Pub Date : 2017-12-12DOI: 10.17709/2409-2231-2017-4-4-3
Г. К. Тайтубаева, И. А. Грибачева, Е. В. Петрова, Т. Ф. Попова
Purpose. To identify risk factors for the development of acute cerebral circulatory impairments (ACCI) in pregnant women. Materials and methods. The material for the study was the medical history of 31 pregnant women with diagnosis ACCI. The average age was 29,5 ± 5,1 years. The comparison group consisted of pregnant women with physiological pregnancy (n = 30) with different gestation periods, the mean age was 29,1 ± 6,7 years. In this study, a comparative analysis of risk factors for stroke was carried out: gynecological and allergic history, smoking and taking contraceptives, the presence of chronic diseases, indicators of the hemostasis and lipid spectrum, polymorphism of thrombophilia genes. Results . The prevalence of ischemic stroke over hemorrhagic stroke was found, which was 77.4% and 22.6%, respectively. In 93.5% of cases, a stroke occurred during pregnancy, in 79.3% of them in the third trimester of gestation. The number of recuperated women was 67.7%. As a result of statistical treatment, a significant difference in study and comparison groups was obtained (p 0.05). Various forms of mutations were identified in the group with ischemic stroke in 14 (58.3%) women, in 2 (28.5%) women in the group with hemorrhagic stroke. Conclusion. Of all the data analyzed in pregnant women with stroke, statistically significant risk factors are: smoking, taking contraceptives, the presence of chronic diseases, including an obstructed obstetric-gynecological anamnesis. Primary and secondary preventive measures will depend on the availability of a particular risk factor.
{"title":"Инсульт и беременность: основные факторы риска","authors":"Г. К. Тайтубаева, И. А. Грибачева, Е. В. Петрова, Т. Ф. Попова","doi":"10.17709/2409-2231-2017-4-4-3","DOIUrl":"https://doi.org/10.17709/2409-2231-2017-4-4-3","url":null,"abstract":"Purpose. To identify risk factors for the development of acute cerebral circulatory impairments (ACCI) in pregnant women. Materials and methods. The material for the study was the medical history of 31 pregnant women with diagnosis ACCI. The average age was 29,5 ± 5,1 years. The comparison group consisted of pregnant women with physiological pregnancy (n = 30) with different gestation periods, the mean age was 29,1 ± 6,7 years. In this study, a comparative analysis of risk factors for stroke was carried out: gynecological and allergic history, smoking and taking contraceptives, the presence of chronic diseases, indicators of the hemostasis and lipid spectrum, polymorphism of thrombophilia genes. Results . The prevalence of ischemic stroke over hemorrhagic stroke was found, which was 77.4% and 22.6%, respectively. In 93.5% of cases, a stroke occurred during pregnancy, in 79.3% of them in the third trimester of gestation. The number of recuperated women was 67.7%. As a result of statistical treatment, a significant difference in study and comparison groups was obtained (p 0.05). Various forms of mutations were identified in the group with ischemic stroke in 14 (58.3%) women, in 2 (28.5%) women in the group with hemorrhagic stroke. Conclusion. Of all the data analyzed in pregnant women with stroke, statistically significant risk factors are: smoking, taking contraceptives, the presence of chronic diseases, including an obstructed obstetric-gynecological anamnesis. Primary and secondary preventive measures will depend on the availability of a particular risk factor.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128673962","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 : 2017-12-12DOI: 10.17709/2409-2231-2017-4-4-2
А. В. Есипов, А. А. Костин, А. Г. Кочетов, А. С. Есипов, В. В. Паршин, О. Ю. Дмитриева
Prevention and treatment of postoperative purulent-inflammatory complications in urological practice remains a subject for study and improvement in all medical centers. The principle of evidence must be taken as a basis of effectiveness of therapy. In this study the quality criteria of demonstrated therapy are immunological parameters. The purpose of this study is to identify the effectiveness of using monooxidase (NO) containing a gas stream replenishing the deficiency of endogenous NO in a group of patients; and to investigate immunological reactivity in patients under complex therapy included nitrogen monoxide and immunomodulators. Materials and methods . In this experimental study we determined the functioning of the main links of the patient’s immunological system. They were determined on the basis of the levels of general T-lymphocytes (T-total), T-helper (T-h), T-suppressor (T-s), natural killer (NK), B-lymphocyte and immunoglobulin G, M, A, circulating immune complexes (CIC). Results. Based on the obtained data, we concluded that the traditional treatment of patients with postoperative complications was less effective than the one proposed in our study. Immunological picture of patient’s condition come back to normal almost from the first day of treatment, and under traditional treatment it was only on the 7th day. Under using complex treatment with nitrogen monoxide, parameters of humoral immunity corresponded to the norm already on the 7–14th day from the beginning of treatment. Conclusion. NO-containing gas flow application in complex prevention of purulent-inflammatory complications made possible to eliminate wound infection in shorter terms and to shorten the period of patient’s hospitalization. The best results were obtained in terms of immunological reactivity in a clinical trial in patients who received complex therapy included nitrogen monoxide and lymphotropic administration of the immunomodulators.
{"title":"ИММУНОЛОГИЧЕСКАЯ РЕАКТИВНОСТЬ У БОЛЬНЫХ УРОЛОГИЧЕСКОГО ПРОФИЛЯ ПРИ КОМБИНИРОВАННОЙ ТЕРАПИИ","authors":"А. В. Есипов, А. А. Костин, А. Г. Кочетов, А. С. Есипов, В. В. Паршин, О. Ю. Дмитриева","doi":"10.17709/2409-2231-2017-4-4-2","DOIUrl":"https://doi.org/10.17709/2409-2231-2017-4-4-2","url":null,"abstract":"Prevention and treatment of postoperative purulent-inflammatory complications in urological practice remains a subject for study and improvement in all medical centers. The principle of evidence must be taken as a basis of effectiveness of therapy. In this study the quality criteria of demonstrated therapy are immunological parameters. The purpose of this study is to identify the effectiveness of using monooxidase (NO) containing a gas stream replenishing the deficiency of endogenous NO in a group of patients; and to investigate immunological reactivity in patients under complex therapy included nitrogen monoxide and immunomodulators. Materials and methods . In this experimental study we determined the functioning of the main links of the patient’s immunological system. They were determined on the basis of the levels of general T-lymphocytes (T-total), T-helper (T-h), T-suppressor (T-s), natural killer (NK), B-lymphocyte and immunoglobulin G, M, A, circulating immune complexes (CIC). Results. Based on the obtained data, we concluded that the traditional treatment of patients with postoperative complications was less effective than the one proposed in our study. Immunological picture of patient’s condition come back to normal almost from the first day of treatment, and under traditional treatment it was only on the 7th day. Under using complex treatment with nitrogen monoxide, parameters of humoral immunity corresponded to the norm already on the 7–14th day from the beginning of treatment. Conclusion. NO-containing gas flow application in complex prevention of purulent-inflammatory complications made possible to eliminate wound infection in shorter terms and to shorten the period of patient’s hospitalization. The best results were obtained in terms of immunological reactivity in a clinical trial in patients who received complex therapy included nitrogen monoxide and lymphotropic administration of the immunomodulators.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116580637","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 : 2017-09-21DOI: 10.17709/2409-2231-2017-4-3-1
I. P. Dudanov, B. C. Abuazab, V. V. Akhmetov
{"title":"COMPARATIVE CHARACTERISTICS OF CLASSICAL AND EVERSION ENDARTERECTOMY OF THE CAROTID ARTERIES","authors":"I. P. Dudanov, B. C. Abuazab, V. V. Akhmetov","doi":"10.17709/2409-2231-2017-4-3-1","DOIUrl":"https://doi.org/10.17709/2409-2231-2017-4-3-1","url":null,"abstract":"","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131156250","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 : 2017-09-21DOI: 10.17709/2409-2231-2017-4-3-13
А. А. Попов
The purpose of the study . The study of morbidity with temporary disability of working officers of the Navy, retired and resigned, as well as affecting the level of certain factors. Materials and methods . A sociological survey of 574 officers of the Navy, who were dismissed from the Armed Forces to the reserve (resignation), was held. 32.7% of them at the time of the survey have been working. Results . 48.8% of respondents rated their health at the time of the survey as a good for their age. The level of morbidity with temporary disability (MWTD) in 100 operating reserve (retired) officers amounted to 94 cases. The number of days of temporary disability was equal to 867 days per 100 employed military pensioners. Most long-term treatment (up to 47 days) were required for patients with blood diseases. Analysis of the structure of diseases of reserve (retired) officers leading to temporary disability, showed that the bulk of the cases (63.7 per cent) were diseases of the respiratory organs, in second place were diseases of the circulatory system (24,5%), the third — diseases of the genitourinary system (4.3%). The average number of existing diseases to working military retirees less than idle: 1.9 vs 2.1. The average number of diseases at the single soldiers discharged was significantly more than that of living in family. Conclusion . The features of level and structure, as well as risk factors of MWTD should be considered in the development and adoption of administrative decisions directed on preservation and strengthening of health of reserve (retired) officers.
{"title":"ЗАБОЛЕВАЕМОСТЬ С ВРЕМЕННОЙ УТРАТОЙ ТРУДОСПОСОБНОСТИ РАБОТАЮЩИХ ВОЕННЫХ ПЕНСИОНЕРОВ","authors":"А. А. Попов","doi":"10.17709/2409-2231-2017-4-3-13","DOIUrl":"https://doi.org/10.17709/2409-2231-2017-4-3-13","url":null,"abstract":"The purpose of the study . The study of morbidity with temporary disability of working officers of the Navy, retired and resigned, as well as affecting the level of certain factors. Materials and methods . A sociological survey of 574 officers of the Navy, who were dismissed from the Armed Forces to the reserve (resignation), was held. 32.7% of them at the time of the survey have been working. Results . 48.8% of respondents rated their health at the time of the survey as a good for their age. The level of morbidity with temporary disability (MWTD) in 100 operating reserve (retired) officers amounted to 94 cases. The number of days of temporary disability was equal to 867 days per 100 employed military pensioners. Most long-term treatment (up to 47 days) were required for patients with blood diseases. Analysis of the structure of diseases of reserve (retired) officers leading to temporary disability, showed that the bulk of the cases (63.7 per cent) were diseases of the respiratory organs, in second place were diseases of the circulatory system (24,5%), the third — diseases of the genitourinary system (4.3%). The average number of existing diseases to working military retirees less than idle: 1.9 vs 2.1. The average number of diseases at the single soldiers discharged was significantly more than that of living in family. Conclusion . The features of level and structure, as well as risk factors of MWTD should be considered in the development and adoption of administrative decisions directed on preservation and strengthening of health of reserve (retired) officers.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123324828","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 : 2017-09-21DOI: 10.17709/2409-2231-2017-4-3-12
А. Геворкян
{"title":"МУНИЦИПАЛЬНО-ЧАСТНОЕ ПАРТНЕРСТВО – МЕХАНИЗМ РАЗВИТИЯ МУНИЦИПАЛЬНОЙ АМБУЛАТОРНОЙ УРОЛОГИИ","authors":"А. Геворкян","doi":"10.17709/2409-2231-2017-4-3-12","DOIUrl":"https://doi.org/10.17709/2409-2231-2017-4-3-12","url":null,"abstract":"","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123545965","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 : 2017-09-21DOI: 10.17709/2409-2231-2017-4-3-11
I. A. Kaprina
Results of sociological research of problem questions of regulation of personnel processes in the medical organizations are presented in this article. The problem of reforming medical organizations is characterized. Proposals on the solution of currently important problems of personnel regulation in medical organizations are formulated. The purpose of the research is to substantiate the directions of improving the management of personnel processes in modern medical organizations based on the sociological analysis of personnel processes and relations in medical organizations. Materials and methods . The paper presents the results of a sociological study of the condition and problems of regulation of personnel processes in medical organizations. The survey involved 240 respondents from among the employees of medical organizations and 97 qualified medical experts. Results . It is proved that the successful functioning of medical organizations is possible with a scientific approach to the management of personnel processes and relations, including analysis of personnel policy issues, sociological support of personnel processes regulation, development of human resources technologies in modern medical organizations. Conclusions . Successful functioning of medical organizations is possible with a scientific approach to the management of personnel processes and relations, including analysis of personnel policy issues, sociological support of personnel processes regulation, development of modern personnel technologies in medical organizations. Achievement of effective management of personnel processes in medical organizations requires the development and implementation of scientifically sound human resources policy in the health care system, improving the regulatory and organizational support for the regulation of personnel processes, enhancing the role of self-regulatory organizationsin the management of personnel processes in medical organizations.
{"title":"СОВЕРШЕНСТВОВАНИЕ УПРАВЛЕНИЯ КАДРОВЫМИ ПРОЦЕССАМИ В МЕДИЦИНСКИХ ОРГАНИЗАЦИЯХ","authors":"I. A. Kaprina","doi":"10.17709/2409-2231-2017-4-3-11","DOIUrl":"https://doi.org/10.17709/2409-2231-2017-4-3-11","url":null,"abstract":"Results of sociological research of problem questions of regulation of personnel processes in the medical organizations are presented in this article. The problem of reforming medical organizations is characterized. Proposals on the solution of currently important problems of personnel regulation in medical organizations are formulated. The purpose of the research is to substantiate the directions of improving the management of personnel processes in modern medical organizations based on the sociological analysis of personnel processes and relations in medical organizations. Materials and methods . The paper presents the results of a sociological study of the condition and problems of regulation of personnel processes in medical organizations. The survey involved 240 respondents from among the employees of medical organizations and 97 qualified medical experts. Results . It is proved that the successful functioning of medical organizations is possible with a scientific approach to the management of personnel processes and relations, including analysis of personnel policy issues, sociological support of personnel processes regulation, development of human resources technologies in modern medical organizations. Conclusions . Successful functioning of medical organizations is possible with a scientific approach to the management of personnel processes and relations, including analysis of personnel policy issues, sociological support of personnel processes regulation, development of modern personnel technologies in medical organizations. Achievement of effective management of personnel processes in medical organizations requires the development and implementation of scientifically sound human resources policy in the health care system, improving the regulatory and organizational support for the regulation of personnel processes, enhancing the role of self-regulatory organizationsin the management of personnel processes in medical organizations.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126262626","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 : 2017-09-21DOI: 10.17709/2409-2231-2017-4-3-10
Д. Сидоров, С.А. Степанов, М. A. Ложкин, Л. Петров, О. A. Гуц, А. А. Костин, А. Исаева
{"title":"Первый Российский опыт применения интегрированной системы лазерной термоабляционной терапии при лечении метастатического рака печени","authors":"Д. Сидоров, С.А. Степанов, М. A. Ложкин, Л. Петров, О. A. Гуц, А. А. Костин, А. Исаева","doi":"10.17709/2409-2231-2017-4-3-10","DOIUrl":"https://doi.org/10.17709/2409-2231-2017-4-3-10","url":null,"abstract":"","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116715471","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 : 2017-09-20DOI: 10.17709/2409-2231-2017-4-3-4
О. П. Грецова, А. А. Костин, Ю. В. Самсонов, Г. В. Петрова, М. Ю. Простов, Ю. И. Простов
In this review we continue the publication of data on the problem of malignant neoplasms (MN) associated with human papillomavirus (HPV), in Russia. In a previous publication (Research’n Practical Medicine Journal 2016; 3(1): 66–78. DOI: 10.17709/2409-2231-2016-3-1-9) we at the first time presented the data on the incidence of malignant tumors associated with HPV in the Russian Federation for the period from 2009 to 2014. This article presents updated data on the incidence of in 2015, as well as data on mortality from the MN associated with HPV in Russia with the analysis of trends in men and women in different age groups. The statistics used in the article is calculated according to the annual state reporting documentation of the statistical form of the Ministry of health No. 7 and No. 35, forms 5 and Rosstat data, the combined database of the state of the cancer register of the Russian Federation.
{"title":"ЗАБОЛЕВАЕМОСТЬ И СМЕРТНОСТЬ ОТ ЗЛОКАЧЕСТВЕННЫХ НОВООБРАЗОВАНИЙ, АССОЦИИРОВАННЫХ С ВИРУСОМ ПАПИЛЛОМЫ ЧЕЛОВЕКА","authors":"О. П. Грецова, А. А. Костин, Ю. В. Самсонов, Г. В. Петрова, М. Ю. Простов, Ю. И. Простов","doi":"10.17709/2409-2231-2017-4-3-4","DOIUrl":"https://doi.org/10.17709/2409-2231-2017-4-3-4","url":null,"abstract":"In this review we continue the publication of data on the problem of malignant neoplasms (MN) associated with human papillomavirus (HPV), in Russia. In a previous publication (Research’n Practical Medicine Journal 2016; 3(1): 66–78. DOI: 10.17709/2409-2231-2016-3-1-9) we at the first time presented the data on the incidence of malignant tumors associated with HPV in the Russian Federation for the period from 2009 to 2014. This article presents updated data on the incidence of in 2015, as well as data on mortality from the MN associated with HPV in Russia with the analysis of trends in men and women in different age groups. The statistics used in the article is calculated according to the annual state reporting documentation of the statistical form of the Ministry of health No. 7 and No. 35, forms 5 and Rosstat data, the combined database of the state of the cancer register of the Russian Federation.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125593195","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 : 2017-09-20DOI: 10.17709/2409-2231-2017-4-3-5
И. Л. Царев, А. В. Мелерзанов
The article discusses modern ideas about the immune therapy of cancer — methods of treatment of oncological diseases based on immunological reactions of the organism to the appearance of malignant cells in it. This area is actively studied in clinical practice in the last decade, and some therapy has already been approved for use by regulators after promising results of clinical trials 3 phase. Immune therapy is based on antitumor immune cycle — the cascade of processes responsible for the immune system’s response to tumor cells. Involved regulatory mechanisms are targets for various therapies, the overall goal is to restore proper functioning of the cycle and to achieve the elimination of cancer cells. Currently, the most studied two types of immune therapy — checkpoint inhibitors and adaptive cell therapy. Checkpoint inhibitors increase the activity of body immune cells, reducing the inhibitory influence of the tumor microenvironment and the tumor cells themselves, which allowed them to get out from under the pressure of the immune system during the development of the disease. Adaptive cell therapy, in turn, allows to compensate the lack of active immune against tumor cells. Mechanisms of action determine the effectiveness of various therapies for different diseases, and for patients inside of one diagnosis. To determine the effectiveness of other treatment prior to a particular patient it is necessary to use the latest achievements in precision medicine, based on the search for new biomarkers and analyzing each patient separately. This approach will significantly reduce costs and save precious time for the patient.
{"title":"ОБЗОР ПОДХОДОВ К ИММУНОТЕРАПИИ В ОНКОЛОГИИ","authors":"И. Л. Царев, А. В. Мелерзанов","doi":"10.17709/2409-2231-2017-4-3-5","DOIUrl":"https://doi.org/10.17709/2409-2231-2017-4-3-5","url":null,"abstract":"The article discusses modern ideas about the immune therapy of cancer — methods of treatment of oncological diseases based on immunological reactions of the organism to the appearance of malignant cells in it. This area is actively studied in clinical practice in the last decade, and some therapy has already been approved for use by regulators after promising results of clinical trials 3 phase. Immune therapy is based on antitumor immune cycle — the cascade of processes responsible for the immune system’s response to tumor cells. Involved regulatory mechanisms are targets for various therapies, the overall goal is to restore proper functioning of the cycle and to achieve the elimination of cancer cells. Currently, the most studied two types of immune therapy — checkpoint inhibitors and adaptive cell therapy. Checkpoint inhibitors increase the activity of body immune cells, reducing the inhibitory influence of the tumor microenvironment and the tumor cells themselves, which allowed them to get out from under the pressure of the immune system during the development of the disease. Adaptive cell therapy, in turn, allows to compensate the lack of active immune against tumor cells. Mechanisms of action determine the effectiveness of various therapies for different diseases, and for patients inside of one diagnosis. To determine the effectiveness of other treatment prior to a particular patient it is necessary to use the latest achievements in precision medicine, based on the search for new biomarkers and analyzing each patient separately. This approach will significantly reduce costs and save precious time for the patient.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117332681","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 : 2017-09-20DOI: 10.17709/2409-2231-2017-4-3-7
L. Yu. Morgunov
In economically developed countries, cirrhosis is one of the six leading causes of death at the age of 35–60 years and ranges from 14 to 30 cases per 100000 population. In the world 40 million people die of cirrhosis each year. At 6% of the population of the Russian Federation there is a diabetes mellitus. The combination of diabetes mellitus in patients with cirrhosis of the liver is a common comorbid pathology. Diabetes mellitusis a risk factor for the development of liver cirrhosis, and the incidence of combination of both diseases is quite high, although the frequency of occurrence varies. About 80% of patients with LC may have impaired glucose metabolism, and 30% have diabetes mellitus. Prospective studies have shown that diabetes is associated with an increased risk of developing hepatic complications and death in patients with cirrhosis of the liver. Diabetes mellitus increases the risk of complications of liver cirrhosis of any etiology (varicose veins of the esophagus, hepatic encephalopathy, hepatic-cell insufficiency) and subsequent survival. The incidence, frequency of hospitalizations and mortality from this combined pathology are very high. There are common mechanisms that provoke metabolic and autoimmune disorders in the development of chronic hepatitis and cirrhosis, leading to steatosis, insulin resistance, impaired glucose tolerance and the development of diabetes mellitus. There are certain features of the evaluation of the compensation of carbohydrate metabolism in patients with cirrhosis of the liver, anemia and impaired protein metabolism. Effective control of glycemia can have a beneficial effect on the treatment of these patients. However, few studies have evaluated the efficacy and safety of antidiabetic drugs and the effect of diabetes treatment on morbidity and mortality in patients with cirrhosis. Previously it was believed that in the presence of cirrhosis the only treatment remains insulin. At present, in connection with the emergence of modern groups of hypoglycemic drugs, as well as new approaches to the treatment of type 2 diabetes, this concept has radically changed. Unfortunately, the issues of correction of carbohydrate metabolism in patients with cirrhosis of the liver are practically not covered in the world literature. This article deals with the correction of carbohydrate metabolism in patients with cirrhosis and hepatocellular insufficiency of insulin analogs, biguanides, drugs with incretin effect — dipeptidyl peptidase‑4 inhibitors, agonists of glucagon-like peptide‑1, inhibitors of sodium-glucose cotransporter 2 diabetes. Particular attention is paid to the development of hepatocellular insufficiency and portal hypertension in patients with cirrhosis and type 2 diabetes, as well as processes for their prevention and insulin alternative correction methods.
{"title":"САХАРНЫЙ ДИАБЕТ У ПАЦИЕНТОВ С ЦИРРОЗОМ ПЕЧЕНИ: НОВЫЕ ВОЗМОЖНОСТИ ЛЕЧЕНИЯ","authors":"L. Yu. Morgunov","doi":"10.17709/2409-2231-2017-4-3-7","DOIUrl":"https://doi.org/10.17709/2409-2231-2017-4-3-7","url":null,"abstract":"In economically developed countries, cirrhosis is one of the six leading causes of death at the age of 35–60 years and ranges from 14 to 30 cases per 100000 population. In the world 40 million people die of cirrhosis each year. At 6% of the population of the Russian Federation there is a diabetes mellitus. The combination of diabetes mellitus in patients with cirrhosis of the liver is a common comorbid pathology. Diabetes mellitusis a risk factor for the development of liver cirrhosis, and the incidence of combination of both diseases is quite high, although the frequency of occurrence varies. About 80% of patients with LC may have impaired glucose metabolism, and 30% have diabetes mellitus. Prospective studies have shown that diabetes is associated with an increased risk of developing hepatic complications and death in patients with cirrhosis of the liver. Diabetes mellitus increases the risk of complications of liver cirrhosis of any etiology (varicose veins of the esophagus, hepatic encephalopathy, hepatic-cell insufficiency) and subsequent survival. The incidence, frequency of hospitalizations and mortality from this combined pathology are very high. There are common mechanisms that provoke metabolic and autoimmune disorders in the development of chronic hepatitis and cirrhosis, leading to steatosis, insulin resistance, impaired glucose tolerance and the development of diabetes mellitus. There are certain features of the evaluation of the compensation of carbohydrate metabolism in patients with cirrhosis of the liver, anemia and impaired protein metabolism. Effective control of glycemia can have a beneficial effect on the treatment of these patients. However, few studies have evaluated the efficacy and safety of antidiabetic drugs and the effect of diabetes treatment on morbidity and mortality in patients with cirrhosis. Previously it was believed that in the presence of cirrhosis the only treatment remains insulin. At present, in connection with the emergence of modern groups of hypoglycemic drugs, as well as new approaches to the treatment of type 2 diabetes, this concept has radically changed. Unfortunately, the issues of correction of carbohydrate metabolism in patients with cirrhosis of the liver are practically not covered in the world literature. This article deals with the correction of carbohydrate metabolism in patients with cirrhosis and hepatocellular insufficiency of insulin analogs, biguanides, drugs with incretin effect — dipeptidyl peptidase‑4 inhibitors, agonists of glucagon-like peptide‑1, inhibitors of sodium-glucose cotransporter 2 diabetes. Particular attention is paid to the development of hepatocellular insufficiency and portal hypertension in patients with cirrhosis and type 2 diabetes, as well as processes for their prevention and insulin alternative correction methods.","PeriodicalId":119961,"journal":{"name":"Research'n Practical Medicine Journal","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133615594","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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