Pub Date : 2024-01-13DOI: 10.17816/mechnikov623001
O. Porembskaya, S. Tsaplin, K. Lobastov, Victoria A. Ilina, V. Kravchuk, Sergey A. Sayganov
Accumulating evidence supports the need to consider pulmonary artery thrombosis the separate thrombotic complication, which requires its own treatment algorithms. The aim of the work is to demonstrate the pulmonary artery thrombosis clinical aspects and the effect of the standard thrombotic prophylactic algorithms with clinical examples. Clinical cases of patients with pulmonary artery thrombosis are presented. Pulmonary artery thrombosis is considered to be the thrombotic obstruction of the pulmonary artery branches in the absence of venous and cardiac chambers thrombosis. Patient S. with COVID-19 and 75% of lung involvement was treated in the accordance with the actual COVID-19 treatment recommendations. Enoxaparin sodium 6000 IE once a day followed by the increasing dosage of 8000 IE twice a day was used. To prevent exacerbation tocilizumab was infused, and systemic thrombolytic therapy was performed. On the 6th day after systemic thrombolytic therapy patient died. Examination revealed thrombi in the pulmonary artery branches. Patient P. with continued growth of cerebral left frontoparietal region glioblastoma was hospitalized. Surgical tumor removal was performed a year ago. Conservative therapy, dexamethasone injections and anticoagulant prophylaxis (enoxaparin sodium 4000 IE once a day) were prescribed. After the patient death thrombi were found in the pulmonary artery segmental branches. Outpatient D. had a history of four episodes of dyspnea during the acute respiratory diseases. Computed tomography performed at the time of the third and fourth episodes revealed thrombi in the pulmonary artery segmental branches. The fourth episode occured despite anticoagulant prophylaxis with rivaroxaban (10 mg once a day). Patient was recommended to switch to low molecular weight heparins in case of any disease. There have been no recurrent episodes over the past 8 months. Distinctive features of pulmonary artery thrombosis pathogenesis determine the development of the complication despite anticoagulant prophylaxis. Preventive effect of anti-inflammatory drugs on the pulmonary artery thrombosis development has not been demonstrated.
{"title":"Pulmonary artery thrombosis. Clinical cases","authors":"O. Porembskaya, S. Tsaplin, K. Lobastov, Victoria A. Ilina, V. Kravchuk, Sergey A. Sayganov","doi":"10.17816/mechnikov623001","DOIUrl":"https://doi.org/10.17816/mechnikov623001","url":null,"abstract":"Accumulating evidence supports the need to consider pulmonary artery thrombosis the separate thrombotic complication, which requires its own treatment algorithms. \u0000The aim of the work is to demonstrate the pulmonary artery thrombosis clinical aspects and the effect of the standard thrombotic prophylactic algorithms with clinical examples. \u0000Clinical cases of patients with pulmonary artery thrombosis are presented. Pulmonary artery thrombosis is considered to be the thrombotic obstruction of the pulmonary artery branches in the absence of venous and cardiac chambers thrombosis. \u0000Patient S. with COVID-19 and 75% of lung involvement was treated in the accordance with the actual COVID-19 treatment recommendations. Enoxaparin sodium 6000 IE once a day followed by the increasing dosage of 8000 IE twice a day was used. To prevent exacerbation tocilizumab was infused, and systemic thrombolytic therapy was performed. On the 6th day after systemic thrombolytic therapy patient died. Examination revealed thrombi in the pulmonary artery branches. \u0000Patient P. with continued growth of cerebral left frontoparietal region glioblastoma was hospitalized. Surgical tumor removal was performed a year ago. Conservative therapy, dexamethasone injections and anticoagulant prophylaxis (enoxaparin sodium 4000 IE once a day) were prescribed. After the patient death thrombi were found in the pulmonary artery segmental branches. \u0000Outpatient D. had a history of four episodes of dyspnea during the acute respiratory diseases. Computed tomography performed at the time of the third and fourth episodes revealed thrombi in the pulmonary artery segmental branches. The fourth episode occured despite anticoagulant prophylaxis with rivaroxaban (10 mg once a day). Patient was recommended to switch to low molecular weight heparins in case of any disease. There have been no recurrent episodes over the past 8 months. \u0000Distinctive features of pulmonary artery thrombosis pathogenesis determine the development of the complication despite anticoagulant prophylaxis. Preventive effect of anti-inflammatory drugs on the pulmonary artery thrombosis development has not been demonstrated.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139531532","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 : 2024-01-13DOI: 10.17816/mechnikov492276
A. R. Alibekov, Vitaliy V. Goldobin, Hosiddin F. Yuldashev, E. Klocheva, Irina A. Lubenets, Aruzhan Zh. Nurmakhanbetova
BACKGROUND: Myasthenia gravis is a rare autoimmune disease,which is difficult to diagnose mainly in the initial stages, when there are single symptoms of the disease or an atypical course. Diagnostic errors are associated with the fact that myasthenia gravis and other diseases of the nervous system have similar symptoms. The most common misdiagnosis in the onset of myasthenia gravis is a stroke. However, the reasons for a false diagnosis remain unspecified and poorly understood. AIM: To determine the factors leading to misdiagnosis of a stroke in the onset of myasthenia gravis. MATERIALS AND METHODS: 133 patients diagnosed with myasthenia gravis were divided into two groups. Patients with misdiagnosed stroke at the onset of myasthenia gravis formed the first group, the rest of the patients – the second group. A comparative assessment was performed according to the age of myasthenia onset, the clinical variant of the onset, primary symptoms, the duration of diagnosis, and the severity of the disease at the time of the correct diagnosis, with the percentage of misdiagnosis calculation. RESULTS: Stroke as misdiagnosis was established more often than others (in 23% of all cases and in 44% of incorrect diagnoses). In the 1st group, complaints of dysarthria and dysphagia were significantly higher, myasthenia gravis began acutely more often, the age of myasthenia onset in patients of the 1st group was statistically higher than in the 2nd. There was no difference between the groups in terms of diagnosis duration, the disease severity, and the history of previous stroke. CONCLUSIONS: Factors leading to stroke misdiagnosis at the onset of myasthenia are advanced age and acute onset with bulbar disorders.
{"title":"Factors of stroke misdiagnosis at the onset of myastenia gravis","authors":"A. R. Alibekov, Vitaliy V. Goldobin, Hosiddin F. Yuldashev, E. Klocheva, Irina A. Lubenets, Aruzhan Zh. Nurmakhanbetova","doi":"10.17816/mechnikov492276","DOIUrl":"https://doi.org/10.17816/mechnikov492276","url":null,"abstract":"BACKGROUND: Myasthenia gravis is a rare autoimmune disease,which is difficult to diagnose mainly in the initial stages, when there are single symptoms of the disease or an atypical course. Diagnostic errors are associated with the fact that myasthenia gravis and other diseases of the nervous system have similar symptoms. The most common misdiagnosis in the onset of myasthenia gravis is a stroke. However, the reasons for a false diagnosis remain unspecified and poorly understood. \u0000AIM: To determine the factors leading to misdiagnosis of a stroke in the onset of myasthenia gravis. \u0000MATERIALS AND METHODS: 133 patients diagnosed with myasthenia gravis were divided into two groups. Patients with misdiagnosed stroke at the onset of myasthenia gravis formed the first group, the rest of the patients – the second group. A comparative assessment was performed according to the age of myasthenia onset, the clinical variant of the onset, primary symptoms, the duration of diagnosis, and the severity of the disease at the time of the correct diagnosis, with the percentage of misdiagnosis calculation. \u0000RESULTS: Stroke as misdiagnosis was established more often than others (in 23% of all cases and in 44% of incorrect diagnoses). In the 1st group, complaints of dysarthria and dysphagia were significantly higher, myasthenia gravis began acutely more often, the age of myasthenia onset in patients of the 1st group was statistically higher than in the 2nd. There was no difference between the groups in terms of diagnosis duration, the disease severity, and the history of previous stroke. \u0000CONCLUSIONS: Factors leading to stroke misdiagnosis at the onset of myasthenia are advanced age and acute onset with bulbar disorders.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"14 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139531184","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 : 2024-01-13DOI: 10.17816/mechnikov624120
Alexey V. Silin, E. Satygo, A. Maryanovich
The article provides a brief overview of the studies regarding changes in the structure and composition of teeth after eruption. The factors of degenerative changes in tooth structures and their relationship with non-carious lesions have been analyzed. The study makes emphasis on the tooth durability and the factors influencing tissue fatigue, explaining increased tissue wear due to local factors. Understanding mechanisms of metabolism of teeth hard tissues is the key to the stability of restorative treatments and occurrence of non-carious tooth lesions. The evolution of views on this problem is noteworthy. The literature review reveals the initial predominance of mechanical actions, abrasion, and mineralization. It is later complemented by a detailed analysis of the influence of destructive stresses and deformation due to mechanical factors. All the leading works of the 2000s are dedicated to analyzing the ultrastructural features of enamel that affect its mechanical characteristics and can explain both the characteristics of the shape and intensity of mechanical tooth wear during the functioning of the stomatognathic system, as well as the durability of the performed restorations. The literature review covers 74 sources over the past 15 years.
{"title":"Enamel and dentin of human teeth. Fatigue strength","authors":"Alexey V. Silin, E. Satygo, A. Maryanovich","doi":"10.17816/mechnikov624120","DOIUrl":"https://doi.org/10.17816/mechnikov624120","url":null,"abstract":"The article provides a brief overview of the studies regarding changes in the structure and composition of teeth after eruption. The factors of degenerative changes in tooth structures and their relationship with non-carious lesions have been analyzed. The study makes emphasis on the tooth durability and the factors influencing tissue fatigue, explaining increased tissue wear due to local factors. Understanding mechanisms of metabolism of teeth hard tissues is the key to the stability of restorative treatments and occurrence of non-carious tooth lesions. The evolution of views on this problem is noteworthy. The literature review reveals the initial predominance of mechanical actions, abrasion, and mineralization. It is later complemented by a detailed analysis of the influence of destructive stresses and deformation due to mechanical factors. All the leading works of the 2000s are dedicated to analyzing the ultrastructural features of enamel that affect its mechanical characteristics and can explain both the characteristics of the shape and intensity of mechanical tooth wear during the functioning of the stomatognathic system, as well as the durability of the performed restorations. The literature review covers 74 sources over the past 15 years.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"25 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139530596","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 : 2024-01-13DOI: 10.17816/mechnikov601813
Boris G. Bezmozgin, Evita V. Poryvaeva, Ekaterina A. Pirozhkova, Oleg V. Babkov, I. Yastrebov, I. M. Batyrshin, Dmitry A. Surov, A. Demko
BACKGROUND: The results of surgical treatment of patients with perforative diverticulitis of the colon are still unsatisfactory today. Since the majority of patients undergo Hartmann surgery, the main problem is a large number of stoma patients. Three quarters of them live with a stoma for a long time, which negatively affects their quality of life and increases the cost of treatment. AIM: The purpose of this research work is to improve the immediate results of treating patients with perforative diverticulitis and peritonitis by using staged surgical tactics. MATERIALS AND METHODS: The reaserach included 14 patients with perforative diverticulitis Hinchey grade II-III. The average value of the Mannheim peritoneal index is 18.9 ± 6.3 points. At the first stage of surgical treatment, all the patients underwent colon resection with a zone of perforation of the diverticulum and leaving its muffled ends in the abdominal cavity. After lavage and drainage, temporary closure of the anterior abdominal wall was performed. After 24–48 hours, all the patients underwent colon reconstraction. RESULTS: The average age of the patients was 52.3 ± 12.4 years with 4 women (28.6%) and 10 men (71.4%). The average duration of the first stage was 105.7 ± 27.2 minutes, the second one — 113.2 ± 40.5 minutes. The average hospital-stays were 16.4 ± 7.2 days. There were no anastomosis failures and no lethal outcomes. Complications were noted in 9 patients (64.3%), grade I according to Clavien – Dindo — 83.4%. CONCLUSIONS: The tactics of early surgical treatment is a promising concept for patients with perforative diverticulitis. It provides rapid elimination of the septic focus during the first surgical operation, assumes early reconstruction of the intestine without increasing the number of complications and mortality, and can be used in patients with peritonitis.
{"title":"Strategy of stage treatment for patients with perforated diverticulitis: first experience","authors":"Boris G. Bezmozgin, Evita V. Poryvaeva, Ekaterina A. Pirozhkova, Oleg V. Babkov, I. Yastrebov, I. M. Batyrshin, Dmitry A. Surov, A. Demko","doi":"10.17816/mechnikov601813","DOIUrl":"https://doi.org/10.17816/mechnikov601813","url":null,"abstract":"BACKGROUND: The results of surgical treatment of patients with perforative diverticulitis of the colon are still unsatisfactory today. Since the majority of patients undergo Hartmann surgery, the main problem is a large number of stoma patients. Three quarters of them live with a stoma for a long time, which negatively affects their quality of life and increases the cost of treatment. \u0000AIM: The purpose of this research work is to improve the immediate results of treating patients with perforative diverticulitis and peritonitis by using staged surgical tactics. \u0000MATERIALS AND METHODS: The reaserach included 14 patients with perforative diverticulitis Hinchey grade II-III. The average value of the Mannheim peritoneal index is 18.9 ± 6.3 points. At the first stage of surgical treatment, all the patients underwent colon resection with a zone of perforation of the diverticulum and leaving its muffled ends in the abdominal cavity. After lavage and drainage, temporary closure of the anterior abdominal wall was performed. After 24–48 hours, all the patients underwent colon reconstraction. \u0000RESULTS: The average age of the patients was 52.3 ± 12.4 years with 4 women (28.6%) and 10 men (71.4%). The average duration of the first stage was 105.7 ± 27.2 minutes, the second one — 113.2 ± 40.5 minutes. The average hospital-stays were 16.4 ± 7.2 days. There were no anastomosis failures and no lethal outcomes. Complications were noted in 9 patients (64.3%), grade I according to Clavien – Dindo — 83.4%. \u0000CONCLUSIONS: The tactics of early surgical treatment is a promising concept for patients with perforative diverticulitis. It provides rapid elimination of the septic focus during the first surgical operation, assumes early reconstruction of the intestine without increasing the number of complications and mortality, and can be used in patients with peritonitis.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"1 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139531534","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 : 2024-01-13DOI: 10.17816/mechnikov604850
V. I. Mazurov, Sergey A. Sayganov, A. I. Martynov, R. Bashkinov, Inna Z. Gaydukova, K. V. Sapozhnikov, D. Tolkacheva, N. Sableva, Alexandra Yu. Tsinzerling
The presented study has been carried out to identify the effect of urate-lowering therapy with xanthine oxidase inhibitors on glomerular filtration rate and serum uric acid in patients with asymptomatic hyperuricemia and chronic kidney disease. A systematic review of randomized controlled trials has been conducted; its results based on meta-analysis has been evaluated. A systematic search and selection of publications in Embase, PubMed, Cochrane Library, and eLibrary databases has been performed. The studied drugs were xanthine oxidase inhibitors: allopurinol and febuxostat. The study considered the following parameters such as efficacy endpoints, namely, glomerular filtration rate and serum uric acid after 3–15 months of follow-up. Clinical and methodological heterogeneity of the included randomized controlled trials has been assessed as well as publication bias and risk of systematic error. Synthesis has been performed using bivariate meta-analysis assessing residual statistical heterogeneity. 7 selected randomized controlled trials (1203 patients) have been included in the meta-analysis. This analysis revealed that medication urate-lowering therapy (allopurinol or febuxostat) was associated with higher glomerular filtration rate (+3.0 ml/min/1.73 m2; 95% confidence interval +0.4 to +5.6; p = 0.022) compared with the controls (placebo/no urate-lowering therapy) at 3–15 months of follow-up. Along with this, medication urate-lowering therapy (allopurinol or febuxostat) has been found to result in lower serum uric acid (−3.3 mg/dl; 95% confidence interval −3.8 to −2.8; р 0.001) compared to the controls (placebo / no urate-lowering therapy) at 3–15 months of follow-up. The results of the meta-analysis have demonstrated a positive role of allopurinol and febuxostat in increasing glomerular filtration rate and decreasing serum uric acid in patients with chronic kidney disease and asymptomatic hyperuricemia. The presented data suggest that therapeutic measures aimed at the elimination of asymptomatic hyperuricemia, including the use of xanthine oxidase inhibitors, may be important in slowing the progression of chronic kidney failure and may be additional factors of nephroprotection.
{"title":"Impact of urate-lowering therapy on the course of chronic kidney disease in patients with asymptomatic hyperuricemia: a meta-analysis of randomized controlled trials","authors":"V. I. Mazurov, Sergey A. Sayganov, A. I. Martynov, R. Bashkinov, Inna Z. Gaydukova, K. V. Sapozhnikov, D. Tolkacheva, N. Sableva, Alexandra Yu. Tsinzerling","doi":"10.17816/mechnikov604850","DOIUrl":"https://doi.org/10.17816/mechnikov604850","url":null,"abstract":"The presented study has been carried out to identify the effect of urate-lowering therapy with xanthine oxidase inhibitors on glomerular filtration rate and serum uric acid in patients with asymptomatic hyperuricemia and chronic kidney disease. A systematic review of randomized controlled trials has been conducted; its results based on meta-analysis has been evaluated. \u0000A systematic search and selection of publications in Embase, PubMed, Cochrane Library, and eLibrary databases has been performed. The studied drugs were xanthine oxidase inhibitors: allopurinol and febuxostat. The study considered the following parameters such as efficacy endpoints, namely, glomerular filtration rate and serum uric acid after 3–15 months of follow-up. Clinical and methodological heterogeneity of the included randomized controlled trials has been assessed as well as publication bias and risk of systematic error. Synthesis has been performed using bivariate meta-analysis assessing residual statistical heterogeneity. \u00007 selected randomized controlled trials (1203 patients) have been included in the meta-analysis. This analysis revealed that medication urate-lowering therapy (allopurinol or febuxostat) was associated with higher glomerular filtration rate (+3.0 ml/min/1.73 m2; 95% confidence interval +0.4 to +5.6; p = 0.022) compared with the controls (placebo/no urate-lowering therapy) at 3–15 months of follow-up. Along with this, medication urate-lowering therapy (allopurinol or febuxostat) has been found to result in lower serum uric acid (−3.3 mg/dl; 95% confidence interval −3.8 to −2.8; р 0.001) compared to the controls (placebo / no urate-lowering therapy) at 3–15 months of follow-up. \u0000The results of the meta-analysis have demonstrated a positive role of allopurinol and febuxostat in increasing glomerular filtration rate and decreasing serum uric acid in patients with chronic kidney disease and asymptomatic hyperuricemia. The presented data suggest that therapeutic measures aimed at the elimination of asymptomatic hyperuricemia, including the use of xanthine oxidase inhibitors, may be important in slowing the progression of chronic kidney failure and may be additional factors of nephroprotection.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"7 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139531673","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 : 2024-01-13DOI: 10.17816/mechnikov606683
B. Sigua, A. A. Kurkov, E. L. Lataria, O. Kozlova, D. V. Gurzhiy, S. Vinnichuk, A. Efimov, Gleb V. Chizhov, Andrey A. Khvatov, Viacheslav P. Zemlianoi
Actinomycosis is a chronic bacterial infection caused by bacteria from the Actinomycetaceae family. The causes of abdominal actinomycosis are usually destructive appendicitis, prolonged presence of an intrauterine contraceptive or perforation of the colon. Of the internal organs, the left colon and sigmoid colon are most often affected, which often leads to surgical complications. At the same time, diagnosis is significantly difficult due to the nonspecific nature of the clinical presentation, which is similar to that of oncological diseases, and verification of the process is possible only with microscopic examination in a specialized institution. A clinical case demonstrating the difficulties of diagnosis and treatment of widespread abdominal actinomycosis complicated by the development of a colovesical fistula is presented.
{"title":"Surgical aspects of the treatment of a patient with actinomycosis of the colon complicated by the formation of a colovesical fistula","authors":"B. Sigua, A. A. Kurkov, E. L. Lataria, O. Kozlova, D. V. Gurzhiy, S. Vinnichuk, A. Efimov, Gleb V. Chizhov, Andrey A. Khvatov, Viacheslav P. Zemlianoi","doi":"10.17816/mechnikov606683","DOIUrl":"https://doi.org/10.17816/mechnikov606683","url":null,"abstract":"Actinomycosis is a chronic bacterial infection caused by bacteria from the Actinomycetaceae family. The causes of abdominal actinomycosis are usually destructive appendicitis, prolonged presence of an intrauterine contraceptive or perforation of the colon. Of the internal organs, the left colon and sigmoid colon are most often affected, which often leads to surgical complications. At the same time, diagnosis is significantly difficult due to the nonspecific nature of the clinical presentation, which is similar to that of oncological diseases, and verification of the process is possible only with microscopic examination in a specialized institution. \u0000A clinical case demonstrating the difficulties of diagnosis and treatment of widespread abdominal actinomycosis complicated by the development of a colovesical fistula is presented.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"22 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139531085","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 : 2024-01-13DOI: 10.17816/mechnikov624558
A. Anisenkova, V. I. Mazurov, S. Apalko, O. Popov, N. Sushentseva, Olga P. Mamaeva, S. V. Mosenko, A. Sarana, Sergey G. Shcherbak
BACKGROUND: Analysis of the effect of comorbid diseases on the concentration of biomarkers will help to deepen the understanding of the pathogenetic mechanisms of the impact of comorbid diseases on the course of COVID-19 and adjust prognostic models for its therapy. AIM: To study the impact of comorbid diseases on the severity and outcomes of COVID-19. In addition, an analysis of the levels of macrophage-derived chemokine, interferon-γ-induced protein 10 kD, soluble CD40 ligand, vascular endothelial growth factor has been carried out in 472 patients with COVID-19, depending on the presence of various forms of comorbid pathology. MATERIALS AND METHODS: To study the concentration of biomarkers an analysis has been conducted in a group of 1648 patients with confirmed COVID-19. The study assessed intergroup differences (disease outcome/severity of disease) in the general group (1648 patients) and in the group of patients without comorbidity (343 patients) — Charlson index less than 2 points. 472 medical histories of patients with COVID-19 have been analyzed, including with certain concentrations of the studied biomarkers and comorbid pathology included in the Charlson Index. For comparison, two samples have been formed: an experimental group consisting of patients with COVID-19 and the presence of a certain comorbid disease and a control group consisting of patients suffering from COVID-19 without a specified comorbid disease. RESULTS: For the first time, data has been obtained indicating that patients with COVID-19 have comorbid conditions with the levels of the studied biomarkers differing significantly from the indicators of the control group. Thus, in patients with arterial hypertension (I10–I15 according to the International Classification of Diseases, 10th revision), chronic heart failure (I50.0), diseases of the vascular system (I70–I79), cerebrovascular diseases (I60–I69), chronic kidney disease (N17–N19), the level of the macrophage-derived chemokine biomarker was significantly lower than in the patients without these diseases. At the same time, in the COVID-19 patients with respiratory diseases (J40–J47), the levels of interferon-γ-induced protein 10 kD and vascular endothelial growth factor were significantly lower than in the patients who did not have lung diseases. CONCLUSIONS: The study findings obtained have confirmed the role of signaling biomarkers in the development of severe forms and death in patients with COVID-19. Significant influence of comorbid pathology on the course of the new coronavirus infection has been shown.
{"title":"The influence of comorbid diseases on the profiles of signaling biomarkers (macrophage-derived chemokine, interferon-γ-induced protein 10 kD, soluble CD40 ligand, vascular endothelial growth factor) and severity in patients with COVID-19: clinical studies","authors":"A. Anisenkova, V. I. Mazurov, S. Apalko, O. Popov, N. Sushentseva, Olga P. Mamaeva, S. V. Mosenko, A. Sarana, Sergey G. Shcherbak","doi":"10.17816/mechnikov624558","DOIUrl":"https://doi.org/10.17816/mechnikov624558","url":null,"abstract":"BACKGROUND: Analysis of the effect of comorbid diseases on the concentration of biomarkers will help to deepen the understanding of the pathogenetic mechanisms of the impact of comorbid diseases on the course of COVID-19 and adjust prognostic models for its therapy. \u0000AIM: To study the impact of comorbid diseases on the severity and outcomes of COVID-19. In addition, an analysis of the levels of macrophage-derived chemokine, interferon-γ-induced protein 10 kD, soluble CD40 ligand, vascular endothelial growth factor has been carried out in 472 patients with COVID-19, depending on the presence of various forms of comorbid pathology. \u0000MATERIALS AND METHODS: To study the concentration of biomarkers an analysis has been conducted in a group of 1648 patients with confirmed COVID-19. The study assessed intergroup differences (disease outcome/severity of disease) in the general group (1648 patients) and in the group of patients without comorbidity (343 patients) — Charlson index less than 2 points. 472 medical histories of patients with COVID-19 have been analyzed, including with certain concentrations of the studied biomarkers and comorbid pathology included in the Charlson Index. For comparison, two samples have been formed: an experimental group consisting of patients with COVID-19 and the presence of a certain comorbid disease and a control group consisting of patients suffering from COVID-19 without a specified comorbid disease. \u0000RESULTS: For the first time, data has been obtained indicating that patients with COVID-19 have comorbid conditions with the levels of the studied biomarkers differing significantly from the indicators of the control group. Thus, in patients with arterial hypertension (I10–I15 according to the International Classification of Diseases, 10th revision), chronic heart failure (I50.0), diseases of the vascular system (I70–I79), cerebrovascular diseases (I60–I69), chronic kidney disease (N17–N19), the level of the macrophage-derived chemokine biomarker was significantly lower than in the patients without these diseases. At the same time, in the COVID-19 patients with respiratory diseases (J40–J47), the levels of interferon-γ-induced protein 10 kD and vascular endothelial growth factor were significantly lower than in the patients who did not have lung diseases. \u0000CONCLUSIONS: The study findings obtained have confirmed the role of signaling biomarkers in the development of severe forms and death in patients with COVID-19. Significant influence of comorbid pathology on the course of the new coronavirus infection has been shown.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"26 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139531573","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 : 2023-12-14DOI: 10.17816/mechnikov472110
L.A. Elizarieva, Marina Yu. Galaktionova, L. Strozenko, Yuriy F. Lobanov, I.Yu. Boldenkova
BACKGROUND: Up to 65% diseases associated with pathological thrombus have been described; more than 100 thrombogenic risk factors leading to vascular accidents have been studied. It is known that physical development is an important indicator of health in children. The relationship between the presence of thrombogenic risk factors in various disorders of physical development in children has been studied. AIM: To determine the relationship between physical development disorders in children and the presence of thrombogenic risk factors. MATERIALS AND METHODS: The study included 396 children aged 14–18 years, who underwent physical growth assessment using the sigma deviation method and genetic testing to determine polymorphisms of folate cycle genes and polymorphisms of thrombophilia genes. Statistical processing was carried out using the application package Statistica 10.0 (StatSoft, Inc., USA). RESULTS: The analysis of anthropometric indicators in children showed that in the group of the patients with thrombogenic risk factors, height and body weight values with average physical disharmonious development due to excess weight were statistically significantly higher than age-reference indicators. CONCLUSIONS: Based on the results of the study, it has been shown that disharmony in physical development in children with high thrombogenic risk factors may be one of the risk factors for the development of thrombotic conditions.
{"title":"Assessment of the physical development of children with and without high thrombogenic risk factors in the Health Center for Children","authors":"L.A. Elizarieva, Marina Yu. Galaktionova, L. Strozenko, Yuriy F. Lobanov, I.Yu. Boldenkova","doi":"10.17816/mechnikov472110","DOIUrl":"https://doi.org/10.17816/mechnikov472110","url":null,"abstract":"BACKGROUND: Up to 65% diseases associated with pathological thrombus have been described; more than 100 thrombogenic risk factors leading to vascular accidents have been studied. It is known that physical development is an important indicator of health in children. The relationship between the presence of thrombogenic risk factors in various disorders of physical development in children has been studied. \u0000AIM: To determine the relationship between physical development disorders in children and the presence of thrombogenic risk factors. \u0000MATERIALS AND METHODS: The study included 396 children aged 14–18 years, who underwent physical growth assessment using the sigma deviation method and genetic testing to determine polymorphisms of folate cycle genes and polymorphisms of thrombophilia genes. Statistical processing was carried out using the application package Statistica 10.0 (StatSoft, Inc., USA). \u0000RESULTS: The analysis of anthropometric indicators in children showed that in the group of the patients with thrombogenic risk factors, height and body weight values with average physical disharmonious development due to excess weight were statistically significantly higher than age-reference indicators. \u0000CONCLUSIONS: Based on the results of the study, it has been shown that disharmony in physical development in children with high thrombogenic risk factors may be one of the risk factors for the development of thrombotic conditions.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"310 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138974207","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 : 2023-12-14DOI: 10.17816/mechnikov567926
N. Lapkina, A. A. Baranov, N. Levshin, J. A. Malysheva, V. Amirdzhanova, A. S. Artyukhov
BACKGROUND: Recently, it has become evident that despite extensive data obtained from randomised placebo-controlled trials, which are still the golden standard for assessing the efficacy and safety of therapy, there are still some fundamentally important questions regarding the optimal management of patients with rheumatoid arthritis. In this regard, it is extremely relevant to assess the results of therapy in real clinical practice. Currently, much attention is paid to the study of the level of proinflammatory cytokines, both as markers of inflammatory activity of rheumatoid arthritis and monitoring the prognosis of anti-inflammatory therapy efficacy. In Russia, there are no works devoted to the study of cytokine concentration dynamics in patients with rheumatoid arthritis on the background upadacitinib therapy, which proves the relevance of the following study. AIM: To investigate the dynamics of clinical and laboratory values of inflammatory activity of the disease and cytokines in patients with rheumatoid arthritis associated with upadacitinib therapy. MATERIALS AND METHODS: We examined 10 patients with a reliable diagnosis of rheumatoid arthritis: patients’ age was 46.30 ± 10.20 years and disease duration was 12.00 (3.00–21.00) years. All the patients had moderate to high disease activity: Disease Activity Score-28 with erythrocyte sedimentation rate 5.48 (4.50–5.80), Clinical Disease Activity Index 28.00 (19.50–32.00) and Simple Disease Activity Index 29.18 (19.51–33.05). All the patients included in the study were treated with upadacitinib at a dose of 15 mg once a day against the background of the therapy with methotrexate, leflunomide, non-steroidal anti-inflammatory drugs and glucocorticoids. Observation was carried out before treatment and after 3, 6 months of therapy. Serum levels of 15 cytokines: interleukin-1β, -4, -6, -10, -17A, -17F, -21, -22, -23, -25, -31, -33, tumor necrosis factor-alpha, interferon gamma, soluble СD40 ligand were studied using multiplex xMAP technology. RESULTS: After 3 and 6 months of upadacitinib therapy, there was a significant decrease in Disease Activity Score-28 with erythrocyte sedimentation rate 3.78 (2.53–4.20) and 3.5 (2.00–3.68), Clinical Disease Activity Index 12.00 (5.00–17.34) and 9.0 (3.00–11.00), Simple Disease Activity Index 12.38 (5.02–17.00) and 9.61 (3.06–11.60), erythrocyte sedimentation rate 19.0 (11.0–26.0), 7.0 (4.0–18.0), CRP 0.56 (0.50–1.99), 0.71 (0.51–1.1). The values of erythrocyte sedimentation rate decreased after 3 months of treatment (baseline 21.0 (15.0–25.0) mm/hour, after 3 months 14,0 (11,0–17,0) mm/hour. After 6 months of upadacitinib therapy, there was a significant decrease in interleukin-10 (p 0.05) and interleukin-33 (p 0.01) levels compared to baseline. On the contrary, the level of interleukin-25 increased by the 6th month of treatment (p 0.01). CONCLUSIONS: The results of the study indicate the effectiveness of upadacitinib in rheumatoid arthritis, and also prov
{"title":"Dynamics of clinical manifestations and cytokine levels in patients with rheumatoid arthritis associated with upadacitinib therapy","authors":"N. Lapkina, A. A. Baranov, N. Levshin, J. A. Malysheva, V. Amirdzhanova, A. S. Artyukhov","doi":"10.17816/mechnikov567926","DOIUrl":"https://doi.org/10.17816/mechnikov567926","url":null,"abstract":"BACKGROUND: Recently, it has become evident that despite extensive data obtained from randomised placebo-controlled trials, which are still the golden standard for assessing the efficacy and safety of therapy, there are still some fundamentally important questions regarding the optimal management of patients with rheumatoid arthritis. In this regard, it is extremely relevant to assess the results of therapy in real clinical practice. Currently, much attention is paid to the study of the level of proinflammatory cytokines, both as markers of inflammatory activity of rheumatoid arthritis and monitoring the prognosis of anti-inflammatory therapy efficacy. In Russia, there are no works devoted to the study of cytokine concentration dynamics in patients with rheumatoid arthritis on the background upadacitinib therapy, which proves the relevance of the following study. \u0000AIM: To investigate the dynamics of clinical and laboratory values of inflammatory activity of the disease and cytokines in patients with rheumatoid arthritis associated with upadacitinib therapy. \u0000MATERIALS AND METHODS: We examined 10 patients with a reliable diagnosis of rheumatoid arthritis: patients’ age was 46.30 ± 10.20 years and disease duration was 12.00 (3.00–21.00) years. All the patients had moderate to high disease activity: Disease Activity Score-28 with erythrocyte sedimentation rate 5.48 (4.50–5.80), Clinical Disease Activity Index 28.00 (19.50–32.00) and Simple Disease Activity Index 29.18 (19.51–33.05). All the patients included in the study were treated with upadacitinib at a dose of 15 mg once a day against the background of the therapy with methotrexate, leflunomide, non-steroidal anti-inflammatory drugs and glucocorticoids. Observation was carried out before treatment and after 3, 6 months of therapy. Serum levels of 15 cytokines: interleukin-1β, -4, -6, -10, -17A, -17F, -21, -22, -23, -25, -31, -33, tumor necrosis factor-alpha, interferon gamma, soluble СD40 ligand were studied using multiplex xMAP technology. \u0000RESULTS: After 3 and 6 months of upadacitinib therapy, there was a significant decrease in Disease Activity Score-28 with erythrocyte sedimentation rate 3.78 (2.53–4.20) and 3.5 (2.00–3.68), Clinical Disease Activity Index 12.00 (5.00–17.34) and 9.0 (3.00–11.00), Simple Disease Activity Index 12.38 (5.02–17.00) and 9.61 (3.06–11.60), erythrocyte sedimentation rate 19.0 (11.0–26.0), 7.0 (4.0–18.0), CRP 0.56 (0.50–1.99), 0.71 (0.51–1.1). The values of erythrocyte sedimentation rate decreased after 3 months of treatment (baseline 21.0 (15.0–25.0) mm/hour, after 3 months 14,0 (11,0–17,0) mm/hour. After 6 months of upadacitinib therapy, there was a significant decrease in interleukin-10 (p 0.05) and interleukin-33 (p 0.01) levels compared to baseline. On the contrary, the level of interleukin-25 increased by the 6th month of treatment (p 0.01). \u0000CONCLUSIONS: The results of the study indicate the effectiveness of upadacitinib in rheumatoid arthritis, and also prov","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"30 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138971692","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 : 2023-12-14DOI: 10.17816/mechnikov582014
G. Khusainova, Olga B. Nesmeyanova, A. I. Dolgushina, O.S. Abramovskikh, V. Genkel, K. Nikushkina
BACKGROUND: Currently, disruption of the barrier function of the intestinal mucosa is considered one of the key mechanisms in the pathogenesis of extraintestinal manifestations of inflammatory bowel diseases, especially damage to the musculoskeletal system. AIM: To study the relationship between the level of zonulin in blood serum and the parameters of the immune status in patients with inflammatory bowel diseases in combination with peripheral arthritis. MATERIALS AND METHODS: 97 patients with ulcerative colitis and Crohn’s disease have been examined, with peripheral arthritis verified in 47 patients; the control group included 50 patients without peripheral arthritis. Zonulin, tumor necrosis factor α, interleukin-1β, -10, -17A, -23 were determined in blood serum using standard kits for direct enzyme immunoassay. RESULTS: Patients with peripheral arthritis were younger with an earlier onset of inflammatory bowel diseases (p 0.001). When assessing the concentration of serum zonulin in the patients with and without arthritis, no significant differences have been found. In the patients with peripheral arthritis, zonulin concentration directly correlated with the level of interleukin-17A (r = 0.323; p = 0.039), interleukin-23 (r = 0.321; p = 0.041). CONCLUSIONS: According to the data obtained, the use of zonulin as a marker of peripheral arthritis in inflammatory bowel diseases is not recommended. Nevertheless, the correlation of zonulin and the concentrations of interleukin-17А and -23 demonstrates its role in the regulation of mucosal immunity in the development of extraintestinal manifestations of inflammatory bowel diseases.
{"title":"Studying zonulin levels in patients with inflammatory bowel disease and peripheral arthritis","authors":"G. Khusainova, Olga B. Nesmeyanova, A. I. Dolgushina, O.S. Abramovskikh, V. Genkel, K. Nikushkina","doi":"10.17816/mechnikov582014","DOIUrl":"https://doi.org/10.17816/mechnikov582014","url":null,"abstract":"BACKGROUND: Currently, disruption of the barrier function of the intestinal mucosa is considered one of the key mechanisms in the pathogenesis of extraintestinal manifestations of inflammatory bowel diseases, especially damage to the musculoskeletal system. \u0000AIM: To study the relationship between the level of zonulin in blood serum and the parameters of the immune status in patients with inflammatory bowel diseases in combination with peripheral arthritis. \u0000MATERIALS AND METHODS: 97 patients with ulcerative colitis and Crohn’s disease have been examined, with peripheral arthritis verified in 47 patients; the control group included 50 patients without peripheral arthritis. Zonulin, tumor necrosis factor α, interleukin-1β, -10, -17A, -23 were determined in blood serum using standard kits for direct enzyme immunoassay. \u0000RESULTS: Patients with peripheral arthritis were younger with an earlier onset of inflammatory bowel diseases (p 0.001). When assessing the concentration of serum zonulin in the patients with and without arthritis, no significant differences have been found. In the patients with peripheral arthritis, zonulin concentration directly correlated with the level of interleukin-17A (r = 0.323; p = 0.039), interleukin-23 (r = 0.321; p = 0.041). \u0000CONCLUSIONS: According to the data obtained, the use of zonulin as a marker of peripheral arthritis in inflammatory bowel diseases is not recommended. Nevertheless, the correlation of zonulin and the concentrations of interleukin-17А and -23 demonstrates its role in the regulation of mucosal immunity in the development of extraintestinal manifestations of inflammatory bowel diseases.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138972879","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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