M. Shakhova, V. A. Fokeev, V. Svistushkin, A. V. Shakhov
Chronic nonspecific pharyngitis (CNP) is an extremely common pathology, but there are no consensus documents regulating the diagnosis and treatment of CNP. We compiled a questionnaire with a list of questions on the problem of CNF, distributed a google form among practitioners and conducted a survey with subsequent analysis of the answers. Then, a search and analysis of scientific works on this topic was carried out on the platforms PubMed, eLibrary.Ru, CyberLeninka, as well as in other open Internet sources. The data of the survey of specialists are compared with the results of the literature review. Therapeutic and diagnostic approaches in CNF are largely determined by the traditional ways of life of a medical institution. This fact, as well as the lack of regulatory documents on the problem of CNF, makes it difficult to competently diagnose and choose an adequate treatment tactics for this disease. The results of the study suggest that CF should be considered as a multifactorial disease, paying attention to the comorbid profile of the patient. The vast majority of respondents consider gastroesophageal reflux and other gastroenterological diseases to be the main predisposing factors. This is confirmed by the literature, and the specialists interviewed by us suggest that the main bias should be made to the assessment of complaints, anamnesis, and pharyngoscopy. Therapy of CNF with the use of only topical drugs is prescribed everywhere, but does not give the desired result. It is necessary to have a multi-stage treatment aimed at eliminating predisposing factors and correcting local changes with the involvement of not only otorhinolaryngologists, but also doctors of other specialties (gastroenterologists, endocrinologists, psychiatrists and neurologists).
{"title":"Chronic nonspecific pharyngitis: еtiopathogenesis and treatment Issues (questionnaire data and literature review)","authors":"M. Shakhova, V. A. Fokeev, V. Svistushkin, A. V. Shakhov","doi":"10.21518/ms2024-095","DOIUrl":"https://doi.org/10.21518/ms2024-095","url":null,"abstract":"Chronic nonspecific pharyngitis (CNP) is an extremely common pathology, but there are no consensus documents regulating the diagnosis and treatment of CNP. We compiled a questionnaire with a list of questions on the problem of CNF, distributed a google form among practitioners and conducted a survey with subsequent analysis of the answers. Then, a search and analysis of scientific works on this topic was carried out on the platforms PubMed, eLibrary.Ru, CyberLeninka, as well as in other open Internet sources. The data of the survey of specialists are compared with the results of the literature review. Therapeutic and diagnostic approaches in CNF are largely determined by the traditional ways of life of a medical institution. This fact, as well as the lack of regulatory documents on the problem of CNF, makes it difficult to competently diagnose and choose an adequate treatment tactics for this disease. The results of the study suggest that CF should be considered as a multifactorial disease, paying attention to the comorbid profile of the patient. The vast majority of respondents consider gastroesophageal reflux and other gastroenterological diseases to be the main predisposing factors. This is confirmed by the literature, and the specialists interviewed by us suggest that the main bias should be made to the assessment of complaints, anamnesis, and pharyngoscopy. Therapy of CNF with the use of only topical drugs is prescribed everywhere, but does not give the desired result. It is necessary to have a multi-stage treatment aimed at eliminating predisposing factors and correcting local changes with the involvement of not only otorhinolaryngologists, but also doctors of other specialties (gastroenterologists, endocrinologists, psychiatrists and neurologists).","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"59 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141123303","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}
T. S. Dushina, L. A. Suplotova, S. Klyashev, N. N. Fedoseeva
Introduction. The global economic and social burden of obesity requires a clear understanding of the causes and underlying factors contributing to its development which will allow to develop and implement effectively the potential therapeutic pathways to direct influence on the pathology. Recently, in the pathogenesis of obesity, great attention is paid to the state and diversity of the intestinal microbiota, its main interaction with men is performed through short-chain fatty acids (SCFAs) – biologically active substances being formed during the anaerobic fermentation of indigestible carbohydrates.Aim. To assess the metabolic activity of the colon microbiota, in terms of quantity and proportion of short-chain fatty acid levels in young obese patients taking into account the degree of obesity in comparison with healthy individuals.Materials and methods. 87 obese patients and 31 subjects with the normal body weight were included in the study. All study participants met the inclusion criteria and signed the informed consent. In addition to filling out a questionnaire specially designed for the goals and objectives of this study, anthropometric measurements were carried out and the level of SCFAs in feces was determined with the help of gas-liquid chromatography usingChromos GC-1000 equipment in the independent INVITRO laboratory.Results. Young obese patients have a higher concentration of SCFAs and SCFA isoforms in feces compared to healthy individuals, while it is statistically significantly higher in the group of patients with BMI more than 40 kg/m2. The proportion of acetate was statistically significantly higher in the normal weight group, while the proportion of propionate was higher in the obese group. No statistical differences were found regarding the proportion of butyrate. In addition, the associations of SCFAs with anthropometric parameters were identified.Conclusion. The results of the study confirm the possible role of SCFA in in pathogenesis of obesity.
{"title":"Metabolic activity of the colon microbiota in patients with obesity (pilot research)","authors":"T. S. Dushina, L. A. Suplotova, S. Klyashev, N. N. Fedoseeva","doi":"10.21518/ms2024-136","DOIUrl":"https://doi.org/10.21518/ms2024-136","url":null,"abstract":"Introduction. The global economic and social burden of obesity requires a clear understanding of the causes and underlying factors contributing to its development which will allow to develop and implement effectively the potential therapeutic pathways to direct influence on the pathology. Recently, in the pathogenesis of obesity, great attention is paid to the state and diversity of the intestinal microbiota, its main interaction with men is performed through short-chain fatty acids (SCFAs) – biologically active substances being formed during the anaerobic fermentation of indigestible carbohydrates.Aim. To assess the metabolic activity of the colon microbiota, in terms of quantity and proportion of short-chain fatty acid levels in young obese patients taking into account the degree of obesity in comparison with healthy individuals.Materials and methods. 87 obese patients and 31 subjects with the normal body weight were included in the study. All study participants met the inclusion criteria and signed the informed consent. In addition to filling out a questionnaire specially designed for the goals and objectives of this study, anthropometric measurements were carried out and the level of SCFAs in feces was determined with the help of gas-liquid chromatography usingChromos GC-1000 equipment in the independent INVITRO laboratory.Results. Young obese patients have a higher concentration of SCFAs and SCFA isoforms in feces compared to healthy individuals, while it is statistically significantly higher in the group of patients with BMI more than 40 kg/m2. The proportion of acetate was statistically significantly higher in the normal weight group, while the proportion of propionate was higher in the obese group. No statistical differences were found regarding the proportion of butyrate. In addition, the associations of SCFAs with anthropometric parameters were identified.Conclusion. The results of the study confirm the possible role of SCFA in in pathogenesis of obesity. ","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"22 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141120035","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. Krivopalov, I. Arustamyan, L. S. Krasheninnikova
Introduction. There is a clear need to discuss separate issues related to acute rhinosinusitis. The rationale is that prevalence rates of the disease remain high. At the same time, the incidence rates are growing globally, including Russia, Europe, the USA and Asia. Apart from that, acute rhinosinusitis significantly deteriorates the patients’ quality of life, causing physical, emotional and professional malaise. Moreover, the complications of acute rhinosinusitis may have serious consequences, and the economic costs to society are significant, including both explicit and implicit costs.Aim. To raise the level of awareness of otolaryngologists about current issues of acute rhinosinusitis based on the analysis and synthesis of literary sources.Materials and methods. An analysis of the published literature on the cause-and-effect relationship between the development and features of acute rhinosinusitis in the specialized academic research databases RSCI, eLibrary.Ru, Scopus, Web of Science, Medline over the last ten-year period was carried out.Results and discussion. We presented a brief overview of the etiology, epidemiology, risk factors, and diagnostic methods of acute rhinosinusitis based on the results of scientific literature review. The issues of treatment and prevention strategies, problems of antibiotic resistance are considered. The article brings to the fore the issues related to risk factors, among which it highlights an increasing incidence of acute respiratory viral infections, environmental and lifestyle influences. Modern diagnostic methods are addressed. We also emphasized the issues of improvement of clinical guidelines with a focus on recent research, stressed the importance of an individual approach to each patient, taking into account the severity and features of the course of the disease in individual patients.Conclusions. The paper considers a conceptual solution for providing medical care to patients with acute rhinosinusitis, which is based on the principles of evidence-based medicine and is regulated by legitimate clinical guidelines, both issued before and currently in force, including international ones.
导言。显然有必要单独讨论与急性鼻炎有关的问题。理由是该病的发病率居高不下。与此同时，包括俄罗斯、欧洲、美国和亚洲在内的全球发病率也在不断上升。此外，急性鼻炎严重影响患者的生活质量，造成身体、情绪和职业方面的不适。此外，急性鼻炎的并发症可能会造成严重后果，给社会带来巨大的经济损失，包括显性和隐性成本。在分析和综合文献资料的基础上，提高耳鼻喉科医生对当前急性鼻炎问题的认识水平。对过去十年间专业学术研究数据库 RSCI、eLibrary.Ru、Scopus、Web of Science、Medline 中已发表的有关急性鼻炎发病原因和特征之间因果关系的文献进行了分析。根据科学文献综述的结果，我们对急性鼻炎的病因、流行病学、风险因素和诊断方法进行了简要概述。文章还考虑了治疗和预防策略问题以及抗生素耐药性问题。文章强调了与风险因素有关的问题，其中突出强调了急性呼吸道病毒感染发病率的增加、环境和生活方式的影响。文章还讨论了现代诊断方法。我们还强调了以最新研究为重点改进临床指南的问题，强调了针对每位患者采取个体化方法的重要性，同时考虑到了每位患者病情的严重程度和病程特点。本文探讨了为急性鼻炎患者提供医疗护理的概念性解决方案，该方案以循证医学原则为基础，并由以前发布的和目前生效的合法临床指南（包括国际指南）加以规范。
{"title":"Key issues of acute rhinosinusitis","authors":"A. A. Krivopalov, I. Arustamyan, L. S. Krasheninnikova","doi":"10.21518/ms2024-087","DOIUrl":"https://doi.org/10.21518/ms2024-087","url":null,"abstract":"Introduction. There is a clear need to discuss separate issues related to acute rhinosinusitis. The rationale is that prevalence rates of the disease remain high. At the same time, the incidence rates are growing globally, including Russia, Europe, the USA and Asia. Apart from that, acute rhinosinusitis significantly deteriorates the patients’ quality of life, causing physical, emotional and professional malaise. Moreover, the complications of acute rhinosinusitis may have serious consequences, and the economic costs to society are significant, including both explicit and implicit costs.Aim. To raise the level of awareness of otolaryngologists about current issues of acute rhinosinusitis based on the analysis and synthesis of literary sources.Materials and methods. An analysis of the published literature on the cause-and-effect relationship between the development and features of acute rhinosinusitis in the specialized academic research databases RSCI, eLibrary.Ru, Scopus, Web of Science, Medline over the last ten-year period was carried out.Results and discussion. We presented a brief overview of the etiology, epidemiology, risk factors, and diagnostic methods of acute rhinosinusitis based on the results of scientific literature review. The issues of treatment and prevention strategies, problems of antibiotic resistance are considered. The article brings to the fore the issues related to risk factors, among which it highlights an increasing incidence of acute respiratory viral infections, environmental and lifestyle influences. Modern diagnostic methods are addressed. We also emphasized the issues of improvement of clinical guidelines with a focus on recent research, stressed the importance of an individual approach to each patient, taking into account the severity and features of the course of the disease in individual patients.Conclusions. The paper considers a conceptual solution for providing medical care to patients with acute rhinosinusitis, which is based on the principles of evidence-based medicine and is regulated by legitimate clinical guidelines, both issued before and currently in force, including international ones.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"77 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141122788","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. Korneenkov, P. A. Ovchinnikov, E. A. Vyazemskaya, A. Y. Medvedeva, Yuri K. Yanov
Introduction. The COVID-19 pandemic has modified the information needs of participants in the public health management system and identified a lack of information for making management and health decisions during the pandemic.Aim. To summarize and provide a general description of information and data that should be available in the health information system of otorhinolaryngological health facilities for decision-making in epidemic settings based on the results of conducted studies.Materials and methods. In this study we used our own experience in addressing information challenges on optimization of otorhinolaryngological care both at the height of pandemic and after renewal of scheduled visits and hospital admissions. We considered studies under the auspices of WHO on assessment of the effectiveness of health information systems as a whole and individual works that were carried out to analyse the impact of the pandemic on provision of otorhinolaryngological care.Results and discussion. The content of data used for decision-making in a pandemic has been substantiated in the following areas: 1) provision of health care should be organized as close as possible to the patient’s personalized care plan with due account for temporal and spatial factors – it is proposed to use patient’s geographic data, patient’s health characteristics indicating the date and time they were registered; 2) health care facilities personnel should be ready to provide medical care – it is proposed to use the results of periodic surveys of health care facilities personnel with regard to their awareness of an epidemic, concern about different risks, working conditions satisfaction, motivation, and emotional status; 3) provision of health care should be simulated, and the optimal option for organizing and distributing the workload should be verified and selected – it is proposed to use service algorithms and necessary resources.
{"title":"Information systems as a source of meaningful information in an epidemic: experience and lessons in restoring routine otorhinolaryngology care after the COVID-19 pandemic","authors":"A. A. Korneenkov, P. A. Ovchinnikov, E. A. Vyazemskaya, A. Y. Medvedeva, Yuri K. Yanov","doi":"10.21518/ms2024-111","DOIUrl":"https://doi.org/10.21518/ms2024-111","url":null,"abstract":"Introduction. The COVID-19 pandemic has modified the information needs of participants in the public health management system and identified a lack of information for making management and health decisions during the pandemic.Aim. To summarize and provide a general description of information and data that should be available in the health information system of otorhinolaryngological health facilities for decision-making in epidemic settings based on the results of conducted studies.Materials and methods. In this study we used our own experience in addressing information challenges on optimization of otorhinolaryngological care both at the height of pandemic and after renewal of scheduled visits and hospital admissions. We considered studies under the auspices of WHO on assessment of the effectiveness of health information systems as a whole and individual works that were carried out to analyse the impact of the pandemic on provision of otorhinolaryngological care.Results and discussion. The content of data used for decision-making in a pandemic has been substantiated in the following areas: 1) provision of health care should be organized as close as possible to the patient’s personalized care plan with due account for temporal and spatial factors – it is proposed to use patient’s geographic data, patient’s health characteristics indicating the date and time they were registered; 2) health care facilities personnel should be ready to provide medical care – it is proposed to use the results of periodic surveys of health care facilities personnel with regard to their awareness of an epidemic, concern about different risks, working conditions satisfaction, motivation, and emotional status; 3) provision of health care should be simulated, and the optimal option for organizing and distributing the workload should be verified and selected – it is proposed to use service algorithms and necessary resources.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"39 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141119014","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. Evaluation of the new biomarker cBIN-1(CS) has advantages; its concentration does not depend on volume status, body weight, CKD, in contrast to natriuretic peptides, which seems valuable in the diagnosis of HF.Aim. To study the diagnostic and prognostic value of serum cBIN-1(CS) in patients who have suffered myocardial infarction.Materials and methods. The study analyzed clinical, laboratory and instrumental data of 100 patients on the 7th day after myocardial infarction. Subgroup I included patients with a history of HF, subgroup II included patients with risk factors for developing HF. Studies included echocardiography, TSH, cBIN-1(CS) determination. Over the course of 18 months, clinical outcomes were recorded for participants: a composite endpoint of death due to cardiac causes, incident ADHF, worsening TSH results, and intensification of pharmacotherapy.Results. In patients with a history of HF, the level of cBIN-1(CS) in the blood was 0.871 ng/ml, in the group with risk factors for HF – 0.690 ng/ml. The results of TSH on day 7 are associated with an increase in cBIN-1(CS) content and a decrease in the result by 80.45 m in the STEMI group and by 177.36 m in the NSTEMI group (p = 0.002). ROC-analysis of the probability of a fatal outcome based on the cBIN-1(CS) level showed the area under the ROC curve in subgroup I with an established diagnosis of HF of 0.743 ± 0.098 (p = 0.023), in subgroup II – 0.746 ± 0.146 (p = 0.103). ROC-analysis of the probability of achieving the composite endpoint for each of the patient subgroups showed AUC of 0.859 ± 0.058 and 0.751 ± 0.063 (p < 0.001), respectively. The cBIN-1(CS) value ≥ 0/826 ng/ml (sensitivity 80.0%, specificity 70.6%) can be considered as a marker of unfavorable outcome after myocardial infarction. According to the Kaplan-Meier survival curve for patients after MI, the cut-off value for cBIN-1(CS) is 0.826 ng/ml (p < 0.0001), which was determined to be the most optimal for separating patients into high and low risk of an adverse outcome.Conclusion. The cBIN-1(CS) biomarker has high sensitivity and specificity and can be used as a marker for assessing myocardial reserve after myocardial infarction to predict adverse events.
{"title":"Diagnostic and prognostic value of cardiospecific integrator protein in patients after myocardial infarction","authors":"R. R. Heirullin, V. Ruzov, M. V. Frolova","doi":"10.21518/ms2024-166","DOIUrl":"https://doi.org/10.21518/ms2024-166","url":null,"abstract":"Introduction. Evaluation of the new biomarker cBIN-1(CS) has advantages; its concentration does not depend on volume status, body weight, CKD, in contrast to natriuretic peptides, which seems valuable in the diagnosis of HF.Aim. To study the diagnostic and prognostic value of serum cBIN-1(CS) in patients who have suffered myocardial infarction.Materials and methods. The study analyzed clinical, laboratory and instrumental data of 100 patients on the 7th day after myocardial infarction. Subgroup I included patients with a history of HF, subgroup II included patients with risk factors for developing HF. Studies included echocardiography, TSH, cBIN-1(CS) determination. Over the course of 18 months, clinical outcomes were recorded for participants: a composite endpoint of death due to cardiac causes, incident ADHF, worsening TSH results, and intensification of pharmacotherapy.Results. In patients with a history of HF, the level of cBIN-1(CS) in the blood was 0.871 ng/ml, in the group with risk factors for HF – 0.690 ng/ml. The results of TSH on day 7 are associated with an increase in cBIN-1(CS) content and a decrease in the result by 80.45 m in the STEMI group and by 177.36 m in the NSTEMI group (p = 0.002). ROC-analysis of the probability of a fatal outcome based on the cBIN-1(CS) level showed the area under the ROC curve in subgroup I with an established diagnosis of HF of 0.743 ± 0.098 (p = 0.023), in subgroup II – 0.746 ± 0.146 (p = 0.103). ROC-analysis of the probability of achieving the composite endpoint for each of the patient subgroups showed AUC of 0.859 ± 0.058 and 0.751 ± 0.063 (p < 0.001), respectively. The cBIN-1(CS) value ≥ 0/826 ng/ml (sensitivity 80.0%, specificity 70.6%) can be considered as a marker of unfavorable outcome after myocardial infarction. According to the Kaplan-Meier survival curve for patients after MI, the cut-off value for cBIN-1(CS) is 0.826 ng/ml (p < 0.0001), which was determined to be the most optimal for separating patients into high and low risk of an adverse outcome.Conclusion. The cBIN-1(CS) biomarker has high sensitivity and specificity and can be used as a marker for assessing myocardial reserve after myocardial infarction to predict adverse events.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"20 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141119413","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. Svistushkin, A. A. Bakulina, P. Bikmulina, A. Zolotova, L. Selezneva, E. Shevchik, P. Kochetkov, N. Serejnikova, A. N. Nikiforova, I. A. Tychkina, A. Shpichka, V. Svistushkin, P. Timashev
Introduction. One of the most pressing issues of modern otorhinolaryngology is the problem of the formation of persistent defects of the vocal cords and tympanic membrane. This state of affairs is due to the variety of reasons that cause the development of these conditions, as well as the fact that the treatment of these processes, as a rule, is a technically complex task and is not always effective.Aim. Experimental evaluation of the possibility of using bioengineered implants based on MSCs, PEG-fibrin gel and collagen matrix to restore defects in vibrating tissues of ENT organs – vocal folds and tympanic membrane.Materials and methods. For the experiment on vocal fold restoration, 6 rabbits were selected, divided equally into 2 groups. After the formation of the vocal fold scar, a bioequivalent was implanted: spheroids based on MSCs + PEG-fibrin gel (group – VF-spheroids, n = 3) in a volume of 0.5 ml, for the control group, the role of bioequivalent was performed by saline solution (VF-control group, n = 3). For the eardrum repair experiment, 6 chinchillas were selected, divided equally into 2 groups. At the first stage, a persistent chronic perforation was created, on which either no intervention was carried out (ED-control group, n = 3), or the perforation was closed using a bioequivalent based on MSC spheroids, PEG-fibrin gel and collagen matrix (ED-spheroid group, n = 3).Results and discussion. Endoscopic and morphological examination revealed a more complete restoration of tissue structure in the treatment groups compared to the control groups.Conclusion. Implantation of the developed bioequivalents in the sites of vocal fold and tympanic membrane injury leads to the formation of tissue morphologically similar to the structure of intact structures.
{"title":"Mesenchymal stromal cells based bioengineered implants in vocal folds and tympanic membrane restoration (рilot experimental results)","authors":"M. Svistushkin, A. A. Bakulina, P. Bikmulina, A. Zolotova, L. Selezneva, E. Shevchik, P. Kochetkov, N. Serejnikova, A. N. Nikiforova, I. A. Tychkina, A. Shpichka, V. Svistushkin, P. Timashev","doi":"10.21518/ms2024-088","DOIUrl":"https://doi.org/10.21518/ms2024-088","url":null,"abstract":"Introduction. One of the most pressing issues of modern otorhinolaryngology is the problem of the formation of persistent defects of the vocal cords and tympanic membrane. This state of affairs is due to the variety of reasons that cause the development of these conditions, as well as the fact that the treatment of these processes, as a rule, is a technically complex task and is not always effective.Aim. Experimental evaluation of the possibility of using bioengineered implants based on MSCs, PEG-fibrin gel and collagen matrix to restore defects in vibrating tissues of ENT organs – vocal folds and tympanic membrane.Materials and methods. For the experiment on vocal fold restoration, 6 rabbits were selected, divided equally into 2 groups. After the formation of the vocal fold scar, a bioequivalent was implanted: spheroids based on MSCs + PEG-fibrin gel (group – VF-spheroids, n = 3) in a volume of 0.5 ml, for the control group, the role of bioequivalent was performed by saline solution (VF-control group, n = 3). For the eardrum repair experiment, 6 chinchillas were selected, divided equally into 2 groups. At the first stage, a persistent chronic perforation was created, on which either no intervention was carried out (ED-control group, n = 3), or the perforation was closed using a bioequivalent based on MSC spheroids, PEG-fibrin gel and collagen matrix (ED-spheroid group, n = 3).Results and discussion. Endoscopic and morphological examination revealed a more complete restoration of tissue structure in the treatment groups compared to the control groups.Conclusion. Implantation of the developed bioequivalents in the sites of vocal fold and tympanic membrane injury leads to the formation of tissue morphologically similar to the structure of intact structures.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141122512","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}
N. Hudiakova, I. Pchelin, A. Shishkin, P. V. Vasilev, N. Semigolovskii, S. Mazurenko, V. V. Smirnov, N. V. Ivanov
In this article, we described а clinical case of a 32-year-old patient with late diagnosis of adrenomyeloneuropathy manifested with gradually increasing neurologic symptoms, mistakenly considered as hereditary spastic paraparesis, later joined by adrenal insufficiency. It is known that ALD is characterized by a pronounced phenotypic polymorphism, which is associated with differences in penetrance and expression of the abnormal gene. The patient was examined for pathogenic mutations associated with spastic paraplegia and hereditary diseases with similar phenotypic manifestations (Neurodegenerative Diseases panel including analysis of 723 genes). No significant changes meeting the search criteria were found. However, the absence of point mutations associated with ALD does not exclude this diagnosis, but requires the exclusion of chromosomal rearrangements by sequencing the ABCD1 gene. This study was not performed on the patient, which subsequently led to the misdiagnosis. Despite the fact that current clinical guidelines allow the diagnosis of ALD without genetic confirmation, due to the variety of ALD “masks” and frequent untimely diagnosis of this disease, sequencing of the ABCD1 gene is advisable. In order to correct adrenal insufficiency, the patient was prescribed hormone replacement therapy (HRT) with hydrocortisone, which eliminated the main clinical manifestations and partially laboratory signs of hypocorticism. However, corticotropin levels indicated inadequacy of HRT and increased risk of secondary corticotropinoma growth. However, the patient has been receiving intrathecal therapy with the GABA agonist baclofen for the past five years. The literature has not yet described the response of stress hormones to intrathecal administration of baclofen in patients with primary hypocorticism. The few data available indicate that GABA agonists may have a multidirectional effect on hypothalamic-pituitary function; therefore, it is difficult to determine the contribution of this effect on corticotropin secretion in this patient.
{"title":"X-linked adrenoleukodystrophy: a case report","authors":"N. Hudiakova, I. Pchelin, A. Shishkin, P. V. Vasilev, N. Semigolovskii, S. Mazurenko, V. V. Smirnov, N. V. Ivanov","doi":"10.21518/ms2024-120","DOIUrl":"https://doi.org/10.21518/ms2024-120","url":null,"abstract":"In this article, we described а clinical case of a 32-year-old patient with late diagnosis of adrenomyeloneuropathy manifested with gradually increasing neurologic symptoms, mistakenly considered as hereditary spastic paraparesis, later joined by adrenal insufficiency. It is known that ALD is characterized by a pronounced phenotypic polymorphism, which is associated with differences in penetrance and expression of the abnormal gene. The patient was examined for pathogenic mutations associated with spastic paraplegia and hereditary diseases with similar phenotypic manifestations (Neurodegenerative Diseases panel including analysis of 723 genes). No significant changes meeting the search criteria were found. However, the absence of point mutations associated with ALD does not exclude this diagnosis, but requires the exclusion of chromosomal rearrangements by sequencing the ABCD1 gene. This study was not performed on the patient, which subsequently led to the misdiagnosis. Despite the fact that current clinical guidelines allow the diagnosis of ALD without genetic confirmation, due to the variety of ALD “masks” and frequent untimely diagnosis of this disease, sequencing of the ABCD1 gene is advisable. In order to correct adrenal insufficiency, the patient was prescribed hormone replacement therapy (HRT) with hydrocortisone, which eliminated the main clinical manifestations and partially laboratory signs of hypocorticism. However, corticotropin levels indicated inadequacy of HRT and increased risk of secondary corticotropinoma growth. However, the patient has been receiving intrathecal therapy with the GABA agonist baclofen for the past five years. The literature has not yet described the response of stress hormones to intrathecal administration of baclofen in patients with primary hypocorticism. The few data available indicate that GABA agonists may have a multidirectional effect on hypothalamic-pituitary function; therefore, it is difficult to determine the contribution of this effect on corticotropin secretion in this patient.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"48 25","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141122038","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. Balbutsky, A. Revishvili, V. M. Zemskov, M. S. Solovyova, M. Kozlova, N. S. Shishkina, V. A. Popov, G. Plotnikov, A. M. Zemskov, V. S. Demidova, S. V. Suchkov, O. S. Vasiliev
Cardiovascular diseases (CVDs) are one of the most common causes of death in the developed as well as in the developing world. Despite improvements in primary prevention, the prevalence of CVD has continued to rise in recent years. Thus, the issues of molecular pathophysiology of CVD and search for new biomarkers related to early and reliable prevention and diagnosis of these diseases still hold relevance today. New genomic techniques provide innovative tools to solve this problem. A research of the current scientific literature clearly indicates that among transcriptomic biomarkers, micro-ribonucleic acids (miRNAs) are the most promising. The microRNAs (miRNAs) are small (~22 nucleotides) non-coding RNAs which regulate gene expression at the post-transcriptional level via inhibition of the translation of messenger RNA (mRNA) or by inducing the degradation of specific miRNAs. The lack of consensus regarding methodologies used for miRNA quantification is one of the main limiting factors in the application of these transcripts. Various studies have proposed the use of circulating miRNAs as biological markers of the acute coronary syndrome, coronary artery disease, heart failure, arrhythmias, myocardial infarction, etc. MiRNAs are involved in many cellular processes such as proliferation, vasculogenesis, apoptosis, cell growth and differentiation, and tumorigenesis.This review considers the most fully studied and clinically significant miRNAs, which physiological role makes them potential biomarkers for various CVDs.
{"title":"Microribonucleic acids as potential markers in cardiovascular diseases","authors":"A. Balbutsky, A. Revishvili, V. M. Zemskov, M. S. Solovyova, M. Kozlova, N. S. Shishkina, V. A. Popov, G. Plotnikov, A. M. Zemskov, V. S. Demidova, S. V. Suchkov, O. S. Vasiliev","doi":"10.21518/ms2024-107","DOIUrl":"https://doi.org/10.21518/ms2024-107","url":null,"abstract":"Cardiovascular diseases (CVDs) are one of the most common causes of death in the developed as well as in the developing world. Despite improvements in primary prevention, the prevalence of CVD has continued to rise in recent years. Thus, the issues of molecular pathophysiology of CVD and search for new biomarkers related to early and reliable prevention and diagnosis of these diseases still hold relevance today. New genomic techniques provide innovative tools to solve this problem. A research of the current scientific literature clearly indicates that among transcriptomic biomarkers, micro-ribonucleic acids (miRNAs) are the most promising. The microRNAs (miRNAs) are small (~22 nucleotides) non-coding RNAs which regulate gene expression at the post-transcriptional level via inhibition of the translation of messenger RNA (mRNA) or by inducing the degradation of specific miRNAs. The lack of consensus regarding methodologies used for miRNA quantification is one of the main limiting factors in the application of these transcripts. Various studies have proposed the use of circulating miRNAs as biological markers of the acute coronary syndrome, coronary artery disease, heart failure, arrhythmias, myocardial infarction, etc. MiRNAs are involved in many cellular processes such as proliferation, vasculogenesis, apoptosis, cell growth and differentiation, and tumorigenesis.This review considers the most fully studied and clinically significant miRNAs, which physiological role makes them potential biomarkers for various CVDs.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"76 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141123582","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}
R. Tokmachev, A. Kravchenko, A. Budnevsky, А. V. Kontsevaya, A. Simion, N. I. Chernyshova, A. V. Chumachenko
IIntriduction. Complex rehabilitation programs makes an important role in improving exercise tolerance and patients functional status with cardiovascular pathology.Aim. To study the physical rehabilitation effect on the functional status, pro-inflammatory cytokines levels and cardiovascular inflammation biomarker (high-sensitivity C-reactive protein) in heart failure patients with different ejection fractions.Materials and methods. The study included 160 patients with chronic heart failure (84 men and 76 women, mean age 69.4 ± 8.8 years). Two groups of patients with preserved and reduced left ventricular ejection fraction were identified. The groups were divided into two subgroups: the first – those who underwent physical rehabilitation for a year and received standard drug therapy; the second one received exclusively standard drug therapy. At inclusion and after a year of observation, patients were examined: determination of functional status, levels of pro-inflammatory cytokines, serum hs-C-reactive protein, NT-proBNP.Results. Regardless of left ventricular ejection fraction, in the studied patients subgroups undergone physical rehabilitation, a statistically significant decrease in the proinflammatory cytokines levels, NT-proBNP and hs-C-reactive protein was noted. The study also demonstrated the physical rehabilitation beneficial effects on the patients with HF functional status. Thus, the distance walked within 6 minutes and its relation to the proper indicator in patients who underwent physical rehabilitation increased in comparison with the initial indicators during the initial examination of patients and in comparison with control subgroups. This may indicate the positive properly selected physical activity impact on circulatory compensation and the HF course.Conclusion. Carrying out physical rehabilitation for chronic heart failure leads to an improvement in functional status, a decrease in the NT-proBNP, pro-inflammatory cytokines and high-sensitivity C-reactive protein level in comparison with the results of managing patients on drug therapy (without rehabilitation).
{"title":"The influence of physical rehabilitation of patients on the course of chronic heart failure","authors":"R. Tokmachev, A. Kravchenko, A. Budnevsky, А. V. Kontsevaya, A. Simion, N. I. Chernyshova, A. V. Chumachenko","doi":"10.21518/ms2024-182","DOIUrl":"https://doi.org/10.21518/ms2024-182","url":null,"abstract":"IIntriduction. Complex rehabilitation programs makes an important role in improving exercise tolerance and patients functional status with cardiovascular pathology.Aim. To study the physical rehabilitation effect on the functional status, pro-inflammatory cytokines levels and cardiovascular inflammation biomarker (high-sensitivity C-reactive protein) in heart failure patients with different ejection fractions.Materials and methods. The study included 160 patients with chronic heart failure (84 men and 76 women, mean age 69.4 ± 8.8 years). Two groups of patients with preserved and reduced left ventricular ejection fraction were identified. The groups were divided into two subgroups: the first – those who underwent physical rehabilitation for a year and received standard drug therapy; the second one received exclusively standard drug therapy. At inclusion and after a year of observation, patients were examined: determination of functional status, levels of pro-inflammatory cytokines, serum hs-C-reactive protein, NT-proBNP.Results. Regardless of left ventricular ejection fraction, in the studied patients subgroups undergone physical rehabilitation, a statistically significant decrease in the proinflammatory cytokines levels, NT-proBNP and hs-C-reactive protein was noted. The study also demonstrated the physical rehabilitation beneficial effects on the patients with HF functional status. Thus, the distance walked within 6 minutes and its relation to the proper indicator in patients who underwent physical rehabilitation increased in comparison with the initial indicators during the initial examination of patients and in comparison with control subgroups. This may indicate the positive properly selected physical activity impact on circulatory compensation and the HF course.Conclusion. Carrying out physical rehabilitation for chronic heart failure leads to an improvement in functional status, a decrease in the NT-proBNP, pro-inflammatory cytokines and high-sensitivity C-reactive protein level in comparison with the results of managing patients on drug therapy (without rehabilitation).","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"25 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141120507","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. A. Kachnov, V. V. Tyrenko, E. S. Bratilova, A. V. Koltsov
Anemia and iron deficiency are common in cardiovascular diseases. The most studied issue is iron deficiency and anemia in patients with heart failure, for whom clear clinical guidelines have been developed. Atrial fibrillation is the most common supraventricular tachyarrhythmia and is characterized by a growing prevalence worldwide. At the same time, iron deficiency anemia is one of the most common diseases in the world, and iron deficiency is the cause of up to 80% of anemia in the adult population. The mutual influence of these two nosological units is currently insufficiently studied. In this regard, the study of the mutual effects of iron deficiency, iron deficiency anemia and atrial fibrillation and the justification of the need for drug correction of iron deficiency in patients with atrial fibrillation is an extremely actual problem. The pathophysiological mechanisms of the effect of iron deficiency on the possibility of atrial fibrillation are quite multifaceted. Among these mechanisms can be distinguished: the effect of iron deficiency on the mitochondrial level, on the cardiomyocyte, on heart function and on the organismal level. At the same time, atrial fibrillation can contribute to the development of iron deficiency. The comorbid course of iron deficiency and atrial fibrillation potentiates the clinical manifestations of each other and reduces the quality of life. The effect of correction of anemia and iron deficiency in patients with atrial fibrillation is currently insufficiently studied to formulate practical recommendations. However, it can be assumed that the treatment of iron deficiency in atrial fibrillation will lead to a reduction in symptoms, an improvement in the quality of life and a decrease in the frequency of hospitalizations.
{"title":"Iron deficiency, anemia and atrial fibrillation","authors":"V. A. Kachnov, V. V. Tyrenko, E. S. Bratilova, A. V. Koltsov","doi":"10.21518/ms2024-001","DOIUrl":"https://doi.org/10.21518/ms2024-001","url":null,"abstract":"Anemia and iron deficiency are common in cardiovascular diseases. The most studied issue is iron deficiency and anemia in patients with heart failure, for whom clear clinical guidelines have been developed. Atrial fibrillation is the most common supraventricular tachyarrhythmia and is characterized by a growing prevalence worldwide. At the same time, iron deficiency anemia is one of the most common diseases in the world, and iron deficiency is the cause of up to 80% of anemia in the adult population. The mutual influence of these two nosological units is currently insufficiently studied. In this regard, the study of the mutual effects of iron deficiency, iron deficiency anemia and atrial fibrillation and the justification of the need for drug correction of iron deficiency in patients with atrial fibrillation is an extremely actual problem. The pathophysiological mechanisms of the effect of iron deficiency on the possibility of atrial fibrillation are quite multifaceted. Among these mechanisms can be distinguished: the effect of iron deficiency on the mitochondrial level, on the cardiomyocyte, on heart function and on the organismal level. At the same time, atrial fibrillation can contribute to the development of iron deficiency. The comorbid course of iron deficiency and atrial fibrillation potentiates the clinical manifestations of each other and reduces the quality of life. The effect of correction of anemia and iron deficiency in patients with atrial fibrillation is currently insufficiently studied to formulate practical recommendations. However, it can be assumed that the treatment of iron deficiency in atrial fibrillation will lead to a reduction in symptoms, an improvement in the quality of life and a decrease in the frequency of hospitalizations. ","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"48 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141122037","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：