Pub Date : 2023-01-01DOI: 10.32364/2587-6821-2023-7-5-11
M. Livzan, O. Gaus, M. M. Fedorin
One of the most urgent problems of modern healthcare in Russia and worldwide is the increase in the number of people with overweight and obesity. It is generally recognized that overweight and obesity increase the risk of coronary heart disease, hypertension, type 2 diabetes mellitus, cholelithiasis, non-alcoholic fatty liver disease (NAFLD). At the same time, recent data indicate that pathomorphism of other chronic non-infectious diseases was also noted during preserving trend towards an increase in the obesity prevalence, for which the presence of overweight or obesity was not considered a traditional risk factor. Using the example of a clinical case concerning a female patient with a combined course of irritable bowel syndrome (IBS) and NAFLD, the article presents up-to-date information on risk factors and pathogenetic mechanisms of such comorbidity and suggests treatment methods to improve the therapy efficacy for this patient cohort. The presence of common risk factors and pathogenetic mechanisms creates the basis for the formation of comorbidity of IBS and NAFLD, which requires the development of patient-centered management. KEYWORDS: irritable bowel syndrome, non-alcoholic fatty liver disease, metabolic syndrome, intestinal permeability, intestinal microbiota, mebeverin, ademetionine. FOR CITATION: Livzan M.A., Gaus O.V., Fedorin M.M. IBS phenotype associated with obesity and overweight: treatment tactics for patient- centered management. Russian Medical Inquiry. 2023;7(5):323–331 (in Russ.). DOI: 10.32364/2587-6821-2023-7-5-11.
{"title":"IBS phenotype associated with obesity and overweight: treatment tactics for patient-centered management","authors":"M. Livzan, O. Gaus, M. M. Fedorin","doi":"10.32364/2587-6821-2023-7-5-11","DOIUrl":"https://doi.org/10.32364/2587-6821-2023-7-5-11","url":null,"abstract":"One of the most urgent problems of modern healthcare in Russia and worldwide is the increase in the number of people with overweight and obesity. It is generally recognized that overweight and obesity increase the risk of coronary heart disease, hypertension, type 2 diabetes mellitus, cholelithiasis, non-alcoholic fatty liver disease (NAFLD). At the same time, recent data indicate that pathomorphism of other chronic non-infectious diseases was also noted during preserving trend towards an increase in the obesity prevalence, for which the presence of overweight or obesity was not considered a traditional risk factor. Using the example of a clinical case concerning a female patient with a combined course of irritable bowel syndrome (IBS) and NAFLD, the article presents up-to-date information on risk factors and pathogenetic mechanisms of such comorbidity and suggests treatment methods to improve the therapy efficacy for this patient cohort. The presence of common risk factors and pathogenetic mechanisms creates the basis for the formation of comorbidity of IBS and NAFLD, which requires the development of patient-centered management. KEYWORDS: irritable bowel syndrome, non-alcoholic fatty liver disease, metabolic syndrome, intestinal permeability, intestinal microbiota, mebeverin, ademetionine. FOR CITATION: Livzan M.A., Gaus O.V., Fedorin M.M. IBS phenotype associated with obesity and overweight: treatment tactics for patient- centered management. Russian Medical Inquiry. 2023;7(5):323–331 (in Russ.). DOI: 10.32364/2587-6821-2023-7-5-11.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74195123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.32364/2587-6821-2023-7-3-167-173
E. Zhugrova, I. Belyaeva, R. Samigullina
Osteoarthritis (OA) is a chronic heterogenic progressive disease involving the deterioration of the cartilage tissue within joints, bone remodeling and the development of osteophytes that cause such clinical manifestations as pain, stiffness, edema and reduced joint function. The review elucidates modern views on the pathogenesis of OA and the up-to-date approaches to its diagnostics and treatment. Today, the emphasis is made on relieving pain and improving the quality of life of patients with OA. Symptomatic slow-acting drugs for osteoarthritis (SYSADOA) are used in OA clinical practice. The drugs of this class have beneficial effects on OA symptoms and their long-term use exerts disease-modifying action. SYSADOA are recommended for use as the first-line therapy and the treatment of choice in OA. Chondroitin sulfate (CS) is considered as a SYSADOA drug whose effectiveness has been proven in multiple clinical trials. CS is included in the EULAR recommendations for the treatment of patients with OA. The use of chondroitin has been shown to reduce pain and improve mobility of the affected joints. The authors present a clinical report of CS beneficial effects in a patient with OA. KEYWORDS: osteoarthritis, pathogenesis, treatment, quality of life, SYSADOA, chondroitin sulfate. FOR CITATION: Zhugrova E.S., Belyaeva I.B., Samigullina R.R. Insights in osteoarthritis from the perspectives of evidence-based medicine and authors' own experience. Russian Medical Inquiry. 2023;7(3):167–173 (in Russ.). DOI: 10.32364/2587-6821-2023-7-3-167-173.
{"title":"Insights in osteoarthritis from the perspectives of evidence-based medicine and authors' own experience","authors":"E. Zhugrova, I. Belyaeva, R. Samigullina","doi":"10.32364/2587-6821-2023-7-3-167-173","DOIUrl":"https://doi.org/10.32364/2587-6821-2023-7-3-167-173","url":null,"abstract":"Osteoarthritis (OA) is a chronic heterogenic progressive disease involving the deterioration of the cartilage tissue within joints, bone remodeling and the development of osteophytes that cause such clinical manifestations as pain, stiffness, edema and reduced joint function. The review elucidates modern views on the pathogenesis of OA and the up-to-date approaches to its diagnostics and treatment. Today, the emphasis is made on relieving pain and improving the quality of life of patients with OA. Symptomatic slow-acting drugs for osteoarthritis (SYSADOA) are used in OA clinical practice. The drugs of this class have beneficial effects on OA symptoms and their long-term use exerts disease-modifying action. SYSADOA are recommended for use as the first-line therapy and the treatment of choice in OA. Chondroitin sulfate (CS) is considered as a SYSADOA drug whose effectiveness has been proven in multiple clinical trials. CS is included in the EULAR recommendations for the treatment of patients with OA. The use of chondroitin has been shown to reduce pain and improve mobility of the affected joints. The authors present a clinical report of CS beneficial effects in a patient with OA. KEYWORDS: osteoarthritis, pathogenesis, treatment, quality of life, SYSADOA, chondroitin sulfate. FOR CITATION: Zhugrova E.S., Belyaeva I.B., Samigullina R.R. Insights in osteoarthritis from the perspectives of evidence-based medicine and authors' own experience. Russian Medical Inquiry. 2023;7(3):167–173 (in Russ.). DOI: 10.32364/2587-6821-2023-7-3-167-173.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81855803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.32364/2587-6821-2023-7-3-160-166
D. S. Aganov, M. Toporkov, I. S. Svintsitskaya, V. V. Tyrenko, O. V. Maksim, I.E. Nurshakirova
The article contains a review of the existing literature on systemic bone mass loss immediately after bone fractures. As a result of such fractures, skeletal bones become more brittle. In addition, fractures have impact on the mechanical bone properties which is considered as a risk factor of future fractures of any location, indicating systemic bone mass loss. Bone mass loss begins soon after a bone is broken in any site of the body and persists for several years. In fact, the quality and mineral density of bone tissue will never return to the baseline, especially in elderly people, while the intensity of bone mass loss correlates with the injury severity and age. It is commonly believed that bone fractures are most often affect post-menopausal women. However, bone mass losses in men are more pronounced and recover slower than in women. It is still assumed that such factors as genetic predisposition, diet characteristics, comorbidities, medications (primarily glucocorticoids), lack of physical activity, systemic inflammation and disorders of calcium-homeostasis-regulating hormones contribute to the progression of bone mass losses. Similarly to bone remodeling in the healthy skeletal tissue, the bone regeneration after fractures is a complex process, where the key role is played by the cytokine system comprising receptor activator of nuclear factor-kappa B, its ligand and osteoprotegerin. The article describes the process of bone reconstruction regulation amid the systemic bone mass loss shortly after a fracture and identifies the main factors which may have impact on the amount of systemic bone mass losses. KEYWORDS: fracture, mineral density of bone tissue, osteoporosis, remodeling, mineral metabolism, cytokines, RANKL/RANK/OPG. FOR CITATION: Aganov D.S., Toporkov M.M., Svintsitskaya I.S. et al. Fracture as a predictor of bone mass loss: pathogenetic aspects and potential methods of treatment. Russian Medical Inquiry. 2023;7(3):160–166 (in Russ.). DOI: 10.32364/2587-6821-2023-7-3-160-166.
{"title":"Fracture as a predictor of bone mass loss: pathogenetic aspects and potential methods of treatment","authors":"D. S. Aganov, M. Toporkov, I. S. Svintsitskaya, V. V. Tyrenko, O. V. Maksim, I.E. Nurshakirova","doi":"10.32364/2587-6821-2023-7-3-160-166","DOIUrl":"https://doi.org/10.32364/2587-6821-2023-7-3-160-166","url":null,"abstract":"The article contains a review of the existing literature on systemic bone mass loss immediately after bone fractures. As a result of such fractures, skeletal bones become more brittle. In addition, fractures have impact on the mechanical bone properties which is considered as a risk factor of future fractures of any location, indicating systemic bone mass loss. Bone mass loss begins soon after a bone is broken in any site of the body and persists for several years. In fact, the quality and mineral density of bone tissue will never return to the baseline, especially in elderly people, while the intensity of bone mass loss correlates with the injury severity and age. It is commonly believed that bone fractures are most often affect post-menopausal women. However, bone mass losses in men are more pronounced and recover slower than in women. It is still assumed that such factors as genetic predisposition, diet characteristics, comorbidities, medications (primarily glucocorticoids), lack of physical activity, systemic inflammation and disorders of calcium-homeostasis-regulating hormones contribute to the progression of bone mass losses. Similarly to bone remodeling in the healthy skeletal tissue, the bone regeneration after fractures is a complex process, where the key role is played by the cytokine system comprising receptor activator of nuclear factor-kappa B, its ligand and osteoprotegerin. The article describes the process of bone reconstruction regulation amid the systemic bone mass loss shortly after a fracture and identifies the main factors which may have impact on the amount of systemic bone mass losses. KEYWORDS: fracture, mineral density of bone tissue, osteoporosis, remodeling, mineral metabolism, cytokines, RANKL/RANK/OPG. FOR CITATION: Aganov D.S., Toporkov M.M., Svintsitskaya I.S. et al. Fracture as a predictor of bone mass loss: pathogenetic aspects and potential methods of treatment. Russian Medical Inquiry. 2023;7(3):160–166 (in Russ.). DOI: 10.32364/2587-6821-2023-7-3-160-166.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85472977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.32364/2587-6821-2023-7-3-124-136
T. Minasov, A. Lila, A. Nazarenko, I. Sarvilina, N. Zagorodniy
Aim: to perform a retrospective analysis of the pattern of changes in the structural and functional characteristics of articular cartilage and biomarkers in the blood serum of patients with knee osteoarthritis (OA), Kellgren-Lawrence Grade 3, and Grade 2 joint dysfunction, taking into consideration the identified phenotypes and endotypes of knee OA during the parenteral treatment with highly purified chondroitin sulfate (CS, Chondroguard®). Patients and Methods: the authors performed a retrospective analysis of the results of the earlier stage of an open prospective controlled randomized study, which included 67 patients with knee OA. The patients were referred to total knee arthroplasty (TKA). All patients received NSAIDs in a standard daily dose. At the stage of open prospective randomized clinical study, the patients were split into the control group (CG, n=35) and the study group (SG, n=32). In addition to NSAIDs, the SG patients received a course of parenteral CS two months prior to TKA. Retrospectively, patients in the SG and CG were divided into subgroups according to three disease phenotypes: an inflammatory phenotype caused by synovitis (CG: n=13; SG: n=11); injury-related phenotype (joint injury in the medical history) (CG: n=10; SG: n=10), and endocrine phenotype (CG: n=12; SG: n=11). Based on the identified phenotypes, the biosamples of the subchondral bone, articular cartilage of the femur and tibia, and the articular capsule obtained during TKA surgery procedure were assessed. Also, the levels of hyaluronic acid, ultrasensitive CRP, TNF-α, IL-6, leptin, adipsin, PIIANP, CTX-1, osteocalcin, MMP-3 and -13, COMP, sclerostin, 25(OH)D3 were determined in the blood at the baseline (visit 0), release from the hospital (visit 1) and 3 months after TKA (visit 3). Results: the morphological analysis of joint tissues and the laboratory blood tests provided a basis for characterizing at the endotype level the following three clinical and pathogenetic knee OA phenotypes: inflammatory, posttraumatic and endocrine. In patients with distinct phenotypes of knee OA, differences were revealed in the intensification of adaptive structural modifications in all layers of the articular cartilage and the extent of inflammation restriction in the synovial membrane of the knee joint, as well as the degradation manifestations in the subchondral bone after a two-month preoperative treatment course with Chondroguard ®. A more pronounced and considerable decrease in the blood levels of all tested compounds along with a significant increase in the blood levels of osteocalcin and 25(OH)D 3 were reported in patients with all phenotypes of knee OA in SG as compared to the changes in the lab tests detected in patients with all phenotypes of knee OA in CG. Conclusion: the extent of CS anti-inflammatory, analgetic, metabolic and structure-modifying effects may depend on endotypes determined in patients with specific OA phenotypes. These findings may pave the way for pe
{"title":"Stratification of decompensated osteoarthritis and modern options of the preoperative therapy using Chondroguard® based on pheno- and endotyping","authors":"T. Minasov, A. Lila, A. Nazarenko, I. Sarvilina, N. Zagorodniy","doi":"10.32364/2587-6821-2023-7-3-124-136","DOIUrl":"https://doi.org/10.32364/2587-6821-2023-7-3-124-136","url":null,"abstract":"Aim: to perform a retrospective analysis of the pattern of changes in the structural and functional characteristics of articular cartilage and biomarkers in the blood serum of patients with knee osteoarthritis (OA), Kellgren-Lawrence Grade 3, and Grade 2 joint dysfunction, taking into consideration the identified phenotypes and endotypes of knee OA during the parenteral treatment with highly purified chondroitin sulfate (CS, Chondroguard®). Patients and Methods: the authors performed a retrospective analysis of the results of the earlier stage of an open prospective controlled randomized study, which included 67 patients with knee OA. The patients were referred to total knee arthroplasty (TKA). All patients received NSAIDs in a standard daily dose. At the stage of open prospective randomized clinical study, the patients were split into the control group (CG, n=35) and the study group (SG, n=32). In addition to NSAIDs, the SG patients received a course of parenteral CS two months prior to TKA. Retrospectively, patients in the SG and CG were divided into subgroups according to three disease phenotypes: an inflammatory phenotype caused by synovitis (CG: n=13; SG: n=11); injury-related phenotype (joint injury in the medical history) (CG: n=10; SG: n=10), and endocrine phenotype (CG: n=12; SG: n=11). Based on the identified phenotypes, the biosamples of the subchondral bone, articular cartilage of the femur and tibia, and the articular capsule obtained during TKA surgery procedure were assessed. Also, the levels of hyaluronic acid, ultrasensitive CRP, TNF-α, IL-6, leptin, adipsin, PIIANP, CTX-1, osteocalcin, MMP-3 and -13, COMP, sclerostin, 25(OH)D3 were determined in the blood at the baseline (visit 0), release from the hospital (visit 1) and 3 months after TKA (visit 3). Results: the morphological analysis of joint tissues and the laboratory blood tests provided a basis for characterizing at the endotype level the following three clinical and pathogenetic knee OA phenotypes: inflammatory, posttraumatic and endocrine. In patients with distinct phenotypes of knee OA, differences were revealed in the intensification of adaptive structural modifications in all layers of the articular cartilage and the extent of inflammation restriction in the synovial membrane of the knee joint, as well as the degradation manifestations in the subchondral bone after a two-month preoperative treatment course with Chondroguard ®. A more pronounced and considerable decrease in the blood levels of all tested compounds along with a significant increase in the blood levels of osteocalcin and 25(OH)D 3 were reported in patients with all phenotypes of knee OA in SG as compared to the changes in the lab tests detected in patients with all phenotypes of knee OA in CG. Conclusion: the extent of CS anti-inflammatory, analgetic, metabolic and structure-modifying effects may depend on endotypes determined in patients with specific OA phenotypes. These findings may pave the way for pe","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90095873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.32364/2587-6821-2023-7-3-113-117
E. Akulinushkina, L. Ivanova, S. Yakupova, E. Yakupov
Background: psoriatic arthritis (PA), even in cases with timely initiation of appropriate therapy, is inevitably associated with pain syndrome which includes a neuropathic component. The neuropathic pain (NP) can be considered as a complication of chronic arthropathy, simulating insufficient efficacy of anti-rheumatoid drugs. Aim: to estimate the prevalence of NP in patients with PA and to determine the correlation between NP and patient gender, activity, disease duration, central sensitization (CS) and quality of life. Patients and Methods: the study included 88 patients with PA. The number of tender joints (TJ) and the number of swollen joints (SJ) were counted in all patients. Also, pain intensity was evaluated by the visual analogue scale (VAS) and the level of C-reactive protein (CRP) was measured. The disease activity in patients with PA was assessed using the DAPSA index. A neurologist relied on the PainDETECT questionnaire to identify NP, CS and quality of life in the patients (SF-36). If PainDETECT was above 19 scores, the patients underwent physical examination to confirm NP. Results: patients with PA were split into two groups: with NP (NP+) — 18 (20.4%) subjects and without NP (NP-) — 60 (79.6%) subjects. The NP+ group consisted of older patients (p=0.001), with higher mean VAS scores for paint severity (р=0.008) and a higher mean number of TJ (р=0.014). No differences were found between the groups as regards the mean level of CRP (р=0.880), the mean DAPSA index value (p=0.213), the mean disease duration (p=0,385), and the mean number of SJ (р=0.197). According to the SF-36 questionnaire, the quality of life (QoL) was reduced in all patients. In NP+ group the mean values of the physical component of quality of life were significantly lower than in NP- group (p=0,012). However, such significant difference was not found for the values of psychological component (р=0.239). The prevalence of clinically important CS was significantly higher in the NP+ group patients (р=0.005). Conclusion: the prevalence of NP was common among PA patients which, to a certain extent, may "overestimate" the disease activity due to the patient's subjective judgements about PA severity, serve as a sign of chronic inflammation and reduce quality of life. KEYWORDS: psoriatic arthritis, neuropathic pain, chronic pain syndrome, quality of life, central sensitization, erosive arthritis. FOR CITATION: Akulinushkina E.Yu., Ivanova L.V., Yakupova S.P., Yakupov E.Z. Impact of the neuropathic component of pain syndrome on clinical and laboratory activity and quality of life in patients with psoriatic arthritis. Russian Medical Inquiry. 2023;7(3):113–117 (in Russ.). DOI: 10.32364/2587-6821-2023-7-3-113-117.
{"title":"Impact of the neuropathic component of pain syndrome on clinical and laboratory activity and quality of life in patients with psoriatic arthritis","authors":"E. Akulinushkina, L. Ivanova, S. Yakupova, E. Yakupov","doi":"10.32364/2587-6821-2023-7-3-113-117","DOIUrl":"https://doi.org/10.32364/2587-6821-2023-7-3-113-117","url":null,"abstract":"Background: psoriatic arthritis (PA), even in cases with timely initiation of appropriate therapy, is inevitably associated with pain syndrome which includes a neuropathic component. The neuropathic pain (NP) can be considered as a complication of chronic arthropathy, simulating insufficient efficacy of anti-rheumatoid drugs. Aim: to estimate the prevalence of NP in patients with PA and to determine the correlation between NP and patient gender, activity, disease duration, central sensitization (CS) and quality of life. Patients and Methods: the study included 88 patients with PA. The number of tender joints (TJ) and the number of swollen joints (SJ) were counted in all patients. Also, pain intensity was evaluated by the visual analogue scale (VAS) and the level of C-reactive protein (CRP) was measured. The disease activity in patients with PA was assessed using the DAPSA index. A neurologist relied on the PainDETECT questionnaire to identify NP, CS and quality of life in the patients (SF-36). If PainDETECT was above 19 scores, the patients underwent physical examination to confirm NP. Results: patients with PA were split into two groups: with NP (NP+) — 18 (20.4%) subjects and without NP (NP-) — 60 (79.6%) subjects. The NP+ group consisted of older patients (p=0.001), with higher mean VAS scores for paint severity (р=0.008) and a higher mean number of TJ (р=0.014). No differences were found between the groups as regards the mean level of CRP (р=0.880), the mean DAPSA index value (p=0.213), the mean disease duration (p=0,385), and the mean number of SJ (р=0.197). According to the SF-36 questionnaire, the quality of life (QoL) was reduced in all patients. In NP+ group the mean values of the physical component of quality of life were significantly lower than in NP- group (p=0,012). However, such significant difference was not found for the values of psychological component (р=0.239). The prevalence of clinically important CS was significantly higher in the NP+ group patients (р=0.005). Conclusion: the prevalence of NP was common among PA patients which, to a certain extent, may \"overestimate\" the disease activity due to the patient's subjective judgements about PA severity, serve as a sign of chronic inflammation and reduce quality of life. KEYWORDS: psoriatic arthritis, neuropathic pain, chronic pain syndrome, quality of life, central sensitization, erosive arthritis. FOR CITATION: Akulinushkina E.Yu., Ivanova L.V., Yakupova S.P., Yakupov E.Z. Impact of the neuropathic component of pain syndrome on clinical and laboratory activity and quality of life in patients with psoriatic arthritis. Russian Medical Inquiry. 2023;7(3):113–117 (in Russ.). DOI: 10.32364/2587-6821-2023-7-3-113-117.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90480762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.32364/2587-6821-2023-7-5-13
L. V. Poddubnaya, G. F. Dubakova, T.S. Geleskul, E. P. Shilova, T. Kolpakova, M. Osipenko, S. Nikonov, V. Drobysheva
Abdominal tuberculosis is a specific tuberculous lesion of the abdominal organs. In children, abdominal tuberculosis is mostly secondary, occurring mainly in the form of mesadenitis and intestinal tuberculosis. In most cases (63–96%), the process is localized in the ileocecal valve. The article presents a case of untimely diagnosed abdominal tuberculosis with lymph node lesions of the peritoneum and intestines in a child with intrathoracic lymph node tuberculosis of all groups during densification and the calcification onset. The examination (computed tomography) revealed a lesion of the ileocecal valve, while histology of biopsy material taken during colonoscopy showed granulomatous colitis of mycobacterial nature. The leading clinical manifestation was malabsorption syndrome with increased protein-energy undernutrition. The disease pattern was the rare localization of a specific lesion — in the small intestine with the development of jejunal stenosis, which led to a significant disorder of enteral nutrition and the development of malabsorption syndrome with severe trophological insufficiency. The decisive factor in determining the cause of the malabsorption syndrome was laparotomy, which was performed in presented signs of acute intestinal obstruction. In our opinion, an indication for diagnostic laparoscopy in children with abdominal tuberculosis should be considered the enteral nutrition disorder and malabsorption syndrome, which cannot be corrected at the therapeutic process stage. KEYWORDS: primary generalized tuberculosis, mycobacterium tuberculosis, intestinal tuberculosis, mesadenitis, malabsorption syndrome, jejunal stenosis, computed tomography, histology. FOR CITATION: Poddubnaya L.V., Dubakova G.F., Geleskul T.S., Shilova E.P., Kolpakova T.A., Osipenko M.F., Nikonov S.D., Drobysheva V.P. Abdominal tuberculosis in a baby (case report). Russian Medical Inquiry. 2023;7(5):337–342 (in Russ.). DOI: 10.32364/2587-6821-2023- 7-5-13.
{"title":"Abdominal tuberculosis in a baby (case report)","authors":"L. V. Poddubnaya, G. F. Dubakova, T.S. Geleskul, E. P. Shilova, T. Kolpakova, M. Osipenko, S. Nikonov, V. Drobysheva","doi":"10.32364/2587-6821-2023-7-5-13","DOIUrl":"https://doi.org/10.32364/2587-6821-2023-7-5-13","url":null,"abstract":"Abdominal tuberculosis is a specific tuberculous lesion of the abdominal organs. In children, abdominal tuberculosis is mostly secondary, occurring mainly in the form of mesadenitis and intestinal tuberculosis. In most cases (63–96%), the process is localized in the ileocecal valve. The article presents a case of untimely diagnosed abdominal tuberculosis with lymph node lesions of the peritoneum and intestines in a child with intrathoracic lymph node tuberculosis of all groups during densification and the calcification onset. The examination (computed tomography) revealed a lesion of the ileocecal valve, while histology of biopsy material taken during colonoscopy showed granulomatous colitis of mycobacterial nature. The leading clinical manifestation was malabsorption syndrome with increased protein-energy undernutrition. The disease pattern was the rare localization of a specific lesion — in the small intestine with the development of jejunal stenosis, which led to a significant disorder of enteral nutrition and the development of malabsorption syndrome with severe trophological insufficiency. The decisive factor in determining the cause of the malabsorption syndrome was laparotomy, which was performed in presented signs of acute intestinal obstruction. In our opinion, an indication for diagnostic laparoscopy in children with abdominal tuberculosis should be considered the enteral nutrition disorder and malabsorption syndrome, which cannot be corrected at the therapeutic process stage. KEYWORDS: primary generalized tuberculosis, mycobacterium tuberculosis, intestinal tuberculosis, mesadenitis, malabsorption syndrome, jejunal stenosis, computed tomography, histology. FOR CITATION: Poddubnaya L.V., Dubakova G.F., Geleskul T.S., Shilova E.P., Kolpakova T.A., Osipenko M.F., Nikonov S.D., Drobysheva V.P. Abdominal tuberculosis in a baby (case report). Russian Medical Inquiry. 2023;7(5):337–342 (in Russ.). DOI: 10.32364/2587-6821-2023- 7-5-13.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86666718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.32364/2587-6821-2023-7-10-7
P.I. Litvinenko, O. Tsygankova, L. Khidirova, A. Starichkova
Nowadays, the accumulated world experience of working in crisis situations shows that psychological assistance to patients experienced COVID-19 is provided mainly on a one-time basis — upon the fact of the incident, while the necessary subsequent psychological rehabilitation and preventive measures are not enough practiced. In most cases, the impact of a powerful stress factor is associated with an increase in the level of depression and anxiety, which can have a negative effect not only on the patient's life quality, but also on the prognosis, both shortterm and long-term. The increased stress have an influence on the immunity decrease, which, in turn, reduces the threshold of resistance to infectious diseases, including COVID-19. In this regard, the WHO information note "Mental Health and Psychosocial Factors in the COVID-19 Outbreak", in addition to the appeal to the population during pandemic, contains recommendations for specialists providing various assistance types to preserve mental health and stabilize psychological state of the population. The presentation of current views on the problem of mental disorders during COVID-19 pandemic, both in patients and medical specialists, is the subject of this literature review. KEYWORDS: mental disorders, anxiety, depression, insomnia, pandemic, COVID-19, medical specialists. FOR CITATION: Litvinenko P.I., Tsygankova O.V., Khidirova L.D., Starichkova A.A. Problems of mental disorder in the context of the COVID-19 pandemic. Russian Medical Inquiry. 2023;7(10). (in Russ.). DOI: 10.32364/2587-6821-2023-7-10-7.
{"title":"Problems of mental disorder in the context of the COVID-19 pandemic","authors":"P.I. Litvinenko, O. Tsygankova, L. Khidirova, A. Starichkova","doi":"10.32364/2587-6821-2023-7-10-7","DOIUrl":"https://doi.org/10.32364/2587-6821-2023-7-10-7","url":null,"abstract":"Nowadays, the accumulated world experience of working in crisis situations shows that psychological assistance to patients experienced COVID-19 is provided mainly on a one-time basis — upon the fact of the incident, while the necessary subsequent psychological rehabilitation and preventive measures are not enough practiced. In most cases, the impact of a powerful stress factor is associated with an increase in the level of depression and anxiety, which can have a negative effect not only on the patient's life quality, but also on the prognosis, both shortterm and long-term. The increased stress have an influence on the immunity decrease, which, in turn, reduces the threshold of resistance to infectious diseases, including COVID-19. In this regard, the WHO information note \"Mental Health and Psychosocial Factors in the COVID-19 Outbreak\", in addition to the appeal to the population during pandemic, contains recommendations for specialists providing various assistance types to preserve mental health and stabilize psychological state of the population. The presentation of current views on the problem of mental disorders during COVID-19 pandemic, both in patients and medical specialists, is the subject of this literature review. KEYWORDS: mental disorders, anxiety, depression, insomnia, pandemic, COVID-19, medical specialists. FOR CITATION: Litvinenko P.I., Tsygankova O.V., Khidirova L.D., Starichkova A.A. Problems of mental disorder in the context of the COVID-19 pandemic. Russian Medical Inquiry. 2023;7(10). (in Russ.). DOI: 10.32364/2587-6821-2023-7-10-7.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"269 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76396312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.32364/2587-6821-2023-7-1-41-48
E. Reznik, YuYu. . Golubev, N.V. Yurtaeva, D.V. Zayats, G.Yu. Ishchenko, A. I. Katkov, D. V. Puzenko, E. Novikova, P. V. Lednev, G. Golukhov
Barlow's disease (BD) is one of the dominant forms of degenerative mitral valve (MV) disease characterized by morphological changes of the connective tissue triggering the mechanism of mitral valve leaflet coaptation failure. The disease is characterized by MV prolapse driven by chordal rupture or elongation, leaflet area enlargement and annular ectasia. Typical BD symptoms are found in 24% of patients with mitral valve prolapse (MPV). It should be noted that BD is a heritable disorder. Patients with BD are typically young women (less than 40-year-old), who remain asymptomatic for a long time. BD is often diagnosed incidentally, during the screening examination. Radical correction of such MV dysfunction can be achieved only by using surgical techniques. Based on echocardiography findings, two types of Barlow's disease are distinguished: a classical one with MV leaflet thickening and a non-classical — without its thickening (presumably associated with dysplasia of the connective tissue). This article is focused on the foundations of semiotics and the main principles of BD patient management. It provides a review of MVP and mitral incompetence causes and describes a clinical case of surgical BD treatment. KEYWORDS: mitral regurgitation, plastic surgery of the mitral valve, Barlow's disease, mitral valve prolapse, heritable disorders of connective tissue, dysplasia. FOR CITATION: Reznik E.V., Golubev Yu.Yu., Yurtaeva N.V. et al. Barlow's disease illustrated by a clinical case. Russian Medical Inquiry. 2023;7(1):41–48 (in Russ.). DOI: 10.32364/2587-6821-2023-7-1-41-48.
{"title":"Barlow's disease illustrated by a clinical case","authors":"E. Reznik, YuYu. . Golubev, N.V. Yurtaeva, D.V. Zayats, G.Yu. Ishchenko, A. I. Katkov, D. V. Puzenko, E. Novikova, P. V. Lednev, G. Golukhov","doi":"10.32364/2587-6821-2023-7-1-41-48","DOIUrl":"https://doi.org/10.32364/2587-6821-2023-7-1-41-48","url":null,"abstract":"Barlow's disease (BD) is one of the dominant forms of degenerative mitral valve (MV) disease characterized by morphological changes of the connective tissue triggering the mechanism of mitral valve leaflet coaptation failure. The disease is characterized by MV prolapse driven by chordal rupture or elongation, leaflet area enlargement and annular ectasia. Typical BD symptoms are found in 24% of patients with mitral valve prolapse (MPV). It should be noted that BD is a heritable disorder. Patients with BD are typically young women (less than 40-year-old), who remain asymptomatic for a long time. BD is often diagnosed incidentally, during the screening examination. Radical correction of such MV dysfunction can be achieved only by using surgical techniques. Based on echocardiography findings, two types of Barlow's disease are distinguished: a classical one with MV leaflet thickening and a non-classical — without its thickening (presumably associated with dysplasia of the connective tissue). This article is focused on the foundations of semiotics and the main principles of BD patient management. It provides a review of MVP and mitral incompetence causes and describes a clinical case of surgical BD treatment. KEYWORDS: mitral regurgitation, plastic surgery of the mitral valve, Barlow's disease, mitral valve prolapse, heritable disorders of connective tissue, dysplasia. FOR CITATION: Reznik E.V., Golubev Yu.Yu., Yurtaeva N.V. et al. Barlow's disease illustrated by a clinical case. Russian Medical Inquiry. 2023;7(1):41–48 (in Russ.). DOI: 10.32364/2587-6821-2023-7-1-41-48.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77607741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.32364/2587-6821-2023-7-3-118-123
D. B. Aliev, O. Inamova, A. Maslyansky, M. Kostik, I. Gaydukova
Background: сomorbidity is one of the factors which considerably reduce life expectancy and affect quality of life of patients with systemic lupus erythematosus (SLE). Interferons (IFNs) are molecules whose changing concentrations may induce the active clinical manifestations of SLE and the increase in risk of comorbidities and their higher severity. The involvement of IFN-α in the development of comorbidities in the adult population of SLE patients may have distinguishing characteristics in cases of childhood-onset SLE and will need further research for better understanding its role. Aim: to assess the relationship between the level of IFN-α and the need for glucocorticosteriods (GCs) and the prevalence of comorbidities in adult SLE patients with different onset ages. Patients and Methods: this non-interventional study included SLE patients (n=71) (SLICC (2012) / EULAR (2019) Criteria) who did not receive genetically engineered biological agents: 43 (60%) patients with SLE onset under the age of 18 years comprised the group of juvenile SLE (jSLE) and 28 (40%) patients with SLE onset at 18 years or older age were included in the group of adult SLE (aSLE). For determining SLE activity during physical examination of patients, the SLEDAI-2K index was used. Serum IFN-α levels were measured by enzyme-linked immunosorbent assay (ELISA). The Charlson comorbidity index (CCI) and the CIRS-G scale were used for assessing comorbidities. Results: in patients with aSLE, serum IFN-α levels were higher and associated with higher GC doses. Also, aSLE patients had higher CCI and CIRS-G scores. As regards comorbid diseases, a statistically significant higher prevalence of peptic (stomach and duodenal) ulcers and menstrual disorders in women was observed. These comorbidities correlated with IFN-α levels. Conclusion: serum IFN-α levels are associated with the use of high GS doses and high CCI and CIRS-G scores, as well as the prevalence of GI diseases and menstrual disorders in women. The anti-interferon therapy seems to be a promising option for reducing "steroid addiction" and related comorbidities. KEYWORDS: systemic lupus erythematosus, interferon, anifrolumab, glucocorticosteroids, comorbidity. FOR CITATION: Aliev D.B., Inamova O.V., Maslyansky A.L. et al. Type I interferon, the need for glucocorticosteroids and comorbidities in patients with systemic lupus erythematosus. Russian Medical Inquiry. 2023;7(3):118–123 (in Russ.). DOI: 10.32364/2587-6821- 2023-7-3-118-123.
{"title":"Type I interferon, the need for glucocorticosteroids and comorbidities in patients with systemic lupus erythematosus","authors":"D. B. Aliev, O. Inamova, A. Maslyansky, M. Kostik, I. Gaydukova","doi":"10.32364/2587-6821-2023-7-3-118-123","DOIUrl":"https://doi.org/10.32364/2587-6821-2023-7-3-118-123","url":null,"abstract":"Background: сomorbidity is one of the factors which considerably reduce life expectancy and affect quality of life of patients with systemic lupus erythematosus (SLE). Interferons (IFNs) are molecules whose changing concentrations may induce the active clinical manifestations of SLE and the increase in risk of comorbidities and their higher severity. The involvement of IFN-α in the development of comorbidities in the adult population of SLE patients may have distinguishing characteristics in cases of childhood-onset SLE and will need further research for better understanding its role. Aim: to assess the relationship between the level of IFN-α and the need for glucocorticosteriods (GCs) and the prevalence of comorbidities in adult SLE patients with different onset ages. Patients and Methods: this non-interventional study included SLE patients (n=71) (SLICC (2012) / EULAR (2019) Criteria) who did not receive genetically engineered biological agents: 43 (60%) patients with SLE onset under the age of 18 years comprised the group of juvenile SLE (jSLE) and 28 (40%) patients with SLE onset at 18 years or older age were included in the group of adult SLE (aSLE). For determining SLE activity during physical examination of patients, the SLEDAI-2K index was used. Serum IFN-α levels were measured by enzyme-linked immunosorbent assay (ELISA). The Charlson comorbidity index (CCI) and the CIRS-G scale were used for assessing comorbidities. Results: in patients with aSLE, serum IFN-α levels were higher and associated with higher GC doses. Also, aSLE patients had higher CCI and CIRS-G scores. As regards comorbid diseases, a statistically significant higher prevalence of peptic (stomach and duodenal) ulcers and menstrual disorders in women was observed. These comorbidities correlated with IFN-α levels. Conclusion: serum IFN-α levels are associated with the use of high GS doses and high CCI and CIRS-G scores, as well as the prevalence of GI diseases and menstrual disorders in women. The anti-interferon therapy seems to be a promising option for reducing \"steroid addiction\" and related comorbidities. KEYWORDS: systemic lupus erythematosus, interferon, anifrolumab, glucocorticosteroids, comorbidity. FOR CITATION: Aliev D.B., Inamova O.V., Maslyansky A.L. et al. Type I interferon, the need for glucocorticosteroids and comorbidities in patients with systemic lupus erythematosus. Russian Medical Inquiry. 2023;7(3):118–123 (in Russ.). DOI: 10.32364/2587-6821- 2023-7-3-118-123.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":" 713","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91409961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.32364/2587-6821-2023-7-5-4
V. Tsukanov
Proton-pump inhibitors (PPIs) are widely used to treat acid-related disorders (ARD). Rabeprazole is a potent inhibitor of gastric H+/K+-ATPase, and it is indicated for the treatment of gastroesophageal reflux disease, Zollinger-Ellison syndrome, gastric and duodenal ulcers and for Helicobacter pylori eradication (in combination with antibiotics), as well as for the treatment of ARD described in this article. Pharmacokinetic and pharmacodynamic data show that rabeprazole provides a marked acid inhibition from the first administration, which persists with repeated use. Due to the predominantly non-enzymatic metabolism, rabeprazole has a lower interaction potential between drugs. Besides, rabeprazole maintains a high intragastric pH and achieves maximum acid inhibition in 24 hours. Rabeprazole is characterized by linearity of pharmacokinetics, which remains unchanged in renal and hepatic insufficiency. Rabeprazole is available in the dosage form of enteric capsules due to the PPIs instability in an acidic environment. Rabeprazole is generally well-tolerated by patients. Besides several minor side effects, rabeprazole is safe to be widely used in the treatment of ARD. KEYWORDS: proton pump inhibitors, antisecretory drugs, rabeprazole, efficacy, safety, expediency, acid-related disorders, gastroesophageal reflux disease, peptic ulcer, gastropathy, dyspepsia. FOR CITATION: Tsukanov V.V. Rabeprazole in the treatment of acid-related disorders. Russian Medical Inquiry. 2023;7(5):264–273 (in Russ.). DOI: 10.32364/2587-6821-2023-7-5-4.
{"title":"Rabeprazole in the treatment of acid-related disorders","authors":"V. Tsukanov","doi":"10.32364/2587-6821-2023-7-5-4","DOIUrl":"https://doi.org/10.32364/2587-6821-2023-7-5-4","url":null,"abstract":"Proton-pump inhibitors (PPIs) are widely used to treat acid-related disorders (ARD). Rabeprazole is a potent inhibitor of gastric H+/K+-ATPase, and it is indicated for the treatment of gastroesophageal reflux disease, Zollinger-Ellison syndrome, gastric and duodenal ulcers and for Helicobacter pylori eradication (in combination with antibiotics), as well as for the treatment of ARD described in this article. Pharmacokinetic and pharmacodynamic data show that rabeprazole provides a marked acid inhibition from the first administration, which persists with repeated use. Due to the predominantly non-enzymatic metabolism, rabeprazole has a lower interaction potential between drugs. Besides, rabeprazole maintains a high intragastric pH and achieves maximum acid inhibition in 24 hours. Rabeprazole is characterized by linearity of pharmacokinetics, which remains unchanged in renal and hepatic insufficiency. Rabeprazole is available in the dosage form of enteric capsules due to the PPIs instability in an acidic environment. Rabeprazole is generally well-tolerated by patients. Besides several minor side effects, rabeprazole is safe to be widely used in the treatment of ARD. KEYWORDS: proton pump inhibitors, antisecretory drugs, rabeprazole, efficacy, safety, expediency, acid-related disorders, gastroesophageal reflux disease, peptic ulcer, gastropathy, dyspepsia. FOR CITATION: Tsukanov V.V. Rabeprazole in the treatment of acid-related disorders. Russian Medical Inquiry. 2023;7(5):264–273 (in Russ.). DOI: 10.32364/2587-6821-2023-7-5-4.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88182239","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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