major obstetric syndromes was revealed. Keywords: great obstetric syndromes, preeclampsia, risk factors, venous thromboembolic complications.","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":"80896278","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: 10.31550/1727-2378-2023-22-3-15-21
M. Kurdup, A. Fisenko, I. Davydova, A. A. Zhuzhula, N. Alyabieva, E. Basargina
Aim: To determine the coverage, efficacy and tolerability of pneumococcal vaccination in young children with cardiovascular disease associated with chronic heart failure. Design: Retro- and prospective randomized comparative study. Materials and methods. The study included 250 patients at the age of 2 months to 5 years with confirmed chronic cardiac failure caused by cardiomyopathy or congenital heart disorder. Within the scope of a specialised laboratory and instrumental examination, all children underwent an assessment of specific immunoglobulin (Ig) levels to the most common pneumococcal serotypes (1-5, 6B, 7F, 8, 9N, 9V, 10A, 11A,12F, 14, 15B, 17F, 18C, 19F, 19A, 20, 22F, 23F, 33F) using VaccZyme Anti-PCP IgG test system. During consultations and vaccination schedule development, pneumococcal vaccination coverage and the reasons for long-term medical exemptions or refusals were analysed. Provided the primary disease was stable, there were no contraindications and a parent gave their consent, patients were vaccinated with 13-valent pneumococcal conjugate vaccine (PCV13). Results. When questioning the parents of patients, it was revealed that before admission to the department, only 97 (38.8%) patients received at least 1 dose of pneumococcal vaccine, while the remaining 153 (61.2%) were not vaccinated. During hospitalization, 65 (42.5%) of 153 unvaccinated patients under 5 years of age who had not received a single pneumococcal vaccine received the first dose (V1) of PCV13; of 97 children vaccinated, 20 (20.6%) received a second dose, 18 (18.6%) — pneumococcal booster. There was a significant difference in the levels of antibodies to Streptococcus pneumoniae between the group of patients who received a full course of immunization according to age and the group of unvaccinated children: 108.1 ± 58.4 vs. 12.14 ± 7.8 mg/l (p < 0.05). In children with an incomplete course of vaccination, the levels of specific IgG to pneumococcal serotypes were lower. In groups of children who received only one dose of the vaccine in the first or second year of life, they amounted to 42.2 ± 11.7 and 40.2 ± 16.2 mg/l, respectively. Children who received at least two doses of vaccine without revaccination (starting before 12 months) had a relatively higher level of 68.2 ± 6.3 mg/L. But, despite a clear trend, there was no significant difference between these groups in our study. In the post-vaccination period, no serious complications were recorded in the examined children. Conclusion. Vaccination against pneumococcal infection in children with chronic heart failure is effective, safe and should be carried out as close as possible to the schedule of the national vaccination calendar, with a limited set of contraindications. Keywords: vaccination, 13-valent pneumococcal conjugate vaccine, immunoglobulin G, chronic heart failure.
{"title":"Pneumococcal Immunization in Young Children with Chronic Heart Failure","authors":"M. Kurdup, A. Fisenko, I. Davydova, A. A. Zhuzhula, N. Alyabieva, E. Basargina","doi":"10.31550/1727-2378-2023-22-3-15-21","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-3-15-21","url":null,"abstract":"Aim: To determine the coverage, efficacy and tolerability of pneumococcal vaccination in young children with cardiovascular disease associated with chronic heart failure. Design: Retro- and prospective randomized comparative study. Materials and methods. The study included 250 patients at the age of 2 months to 5 years with confirmed chronic cardiac failure caused by cardiomyopathy or congenital heart disorder. Within the scope of a specialised laboratory and instrumental examination, all children underwent an assessment of specific immunoglobulin (Ig) levels to the most common pneumococcal serotypes (1-5, 6B, 7F, 8, 9N, 9V, 10A, 11A,12F, 14, 15B, 17F, 18C, 19F, 19A, 20, 22F, 23F, 33F) using VaccZyme Anti-PCP IgG test system. During consultations and vaccination schedule development, pneumococcal vaccination coverage and the reasons for long-term medical exemptions or refusals were analysed. Provided the primary disease was stable, there were no contraindications and a parent gave their consent, patients were vaccinated with 13-valent pneumococcal conjugate vaccine (PCV13). Results. When questioning the parents of patients, it was revealed that before admission to the department, only 97 (38.8%) patients received at least 1 dose of pneumococcal vaccine, while the remaining 153 (61.2%) were not vaccinated. During hospitalization, 65 (42.5%) of 153 unvaccinated patients under 5 years of age who had not received a single pneumococcal vaccine received the first dose (V1) of PCV13; of 97 children vaccinated, 20 (20.6%) received a second dose, 18 (18.6%) — pneumococcal booster. There was a significant difference in the levels of antibodies to Streptococcus pneumoniae between the group of patients who received a full course of immunization according to age and the group of unvaccinated children: 108.1 ± 58.4 vs. 12.14 ± 7.8 mg/l (p < 0.05). In children with an incomplete course of vaccination, the levels of specific IgG to pneumococcal serotypes were lower. In groups of children who received only one dose of the vaccine in the first or second year of life, they amounted to 42.2 ± 11.7 and 40.2 ± 16.2 mg/l, respectively. Children who received at least two doses of vaccine without revaccination (starting before 12 months) had a relatively higher level of 68.2 ± 6.3 mg/L. But, despite a clear trend, there was no significant difference between these groups in our study. In the post-vaccination period, no serious complications were recorded in the examined children. Conclusion. Vaccination against pneumococcal infection in children with chronic heart failure is effective, safe and should be carried out as close as possible to the schedule of the national vaccination calendar, with a limited set of contraindications. Keywords: vaccination, 13-valent pneumococcal conjugate vaccine, immunoglobulin G, chronic heart failure.","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":"82352314","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: 10.31550/1727-2378-2023-22-3-40-44
N. Potapova, A. Markovskaya
Aim: To present the relevant information on the new approaches to the management of obliterating bronchiolitis in children, based on the data generated by foreign researchers. Key Points. Obliterating bronchiolitis is a non-reversible chronic obstructive lung disease associated with respiratory insufficiency, significant deterioration in the quality of life, and steady signs of disability. Despite the fact that this topic is of high interest, the management of patients and efficient therapy algorithms are a burning issue. A risk of side effects from systemic corticosteroids necessitates the search for alternative therapies. This overview presents information on a combined use of inhaled corticosteroids, azithromycin, monteleukast, and N-acetylcysteine. Conclusion. Further development of alternative therapies for chronic obliterating bronchiolitis can help in achieving efficient control of this disease. Keywords: obliterating bronchiolitis, therapy, children.
{"title":"Analysis of Anti-Inflammatory Therapy Options for Bronchiolitis Obliterans in Children","authors":"N. Potapova, A. Markovskaya","doi":"10.31550/1727-2378-2023-22-3-40-44","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-3-40-44","url":null,"abstract":"Aim: To present the relevant information on the new approaches to the management of obliterating bronchiolitis in children, based on the data generated by foreign researchers. Key Points. Obliterating bronchiolitis is a non-reversible chronic obstructive lung disease associated with respiratory insufficiency, significant deterioration in the quality of life, and steady signs of disability. Despite the fact that this topic is of high interest, the management of patients and efficient therapy algorithms are a burning issue. A risk of side effects from systemic corticosteroids necessitates the search for alternative therapies. This overview presents information on a combined use of inhaled corticosteroids, azithromycin, monteleukast, and N-acetylcysteine. Conclusion. Further development of alternative therapies for chronic obliterating bronchiolitis can help in achieving efficient control of this disease. Keywords: obliterating bronchiolitis, therapy, children.","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":"80213591","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: 10.31550/1727-2378-2023-22-2-51-56
E. Bolotova, K. Yumukyan, A. Dudnikova
Aim: To assess the quality of life, the level of anxiety and depression in patients with ulcerative colitis (UC) depending on disease active/inactive status. Design: comparative prospective study. Materials and methods. In 2018–2020, a clinical study was conducted in Prof. S. V. Ochapovskiy Regional Clinical Hospital No. 1, which enrolled 218 patients: 178 patients with UC (139 patients with active disease and 39 patients with inactive disease) and 40 healthy volunteers (control group). In addition to routine examinations and faecal inflammatory markers, all patients underwent a quality-of-life assessment using The Short Form-36 (SF-36) and Inflammatory Bowel Disease Questionnaire (IBDQ), Clinical Activity Index (CAI), anxiety and depression evaluation using the Hospital Anxiety and Depression (HADS) scale. Results. The lowest mean values for SF-36 and the strongest correlations with CAI were observed in UC patients for the following domains: viability scale, overall health and emotional functioning (р < 0.05). Significant differences were recorded for IBDQ in mean values and correlations between the points on the scale and CAI for all domains (р = 0.0001). The strongest correlations were observed for the overall points and the “intestinal factor” domain (р = 0.0001). Lower mean values for SF-36 were in patients with chronic diseases not related to UC; for IBDQ, the situation was opposite — patients with extraintestinal UC signs had lower mean values. We found a correlation between HADS and CAI points which shows severity of an UC episode (r = 0.560; р = 0.01). Conclusions. The results demonstrate the importance of evaluation of the quality of life of patients with UC using both specific and nonspecific questionnaires, since they complement each other and allow personalising therapeutic approaches for patients with UC. Keywords: ulcerative colitis; inflammatory bowel diseases; quality of life; anxiety; depression.
{"title":"Comparative Assessment of the Quality of Life and the Level of Anxiety and Depression in Patients with Ulcerative Colitis","authors":"E. Bolotova, K. Yumukyan, A. Dudnikova","doi":"10.31550/1727-2378-2023-22-2-51-56","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-2-51-56","url":null,"abstract":"Aim: To assess the quality of life, the level of anxiety and depression in patients with ulcerative colitis (UC) depending on disease active/inactive status. Design: comparative prospective study. Materials and methods. In 2018–2020, a clinical study was conducted in Prof. S. V. Ochapovskiy Regional Clinical Hospital No. 1, which enrolled 218 patients: 178 patients with UC (139 patients with active disease and 39 patients with inactive disease) and 40 healthy volunteers (control group). In addition to routine examinations and faecal inflammatory markers, all patients underwent a quality-of-life assessment using The Short Form-36 (SF-36) and Inflammatory Bowel Disease Questionnaire (IBDQ), Clinical Activity Index (CAI), anxiety and depression evaluation using the Hospital Anxiety and Depression (HADS) scale. Results. The lowest mean values for SF-36 and the strongest correlations with CAI were observed in UC patients for the following domains: viability scale, overall health and emotional functioning (р < 0.05). Significant differences were recorded for IBDQ in mean values and correlations between the points on the scale and CAI for all domains (р = 0.0001). The strongest correlations were observed for the overall points and the “intestinal factor” domain (р = 0.0001). Lower mean values for SF-36 were in patients with chronic diseases not related to UC; for IBDQ, the situation was opposite — patients with extraintestinal UC signs had lower mean values. We found a correlation between HADS and CAI points which shows severity of an UC episode (r = 0.560; р = 0.01). Conclusions. The results demonstrate the importance of evaluation of the quality of life of patients with UC using both specific and nonspecific questionnaires, since they complement each other and allow personalising therapeutic approaches for patients with UC. Keywords: ulcerative colitis; inflammatory bowel diseases; quality of life; anxiety; depression.","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":"90552270","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: 10.31550/1727-2378-2023-22-2-26-31
Yu.R. Gvozdeva, E. Kantimirova, D. Dmitrenko
Objective of the Review: To demonstrate the complexity in diagnosing postural orthostatic tachycardia syndrome. Key Points. Clinical manifestations of postural orthostatic tachycardia syndrome vary and can have a clinical phenotype that is similar to a number of neurological and somatic conditions. Conclusion. The case studies presented demonstrate the significance of diagnostic manoeuvres in differentiating this syndrome from other types of impairment of consciousness. An active test in standing position which is easy to conduct can be a diagnostic prompt, if it is verified with a history of typical chronic orthostatic intolerability, postural heart acceleration, and a variety of accompanying complaints. Keywords: postural orthostatic tachycardia syndrome, loss of consciousness, diagnostics.
{"title":"Problems with the Diagnostics of Postural Orthostatic Tachycardia Syndrome. Case Studies","authors":"Yu.R. Gvozdeva, E. Kantimirova, D. Dmitrenko","doi":"10.31550/1727-2378-2023-22-2-26-31","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-2-26-31","url":null,"abstract":"Objective of the Review: To demonstrate the complexity in diagnosing postural orthostatic tachycardia syndrome. Key Points. Clinical manifestations of postural orthostatic tachycardia syndrome vary and can have a clinical phenotype that is similar to a number of neurological and somatic conditions. Conclusion. The case studies presented demonstrate the significance of diagnostic manoeuvres in differentiating this syndrome from other types of impairment of consciousness. An active test in standing position which is easy to conduct can be a diagnostic prompt, if it is verified with a history of typical chronic orthostatic intolerability, postural heart acceleration, and a variety of accompanying complaints. Keywords: postural orthostatic tachycardia syndrome, loss of consciousness, diagnostics.","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":"89815018","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: 10.31550/1727-2378-2023-22-2-32-38
M. A. Cherepnin, V. Tsukanov, A. Savchenko, A. Vasyutin, Yu. L. Tonkikh, A. Borisov
Aim: to compare the clinical manifestations in patients with genotypes 1 and 3 of viral hepatitis C (HCV) depending on the severity of liver fibrosis (LF). Study Design: a comparative study of randomized groups of patients treated in an inpatient or outpatient setting. Materials and methods. A total of 297 patients with HCV genotype 1 and 231 patients with HCV genotype 3 were examined. The diagnosis of chronic viral hepatitis C was established according to the recommendations of the European Association for the Study of the Liver. All patients underwent clinical and biochemical blood tests, ultrasound examination of the liver and pancreas. LF was studied by shear wave transient elastometry with METAVIR score. Results. Severe LF was associated in both groups of patients with an increase in the frequency of liver complaints, hepatomegaly and splenomegaly, an increase in the content of bilirubin and alanine aminotransferase in the blood, a decrease in the number of platelets and the concentration of albumin in the blood. Only in patients with HCV genotype 3 was an increase in viral load and a trend towards a decrease in the proportion of neutrophils in the blood in patients with stages 3–4 LF compared with 0–2 stages of LF according to METAVIR. Conclusion. We think that the explanation for the higher incidence of severe LF in patients with HCV genotype 3 is probably a more significant deformation of the immune response, leading to an increase in viral load and an aggressive course of pathology. Keywords: viral hepatitis C, virus genotype, liver fibrosis, clinical manifestations.
{"title":"Clinical Manifestations in Patients with Genotypes 1 and 3 of Viral Hepatitis C, Depending on the Severity of Liver Fibrosis","authors":"M. A. Cherepnin, V. Tsukanov, A. Savchenko, A. Vasyutin, Yu. L. Tonkikh, A. Borisov","doi":"10.31550/1727-2378-2023-22-2-32-38","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-2-32-38","url":null,"abstract":"Aim: to compare the clinical manifestations in patients with genotypes 1 and 3 of viral hepatitis C (HCV) depending on the severity of liver fibrosis (LF). Study Design: a comparative study of randomized groups of patients treated in an inpatient or outpatient setting. Materials and methods. A total of 297 patients with HCV genotype 1 and 231 patients with HCV genotype 3 were examined. The diagnosis of chronic viral hepatitis C was established according to the recommendations of the European Association for the Study of the Liver. All patients underwent clinical and biochemical blood tests, ultrasound examination of the liver and pancreas. LF was studied by shear wave transient elastometry with METAVIR score. Results. Severe LF was associated in both groups of patients with an increase in the frequency of liver complaints, hepatomegaly and splenomegaly, an increase in the content of bilirubin and alanine aminotransferase in the blood, a decrease in the number of platelets and the concentration of albumin in the blood. Only in patients with HCV genotype 3 was an increase in viral load and a trend towards a decrease in the proportion of neutrophils in the blood in patients with stages 3–4 LF compared with 0–2 stages of LF according to METAVIR. Conclusion. We think that the explanation for the higher incidence of severe LF in patients with HCV genotype 3 is probably a more significant deformation of the immune response, leading to an increase in viral load and an aggressive course of pathology. Keywords: viral hepatitis C, virus genotype, liver fibrosis, clinical manifestations.","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":"78326570","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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