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: 10.32364/2587-6821-2023-7-11-5
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: 10.32364/2587-6821-2023-7-2-96-102
N. Kravchenko, T. Molostova, A. Belevsky, N. Makaryants, I. V. Kuneevskaya, Z.N. Gaychieva
Aim: to assess specific characteristics of exacerbation development in patients with different phenotypes of severe asthma (SA) based on the analysis of the Russian Severe Asthma Registry of the Russian Respiratory Society. Patients and Methods: this retrospective study assessed the risk factors of asthma exacerbations, clinical signs, functional and laboratory test indicators recorded during disease exacerbations in 2060 patients with various SA phenotypes: allergic, non-allergic, associated with obesity, and asthma with fixed bronchial obstruction. The authors reviewed data of patient surveys and questionnaires, as well as medical documentation (patient physical examination, clinical history, results of laboratory and functional tests). Results: the largest group consisted of patients with non-allergic asthma phenotype. Their SA attacks were associated with inadequate background therapy and such aggressive factors as smoking and occupational hazards. Patients with non-allergic SA held the second position as regards the number of frequent exacerbation (more than three per year) and ranked first in terms of the number of patients receiving inadequate background therapy. The highest rate of exacerbations was observed in patients with allergic phenotype of the disease. This group included the fewest number of patients. Sensitization and failure to control SA were the major causes of disease exacerbations in these patients. The number of smokers and patients with comorbidities were the lowest in this group. The biggest risk of fatal exacerbations was reported in obese patients which is attributed to a very high comorbidity index. Patients with "obese" SA were the oldest ones. The disease onset occurred in these persons later than in other groups, and they had a long history of smoking. Half of patients in this group had more than three exacerbations yearly, and the increasing dyspnea was a specific characteristic of exacerbations. Patients suffering from SA with fixed obstruction phenotype had the lowest indicators of obstruction and its reversibility. Besides, they most frequently needed "emergency" inhalers. Smoking and previous upper respiratory tract infections were associated with exacerbation rate. Conclusion: the awareness of the disease exacerbation risk factors and specific characteristics of its clinical course related to a certain SA phenotype will help to develop an individualized management plan for such patients and thus to improve their treatment. KEYWORDS: severe asthma, asthma exacerbations, risk factors of exacerbations, asthma phenotypes, allergic phenotype, non-allergic phenotype, phenotype associated with obesity, phenotype with fixed bronchial obstruction. FOR CITATION: Kravchenko N.Yu., Molostova T.N., Belevsky A.S. et al. Specific characteristics of exacerbation development in patients with different phenotypes of severe asthma. Russian Medical Inquiry. 2023;7(2):96–102 (in Russ.). DOI: 10.32364/2587-6821-2023-7-2-96-102.
{"title":"Specific characteristics of exacerbation development in patients with different phenotypes of severe asthma","authors":"N. Kravchenko, T. Molostova, A. Belevsky, N. Makaryants, I. V. Kuneevskaya, Z.N. Gaychieva","doi":"10.32364/2587-6821-2023-7-2-96-102","DOIUrl":"https://doi.org/10.32364/2587-6821-2023-7-2-96-102","url":null,"abstract":"Aim: to assess specific characteristics of exacerbation development in patients with different phenotypes of severe asthma (SA) based on the analysis of the Russian Severe Asthma Registry of the Russian Respiratory Society. Patients and Methods: this retrospective study assessed the risk factors of asthma exacerbations, clinical signs, functional and laboratory test indicators recorded during disease exacerbations in 2060 patients with various SA phenotypes: allergic, non-allergic, associated with obesity, and asthma with fixed bronchial obstruction. The authors reviewed data of patient surveys and questionnaires, as well as medical documentation (patient physical examination, clinical history, results of laboratory and functional tests). Results: the largest group consisted of patients with non-allergic asthma phenotype. Their SA attacks were associated with inadequate background therapy and such aggressive factors as smoking and occupational hazards. Patients with non-allergic SA held the second position as regards the number of frequent exacerbation (more than three per year) and ranked first in terms of the number of patients receiving inadequate background therapy. The highest rate of exacerbations was observed in patients with allergic phenotype of the disease. This group included the fewest number of patients. Sensitization and failure to control SA were the major causes of disease exacerbations in these patients. The number of smokers and patients with comorbidities were the lowest in this group. The biggest risk of fatal exacerbations was reported in obese patients which is attributed to a very high comorbidity index. Patients with \"obese\" SA were the oldest ones. The disease onset occurred in these persons later than in other groups, and they had a long history of smoking. Half of patients in this group had more than three exacerbations yearly, and the increasing dyspnea was a specific characteristic of exacerbations. Patients suffering from SA with fixed obstruction phenotype had the lowest indicators of obstruction and its reversibility. Besides, they most frequently needed \"emergency\" inhalers. Smoking and previous upper respiratory tract infections were associated with exacerbation rate. Conclusion: the awareness of the disease exacerbation risk factors and specific characteristics of its clinical course related to a certain SA phenotype will help to develop an individualized management plan for such patients and thus to improve their treatment. KEYWORDS: severe asthma, asthma exacerbations, risk factors of exacerbations, asthma phenotypes, allergic phenotype, non-allergic phenotype, phenotype associated with obesity, phenotype with fixed bronchial obstruction. FOR CITATION: Kravchenko N.Yu., Molostova T.N., Belevsky A.S. et al. Specific characteristics of exacerbation development in patients with different phenotypes of severe asthma. Russian Medical Inquiry. 2023;7(2):96–102 (in Russ.). DOI: 10.32364/2587-6821-2023-7-2-96-102.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74909157","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: 10.32364/2587-6821-2023-7-1-36-40
V. Akhmedov
Dyslipidemia is one of the most common comorbidities in patients infected with the SARS-CoV-2 coronavirus. In this review based on the up- to-date publications the authors assess the potential impact of dyslipidemia on the clinical course and prognosis in COVID-19 infected patients, as well as the viral infection effects on the lipid profile in patients with dyslipidemia. The COVID-19 driven inflammatory response leads to an increase in high-density lipoprotein (HDL) levels, modulation of apolipoproteins, increase in serum amyloid protein A concentration, and a decrease in apolipoprotein A-I, M and E levels, thus affecting the antioxidant, anti-inflammatory and immunomodulatory properties of HDL. The use of statins in patients with COVID-19 may mitigate the risk of lipid disorders. By inhibiting endogenous cholesterol synthesis, statins reduce its amount in lipid rafts and therefore may limit the entry of the SARS-CoV-2 virus into host cells. Moreover, statins, by reducing the overexpression of proinflammatory cytokines, can counteract COVID-19-associated cytokine storm. KEYWORDS: COVID-19, dyslipidemia, obesity, treatment, lipoproteins, statins, fibrates. FOR CITATION: Akhmedov V.A. Coronavirus disease and dyslipidemia — is there an association? Russian Medical Inquiry. 2023;7(1):36– 40 (in Russ.). DOI: 10.32364/2587-6821-2023-7-1-36-40.
{"title":"Coronavirus disease and dyslipidemia — is there an association?","authors":"V. Akhmedov","doi":"10.32364/2587-6821-2023-7-1-36-40","DOIUrl":"https://doi.org/10.32364/2587-6821-2023-7-1-36-40","url":null,"abstract":"Dyslipidemia is one of the most common comorbidities in patients infected with the SARS-CoV-2 coronavirus. In this review based on the up- to-date publications the authors assess the potential impact of dyslipidemia on the clinical course and prognosis in COVID-19 infected patients, as well as the viral infection effects on the lipid profile in patients with dyslipidemia. The COVID-19 driven inflammatory response leads to an increase in high-density lipoprotein (HDL) levels, modulation of apolipoproteins, increase in serum amyloid protein A concentration, and a decrease in apolipoprotein A-I, M and E levels, thus affecting the antioxidant, anti-inflammatory and immunomodulatory properties of HDL. The use of statins in patients with COVID-19 may mitigate the risk of lipid disorders. By inhibiting endogenous cholesterol synthesis, statins reduce its amount in lipid rafts and therefore may limit the entry of the SARS-CoV-2 virus into host cells. Moreover, statins, by reducing the overexpression of proinflammatory cytokines, can counteract COVID-19-associated cytokine storm. KEYWORDS: COVID-19, dyslipidemia, obesity, treatment, lipoproteins, statins, fibrates. FOR CITATION: Akhmedov V.A. Coronavirus disease and dyslipidemia — is there an association? Russian Medical Inquiry. 2023;7(1):36– 40 (in Russ.). DOI: 10.32364/2587-6821-2023-7-1-36-40.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88847280","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: 10.32364/2587-6821-2023-7-2-81-88
V. Popova, O. Puzikova, A. Kozhin, E. Churyukina, A. Moskovkina, G. A. Galkina, D. Sozaeva, L. V. Kravchenko, M. Y. Zulpikarova
Aim: to assess relationship between the humoral immunity status and the amounts of chemical elements (CE) in schoolchildren with hypothyroidism living in the regions with different levels and characteristics of technogenic environmental pollution. Patients and Methods: this study included 340 children 4–7 years old. The children underwent medical examination in the kindergartens located in a rural area of Rostov Region; industrial district of Rostov-on-Don (hereinafter referred to as Rostov); Shakhty, a city located in the coal mining area of the region; and in a dacha village in Rostov suburbs located distantly from the industrial facilities. In the rural area 105 children (group 1) were examined, in Rostov City — 125 children (group 2), in Shakhty — 90 (group 3). Group 4 (control) included 20 healthy children living in a dacha village of Rostov suburbs. The authors analyzed the Federal Service for Surveillance on Consumer Rights Protection and Human Well-being (Rospotrebnadzor) data characterizing the technogenic environmental pollution in the areas of residence of the studied children. Clinical laboratory tests were performed in all children. Results: such components of mineral fertilizers and pesticides as chlorides, nitrates, and phosphorus compounds prevailed among the technogenic contaminants in the rural regions. An intense xenogeneic burden was identified in the Rostov areas where kindergartens were located, while the highest xenogeneic burden was found in Shakhty. In groups 1, 2 and 3, free Т4 (fТ4) and free Т3 (fТ3) concentrations were lower than those in other groups. Moreover, the children of the first three groups had the highest thyrotropin (TSH) levels. In groups 1,2 and 3, serum IgM, IgG and total IgE levels were increased, and IgA level was decreased, while the most significant deviations from the normal values were found in the group 3 children who lived in the area with the highest adverse environmental impact. A positive statistically significant correlation was found between IgM and TSH levels (r=0,59, р=0,03) and between IgA и fТ4 levels (r=0.47, р=0.04). In addition, a negative statistically significant correlation was found between IgG и fТ4 levels (r=-0.49, р=0.04). In the group 1, 2 and 3 children, lead levels in the urine were higher than in the comparison group, and particularly high lead levels were detected in the group 3 children who lived in the area with the worst adverse environmental impact. In the same group, a positive statistically significant correlation was found between lead and TSH levels (r=0.62, р=0.02), between IgA and zinc (r=0.51, р=0.03), as well as between selenium and fТ4 (r=0.45, р=0.04). Also, a negative statistically significant correlation was determined between lead and fТ4 (r=-0.54, р=0.03) and between lead and IgA levels (r=-0.41, р=0.045). The ratio of selenium and lead in the group 3 children was significantly lower than in groups 1, 2 and 4. Conclusion: indicators demonstrating the inte
{"title":"Microelementoses as predictors of immunological disorders in children with hypothyroidism living in the regions with different levels of technogenic pollution","authors":"V. Popova, O. Puzikova, A. Kozhin, E. Churyukina, A. Moskovkina, G. A. Galkina, D. Sozaeva, L. V. Kravchenko, M. Y. Zulpikarova","doi":"10.32364/2587-6821-2023-7-2-81-88","DOIUrl":"https://doi.org/10.32364/2587-6821-2023-7-2-81-88","url":null,"abstract":"Aim: to assess relationship between the humoral immunity status and the amounts of chemical elements (CE) in schoolchildren with hypothyroidism living in the regions with different levels and characteristics of technogenic environmental pollution. Patients and Methods: this study included 340 children 4–7 years old. The children underwent medical examination in the kindergartens located in a rural area of Rostov Region; industrial district of Rostov-on-Don (hereinafter referred to as Rostov); Shakhty, a city located in the coal mining area of the region; and in a dacha village in Rostov suburbs located distantly from the industrial facilities. In the rural area 105 children (group 1) were examined, in Rostov City — 125 children (group 2), in Shakhty — 90 (group 3). Group 4 (control) included 20 healthy children living in a dacha village of Rostov suburbs. The authors analyzed the Federal Service for Surveillance on Consumer Rights Protection and Human Well-being (Rospotrebnadzor) data characterizing the technogenic environmental pollution in the areas of residence of the studied children. Clinical laboratory tests were performed in all children. Results: such components of mineral fertilizers and pesticides as chlorides, nitrates, and phosphorus compounds prevailed among the technogenic contaminants in the rural regions. An intense xenogeneic burden was identified in the Rostov areas where kindergartens were located, while the highest xenogeneic burden was found in Shakhty. In groups 1, 2 and 3, free Т4 (fТ4) and free Т3 (fТ3) concentrations were lower than those in other groups. Moreover, the children of the first three groups had the highest thyrotropin (TSH) levels. In groups 1,2 and 3, serum IgM, IgG and total IgE levels were increased, and IgA level was decreased, while the most significant deviations from the normal values were found in the group 3 children who lived in the area with the highest adverse environmental impact. A positive statistically significant correlation was found between IgM and TSH levels (r=0,59, р=0,03) and between IgA и fТ4 levels (r=0.47, р=0.04). In addition, a negative statistically significant correlation was found between IgG и fТ4 levels (r=-0.49, р=0.04). In the group 1, 2 and 3 children, lead levels in the urine were higher than in the comparison group, and particularly high lead levels were detected in the group 3 children who lived in the area with the worst adverse environmental impact. In the same group, a positive statistically significant correlation was found between lead and TSH levels (r=0.62, р=0.02), between IgA and zinc (r=0.51, р=0.03), as well as between selenium and fТ4 (r=0.45, р=0.04). Also, a negative statistically significant correlation was determined between lead and fТ4 (r=-0.54, р=0.03) and between lead and IgA levels (r=-0.41, р=0.045). The ratio of selenium and lead in the group 3 children was significantly lower than in groups 1, 2 and 4. Conclusion: indicators demonstrating the inte","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78533435","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: 10.32364/2587-6821-2023-7-9-1
E. Zhdanova, A. Volynkina, L. P. Kolimbet, T. N. Petrova, Yu.V. Khodarina
Background: the high prevalence of diabetes mellitus (DM) in the Russian Federation is one of the most important medical and social problems of modern healthcare. In order to monitor clinical and epidemiological characteristics and assess the current state of diabetic care, the Federal Diabetes Register (FDR) was created. Aim: to analyze the clinical and epidemiological characteristics of DM in the adult population of the Voronezh region. Patients and Methods: the prevalence, morbidity and mortality, sex and age characteristics, and the structure of DM complications in adult patients for the 2018–2022 period were analyzed according to the data of the FDR regional segment. Results and Discussion: 91,104 people were registered at the dispensary with DM as of 01.01.2023 in the Voronezh region, among which 4.7% of patients were with type 1 DM, 95% — with type 2 diabetes, and 0.3% of patients with other DM forms. The prevalence of type 1 DM in 2022 was 230,2 per 100 thousand population, type 2 DM — 4 608,15 per 100 thousand population. The prevalance trend of type 1 DM in 2018–2022 amounted to 8,7–6,9 per 100 thousand population, type 2 DM — 440.4–345.4 per 100 thousand population. Among patients with type 1 DM, men predominated (57.1%), while among patients with type 2 DM — women (69.2%). The peak prevalence of type 1 DM occurred at the age of 30–39 years, and type 2 DM — at 60–69 years. Commonly, DM was complicated by neuropathy, retinopathy and nephropathy (62,1%, 56,8% and 37,4% with type 1 DM and 30,5%, 26,2% and 13,2% with type 2 DM, respectively). The mean age of death of patients with type 1 and type 2 DM in 2022 was 55.4 and 74.0 years, respectively. The leading causes of fatal outcome were circulatory system diseases, old age and oncological diseases. In general, most of the clinical and epidemiological characteristics of DM in the Voronezh region corresponded to the all-Russian values. Conclusion: the use of the FDR regional segment as a tool for clinical and epidemiological monitoring of DM allows to assess the state of diabetic care in the region and plan its further development. KEYWORDS: diabetes mellitus, epidemiology, Voronezh region, prevalence, incidence, mortality, complications, Federal Diabetes Register. FOR CITATION: Zhdanova E.A., Volynkina A.P., Kolimbet L.P., Petrova T.N., Khodarina Yu.V. Clinical and epidemiological characteristics of diabetes mellitus and its complications in the Voronezh region. Russian Medical Inquiry. 2023;7(9) (in Russ.). DOI: 10.32364/2587-6821- 2023-7-9-1.
{"title":"Clinical and epidemiological characteristics of diabetes mellitus and its complications in the Voronezh region","authors":"E. Zhdanova, A. Volynkina, L. P. Kolimbet, T. N. Petrova, Yu.V. Khodarina","doi":"10.32364/2587-6821-2023-7-9-1","DOIUrl":"https://doi.org/10.32364/2587-6821-2023-7-9-1","url":null,"abstract":"Background: the high prevalence of diabetes mellitus (DM) in the Russian Federation is one of the most important medical and social problems of modern healthcare. In order to monitor clinical and epidemiological characteristics and assess the current state of diabetic care, the Federal Diabetes Register (FDR) was created. Aim: to analyze the clinical and epidemiological characteristics of DM in the adult population of the Voronezh region. Patients and Methods: the prevalence, morbidity and mortality, sex and age characteristics, and the structure of DM complications in adult patients for the 2018–2022 period were analyzed according to the data of the FDR regional segment. Results and Discussion: 91,104 people were registered at the dispensary with DM as of 01.01.2023 in the Voronezh region, among which 4.7% of patients were with type 1 DM, 95% — with type 2 diabetes, and 0.3% of patients with other DM forms. The prevalence of type 1 DM in 2022 was 230,2 per 100 thousand population, type 2 DM — 4 608,15 per 100 thousand population. The prevalance trend of type 1 DM in 2018–2022 amounted to 8,7–6,9 per 100 thousand population, type 2 DM — 440.4–345.4 per 100 thousand population. Among patients with type 1 DM, men predominated (57.1%), while among patients with type 2 DM — women (69.2%). The peak prevalence of type 1 DM occurred at the age of 30–39 years, and type 2 DM — at 60–69 years. Commonly, DM was complicated by neuropathy, retinopathy and nephropathy (62,1%, 56,8% and 37,4% with type 1 DM and 30,5%, 26,2% and 13,2% with type 2 DM, respectively). The mean age of death of patients with type 1 and type 2 DM in 2022 was 55.4 and 74.0 years, respectively. The leading causes of fatal outcome were circulatory system diseases, old age and oncological diseases. In general, most of the clinical and epidemiological characteristics of DM in the Voronezh region corresponded to the all-Russian values. Conclusion: the use of the FDR regional segment as a tool for clinical and epidemiological monitoring of DM allows to assess the state of diabetic care in the region and plan its further development. KEYWORDS: diabetes mellitus, epidemiology, Voronezh region, prevalence, incidence, mortality, complications, Federal Diabetes Register. FOR CITATION: Zhdanova E.A., Volynkina A.P., Kolimbet L.P., Petrova T.N., Khodarina Yu.V. Clinical and epidemiological characteristics of diabetes mellitus and its complications in the Voronezh region. Russian Medical Inquiry. 2023;7(9) (in Russ.). DOI: 10.32364/2587-6821- 2023-7-9-1.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84918344","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: 10.32364/2587-6821-2023-7-9-4
A. Gazdanova, S. Knyazeva, A.A. Marakhovskay, Yu.V. Protopopova, A. Sedova, J.B. Rakhimov, A.F. Salmanov, S. Magomedova
The review provides a detailed description of ophthalmic disorders associated with the most common endocrine diseases — diabetes mellitus, hypo- and hyperthyroidism, chronic adrenal insufficiency, Cushing syndrome, and obesity. Specific characteristics of ocular disorders co-occurring with these diseases are highlighted in the article. In diabetes mellitus, there is a lesion of both the periorbital region — inflammatory processes of the eyelids and conjunctiva, xanthelasm of the eyelids, and intraocular structures — the retina, macula, lens and cornea. Ophthalmological changes in thyroid pathology are manifested by a combination of various "ocular" symptoms, the most famous of which are exophthalmos, dilation of the ocular slit, eye shine, convergence disorder. However, the first complaints of patients may be unstable diplopia, swelling of the eyelids (mainly in the morning), a feeling of "clogging", dryness, lacrimation and/or photophobia, spontaneous retrobulbar pain, pain when moving the eyes, redness of the eyelids, conjunctival injection, redness and swelling of the semilunar fold and lacrimal meat, hyperpigmentation of the eyelids — a symptom Jellineka, swelling and meniscus-like drooping of the eyelids are a symptom of a Singer. Some endocrine diseases may cause symptomatic arterial hypertension, e.g. Cushing disease (syndrome), primary hyperaldosteronism (Conn's disease), acromegaly, and pheochromocytoma. Early signs of the above diseases may include eye disorders which develop prior to other manifestations due to the onset of hypertensive retinopathy. The adequate assessment of the disorders of eyes and paraorbital tissues in patients with endocrine diseases may facilitate more accurate diagnosis and timely treatment. The publication could potentially benefit ophthalmologists, therapists, endocrinologists, pediatricians and general practitioners. Keywords: ophthalmic manifestations, diabetes mellitus, hyperthyroidism, hypothyroidism, adrenal insufficiency, endocrine diseases. For citation: Gazdanova A.A., Knyazeva S.A., Marakhovskaya A.A., Protopopova Yu.V., Sedova A.A., Rakhimov J.B., Salmanov A.F., Magomedova S.A. Ophthalmic manifestations of endocrine diseases. Russian Medical Inquiry. 2023;7(9) (in Russ.). DOI: 10.32364/2587-6821-2023-7-9-4.
{"title":"Ophthalmic manifestations of endocrine diseases","authors":"A. Gazdanova, S. Knyazeva, A.A. Marakhovskay, Yu.V. Protopopova, A. Sedova, J.B. Rakhimov, A.F. Salmanov, S. Magomedova","doi":"10.32364/2587-6821-2023-7-9-4","DOIUrl":"https://doi.org/10.32364/2587-6821-2023-7-9-4","url":null,"abstract":"The review provides a detailed description of ophthalmic disorders associated with the most common endocrine diseases — diabetes mellitus, hypo- and hyperthyroidism, chronic adrenal insufficiency, Cushing syndrome, and obesity. Specific characteristics of ocular disorders co-occurring with these diseases are highlighted in the article. In diabetes mellitus, there is a lesion of both the periorbital region — inflammatory processes of the eyelids and conjunctiva, xanthelasm of the eyelids, and intraocular structures — the retina, macula, lens and cornea. Ophthalmological changes in thyroid pathology are manifested by a combination of various \"ocular\" symptoms, the most famous of which are exophthalmos, dilation of the ocular slit, eye shine, convergence disorder. However, the first complaints of patients may be unstable diplopia, swelling of the eyelids (mainly in the morning), a feeling of \"clogging\", dryness, lacrimation and/or photophobia, spontaneous retrobulbar pain, pain when moving the eyes, redness of the eyelids, conjunctival injection, redness and swelling of the semilunar fold and lacrimal meat, hyperpigmentation of the eyelids — a symptom Jellineka, swelling and meniscus-like drooping of the eyelids are a symptom of a Singer. Some endocrine diseases may cause symptomatic arterial hypertension, e.g. Cushing disease (syndrome), primary hyperaldosteronism (Conn's disease), acromegaly, and pheochromocytoma. Early signs of the above diseases may include eye disorders which develop prior to other manifestations due to the onset of hypertensive retinopathy. The adequate assessment of the disorders of eyes and paraorbital tissues in patients with endocrine diseases may facilitate more accurate diagnosis and timely treatment. The publication could potentially benefit ophthalmologists, therapists, endocrinologists, pediatricians and general practitioners. Keywords: ophthalmic manifestations, diabetes mellitus, hyperthyroidism, hypothyroidism, adrenal insufficiency, endocrine diseases. For citation: Gazdanova A.A., Knyazeva S.A., Marakhovskaya A.A., Protopopova Yu.V., Sedova A.A., Rakhimov J.B., Salmanov A.F., Magomedova S.A. Ophthalmic manifestations of endocrine diseases. Russian Medical Inquiry. 2023;7(9) (in Russ.). DOI: 10.32364/2587-6821-2023-7-9-4.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"77 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79958307","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: 10.32364/2587-6821-2023-7-5-12
I. G. Pakhomova
Over the past decades, there has been a clear trend towards an increase in the number of patients suffering from cholelithiasis, especially among persons of working age. At the same time, the early phase of the disease (biliary sludge), which commonly proceeds without clinical symptoms, acquires the greatest relevance. Besides, the cholelithiasis course can also be accompanied by biliary dyskinesia, which accelerates the process of calculus formation. That is why preventive conservative treatment allows most patients to avoid lithiasis at the early phase of cholelithiasis. And there is no gold standard of the treatment tactics for patient management at this phase. Some patients diagnosed with phase 1 cholelithiasis remain without therapy and monitoring. An oral litholytic therapy with ursodeoxycholic acid (UDCA) is proposed in some cases. This article draws increasing attention to the modern method for the treatment in the early phase of cholelithiasis, demonstrating a clinical example of a successful integrated treatment approach for a patient with biliary sludge, biliary dyskinesia and overweight. This method is aimed at correcting various pathogenetic factors of biliary sludge and reckons for the prescription of not only the UDCA drug but also a prokinetic. KEYWORDS: biliary sludge, biliary tract disorder, ursodeoxycholic acid, trimebutine, prevention, obesity, prokinetics. FOR CITATION: Pakhomova I.G. Main therapy aspects of the cholelithiasis early phase. Do we need to search for the gold standard nowadays? Russian Medical Inquiry. 2023;7(5):332–336 (in Russ.). DOI: 10.32364/2587-6821-2023-7-5-12.
{"title":"Main therapy aspects of the cholelithiasis early phase. Do we need to search for the gold standard nowadays?","authors":"I. G. Pakhomova","doi":"10.32364/2587-6821-2023-7-5-12","DOIUrl":"https://doi.org/10.32364/2587-6821-2023-7-5-12","url":null,"abstract":"Over the past decades, there has been a clear trend towards an increase in the number of patients suffering from cholelithiasis, especially among persons of working age. At the same time, the early phase of the disease (biliary sludge), which commonly proceeds without clinical symptoms, acquires the greatest relevance. Besides, the cholelithiasis course can also be accompanied by biliary dyskinesia, which accelerates the process of calculus formation. That is why preventive conservative treatment allows most patients to avoid lithiasis at the early phase of cholelithiasis. And there is no gold standard of the treatment tactics for patient management at this phase. Some patients diagnosed with phase 1 cholelithiasis remain without therapy and monitoring. An oral litholytic therapy with ursodeoxycholic acid (UDCA) is proposed in some cases. This article draws increasing attention to the modern method for the treatment in the early phase of cholelithiasis, demonstrating a clinical example of a successful integrated treatment approach for a patient with biliary sludge, biliary dyskinesia and overweight. This method is aimed at correcting various pathogenetic factors of biliary sludge and reckons for the prescription of not only the UDCA drug but also a prokinetic. KEYWORDS: biliary sludge, biliary tract disorder, ursodeoxycholic acid, trimebutine, prevention, obesity, prokinetics. FOR CITATION: Pakhomova I.G. Main therapy aspects of the cholelithiasis early phase. Do we need to search for the gold standard nowadays? Russian Medical Inquiry. 2023;7(5):332–336 (in Russ.). DOI: 10.32364/2587-6821-2023-7-5-12.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80833494","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: 10.32364/2587-6821-2023-7-7-2
E. Samoylenko, N. Kolesnikova
Infectious endocarditis is a disease with the primary pathogen localization on the heart valves and the mural endocardium, occurring with the possible generalization of the septic process and the immunopathological changes that are very significant in the disease manifestation and course. Based on the fact that 30–50% of cases concerning infectious endocarditis develop without the obvious involvement of standard risk factors (invasive procedures or endovascular disorders), it can be assumed that molecular genetic factors are involved in the disease pathogenesis and its complications. There is reason to believe that the activation of inadequate inflammation in response to the microbial invasion may be due to polymorphism in the genes controlling the cytokine activity. However, the information available today on the various cytokines level and the gene polymorphism in various clinical variants of infectious endocarditis is very limited and commonly contradictory, which requires a deeper study of the pathogenetic association of infectious endocarditis with cytokine genetic defects. In this regard, the expansion of ideas concerning the of cytokine gene polymorphisms in the form of point mutations (SNP), capable of regulating the intensity of cytokine expression and their biological effects, will allow to predict the risk of infectious endocarditis, the severity of its course, the risk of possible complications, as well as the individual treatment tactics for patients. KEYWORDS: infectious endocarditis, clinical variants, complications, cytokines, cytokine genes, genetic polymorphism, pathogenesis, diagnosis. FOR CITATION: Samoylenko E.S., Kolesnikova N.V. Cytokine gene single nucleotide polymorphisms associated with infectious endocarditis. Russian Medical Inquiry. 2023;7(7) (in Russ.). DOI: 10.32364/2587-6821-2023-7-7-2.
{"title":"Cytokine gene single nucleotide polymorphisms associated with infectious endocarditis","authors":"E. Samoylenko, N. Kolesnikova","doi":"10.32364/2587-6821-2023-7-7-2","DOIUrl":"https://doi.org/10.32364/2587-6821-2023-7-7-2","url":null,"abstract":"Infectious endocarditis is a disease with the primary pathogen localization on the heart valves and the mural endocardium, occurring with the possible generalization of the septic process and the immunopathological changes that are very significant in the disease manifestation and course. Based on the fact that 30–50% of cases concerning infectious endocarditis develop without the obvious involvement of standard risk factors (invasive procedures or endovascular disorders), it can be assumed that molecular genetic factors are involved in the disease pathogenesis and its complications. There is reason to believe that the activation of inadequate inflammation in response to the microbial invasion may be due to polymorphism in the genes controlling the cytokine activity. However, the information available today on the various cytokines level and the gene polymorphism in various clinical variants of infectious endocarditis is very limited and commonly contradictory, which requires a deeper study of the pathogenetic association of infectious endocarditis with cytokine genetic defects. In this regard, the expansion of ideas concerning the of cytokine gene polymorphisms in the form of point mutations (SNP), capable of regulating the intensity of cytokine expression and their biological effects, will allow to predict the risk of infectious endocarditis, the severity of its course, the risk of possible complications, as well as the individual treatment tactics for patients. KEYWORDS: infectious endocarditis, clinical variants, complications, cytokines, cytokine genes, genetic polymorphism, pathogenesis, diagnosis. FOR CITATION: Samoylenko E.S., Kolesnikova N.V. Cytokine gene single nucleotide polymorphisms associated with infectious endocarditis. Russian Medical Inquiry. 2023;7(7) (in Russ.). DOI: 10.32364/2587-6821-2023-7-7-2.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82881766","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: 10.32364/2587-6821-2023-7-2-75-80
T. S. Lepeshkova
Aim: to assess the spectrum of sensitization and reveal causative allergens in Ekaterinburg children with the clinical history of food-induced anaphylaxis (FIA) for reducing the number of life-threatening food allergy (FA) episodes in these children. Patients and Methods: the study included 60 children — 36 (60.0%) boys and 24 (40.0%) girls aged from 4 months to 16 years who lived in Yekaterinburg. All children had (FIA) episodes in their clinical histories. The children underwent physical examination, and their allergy- focused clinical history was taken. Also, the ISAC-112 ImmunoCAP assay, a multiplex test with allergen components, was used. Results: the sensitization was assessed, and the causative allergens were identified in 100% of cases. In 31 children (51.67%) FIA was initiated by milk proteins (Bos d4, Bos d5, Bos d8); in 10 (16.67%) – chicken egg (Gal d2, Gal d1); in 10 (16.67%) – walnut (Jug r1, Jug r2, Jug r3); in 9 (15.00%) – fish (Gad c1); in 7 (11.67%) – kiwi (Act d1); in 7 (11.67%) – peanut (Ara h1, Ara h2, Ara h3, Ara h6); and in 20 (33%) – by different nuts (Ber e1, Ana o2, Cora 9, Cora 8). Elevated specific immunoglobulin E (sIgE) levels for birch tree allergens (Bet v1) were found in 39 (65.00%) patients, cat allergens (Fel d1, Fel d2, Fel d4) – in 41 (68.33%), dog allergens (Can f1, Can f2, Can f3, Can f5) – in 24 (40.0%), timothy allergens (Phl p1, Phl p4, Phl p5) – in 10 (16.6%), artemisia allergens (Art v1) – in 8 (13.3%), and house dust mites in 2 (3.33%). Respiratory symptoms in sensitized children with FIA developed in 4 of 5 cases. Conclusion: to reduce the number of life-threatening FA episodes in children with FIA it is necessary to reveal and assess the entire spectrum of sensitization, identify the causative allergens and triggers of potential anaphylactic reaction for the further development of an elimination diet and individualized patient management plan. KEYWORDS: food allergy, food-induced anaphylaxis, children, allergens, sensitization. FOR CITATION: Lepeshkova T.S. Causative allergens and sensitization spectrum in children with the history of food-induced anaphylaxis. Russian Medical Inquiry. 2023;7(2):75–80 (in Russ.). DOI: 10.32364/2587-6821-2023-7-2-75-80.
目的:评估叶卡捷琳堡有食物过敏性反应(FIA)临床史儿童的致敏谱，揭示致敏原，以减少这些儿童中危及生命的食物过敏(FA)发作次数。患者和方法:该研究包括60名儿童，其中36名(60.0%)男孩和24名(40.0%)女孩，年龄从4个月到16岁，居住在叶卡捷琳堡。所有患儿的临床病史均有FIA发作。这些儿童接受了体格检查，并记录了以过敏为重点的临床病史。此外，还使用了ISAC-112免疫cap试验，这是一种含有过敏原成分的多重试验。结果:对致敏性进行评估，100%的病例发现致敏原。31例患儿(51.67%)FIA由乳蛋白引发(Bos d4、Bos d5、Bos d8);10个(16.67%)-鸡蛋(Gal d2, Gal d1);10个(16.67%)-核桃(壶r1，壶r2，壶r3);9例(15.00%)-鱼(Gad c1);in 7 (11.67%) - kiwi (Act d1);7例(11.67%)-花生(Ara h1, Ara h2, Ara h3, Ara h6);和20例(33%),由不同的坚果(误码率e1,安娜o2,科拉科拉8),特定的免疫球蛋白E(锗硅)水平升高桦树过敏原(打赌v1)被发现在39例(65.00%)患者中,猫过敏原(恶魔d1,恶魔d2,恶魔d4)——在41个(68.33%),狗过敏原(f1, f2, f3, f5) - 24(40.0%)、盖过敏原(Phl p1、Phl p4 Phl p5) - 10(16.6%)、艾过敏原(艺术v1) - 8(13.3%),和众议院尘螨在2(3.33%)。5例FIA致敏儿童中有4例出现呼吸道症状。结论:为了减少FIA患儿危及生命的FA发作次数，有必要揭示和评估整个致敏谱，确定致敏原和潜在过敏反应的触发因素，以便进一步制定消除饮食和个性化的患者管理计划。关键词:食物过敏，食物过敏性反应，儿童，过敏原，致敏。引证:Lepeshkova T.S.致病过敏原和致敏谱的儿童与食物过敏性反应的历史。俄罗斯医学调查。2023;7(2):75-80(俄文)。DOI: 10.32364 / 2587-6821-2023-7-2-75-80。
{"title":"Causative allergens and sensitization spectrum in children with the history of food-induced anaphylaxis","authors":"T. S. Lepeshkova","doi":"10.32364/2587-6821-2023-7-2-75-80","DOIUrl":"https://doi.org/10.32364/2587-6821-2023-7-2-75-80","url":null,"abstract":"Aim: to assess the spectrum of sensitization and reveal causative allergens in Ekaterinburg children with the clinical history of food-induced anaphylaxis (FIA) for reducing the number of life-threatening food allergy (FA) episodes in these children. Patients and Methods: the study included 60 children — 36 (60.0%) boys and 24 (40.0%) girls aged from 4 months to 16 years who lived in Yekaterinburg. All children had (FIA) episodes in their clinical histories. The children underwent physical examination, and their allergy- focused clinical history was taken. Also, the ISAC-112 ImmunoCAP assay, a multiplex test with allergen components, was used. Results: the sensitization was assessed, and the causative allergens were identified in 100% of cases. In 31 children (51.67%) FIA was initiated by milk proteins (Bos d4, Bos d5, Bos d8); in 10 (16.67%) – chicken egg (Gal d2, Gal d1); in 10 (16.67%) – walnut (Jug r1, Jug r2, Jug r3); in 9 (15.00%) – fish (Gad c1); in 7 (11.67%) – kiwi (Act d1); in 7 (11.67%) – peanut (Ara h1, Ara h2, Ara h3, Ara h6); and in 20 (33%) – by different nuts (Ber e1, Ana o2, Cora 9, Cora 8). Elevated specific immunoglobulin E (sIgE) levels for birch tree allergens (Bet v1) were found in 39 (65.00%) patients, cat allergens (Fel d1, Fel d2, Fel d4) – in 41 (68.33%), dog allergens (Can f1, Can f2, Can f3, Can f5) – in 24 (40.0%), timothy allergens (Phl p1, Phl p4, Phl p5) – in 10 (16.6%), artemisia allergens (Art v1) – in 8 (13.3%), and house dust mites in 2 (3.33%). Respiratory symptoms in sensitized children with FIA developed in 4 of 5 cases. Conclusion: to reduce the number of life-threatening FA episodes in children with FIA it is necessary to reveal and assess the entire spectrum of sensitization, identify the causative allergens and triggers of potential anaphylactic reaction for the further development of an elimination diet and individualized patient management plan. KEYWORDS: food allergy, food-induced anaphylaxis, children, allergens, sensitization. FOR CITATION: Lepeshkova T.S. Causative allergens and sensitization spectrum in children with the history of food-induced anaphylaxis. Russian Medical Inquiry. 2023;7(2):75–80 (in Russ.). DOI: 10.32364/2587-6821-2023-7-2-75-80.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84837444","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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