N. Kuzubova, O. N. Titova, D. B. Skliarova, V. A. Volchkov
Idiopathic pulmonary fibrosis (IPF) is a chronic progressive fibrotic interstitial lung disease of unknown cause. IPF is characterized by excessive production and deposition of extracellular matrix components, which lead to irreversible violations of the architectonics of lung tissue and loss of function. Without treatment, the average survival rate of patients after diagnosis does not exceed 3–5 years. However, published observations report improved survival over the past decade, due to the advent of antifibrotic drugs and earlier diagnosis. The benefits of antifibrotic therapy include a slower rate of reduction in forced lung capacity (FVC) and a reduction in mortality. Pirfenidone and nantedanib are the only currently approved antifibrotic drugs for the treatment of IPF. Several generic drugs with the INN pirfenidone are registered on the Russian market, including the drug PIRFASPEC® (267 mg capsules). Their efficacy and safety have been demonstrated both in randomized clinical trials and in real clinical practice studies. IPF patient registries, which have been maintained in many countries since 2010, provide additional information regarding the progression of the disease, the effectiveness of therapy, and the frequency of adverse events. Although they have a different mechanism of action and safety profile, their effectiveness in slowing the decline of FVC and reducing the risk of mortality over time is similar. However, IPF is still characterized by progressive shortness of breath and poor prognosis, as treatment can only delay the progression of IPF and cannot stop or reverse the damage. Although clinical trials of new drugs for the treatment of IPF are currently underway, no other drugs have yet been approved in the Russian Federation.
{"title":"What has antifibrotic therapy changed for patients with idiopathic pulmonary fibrosis","authors":"N. Kuzubova, O. N. Titova, D. B. Skliarova, V. A. Volchkov","doi":"10.21518/ms2024-105","DOIUrl":"https://doi.org/10.21518/ms2024-105","url":null,"abstract":"Idiopathic pulmonary fibrosis (IPF) is a chronic progressive fibrotic interstitial lung disease of unknown cause. IPF is characterized by excessive production and deposition of extracellular matrix components, which lead to irreversible violations of the architectonics of lung tissue and loss of function. Without treatment, the average survival rate of patients after diagnosis does not exceed 3–5 years. However, published observations report improved survival over the past decade, due to the advent of antifibrotic drugs and earlier diagnosis. The benefits of antifibrotic therapy include a slower rate of reduction in forced lung capacity (FVC) and a reduction in mortality. Pirfenidone and nantedanib are the only currently approved antifibrotic drugs for the treatment of IPF. Several generic drugs with the INN pirfenidone are registered on the Russian market, including the drug PIRFASPEC® (267 mg capsules). Their efficacy and safety have been demonstrated both in randomized clinical trials and in real clinical practice studies. IPF patient registries, which have been maintained in many countries since 2010, provide additional information regarding the progression of the disease, the effectiveness of therapy, and the frequency of adverse events. Although they have a different mechanism of action and safety profile, their effectiveness in slowing the decline of FVC and reducing the risk of mortality over time is similar. However, IPF is still characterized by progressive shortness of breath and poor prognosis, as treatment can only delay the progression of IPF and cannot stop or reverse the damage. Although clinical trials of new drugs for the treatment of IPF are currently underway, no other drugs have yet been approved in the Russian Federation.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"8 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141385433","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}
Introduction. The etiological aspects of functional dyspepsia (FD) and irritable bowel syndrome (IBS) are not clear; the epidemiology of diseases in age groups and societies can help in understanding the starting causes of the pathology.Aim. To assess the risk factors for the development and prevalence of abdominal symptoms characteristic of FD and IBS among active users of Internet communities.Materials and methods. An anonymous online survey was conducted among medical university students. The questionnaire contains questions about complaints typical of FD and IBS over the past week, “alarm” symptoms, personal characteristics of the respondent and possible risk factors: smoking, family history, taking antibiotics, iron pills, non-steroidal anti-inflammatory drugs (NSAIDs).Results and discussion. The study included 983 respondents aged 18−26 years, 279 men and 704 women. Symptoms of unstudied regular (>1 time per week) postprandial dyspeptic disorders, bloating and abdominal pain were identified in 391 (39.8%) people, of which 29% were men and 44% were women (p < 0.001). Risk factors for regular unstudied disorders were having relatives with chronic gastrointestinal diseases (OR 2.05 [1.56, 2.70]); female gender (OR 1.92 [1.43, 2.59]); taking NSAIDs (OR 1.48 [1.14; 1.91]); for women – smoking (OR 2.24 [1.57; 3.18]). 6.5% of respondents met the criteria for FD, of which 23.4% had isolated epigastric pain, 26.6% had isolated postprandial distress syndrome, and 50% had combined FD. 2.5% of respondents met the criteria for IBS, 64% of whom had overlap syndrome with FD. The presence of FD was associated with NSAIDs use: r = 0.081; p = 0.011 (OR 1.95 [1.16; 3.30]).Conclusions. The prevalence of FD and/or IBS among people aged 18−26 years is 7.4%, with no significant differences between men and women. Taking NSAIDs can be considered as a factor contributing to the development of FD.
{"title":"Prevalence and risk factors of functional abdominal disorders according to a survey study among young people","authors":"T. V. Zhestkova","doi":"10.21518/ms2024-193","DOIUrl":"https://doi.org/10.21518/ms2024-193","url":null,"abstract":"Introduction. The etiological aspects of functional dyspepsia (FD) and irritable bowel syndrome (IBS) are not clear; the epidemiology of diseases in age groups and societies can help in understanding the starting causes of the pathology.Aim. To assess the risk factors for the development and prevalence of abdominal symptoms characteristic of FD and IBS among active users of Internet communities.Materials and methods. An anonymous online survey was conducted among medical university students. The questionnaire contains questions about complaints typical of FD and IBS over the past week, “alarm” symptoms, personal characteristics of the respondent and possible risk factors: smoking, family history, taking antibiotics, iron pills, non-steroidal anti-inflammatory drugs (NSAIDs).Results and discussion. The study included 983 respondents aged 18−26 years, 279 men and 704 women. Symptoms of unstudied regular (>1 time per week) postprandial dyspeptic disorders, bloating and abdominal pain were identified in 391 (39.8%) people, of which 29% were men and 44% were women (p < 0.001). Risk factors for regular unstudied disorders were having relatives with chronic gastrointestinal diseases (OR 2.05 [1.56, 2.70]); female gender (OR 1.92 [1.43, 2.59]); taking NSAIDs (OR 1.48 [1.14; 1.91]); for women – smoking (OR 2.24 [1.57; 3.18]). 6.5% of respondents met the criteria for FD, of which 23.4% had isolated epigastric pain, 26.6% had isolated postprandial distress syndrome, and 50% had combined FD. 2.5% of respondents met the criteria for IBS, 64% of whom had overlap syndrome with FD. The presence of FD was associated with NSAIDs use: r = 0.081; p = 0.011 (OR 1.95 [1.16; 3.30]).Conclusions. The prevalence of FD and/or IBS among people aged 18−26 years is 7.4%, with no significant differences between men and women. Taking NSAIDs can be considered as a factor contributing to the development of FD.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"21 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141388138","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}
Сough is a common symptom that requires medical attention. The range of diseases in which cough occurs is quite large. These are not only patients with bronchopulmonary pathology, cough can also occur in diseases of the gastrointestinal tract, cardiovascular system, diseases of the upper respiratory tract, taking medications and a number of other reasons. Cough has different developmental mechanisms and clinical characteristics. Treatment of cough should be primarily aimed at eliminating the cause of cough, the nosological form that triggered the development of this symptom. However, cough often requires a complex long-term diagnosis and personalized approach to therapy. Symptomatic treatment is often required before the cause of chronic cough is established and for patients with acute and subacute cough. When choosing symptomatic cough therapy, it is necessary to focus on a specific clinical situation and take a differentiated approach to the choice of medications. Combination medications are an effective symptomatic remedy in the treatment of cough, especially in situations where the patient has several symptoms at the same time (cough, viscous, difficult-to-separate sputum, bronchial obstruction). An example of such a combination are drugs that include bromhexine (mucolytic), guaifenesine (mucolytic/mucokinetic) and salbutamol (β2-adrenomimetic). The drugs have a synergistic effect, have an antitussive effect, improve mucociliary clearance, improve the rheological properties of bronchial secretions, reducing excessive bronchial tone, which leads to rapid cleansing of the bronchi from altered bronchial secretions and a decrease / cessation of coughing.
{"title":"Cough at the doctor’s office","authors":"G. Shakirova, E. D. Gizatullina, A. S. Burchagina","doi":"10.21518/ms2024-192","DOIUrl":"https://doi.org/10.21518/ms2024-192","url":null,"abstract":"Сough is a common symptom that requires medical attention. The range of diseases in which cough occurs is quite large. These are not only patients with bronchopulmonary pathology, cough can also occur in diseases of the gastrointestinal tract, cardiovascular system, diseases of the upper respiratory tract, taking medications and a number of other reasons. Cough has different developmental mechanisms and clinical characteristics. Treatment of cough should be primarily aimed at eliminating the cause of cough, the nosological form that triggered the development of this symptom. However, cough often requires a complex long-term diagnosis and personalized approach to therapy. Symptomatic treatment is often required before the cause of chronic cough is established and for patients with acute and subacute cough. When choosing symptomatic cough therapy, it is necessary to focus on a specific clinical situation and take a differentiated approach to the choice of medications. Combination medications are an effective symptomatic remedy in the treatment of cough, especially in situations where the patient has several symptoms at the same time (cough, viscous, difficult-to-separate sputum, bronchial obstruction). An example of such a combination are drugs that include bromhexine (mucolytic), guaifenesine (mucolytic/mucokinetic) and salbutamol (β2-adrenomimetic). The drugs have a synergistic effect, have an antitussive effect, improve mucociliary clearance, improve the rheological properties of bronchial secretions, reducing excessive bronchial tone, which leads to rapid cleansing of the bronchi from altered bronchial secretions and a decrease / cessation of coughing.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141387507","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}
L. I. Kadnikov, N. Izmozherova, A. A. Popov, I. Antropova
Introduction. Platelets play an important role in arterial thrombosis, and the effects of SARS-CoV-2 on platelets contribute to an increased risk of thrombosis.Aim. To evaluate platelet link of hemostasis system and polymorbidity in patients with acute coronary syndrome and COVID-19 at the time of admission to the hospital.Materials and methods. The case-control study included 96 pairs of patients with acute coronary syndrome (ACS). The groups were adjusted by gender, age and diagnosis of ACS. Group 1 had ACS and COVID-19, Group 2 had ACS without COVID-19. Blood indicators were examined using the Mindray BC-5150 and ABX Micros-60 automatic hematology analyzers, the results of which were comparable Statistica 13.0 environment was used for statistical processing. The study was approved by the Local Ethics Committee of Ural State Medical University by Protocol No. 9 dated 10.22.2021.Results. Platelet level (PLT) was 242 (178÷299) x 109/L Group 1 and 236 (199÷291) x 109/L, in Group 2, p = 0.927. Mean platelet volume (MPV) was 10.0 (9.3÷11.5) fl in Group 1 and 8.0 (7.6÷8.8) fl, in Group 2, p < 0.001. Platelet distribution width (PDW) was 16.2 (15.9÷16.4) in Group 1, and 15.7 (14.7÷16.7) in Group 2, p < 0.001. Plateletcrit (PCT) was 0.24 (0.18÷0.30)% in Group 1 and 0.19 (0.16÷0.24)% in Group 2, p < 0.001. Platelet-to-lymphocyte ratio (PLR) 159.4 (109.5÷232.9) in Group 1 and 118.4 (88.2÷158.1) in Group 2, p < 0.001. The Charlson polymorbidity index in Group 1 was 5 (4÷6) points, in Group 2 – 4 (4÷6) points, p = 0.047.Conclusions. Higher PDW, MPV, PCT values with the same PLT, higher PLR level and higher polymorbidity at the time of hospitalization may indicate more pronounced platelet activation due to inflammation, severe immunosuppression and concomitant diseases in patients with COVID-19.
{"title":"Platelet link of hemostasis in polymorbid patients with acute coronary syndrome and COVID-19","authors":"L. I. Kadnikov, N. Izmozherova, A. A. Popov, I. Antropova","doi":"10.21518/ms2024-018","DOIUrl":"https://doi.org/10.21518/ms2024-018","url":null,"abstract":"Introduction. Platelets play an important role in arterial thrombosis, and the effects of SARS-CoV-2 on platelets contribute to an increased risk of thrombosis.Aim. To evaluate platelet link of hemostasis system and polymorbidity in patients with acute coronary syndrome and COVID-19 at the time of admission to the hospital.Materials and methods. The case-control study included 96 pairs of patients with acute coronary syndrome (ACS). The groups were adjusted by gender, age and diagnosis of ACS. Group 1 had ACS and COVID-19, Group 2 had ACS without COVID-19. Blood indicators were examined using the Mindray BC-5150 and ABX Micros-60 automatic hematology analyzers, the results of which were comparable Statistica 13.0 environment was used for statistical processing. The study was approved by the Local Ethics Committee of Ural State Medical University by Protocol No. 9 dated 10.22.2021.Results. Platelet level (PLT) was 242 (178÷299) x 109/L Group 1 and 236 (199÷291) x 109/L, in Group 2, p = 0.927. Mean platelet volume (MPV) was 10.0 (9.3÷11.5) fl in Group 1 and 8.0 (7.6÷8.8) fl, in Group 2, p < 0.001. Platelet distribution width (PDW) was 16.2 (15.9÷16.4) in Group 1, and 15.7 (14.7÷16.7) in Group 2, p < 0.001. Plateletcrit (PCT) was 0.24 (0.18÷0.30)% in Group 1 and 0.19 (0.16÷0.24)% in Group 2, p < 0.001. Platelet-to-lymphocyte ratio (PLR) 159.4 (109.5÷232.9) in Group 1 and 118.4 (88.2÷158.1) in Group 2, p < 0.001. The Charlson polymorbidity index in Group 1 was 5 (4÷6) points, in Group 2 – 4 (4÷6) points, p = 0.047.Conclusions. Higher PDW, MPV, PCT values with the same PLT, higher PLR level and higher polymorbidity at the time of hospitalization may indicate more pronounced platelet activation due to inflammation, severe immunosuppression and concomitant diseases in patients with COVID-19.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"19 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141120814","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}
S. Bulgakova, P. Y. Merzlova, O. A. Novikova, L. A. Sharonova, Y. Dolgikh, O. Kosareva
Autoimmune polyglandular syndromes are a group of rare multi-organ pathologies resulting from autoimmune aggression and characterized by polymorphic endocrine and non-endocrine organ lesions. Depending on the combination of organs involved in the autoimmune process, there are 4 types of autoimmune polyglandular syndrome. Type 1 has an autosomal recessive type of inheritance, more common in children and adolescents. Types 2–4 are associated with the expression of antigens the HLA system and manifest typically in adult patients. The article provides a brief description of all types of autoimmune polyglandular syndromes, in more detail describes type 2 (Schmidt syndrome), the clinical case of which is addressed in this article. The following is a clinical case: observation of a 46-year-old male hospitalized in the endocrinological department of Samara City Hospital No. 5 with autoimmune polyglandular syndrome type 2 with decompensation of adrenal insufficiency and hypothyroidism. Submitted complaints, anamnesis, laboratory and instrumental examination of the patient, results of screening for the presence of antibodies that confirm the diagnosis of autoimmune polyglandular syndrome type 2. Surveys have been conducted to eliminate other causes of primary adrenal insufficiency. Additional surveys carried out to identify other possible components of autoimmune polyglandular syndrome type 2 are described. The prescribed treatment according to the nationalclinical recommendations, as well as the features of the prescription of hormone replacement therapy, described further dynamic observation at the outpatient stage and given laboratory control indicators. Conclusions are made about possible difficultiesin the diagnosis and treatment of this pathology.
{"title":"Autoimmune polyglandular syndrome type 2 in the practice of an endocrinologist","authors":"S. Bulgakova, P. Y. Merzlova, O. A. Novikova, L. A. Sharonova, Y. Dolgikh, O. Kosareva","doi":"10.21518/ms2024-206","DOIUrl":"https://doi.org/10.21518/ms2024-206","url":null,"abstract":"Autoimmune polyglandular syndromes are a group of rare multi-organ pathologies resulting from autoimmune aggression and characterized by polymorphic endocrine and non-endocrine organ lesions. Depending on the combination of organs involved in the autoimmune process, there are 4 types of autoimmune polyglandular syndrome. Type 1 has an autosomal recessive type of inheritance, more common in children and adolescents. Types 2–4 are associated with the expression of antigens the HLA system and manifest typically in adult patients. The article provides a brief description of all types of autoimmune polyglandular syndromes, in more detail describes type 2 (Schmidt syndrome), the clinical case of which is addressed in this article. The following is a clinical case: observation of a 46-year-old male hospitalized in the endocrinological department of Samara City Hospital No. 5 with autoimmune polyglandular syndrome type 2 with decompensation of adrenal insufficiency and hypothyroidism. Submitted complaints, anamnesis, laboratory and instrumental examination of the patient, results of screening for the presence of antibodies that confirm the diagnosis of autoimmune polyglandular syndrome type 2. Surveys have been conducted to eliminate other causes of primary adrenal insufficiency. Additional surveys carried out to identify other possible components of autoimmune polyglandular syndrome type 2 are described. The prescribed treatment according to the nationalclinical recommendations, as well as the features of the prescription of hormone replacement therapy, described further dynamic observation at the outpatient stage and given laboratory control indicators. Conclusions are made about possible difficultiesin the diagnosis and treatment of this pathology.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"41 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141119126","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}
V. I. Shevcova, A. A. Pashkova, M. G. Kolpacheva, V. N. Salamatova
Chronic heart failure is one of the main causes of the increase in mortality and disability of the population around the world. In the final stages of chronic heart failure, when the debilitating symptoms of patients no longer respond to treatment, the issue of palliative care arises. To date, current clinical recommendations and guidelines do not contain data on palliative measures for this category of patients – in such conditions, doctors often do not understand what tactics of patient management they need to choose. Therefore, the importance of integrating palliative care into the treatment of chronic heart failure is increasing. Many symptoms associated with the terminal stages of chronic heart failure have a negative impact on the general condition and quality of life of patients. The main ones are shortness of breath, pain, manifestations of asthenia, as well as anxiety-depressive disorders. In order to maximize the possible improvement in the quality of life of such patients, palliative care should be comprehensive: regular pharmacotherapy prescribed in accordance with current clinical recommendations, combined with various non-drug methods for relieving the main symptoms. As such methods, the main cardiac rehabilitation measures can be considered, including regular physical training, training in compliance with the treatment regimen, stress management techniques, and psychological support. The relationship of patients and caregivers with medical professionals is important in the organization of palliative care. Adequate and timely communication is necessary to improve self-control and compliance with medication, prevent unplanned hospitalization, inform decision-making and, ultimately, ensure a safe death. The article discusses the basic concepts of organizing and providing palliative care to patients with chronic heart failure, as well as non-pharmacological palliative measures proposed by European, American, and Russian specialists.
{"title":"Palliative care for chronic heart failure: non-pharmacological methods of relieving the main symptoms","authors":"V. I. Shevcova, A. A. Pashkova, M. G. Kolpacheva, V. N. Salamatova","doi":"10.21518/ms2024-019.","DOIUrl":"https://doi.org/10.21518/ms2024-019.","url":null,"abstract":"Chronic heart failure is one of the main causes of the increase in mortality and disability of the population around the world. In the final stages of chronic heart failure, when the debilitating symptoms of patients no longer respond to treatment, the issue of palliative care arises. To date, current clinical recommendations and guidelines do not contain data on palliative measures for this category of patients – in such conditions, doctors often do not understand what tactics of patient management they need to choose. Therefore, the importance of integrating palliative care into the treatment of chronic heart failure is increasing. Many symptoms associated with the terminal stages of chronic heart failure have a negative impact on the general condition and quality of life of patients. The main ones are shortness of breath, pain, manifestations of asthenia, as well as anxiety-depressive disorders. In order to maximize the possible improvement in the quality of life of such patients, palliative care should be comprehensive: regular pharmacotherapy prescribed in accordance with current clinical recommendations, combined with various non-drug methods for relieving the main symptoms. As such methods, the main cardiac rehabilitation measures can be considered, including regular physical training, training in compliance with the treatment regimen, stress management techniques, and psychological support. The relationship of patients and caregivers with medical professionals is important in the organization of palliative care. Adequate and timely communication is necessary to improve self-control and compliance with medication, prevent unplanned hospitalization, inform decision-making and, ultimately, ensure a safe death. The article discusses the basic concepts of organizing and providing palliative care to patients with chronic heart failure, as well as non-pharmacological palliative measures proposed by European, American, and Russian specialists.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"16 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141121028","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}
A. A. Tulsky, O. A. Myrinova, A. O. Shchetinina, N. Martirosian, E. V. Goncharova, I. A. Kuzina, M. E. Telnova, F. Valeeva, N. Petunina
The article is devoted to modern researches about the potential role of gut microbiota in the development of thyroid pathology. Gut microbiota plays a major role both in the formation and maintenance of human health and in the pathogenesis of a wide range of diseases. There is evidence of the relationship between the gut microbiota and the immune system, the risk of developing several malignant and autoimmune diseases. The article discusses the functions of the gut microbiota and the factors that determine its composition. Studies have shown a connection between the gut microbiota and the thyroid gland, which formed the basis for the formation of the theory of the gut-thyroid axis. It has been shown that the gut microbiota takes part in the metabolism of thyroid hormones and ensures their enterohepatic circulation. It is assumed that one of the links between the thyroid gland and gastrointestinal microorganisms is the immune system. The results of studies examining the taxonomic composition of the gut microbiota in patients with autoimmune thyroiditis and Graves’ disease are presented. It is hypothesized that the composition of the gut microbiota may influence the requirement for levothyroxine, especially in patients with subclinical hypothyroidism. On the other hand, levothyroxine, to a lesser extent, directly hypothyroidism as a result of autoimmune thyroiditis are associated with bacterial overgrowth syndrome despite the achievement of euthyroidism, and may affect the composition of the microbiota. Even though autoimmune thyroid diseases are quite common in the general population, little work has been done on this issue. More reliable basic and clinical researches are needed to identify specific relationships and mechanisms of development of thyroid pathology depending on changes in the composition of the gut microbiota, as well as to assess the potential for therapeutic use.
{"title":"Association between gut microbiota and thyroid dysfunction","authors":"A. A. Tulsky, O. A. Myrinova, A. O. Shchetinina, N. Martirosian, E. V. Goncharova, I. A. Kuzina, M. E. Telnova, F. Valeeva, N. Petunina","doi":"10.21518/ms2024-073.","DOIUrl":"https://doi.org/10.21518/ms2024-073.","url":null,"abstract":"The article is devoted to modern researches about the potential role of gut microbiota in the development of thyroid pathology. Gut microbiota plays a major role both in the formation and maintenance of human health and in the pathogenesis of a wide range of diseases. There is evidence of the relationship between the gut microbiota and the immune system, the risk of developing several malignant and autoimmune diseases. The article discusses the functions of the gut microbiota and the factors that determine its composition. Studies have shown a connection between the gut microbiota and the thyroid gland, which formed the basis for the formation of the theory of the gut-thyroid axis. It has been shown that the gut microbiota takes part in the metabolism of thyroid hormones and ensures their enterohepatic circulation. It is assumed that one of the links between the thyroid gland and gastrointestinal microorganisms is the immune system. The results of studies examining the taxonomic composition of the gut microbiota in patients with autoimmune thyroiditis and Graves’ disease are presented. It is hypothesized that the composition of the gut microbiota may influence the requirement for levothyroxine, especially in patients with subclinical hypothyroidism. On the other hand, levothyroxine, to a lesser extent, directly hypothyroidism as a result of autoimmune thyroiditis are associated with bacterial overgrowth syndrome despite the achievement of euthyroidism, and may affect the composition of the microbiota. Even though autoimmune thyroid diseases are quite common in the general population, little work has been done on this issue. More reliable basic and clinical researches are needed to identify specific relationships and mechanisms of development of thyroid pathology depending on changes in the composition of the gut microbiota, as well as to assess the potential for therapeutic use.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"10 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141119337","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}
A. V. Andrianov, M. V. Drozdova, S. Alekseenko, A. A. Vasilyeva, D. Y. Spichak
Diseases of the nose, paranasal sinuses and upper respiratory tract occupy a leading place in the structure of acute pathology in children of all ages. This also applies to adenotonsillar problems in children. Oncological diseases in children are quite rare, especially those localized in the ENT organs. It must be remembered that under the guise of acute ENT pathology and adenotonsillar problems, quite rare diseases, including cancer, can be hidden. A complaint of difficulty in nasal breathing may be the only manifestation of this pathology. The doctor’s task is to identify cancer pathology at the earliest possible stage. The main methods for differential diagnosis are x-ray and endoscopic examination, regardless of age. Neurofibromatosis (NF) is a group of systemic diseases that are inherited. Refers to phakomatoses. Features include disturbances in the formation of systems of ectodermal and mesodermal origin. The skin, nervous and skeletal systems are most often affected. The formation of the development of malignant neoplasms is characteristic. The disease is rare but results in a greater cancer burden on the nervous system than any other neoplastic disease. In this regard, tumor formations may have different localization and clinical manifestations. The disease affects multiple systems with cutaneous, neurological and orthopedic manifestations that lead to disability or mortality of the patient. The purpose of our study was to demonstrate a rare oncological disease – neurofibromatosis, the first manifestations of which were manifestations in the ENT organs of a 6-year-old child with a family history. The interest of the presented clinical case lies in the rare localization of neurofibroma with localization in the structures of the neck with the involvement of the pharynx, larynx, mediastinum, and neck vessels.
鼻腔、副鼻窦和上呼吸道疾病在所有年龄段儿童的急性病理结构中都占主要地位。儿童腺扁桃体疾病也是如此。儿童肿瘤疾病非常罕见，尤其是耳鼻喉科器官的肿瘤。要知道，在急性耳鼻喉科病变和腺扁桃体疾病的幌子下，可能隐藏着包括癌症在内的罕见疾病。鼻呼吸困难的主诉可能是这种病变的唯一表现。医生的任务是尽早发现癌症病变。鉴别诊断的主要方法是 X 光和内窥镜检查，与年龄无关。神经纤维瘤病（NF）是一组遗传性系统疾病。指的是噬瘤病。特征包括外胚层和中胚层系统形成障碍。皮肤、神经和骨骼系统最常受到影响。恶性肿瘤的形成发展是其特征。这种疾病虽然罕见，但对神经系统造成的癌症负担比其他任何肿瘤性疾病都要大。在这方面，肿瘤的形成可能有不同的定位和临床表现。该病影响多个系统，有皮肤、神经和骨科表现，导致患者残疾或死亡。我们的研究旨在展示一种罕见的肿瘤疾病--神经纤维瘤病，该病的首发症状是一名有家族史的 6 岁儿童的耳鼻喉器官。本临床病例的意义在于，神经纤维瘤罕见地位于颈部结构，累及咽、喉、纵隔和颈部血管。
{"title":"A rare oncological disease in a child with manifestation in the ENT organs","authors":"A. V. Andrianov, M. V. Drozdova, S. Alekseenko, A. A. Vasilyeva, D. Y. Spichak","doi":"10.21518/ms2024-070","DOIUrl":"https://doi.org/10.21518/ms2024-070","url":null,"abstract":"Diseases of the nose, paranasal sinuses and upper respiratory tract occupy a leading place in the structure of acute pathology in children of all ages. This also applies to adenotonsillar problems in children. Oncological diseases in children are quite rare, especially those localized in the ENT organs. It must be remembered that under the guise of acute ENT pathology and adenotonsillar problems, quite rare diseases, including cancer, can be hidden. A complaint of difficulty in nasal breathing may be the only manifestation of this pathology. The doctor’s task is to identify cancer pathology at the earliest possible stage. The main methods for differential diagnosis are x-ray and endoscopic examination, regardless of age. Neurofibromatosis (NF) is a group of systemic diseases that are inherited. Refers to phakomatoses. Features include disturbances in the formation of systems of ectodermal and mesodermal origin. The skin, nervous and skeletal systems are most often affected. The formation of the development of malignant neoplasms is characteristic. The disease is rare but results in a greater cancer burden on the nervous system than any other neoplastic disease. In this regard, tumor formations may have different localization and clinical manifestations. The disease affects multiple systems with cutaneous, neurological and orthopedic manifestations that lead to disability or mortality of the patient. The purpose of our study was to demonstrate a rare oncological disease – neurofibromatosis, the first manifestations of which were manifestations in the ENT organs of a 6-year-old child with a family history. The interest of the presented clinical case lies in the rare localization of neurofibroma with localization in the structures of the neck with the involvement of the pharynx, larynx, mediastinum, and neck vessels.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"9 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141120115","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}
M. V. Komarov, A. A. Fedotova, E. Bezrukova, R. F. Galeev
Introduction. Chronic otitis media with effusion (COME) is a middle ear disease, characterized by mucous effusion accumulation in its structures. One of the important COME formation mechanism is gastric reflux. Gastric contents reflux into the tympanic cavity which contributes to the irreversible transformation of its mucous membrane.Aim. To substantiate the significance of the gastric reflux in the middle ear mucosa fibrous remodeling.Materials and methods. The study included 96 people diagnosed with COME and concomitant gastroesophageal reflux disease (GERD), 54 women and 42 men, in the age range from 18 to 65 years (mean age 51.4 years). All patients underwent tympanostomy tube installation and supervised by an otolaryngologist during 12 months. Patients were divided into 2 groups depending on their consent to GERD therapy. The conservative treatment of COME and GERD was carried out in accordance with established and current medical care standards and clinical guidelines for the relevant nosology.Results and discussion. 14 days after the tympanostomy, the otorrhea decrease was noted in 31 (75.6%) of the main group and 31 (56.6%) participants in the comparison group (n = 96).By the end of 12 months observation a positive disease outcome such as exudation reduction and complete tympanic membrane repair was recorded in 35 (83.3%) and 25 (62.5%) patients of both groups respectively (n = 82).Patients with a mixed 34 (35.4%) and non-acid 11 (11.5%) types of reflux showed worse disease outcome rates, just like in patients with COME who delayed GERD treatment 8 (8.3%).Conclusions. The combination of infectious agent exposure causes an active mucous membrane exudation in the disease early stages with mixed and non-acid gastric reflux leads to mucous membrane middle ear fibrous remodeling. It has also been established that an unsuccessful COME treatment duration aggravates the outcome of the disease in the absence of GERD therapy.
{"title":"The GERD-caused middle ear mucous membrane transformation features in chronic otitis media with effusion","authors":"M. V. Komarov, A. A. Fedotova, E. Bezrukova, R. F. Galeev","doi":"10.21518/ms2024-074","DOIUrl":"https://doi.org/10.21518/ms2024-074","url":null,"abstract":"Introduction. Chronic otitis media with effusion (COME) is a middle ear disease, characterized by mucous effusion accumulation in its structures. One of the important COME formation mechanism is gastric reflux. Gastric contents reflux into the tympanic cavity which contributes to the irreversible transformation of its mucous membrane.Aim. To substantiate the significance of the gastric reflux in the middle ear mucosa fibrous remodeling.Materials and methods. The study included 96 people diagnosed with COME and concomitant gastroesophageal reflux disease (GERD), 54 women and 42 men, in the age range from 18 to 65 years (mean age 51.4 years). All patients underwent tympanostomy tube installation and supervised by an otolaryngologist during 12 months. Patients were divided into 2 groups depending on their consent to GERD therapy. The conservative treatment of COME and GERD was carried out in accordance with established and current medical care standards and clinical guidelines for the relevant nosology.Results and discussion. 14 days after the tympanostomy, the otorrhea decrease was noted in 31 (75.6%) of the main group and 31 (56.6%) participants in the comparison group (n = 96).By the end of 12 months observation a positive disease outcome such as exudation reduction and complete tympanic membrane repair was recorded in 35 (83.3%) and 25 (62.5%) patients of both groups respectively (n = 82).Patients with a mixed 34 (35.4%) and non-acid 11 (11.5%) types of reflux showed worse disease outcome rates, just like in patients with COME who delayed GERD treatment 8 (8.3%).Conclusions. The combination of infectious agent exposure causes an active mucous membrane exudation in the disease early stages with mixed and non-acid gastric reflux leads to mucous membrane middle ear fibrous remodeling. It has also been established that an unsuccessful COME treatment duration aggravates the outcome of the disease in the absence of GERD therapy.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"73 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141121748","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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