Pub Date : 2023-01-01DOI: 10.32364/2587-6821-2023-7-2-89-95
S. I. Bardenikova, T. I. Rychkova, E. V. Kulikova, O. B. Dovgun, T. Belyaeva
Aim: to assess changes in the patterns of sensitization to house dust allergens in a cohort of children with allergic disorders over the last 30 years. Patients and Methods: this retrospective analysis included 26,343 protocols of allergy tests to house dust and its allergenic components (house mix, D. pteronyssinus and D. farinae mites, library dust) that had been carried out in children 4–18 years old over the period from 1989 to 2019. Skin testing was performed using the generally accepted scarification technique on the anterior surface of the forearm through a drop of the tested allergen. Then, the test results are assessed by visual inspection with a score of 1 — 4. The results of continuous monitoring were summarized and statistically processed for all years of the observation period, but the article presents analysis of the "cross-section" indicators only for those years that were convenient for comparison. The authors calculated a percentage ratio of the number of patients sensitized to the studied allergen to the total number of patients tested for hypersensitivity to this allergen during a particular year. Then, they compared the percentage of patients with low (1–2) and high (3–4) scores. Results and Discussion: the analysis showed a steady increase in IgE hypersensitivity to the house dust mix (from 23.7% in 1989 to 71.2% in 2019). Also, it demonstrated an increase in the degree of sensitization (3 — 4 scores) to the integral dust mix (from 4.2% in 1989 to 16.6% in 2019), which was significantly higher than that to the dust mites themselves due to the diverse composition of specific proteins of epidermal, fungal, bacterial, and insect origin that can induce antibodies independently on each other. There was a similar 2.6-fold growth in sensitization to the library dust over the first 10 years of observation, and by 2019 hypersensitization developed in 57.2% of children from this cohort. However, a dramatic decline in high scores (3–4) of the detected level to 5% was reported in 2019 which was associated with the changes in the ways of in-house data storage. Conclusion: the study findings provide a rationale for the mandatory control of dynamic changes in sensitization among children with allergic disorders using an expended household allergen panel. The steady increase in sensitization to house dust allergens confirms a low effectiveness of elimination measures and suggests a progressive immune imbalance under the everyday pressure of urban ecology. KEYWORDS: children, house dust, allergens of house and library dust, household sensitization, mites. FOR CITATION: Bardenikova S.I., Rychkova T.I., Kulikova E.V. et al. House dust mites: the insidious symbiosis. Russian Medical Inquiry. 2023;7(2):89–95 (in Russ.). DOI: 10.32364/2587-6821-2023-7-2-89-95.
{"title":"House dust mites: the insidious symbiosis","authors":"S. I. Bardenikova, T. I. Rychkova, E. V. Kulikova, O. B. Dovgun, T. Belyaeva","doi":"10.32364/2587-6821-2023-7-2-89-95","DOIUrl":"https://doi.org/10.32364/2587-6821-2023-7-2-89-95","url":null,"abstract":"Aim: to assess changes in the patterns of sensitization to house dust allergens in a cohort of children with allergic disorders over the last 30 years. Patients and Methods: this retrospective analysis included 26,343 protocols of allergy tests to house dust and its allergenic components (house mix, D. pteronyssinus and D. farinae mites, library dust) that had been carried out in children 4–18 years old over the period from 1989 to 2019. Skin testing was performed using the generally accepted scarification technique on the anterior surface of the forearm through a drop of the tested allergen. Then, the test results are assessed by visual inspection with a score of 1 — 4. The results of continuous monitoring were summarized and statistically processed for all years of the observation period, but the article presents analysis of the \"cross-section\" indicators only for those years that were convenient for comparison. The authors calculated a percentage ratio of the number of patients sensitized to the studied allergen to the total number of patients tested for hypersensitivity to this allergen during a particular year. Then, they compared the percentage of patients with low (1–2) and high (3–4) scores. Results and Discussion: the analysis showed a steady increase in IgE hypersensitivity to the house dust mix (from 23.7% in 1989 to 71.2% in 2019). Also, it demonstrated an increase in the degree of sensitization (3 — 4 scores) to the integral dust mix (from 4.2% in 1989 to 16.6% in 2019), which was significantly higher than that to the dust mites themselves due to the diverse composition of specific proteins of epidermal, fungal, bacterial, and insect origin that can induce antibodies independently on each other. There was a similar 2.6-fold growth in sensitization to the library dust over the first 10 years of observation, and by 2019 hypersensitization developed in 57.2% of children from this cohort. However, a dramatic decline in high scores (3–4) of the detected level to 5% was reported in 2019 which was associated with the changes in the ways of in-house data storage. Conclusion: the study findings provide a rationale for the mandatory control of dynamic changes in sensitization among children with allergic disorders using an expended household allergen panel. The steady increase in sensitization to house dust allergens confirms a low effectiveness of elimination measures and suggests a progressive immune imbalance under the everyday pressure of urban ecology. KEYWORDS: children, house dust, allergens of house and library dust, household sensitization, mites. FOR CITATION: Bardenikova S.I., Rychkova T.I., Kulikova E.V. et al. House dust mites: the insidious symbiosis. Russian Medical Inquiry. 2023;7(2):89–95 (in Russ.). DOI: 10.32364/2587-6821-2023-7-2-89-95.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82295859","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: 10.32364/2587-6821-2023-7-3-144-149
I. Viktorova, D. S. Ivanova, A.M. Poltavtseva, D.B. Tulkibaevа, A. M. Adyrbaev
Chernogubov-Ehlers-Danlos and Marfan syndromes are among the most prevalent disorders of connective tissue, and health care providers of various specialties may deal with such patients. The agreed diagnostic criteria have been devised for these diseases and they should be used for conducting a thorough medical examination. The article refers to some difficulties associated with the application of these criteria to clinical practice. As a result, in Russian-language literature the patients with these syndromes are formally excluded from the research, and in this context a term "non-differentiated connective tissue dysplasia" is commonly used. As noted, multisystem dysplasia disorders with the involvement of different organs that occur in patients with monogenic syndromes are not fully reflected in the modern diagnostic criteria. At the same time a delayed diagnosis may lead to the absence of alert about the conditions that potentially complicate the course of physiological processes (e.g. pregnancy) or even cause lethal outcomes. The authors emphasize the need for developing intellectual technologies to support physician's decisions that are focused on a broader and timely diagnosis of monogenic syndrome as they will help to improve the quality of medical care. KEYWORDS: Marfan syndrome, Chernogubov-Ehlers-Danlos syndrome, dysplasia of connective tissue, dysplasia phenotype, dural ectasia, Ghent criteria, Villefranche criteria. FOR CITATION: Viktorova I.A., Ivanova D.S., Poltavtseva A.M. et al. Modern criteria of diagnosis of the main dysplasia phenotypes (Marfan and Chernogubov-Ehlers-Danlos syndromes): sufficiency and applicability to medical practice. Russian Medical Inquiry. 2023;7(3):144–149 (in Russ.). DOI: 10.32364/2587-6821-2023-7-3-144-149.
{"title":"Modern criteria of diagnosis of the main dysplasia phenotypes (Marfan and Chernogubov-Ehlers-Danlos syndromes): sufficiency and applicability to medical practice","authors":"I. Viktorova, D. S. Ivanova, A.M. Poltavtseva, D.B. Tulkibaevа, A. M. Adyrbaev","doi":"10.32364/2587-6821-2023-7-3-144-149","DOIUrl":"https://doi.org/10.32364/2587-6821-2023-7-3-144-149","url":null,"abstract":"Chernogubov-Ehlers-Danlos and Marfan syndromes are among the most prevalent disorders of connective tissue, and health care providers of various specialties may deal with such patients. The agreed diagnostic criteria have been devised for these diseases and they should be used for conducting a thorough medical examination. The article refers to some difficulties associated with the application of these criteria to clinical practice. As a result, in Russian-language literature the patients with these syndromes are formally excluded from the research, and in this context a term \"non-differentiated connective tissue dysplasia\" is commonly used. As noted, multisystem dysplasia disorders with the involvement of different organs that occur in patients with monogenic syndromes are not fully reflected in the modern diagnostic criteria. At the same time a delayed diagnosis may lead to the absence of alert about the conditions that potentially complicate the course of physiological processes (e.g. pregnancy) or even cause lethal outcomes. The authors emphasize the need for developing intellectual technologies to support physician's decisions that are focused on a broader and timely diagnosis of monogenic syndrome as they will help to improve the quality of medical care. KEYWORDS: Marfan syndrome, Chernogubov-Ehlers-Danlos syndrome, dysplasia of connective tissue, dysplasia phenotype, dural ectasia, Ghent criteria, Villefranche criteria. FOR CITATION: Viktorova I.A., Ivanova D.S., Poltavtseva A.M. et al. Modern criteria of diagnosis of the main dysplasia phenotypes (Marfan and Chernogubov-Ehlers-Danlos syndromes): sufficiency and applicability to medical practice. Russian Medical Inquiry. 2023;7(3):144–149 (in Russ.). DOI: 10.32364/2587-6821-2023-7-3-144-149.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"111 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88692139","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: 10.32364/2587-6821-2023-7-11-5
T. Glazanova, E. Shilova, I. Pavlova
Recent studies devoted to the patterns of the COVID-19 course in patients of various groups indicate a significant role of the immunity state in the disease development. Risk groups of severe disease course, including senile age, obesity and immunodeficiency conditions, have been identified. Research is underway to identify the genetic predisposition to SARS-CoV-2 infection and determine the poor prognosis in COVID-19. The presented article examines the immunological aspects of pathological conditions associated with an unfavorable prognosis of COVID-19. A complex immune response (including both innate immune mechanisms and an adaptive systemic response) develops in response to SARS-CoV-2 infection. The key mechanism of multisystem organ failure is a hyperimmune reaction with the development of a systemic inflammatory response, the so-called "cytokine storm", and the characteristics of the immune response largely determine the disease severity. In this regard, the immune response characteristics in patients at risk are of particular interest, including studies concerning the immunological aspects of a more severe disease course depending on age, the history of obesity, diabetes mellitus and other pathological conditions, as well as various genetic factors, which is the subject of active study at present. KEYWORDS: immune system, COVID-19, SARS-CoV-2, risk factors, obesity, oncological diseases, genetic predisposition, immune response. FOR CITATION: Glazanova T.V., Shilova E.R., Pavlova I.E. Risk factors of COVID-19: immunological aspects. Russian Medical Inquiry. 2023;7(11). (in Russ.). DOI: 10.32364/2587-6821-2023-7-11-5.
{"title":"Risk factors of COVID-19: immunological aspects","authors":"T. Glazanova, E. Shilova, I. Pavlova","doi":"10.32364/2587-6821-2023-7-11-5","DOIUrl":"https://doi.org/10.32364/2587-6821-2023-7-11-5","url":null,"abstract":"Recent studies devoted to the patterns of the COVID-19 course in patients of various groups indicate a significant role of the immunity state in the disease development. Risk groups of severe disease course, including senile age, obesity and immunodeficiency conditions, have been identified. Research is underway to identify the genetic predisposition to SARS-CoV-2 infection and determine the poor prognosis in COVID-19. The presented article examines the immunological aspects of pathological conditions associated with an unfavorable prognosis of COVID-19. A complex immune response (including both innate immune mechanisms and an adaptive systemic response) develops in response to SARS-CoV-2 infection. The key mechanism of multisystem organ failure is a hyperimmune reaction with the development of a systemic inflammatory response, the so-called \"cytokine storm\", and the characteristics of the immune response largely determine the disease severity. In this regard, the immune response characteristics in patients at risk are of particular interest, including studies concerning the immunological aspects of a more severe disease course depending on age, the history of obesity, diabetes mellitus and other pathological conditions, as well as various genetic factors, which is the subject of active study at present. KEYWORDS: immune system, COVID-19, SARS-CoV-2, risk factors, obesity, oncological diseases, genetic predisposition, immune response. FOR CITATION: Glazanova T.V., Shilova E.R., Pavlova I.E. Risk factors of COVID-19: immunological aspects. Russian Medical Inquiry. 2023;7(11). (in Russ.). DOI: 10.32364/2587-6821-2023-7-11-5.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90263386","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: 10.32364/2587-6821-2023-7-1-30-35
A. B. Khadzegova
Over the last few years, there has been an increasing trend in the prevalence of chronic kidney diseases (CKD) in patients with chronic heart failure (CHF). CKD is a well-known comorbidity in chronic heart failure, associated with lower survival rates, while cardiovascular complications are the leading cause of death among patients with CKD. The ability to identify early CKD in patients with CHF is critical for estimating prognosis, developing treatment strategy and tactics, and ultimately for preventing cardiovascular and renal complications. Considering the CKD prevalence in CHF, it is important to develop strategies for the administration of renin-angiotensin-aldosterone system inhibitors in view of their nephroprotective action with antiproteinuric and antiproliferative effects that can be also associated with improved survival. An angiotensin converting enzyme inhibitor such as fosinopril appears particularly beneficial for the treatment of CHF patients. Fosinopril undergoes enzymatic hydrolysis primarily in the liver and gastrointestinal mucosa and is converted to fosinoprilat which is eliminated equally by the kidneys and liver. In patients with renal dysfunction, the decreased fosinoprilat elimination with urine is compensated by the increased hepatic metabolism. Fosinoprilat exhibits less accumulation than enalapril or lisinopril in patients with CDK. KEYWORDS: chronic heart failure, renal function, chronic kidney disease, fosinopril, fosinoprilat, nephroprotection. FOR CITATION: Khadzegova A.B. Renal function in patients with heart failure — a predictor for selecting RAAS inhibitors. Russian Medical Inquiry. 2023;7(1):30–35 (in Russ.). DOI: 10.32364/2587-6821-2023-7-1-30-35.
{"title":"Renal function in patients with heart failure — a predictor for selecting RAAS inhibitors","authors":"A. B. Khadzegova","doi":"10.32364/2587-6821-2023-7-1-30-35","DOIUrl":"https://doi.org/10.32364/2587-6821-2023-7-1-30-35","url":null,"abstract":"Over the last few years, there has been an increasing trend in the prevalence of chronic kidney diseases (CKD) in patients with chronic heart failure (CHF). CKD is a well-known comorbidity in chronic heart failure, associated with lower survival rates, while cardiovascular complications are the leading cause of death among patients with CKD. The ability to identify early CKD in patients with CHF is critical for estimating prognosis, developing treatment strategy and tactics, and ultimately for preventing cardiovascular and renal complications. Considering the CKD prevalence in CHF, it is important to develop strategies for the administration of renin-angiotensin-aldosterone system inhibitors in view of their nephroprotective action with antiproteinuric and antiproliferative effects that can be also associated with improved survival. An angiotensin converting enzyme inhibitor such as fosinopril appears particularly beneficial for the treatment of CHF patients. Fosinopril undergoes enzymatic hydrolysis primarily in the liver and gastrointestinal mucosa and is converted to fosinoprilat which is eliminated equally by the kidneys and liver. In patients with renal dysfunction, the decreased fosinoprilat elimination with urine is compensated by the increased hepatic metabolism. Fosinoprilat exhibits less accumulation than enalapril or lisinopril in patients with CDK. KEYWORDS: chronic heart failure, renal function, chronic kidney disease, fosinopril, fosinoprilat, nephroprotection. FOR CITATION: Khadzegova A.B. Renal function in patients with heart failure — a predictor for selecting RAAS inhibitors. Russian Medical Inquiry. 2023;7(1):30–35 (in Russ.). DOI: 10.32364/2587-6821-2023-7-1-30-35.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"82 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81035170","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: 10.32364/2587-6821-2023-7-5-8
M. Livzan, O. Gaus, D. A. Gavrilenko
According to the frequency of seeking medical care, diarrhea is one of the most common complaints, being an important health problem. Acute diarrhea, as a rule, is infectious in nature, thus, the scope of diagnostics is aimed at assessing the patient's condition and clarifying the pathogen etiology. Chronic diarrhea has a diverse etiology, which poses a difficult task for the clinician to conduct differential diagnosis. Therefore, most guidelines on the relevant problem suggest the use of medical algorithms aimed at step-by-step exclusion of diseases accompanied by diarrhea: from the most common causes to the more rare ones. First of all, it is necessary to detail complaints, identify the presence of red flags, collect an epidemiological, drug and hereditary history, assess the nutrition habits, dietary preferences of the patient and their possible association with the manifestation of diarrhea. The general examination reveals signs of dehydration and malabsorption, as well as the presence of stigma of the underlying disease. Also, at the first stage, it is advisable to conduct the minimum necessary laboratory and instrumental studies. Subsequently, if there are difficulties in establishing the diagnosis, it is advised to re-assess the clinical picture and prescribe additional examination methods. Alongside this, symptomatic and pathogenetic therapy, dehydration, timely detection and correction of electrolyte disorders should be indicated for all patients with acute and chronic diarrhea at the stage of further examination and diagnosis confirmation. KEYWORDS: acute diarrhea, chronic diarrhea, diagnostic algorithm, celiac disease, intestinal tuberculosis, ischemic colitis, radiation colitis, eosinophilic colitis, microscopic colitis, Whipple disease. FOR CITATION: Livzan M.A., Gaus O.V., Gavrilenko D.A. Diarrheal syndrome in the practice of a general practitioner: medical algorithm. Russian Medical Inquiry. 2023;7(5):300–309 (in Russ.). DOI: 10.32364/2587-6821-2023-7-5-8.
{"title":"Diarrheal syndrome in the practice of a general practitioner: medical algorithm","authors":"M. Livzan, O. Gaus, D. A. Gavrilenko","doi":"10.32364/2587-6821-2023-7-5-8","DOIUrl":"https://doi.org/10.32364/2587-6821-2023-7-5-8","url":null,"abstract":"According to the frequency of seeking medical care, diarrhea is one of the most common complaints, being an important health problem. Acute diarrhea, as a rule, is infectious in nature, thus, the scope of diagnostics is aimed at assessing the patient's condition and clarifying the pathogen etiology. Chronic diarrhea has a diverse etiology, which poses a difficult task for the clinician to conduct differential diagnosis. Therefore, most guidelines on the relevant problem suggest the use of medical algorithms aimed at step-by-step exclusion of diseases accompanied by diarrhea: from the most common causes to the more rare ones. First of all, it is necessary to detail complaints, identify the presence of red flags, collect an epidemiological, drug and hereditary history, assess the nutrition habits, dietary preferences of the patient and their possible association with the manifestation of diarrhea. The general examination reveals signs of dehydration and malabsorption, as well as the presence of stigma of the underlying disease. Also, at the first stage, it is advisable to conduct the minimum necessary laboratory and instrumental studies. Subsequently, if there are difficulties in establishing the diagnosis, it is advised to re-assess the clinical picture and prescribe additional examination methods. Alongside this, symptomatic and pathogenetic therapy, dehydration, timely detection and correction of electrolyte disorders should be indicated for all patients with acute and chronic diarrhea at the stage of further examination and diagnosis confirmation. KEYWORDS: acute diarrhea, chronic diarrhea, diagnostic algorithm, celiac disease, intestinal tuberculosis, ischemic colitis, radiation colitis, eosinophilic colitis, microscopic colitis, Whipple disease. FOR CITATION: Livzan M.A., Gaus O.V., Gavrilenko D.A. Diarrheal syndrome in the practice of a general practitioner: medical algorithm. Russian Medical Inquiry. 2023;7(5):300–309 (in Russ.). DOI: 10.32364/2587-6821-2023-7-5-8.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75559336","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: 10.32364/2587-6821-2023-7-3-174-180
D.A. Kuzminykh, Yu. V. Eliseev, M. Matrosova, P. A. Glazunov, E. Zhilyaev
The risk of serious infectious diseases is significantly increased in individuals with systemic lupus erythematosus (SLE). The article describes a clinical case of meningoencephalitis caused by Cryptococcus neoformans, in a 33-year-old female patient with SLE. The diagnosis was based on the results of cerebrospinal fluid analysis, brain magnetic resonance imaging scans, and retrospective analysis of chest computed tomography features. The antifungal therapy comprising liposomal amphotericin B and fluconazole was used successfully. Distinctive features of this clinical case include a delayed diagnosis due to the slow development and the presence of non-specific neurological symptoms, as well as the onset of acute renal disorders amid the use of antifungal therapy. The authors discuss the issues of diagnosing infectious complications in patients with SLE, particularly fungal infections, and the up-to-date approaches to therapy of cryptococcal meningitis. The presented clinical report could help therapists and rheumatologists to improve timely recognition of cryptococcal infections in SLE patients. The authors emphasized that CSF examination plays the key role in diagnosing cryptococcal meningitis. KEYWORDS: cerebral cryptococcosis, opportunistic infection, meningoencephalitis in patients with systemic lupus erythematosus, clinical case, fungal infection, systemic lupus erythematosus. FOR CITATION: Kuzminykh D.A., Eliseev Yu.V., Matrosova M.S. et al. A clinical case of cryptococcal meningitis in patient with systemic lupus erythematosus. Russian Medical Inquiry. 2023;7(3):174–180 (in Russ.). DOI: 10.32364/2587-6821-2023-7-3-174-180.
{"title":"A clinical case of cryptococcal meningitis in patient with systemic lupus erythematosus","authors":"D.A. Kuzminykh, Yu. V. Eliseev, M. Matrosova, P. A. Glazunov, E. Zhilyaev","doi":"10.32364/2587-6821-2023-7-3-174-180","DOIUrl":"https://doi.org/10.32364/2587-6821-2023-7-3-174-180","url":null,"abstract":"The risk of serious infectious diseases is significantly increased in individuals with systemic lupus erythematosus (SLE). The article describes a clinical case of meningoencephalitis caused by Cryptococcus neoformans, in a 33-year-old female patient with SLE. The diagnosis was based on the results of cerebrospinal fluid analysis, brain magnetic resonance imaging scans, and retrospective analysis of chest computed tomography features. The antifungal therapy comprising liposomal amphotericin B and fluconazole was used successfully. Distinctive features of this clinical case include a delayed diagnosis due to the slow development and the presence of non-specific neurological symptoms, as well as the onset of acute renal disorders amid the use of antifungal therapy. The authors discuss the issues of diagnosing infectious complications in patients with SLE, particularly fungal infections, and the up-to-date approaches to therapy of cryptococcal meningitis. The presented clinical report could help therapists and rheumatologists to improve timely recognition of cryptococcal infections in SLE patients. The authors emphasized that CSF examination plays the key role in diagnosing cryptococcal meningitis. KEYWORDS: cerebral cryptococcosis, opportunistic infection, meningoencephalitis in patients with systemic lupus erythematosus, clinical case, fungal infection, systemic lupus erythematosus. FOR CITATION: Kuzminykh D.A., Eliseev Yu.V., Matrosova M.S. et al. A clinical case of cryptococcal meningitis in patient with systemic lupus erythematosus. Russian Medical Inquiry. 2023;7(3):174–180 (in Russ.). DOI: 10.32364/2587-6821-2023-7-3-174-180.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"236 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75573168","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: 10.32364/2587-6821-2023-7-5-3
V. A. Belozerov, N. N. Grigoriev, V. Prokopov, D.E. Belozerova
Aim: to evaluate the possibilities of diagnosed during endoscopic ultrasound (EUS) in clarifying diagnosis of peripapillary diverticula (PD) and optimization of treatment tactics depending on the type of mutual location of the diverticulum and the major duodenal papilla (MDP). Patients and Methods: the study included 304 patients (186 (61.2%) female patients) with peripapillary duodenal diverticulum (PDD). By the criterion of the diverticulum and MDP mutual location, patients were divided into three groups: 195 (64.1%) patients with suprapapillary diverticulum, 59 (19.4%) — with diverticulum of the "butterfly" type, 50 (16.5%) — with intradiverticular MDP. Anatomical features of various diverticula types and associated pathology of periampullary region were studied on the basis of endosonography data, as well as the treatment results of biliary diseases, technical success and complications of transpapillary interventions in various types of diverticula were analyzed. Results and Discussion: patients with intradiverticular MDP were significantly older (69.8±4.4 years). In this group, the size of diverticula (21 mm) and dilatation of choledochus (18 mm) were larger. Patients in this group were significantly more commonly diagnosed with stenosis of the MDP and secondary choledocholithiasis. Indications for endoscopic papillosphincterotomy in patients with PDD were choledocholithiasis — 124 (57.1%), stenosis of the MDP — 44 (20.3%), diverticular compression in terminal choledochus — 49 (22.6%), EUS. The complication rate of transpapillary interventions did not significantly differ and amounted to 2.8%. However, the share of failures during MDP standard biliary cannulation and lithoextraction was higher in the intradiverticular MDP and amounted to 34.5% and 8.8%, respectively, which forced the use of rendezvous procedures that were used in 10 (34.5%) patients of this group. Conclusion: EUS is a highly informative method of diagnostic clarification in PD, providing direct visual inspection of the papillary zone and its echocardiogram. The use of EUS at the initial stage of diagnostics allows to significantly optimize the treatment tactics, determining the indications for transpapillary interventions and ensuring their rational choice. The greatest technical difficulties and failures are expected to occur during manipulations on the intradiverticular MDP, which forces the use of rendezvous procedures, antegrade common bile duct access and laparotomic interventions. KEYWORDS: peripapillary diverticulum, endoscopic ultrasound, transpapillary interventions endoscopic papillosphincterotomy, biliary hypertension. FOR CITATION: Belozerov V.A., Grigoriev N.N., Prokopov V.A., Belozerova D.E. Endoscopic ultrasound and transpapillary interventions in patients with peripapillary diverticula. Russian Medical Inquiry. 2023;7(5):258–263 (in Russ.). DOI: 10.32364/2587-6821-2023-7-5-3.
{"title":"Endoscopic ultrasound and transpapillary interventions in patients with peripapillary diverticula","authors":"V. A. Belozerov, N. N. Grigoriev, V. Prokopov, D.E. Belozerova","doi":"10.32364/2587-6821-2023-7-5-3","DOIUrl":"https://doi.org/10.32364/2587-6821-2023-7-5-3","url":null,"abstract":"Aim: to evaluate the possibilities of diagnosed during endoscopic ultrasound (EUS) in clarifying diagnosis of peripapillary diverticula (PD) and optimization of treatment tactics depending on the type of mutual location of the diverticulum and the major duodenal papilla (MDP). Patients and Methods: the study included 304 patients (186 (61.2%) female patients) with peripapillary duodenal diverticulum (PDD). By the criterion of the diverticulum and MDP mutual location, patients were divided into three groups: 195 (64.1%) patients with suprapapillary diverticulum, 59 (19.4%) — with diverticulum of the \"butterfly\" type, 50 (16.5%) — with intradiverticular MDP. Anatomical features of various diverticula types and associated pathology of periampullary region were studied on the basis of endosonography data, as well as the treatment results of biliary diseases, technical success and complications of transpapillary interventions in various types of diverticula were analyzed. Results and Discussion: patients with intradiverticular MDP were significantly older (69.8±4.4 years). In this group, the size of diverticula (21 mm) and dilatation of choledochus (18 mm) were larger. Patients in this group were significantly more commonly diagnosed with stenosis of the MDP and secondary choledocholithiasis. Indications for endoscopic papillosphincterotomy in patients with PDD were choledocholithiasis — 124 (57.1%), stenosis of the MDP — 44 (20.3%), diverticular compression in terminal choledochus — 49 (22.6%), EUS. The complication rate of transpapillary interventions did not significantly differ and amounted to 2.8%. However, the share of failures during MDP standard biliary cannulation and lithoextraction was higher in the intradiverticular MDP and amounted to 34.5% and 8.8%, respectively, which forced the use of rendezvous procedures that were used in 10 (34.5%) patients of this group. Conclusion: EUS is a highly informative method of diagnostic clarification in PD, providing direct visual inspection of the papillary zone and its echocardiogram. The use of EUS at the initial stage of diagnostics allows to significantly optimize the treatment tactics, determining the indications for transpapillary interventions and ensuring their rational choice. The greatest technical difficulties and failures are expected to occur during manipulations on the intradiverticular MDP, which forces the use of rendezvous procedures, antegrade common bile duct access and laparotomic interventions. KEYWORDS: peripapillary diverticulum, endoscopic ultrasound, transpapillary interventions endoscopic papillosphincterotomy, biliary hypertension. FOR CITATION: Belozerov V.A., Grigoriev N.N., Prokopov V.A., Belozerova D.E. Endoscopic ultrasound and transpapillary interventions in patients with peripapillary diverticula. Russian Medical Inquiry. 2023;7(5):258–263 (in Russ.). DOI: 10.32364/2587-6821-2023-7-5-3.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"28 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":"90588220","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: 10.32364/2587-6821-2023-7-1-22-29
O. Tsygankova, N. Evdokimova, L. Latyntseva
Aim: to assess the fat depot compartments and some cardiometabolic risk markers in patients with chronic heart failure with preserved ejection fraction (CHFpEF), prediabetes and abdominal obesity. Patients and Methods: this randomized open single-center study was carried out in the Research Institute for Therapy and Preventive Medicine — Branch of the Federal Research Center Institute of Cytology and Genetics of the Siberian Branch of the RAS and included 64 subjects (32 of them were males) with CHFpEF, prediabetes and abdominal obesity. The standard general clinical examination and laboratory tests, measurements of NT-proBNP and high-sensitivity C-reactive protein (CRP) in blood plasma, as well as ultrasonography for imaging epicardial and preperitoneal fat depots (lipometry) were used to evaluate patients. Results: median age of the studied male patients was 58.00 [54.25; 60.00] years, female patients — 58.00 [56.00; 59.00] years. Males had a higher body weight as compared to females (р=0.036). The level of NT-proBNP in women was lower than in men (p=0.036), just as the glomerular filtration rate (р=0.034). The thickness of the epicardial and preperitoneal fat layers were similar in men and women, while the subcutaneous fat layer was thicker in women (р=0.001). Male patients with grade 3 obesity had the lowest NT-proBNP concentration in blood plasma. In women with grade 2 and 3 obesity the concentration of high-sensitivity C-reactive protein (CRP) in blood plasma was higher than in women with overweight and grade 1 obesity (р=0.047). A moderate linear relationship between NT-proBNP and high-sensitivity CRP levels was found in female patients (r=0.375, p=0.034). Conclusion: body weight measurements, glomerular filtration rates and NT-proBNP concentrations in blood plasma were higher in the studied sample of men as compared to those in women. Male patients with grade 3 obesity had the minimal NT-proBNP level (just slightly above the diagnostic limit). The highest high-sensitivity CRP measurements were reported in women with grade 2 and 3 obesity which underscores their proinflammatory status. No significant differences in the visceral epicardial and preperitoneal fat compartments were found between male and female patients. KEYWORDS: chronic heart failure with preserved ejection fraction, prediabetes, obesity, NT-proBNP, C-reactive protein, epicardial fat, premesenteric fat, subcutaneous fat, males, females. FOR CITATION: Tsygankova O.V., Evdokimova N.E., Latyntseva L.D. Chronic heart failure with preserved ejection fraction amid prediabetes and abdominal obesity: fat depot compartments and cardiometabolic risk markers. Russian Medical Inquiry. 2023;7(1):22–29 (in Russ.). DOI: 10.32364/2587-6821-2023-7-1-22-29.
{"title":"Chronic heart failure with preserved ejection fraction amid prediabetes and abdominal obesity: fat depot compartments and cardiometabolic risk markers","authors":"O. Tsygankova, N. Evdokimova, L. Latyntseva","doi":"10.32364/2587-6821-2023-7-1-22-29","DOIUrl":"https://doi.org/10.32364/2587-6821-2023-7-1-22-29","url":null,"abstract":"Aim: to assess the fat depot compartments and some cardiometabolic risk markers in patients with chronic heart failure with preserved ejection fraction (CHFpEF), prediabetes and abdominal obesity. Patients and Methods: this randomized open single-center study was carried out in the Research Institute for Therapy and Preventive Medicine — Branch of the Federal Research Center Institute of Cytology and Genetics of the Siberian Branch of the RAS and included 64 subjects (32 of them were males) with CHFpEF, prediabetes and abdominal obesity. The standard general clinical examination and laboratory tests, measurements of NT-proBNP and high-sensitivity C-reactive protein (CRP) in blood plasma, as well as ultrasonography for imaging epicardial and preperitoneal fat depots (lipometry) were used to evaluate patients. Results: median age of the studied male patients was 58.00 [54.25; 60.00] years, female patients — 58.00 [56.00; 59.00] years. Males had a higher body weight as compared to females (р=0.036). The level of NT-proBNP in women was lower than in men (p=0.036), just as the glomerular filtration rate (р=0.034). The thickness of the epicardial and preperitoneal fat layers were similar in men and women, while the subcutaneous fat layer was thicker in women (р=0.001). Male patients with grade 3 obesity had the lowest NT-proBNP concentration in blood plasma. In women with grade 2 and 3 obesity the concentration of high-sensitivity C-reactive protein (CRP) in blood plasma was higher than in women with overweight and grade 1 obesity (р=0.047). A moderate linear relationship between NT-proBNP and high-sensitivity CRP levels was found in female patients (r=0.375, p=0.034). Conclusion: body weight measurements, glomerular filtration rates and NT-proBNP concentrations in blood plasma were higher in the studied sample of men as compared to those in women. Male patients with grade 3 obesity had the minimal NT-proBNP level (just slightly above the diagnostic limit). The highest high-sensitivity CRP measurements were reported in women with grade 2 and 3 obesity which underscores their proinflammatory status. No significant differences in the visceral epicardial and preperitoneal fat compartments were found between male and female patients. KEYWORDS: chronic heart failure with preserved ejection fraction, prediabetes, obesity, NT-proBNP, C-reactive protein, epicardial fat, premesenteric fat, subcutaneous fat, males, females. FOR CITATION: Tsygankova O.V., Evdokimova N.E., Latyntseva L.D. Chronic heart failure with preserved ejection fraction amid prediabetes and abdominal obesity: fat depot compartments and cardiometabolic risk markers. Russian Medical Inquiry. 2023;7(1):22–29 (in Russ.). DOI: 10.32364/2587-6821-2023-7-1-22-29.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"270 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85193172","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: 10.32364/2587-6821-2023-7-1-13-21
E. Reznik, N. Ushakova, N. S. Ershov, E. Krupnova, E. Platonova, O.V. Gavrilova, G. Golukhov
Aim: to assess and describe gender- and age-specific characteristics of patients with chronic heart failure (CHF). Patients and Methods: in this retrospective study with a prospective component the authors analyzed medical records of 197 patients with CHF, including: CHF stage and functional class, co-morbidities, and echocardiography (Echo) findings. Twenty four (21, 28) months after discharging patients from the hospital, telephone follow-up calls were made to the patients and/or their relatives, and medical documentation of the medical information system was reviewed to assess the vital status of patients or the causes of lethal outcomes. For evaluating the obtained results, patients were divided into groups by gender and age. The middle-aged group comprised of males (45 to 59 years) and females (45 to 54 years) — 18 (9.1%) patients. The group of elderly persons included males (60 to 74 years) and females (55 to 74 years) — 69 (35.1%) patients. The senile group consisted of persons aged 75 years and over — 110 (55.8%) patients. Results: the median and interquartile range of patient age were 74.7 (68, 82) years. In the groups of middle-aged and elderly persons there were more men than women (р=0.001), while women prevailed in the senile group (р<0.001). The diagnosis of HF with reduced ejection fraction (HFrEF) was established more frequently in males than in females, and the difference was statistically significant (p=0.006). There were no statistically significant differences between male and female patients as regards the prevalence of HF with moderately reduced LVEF (HFmrEF). HF with preserved LVEF (HFpEF) was diagnosed more frequently in females than in males, and the difference was statistically significant (p=0.007). Using pair-wise comparison of LVEF in women of different age groups, it was shown that HFmrEF was more prevalent in middle-aged than in elderly (р=0.024) or senile (р=0.011) patients. The prevalence of HFpEF was higher in senile than in middle-aged women (р=0.012). No statistically significant differences in LVEF were found between the male patients of different age groups. There were no significant differences between males and females of middle-aged and elderly groups as regards the prevalence of co-morbidities. However, among senile persons co- morbidities were found more frequently in women than in men, and the difference was statistically significant (p<0.001). Conclusion: more than half of the patients with CHF were senile persons. Most patients with CHF in the elderly group were males, and in the senile group — females. It is necessary to consider gender and age-specific characteristics in the management of CHF patients, risk stratification and in the selection of adequate therapy. KEYWORDS: chronic heart failure, comorbidity, concomitant diseases, age ranges, gender characteristics. FOR CITATION: Reznik E.V., Ushakova N.A., Ershov N.S. et al. Gender- and age-specific characteristics of patients with chronic heart fai
{"title":"Gender- and age-specific characteristics of patients with chronic heart failure in real clinical practice","authors":"E. Reznik, N. Ushakova, N. S. Ershov, E. Krupnova, E. Platonova, O.V. Gavrilova, G. Golukhov","doi":"10.32364/2587-6821-2023-7-1-13-21","DOIUrl":"https://doi.org/10.32364/2587-6821-2023-7-1-13-21","url":null,"abstract":"Aim: to assess and describe gender- and age-specific characteristics of patients with chronic heart failure (CHF). Patients and Methods: in this retrospective study with a prospective component the authors analyzed medical records of 197 patients with CHF, including: CHF stage and functional class, co-morbidities, and echocardiography (Echo) findings. Twenty four (21, 28) months after discharging patients from the hospital, telephone follow-up calls were made to the patients and/or their relatives, and medical documentation of the medical information system was reviewed to assess the vital status of patients or the causes of lethal outcomes. For evaluating the obtained results, patients were divided into groups by gender and age. The middle-aged group comprised of males (45 to 59 years) and females (45 to 54 years) — 18 (9.1%) patients. The group of elderly persons included males (60 to 74 years) and females (55 to 74 years) — 69 (35.1%) patients. The senile group consisted of persons aged 75 years and over — 110 (55.8%) patients. Results: the median and interquartile range of patient age were 74.7 (68, 82) years. In the groups of middle-aged and elderly persons there were more men than women (р=0.001), while women prevailed in the senile group (р<0.001). The diagnosis of HF with reduced ejection fraction (HFrEF) was established more frequently in males than in females, and the difference was statistically significant (p=0.006). There were no statistically significant differences between male and female patients as regards the prevalence of HF with moderately reduced LVEF (HFmrEF). HF with preserved LVEF (HFpEF) was diagnosed more frequently in females than in males, and the difference was statistically significant (p=0.007). Using pair-wise comparison of LVEF in women of different age groups, it was shown that HFmrEF was more prevalent in middle-aged than in elderly (р=0.024) or senile (р=0.011) patients. The prevalence of HFpEF was higher in senile than in middle-aged women (р=0.012). No statistically significant differences in LVEF were found between the male patients of different age groups. There were no significant differences between males and females of middle-aged and elderly groups as regards the prevalence of co-morbidities. However, among senile persons co- morbidities were found more frequently in women than in men, and the difference was statistically significant (p<0.001). Conclusion: more than half of the patients with CHF were senile persons. Most patients with CHF in the elderly group were males, and in the senile group — females. It is necessary to consider gender and age-specific characteristics in the management of CHF patients, risk stratification and in the selection of adequate therapy. KEYWORDS: chronic heart failure, comorbidity, concomitant diseases, age ranges, gender characteristics. FOR CITATION: Reznik E.V., Ushakova N.A., Ershov N.S. et al. Gender- and age-specific characteristics of patients with chronic heart fai","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"136 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76436220","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: 10.32364/2587-6821-2023-7-3-150-159
A. Babaeva, E. Kalinina, M.S. Zvonorenk, K. Solodenkova, M. A. Osadchuk
Cardiovascular and metabolic comorbidities in patients with rheumatic diseases (RD) determine the risk of adverse outcomes. Gout is one of the diseases which significantly increase the cardiovascular risk (CVR). The authors present a literature review elucidating the prevalence and spectrum of cardiovascular (CVD) and metabolic diseases, as well as the proven CVR factors in persons with RDs, including gout. As demonstrated, the increased CVR amid RDs is caused not only by a higher prevalence of the traditional CVR factors but is also related to multiple specific disease-associated risk factors. Chronic systemic inflammation, the development of internal organ lesions and the long-term use of anti-inflammatory therapy contribute negatively to the overall CVR. Thus, RDs are considered as important CVR re-classifiers and require a compulsory revision of the risk factors. Currently, the national and international guidelines for the CVR prevention in persons with RD have been developed and used in practice. Among RDs, a special place is held by gout which is characterized by common cardiovascular comorbidities and reduced glomerular filtration rate. The recent studies have demonstrated that in the management of patients with hyperuricemia (HU) and gout it is necessary to achieve a sustained target level of uric acid for preventing adverse effects on the organ systems and reducing CVR. Among the recommended therapeutic options for patients with cardiovascular and renal comorbidities, the preference is given to febuxostat, a urate-lowering drug with high activity and proven safety. KEYWORDS: comorbidities, rheumatic diseases, gout, cardiovascular risk, febuxostat. FOR CITATION: Babaeva A.R., Kalinina E.V., Zvonorenko M.S. et al. Cardiovascular and metabolic comorbidities associated with rheumatic diseases: focus on hyperuricemia and gout. Russian Medical Inquiry. 2023;7(3):150–159 (in Russ.). DOI: 10.32364/2587- 6821-2023-7-3-150-159.
{"title":"Cardiovascular and metabolic comorbidities associated with rheumatic diseases: focus on hyperuricemia and gout","authors":"A. Babaeva, E. Kalinina, M.S. Zvonorenk, K. Solodenkova, M. A. Osadchuk","doi":"10.32364/2587-6821-2023-7-3-150-159","DOIUrl":"https://doi.org/10.32364/2587-6821-2023-7-3-150-159","url":null,"abstract":"Cardiovascular and metabolic comorbidities in patients with rheumatic diseases (RD) determine the risk of adverse outcomes. Gout is one of the diseases which significantly increase the cardiovascular risk (CVR). The authors present a literature review elucidating the prevalence and spectrum of cardiovascular (CVD) and metabolic diseases, as well as the proven CVR factors in persons with RDs, including gout. As demonstrated, the increased CVR amid RDs is caused not only by a higher prevalence of the traditional CVR factors but is also related to multiple specific disease-associated risk factors. Chronic systemic inflammation, the development of internal organ lesions and the long-term use of anti-inflammatory therapy contribute negatively to the overall CVR. Thus, RDs are considered as important CVR re-classifiers and require a compulsory revision of the risk factors. Currently, the national and international guidelines for the CVR prevention in persons with RD have been developed and used in practice. Among RDs, a special place is held by gout which is characterized by common cardiovascular comorbidities and reduced glomerular filtration rate. The recent studies have demonstrated that in the management of patients with hyperuricemia (HU) and gout it is necessary to achieve a sustained target level of uric acid for preventing adverse effects on the organ systems and reducing CVR. Among the recommended therapeutic options for patients with cardiovascular and renal comorbidities, the preference is given to febuxostat, a urate-lowering drug with high activity and proven safety. KEYWORDS: comorbidities, rheumatic diseases, gout, cardiovascular risk, febuxostat. FOR CITATION: Babaeva A.R., Kalinina E.V., Zvonorenko M.S. et al. Cardiovascular and metabolic comorbidities associated with rheumatic diseases: focus on hyperuricemia and gout. Russian Medical Inquiry. 2023;7(3):150–159 (in Russ.). DOI: 10.32364/2587- 6821-2023-7-3-150-159.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"16 3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79291720","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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