Pub Date : 2022-01-01DOI: 10.32364/2587-6821-2022-6-10-580-588
A. Polushin, Yury R. Zalyalov, A. Tsynchenko, E. Lopatina, D.Yu. Zamorina, Y. Skiba, D. Skulyabin, O. V. Sergienya
CLIPPERS (chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids) syndrome is a chronic lymphocytic inflammation of the pons with perivascular accumulation of contrast agent responding to glucocorticosteroid therapy (GCS). This immune- mediated brainstem lesion syndrome requires extensive differential diagnosis. The literature provides descriptions of CLIPPERS with delayed response to GCS or refractory to GCS. Such cases require a customized treatment tactics. In the clinical case of CLIPPERS presented by the authors, it was possible to achieve disease remission using an adapted chemotherapeutic protocol regimen "fludarabine-cyclophosphamide- dexamethasone-rituximab". During the follow-up, the patient did not have any disease relapses. Persistent immunosuppressive effect a year after therapy according to flow cytometry indicated effective inhibition of proinflammatory phenotypes of cellular components. The stabilization of the condition with the improvement of parameters according to the rating scales was noted. The study of cerebrospinal fluid 12 months after nonselective immune depletion indicated a decrease in the myelin basic protein content, normalization of lambda free light chains, the blood-brain barrier permeability and a change in the synthesis type from oligoclonal to polyclonal. The authors conclude that using this method, a long-term clinical, radiological and immunological remission of potentially any autoimmune process can be achieved. KEYWORDS: CLIPPERS, immunosuppressive therapy, fludarabine, rituximab, cyclophosphamide, immunosuppression, autoimmune disease. FOR CITATION: Polushin A.Yu., Zalyalov Yu.R., Tsynchenko A.A. et al. Efficacy of the adapted protocol of complex immunosuppressive therapy regimen "fludarabine-cyclophosphamide-dexamethasone-rituximab" in CLIPPERS syndrome (clinical case). Russian Medical Inquiry. 2022;6(10):580–588 (in Russ.). DOI: 10.32364/2587-6821-2022-6-10-580-588.
{"title":"Efficacy of the adapted protocol of complex immunosuppressive therapy regimen \"fludarabine-cyclophosphamide-dexamethasone- rituximab\" in CLIPPERS syndromee (clinical case)","authors":"A. Polushin, Yury R. Zalyalov, A. Tsynchenko, E. Lopatina, D.Yu. Zamorina, Y. Skiba, D. Skulyabin, O. V. Sergienya","doi":"10.32364/2587-6821-2022-6-10-580-588","DOIUrl":"https://doi.org/10.32364/2587-6821-2022-6-10-580-588","url":null,"abstract":"CLIPPERS (chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids) syndrome is a chronic lymphocytic inflammation of the pons with perivascular accumulation of contrast agent responding to glucocorticosteroid therapy (GCS). This immune- mediated brainstem lesion syndrome requires extensive differential diagnosis. The literature provides descriptions of CLIPPERS with delayed response to GCS or refractory to GCS. Such cases require a customized treatment tactics. In the clinical case of CLIPPERS presented by the authors, it was possible to achieve disease remission using an adapted chemotherapeutic protocol regimen \"fludarabine-cyclophosphamide- dexamethasone-rituximab\". During the follow-up, the patient did not have any disease relapses. Persistent immunosuppressive effect a year after therapy according to flow cytometry indicated effective inhibition of proinflammatory phenotypes of cellular components. The stabilization of the condition with the improvement of parameters according to the rating scales was noted. The study of cerebrospinal fluid 12 months after nonselective immune depletion indicated a decrease in the myelin basic protein content, normalization of lambda free light chains, the blood-brain barrier permeability and a change in the synthesis type from oligoclonal to polyclonal. The authors conclude that using this method, a long-term clinical, radiological and immunological remission of potentially any autoimmune process can be achieved. KEYWORDS: CLIPPERS, immunosuppressive therapy, fludarabine, rituximab, cyclophosphamide, immunosuppression, autoimmune disease. FOR CITATION: Polushin A.Yu., Zalyalov Yu.R., Tsynchenko A.A. et al. Efficacy of the adapted protocol of complex immunosuppressive therapy regimen \"fludarabine-cyclophosphamide-dexamethasone-rituximab\" in CLIPPERS syndrome (clinical case). Russian Medical Inquiry. 2022;6(10):580–588 (in Russ.). DOI: 10.32364/2587-6821-2022-6-10-580-588.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"65 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89083151","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 : 2022-01-01DOI: 10.32364/2587-6821-2022-6-1-45-51
D. Sedykh, V. Kashtalap, O. Barbarash
Heart failure (HF) is a major issue in the modern society. A growing number of users, re-hospitalizations due to decompensation and disability cause significant economic costs and a high workload for both in-patient and out-patient practitioners. This article highlights the practical importance of timely prescription of mineralocorticoid receptor antagonists (specifically, eplerenone, a selective drug) in inpatient and outpatient settings. The efficacy and tolerability of this drug are established through the results of large studies. Eplerenone is included in the clinical guidelines of the Ministry of Health of Russian Federation, national guidelines on acute heart failure of the Russian Cardiological Society and Russian Therapeutic Society guidelines on HF diagnosis and treatment. It is recommended for all patients with moderate and severe HF, irrespective of the origin and LV ejection fraction. The established safety of eplerenon allows for its use in multimorbid patients. This case report demonstrates the effects of bioequivalent eplerenone (Espiro) for stabilizing the condition after HF decompensation with a transient decrease in LV ejection fraction. KEYWORDS: heart failure, decompensation, mineralocorticoid receptor antagonists, eplerenon. FOR CITATION: Sedykh D.Yu., Kashtalap V.V., Barbarash O.L. Optimal medical therapy for heart failure: eplerenon in a hospital setting (case report). Russian Medical Inquiry. 2022;6(1):45–51 (in Russ.). DOI: 10.32364/2587-6821-2022-6-1-45-51.
{"title":"Optimal medical therapy for heart failure: eplerenon in a hospital setting (case report)","authors":"D. Sedykh, V. Kashtalap, O. Barbarash","doi":"10.32364/2587-6821-2022-6-1-45-51","DOIUrl":"https://doi.org/10.32364/2587-6821-2022-6-1-45-51","url":null,"abstract":"Heart failure (HF) is a major issue in the modern society. A growing number of users, re-hospitalizations due to decompensation and disability cause significant economic costs and a high workload for both in-patient and out-patient practitioners. This article highlights the practical importance of timely prescription of mineralocorticoid receptor antagonists (specifically, eplerenone, a selective drug) in inpatient and outpatient settings. The efficacy and tolerability of this drug are established through the results of large studies. Eplerenone is included in the clinical guidelines of the Ministry of Health of Russian Federation, national guidelines on acute heart failure of the Russian Cardiological Society and Russian Therapeutic Society guidelines on HF diagnosis and treatment. It is recommended for all patients with moderate and severe HF, irrespective of the origin and LV ejection fraction. The established safety of eplerenon allows for its use in multimorbid patients. This case report demonstrates the effects of bioequivalent eplerenone (Espiro) for stabilizing the condition after HF decompensation with a transient decrease in LV ejection fraction. KEYWORDS: heart failure, decompensation, mineralocorticoid receptor antagonists, eplerenon. FOR CITATION: Sedykh D.Yu., Kashtalap V.V., Barbarash O.L. Optimal medical therapy for heart failure: eplerenon in a hospital setting (case report). Russian Medical Inquiry. 2022;6(1):45–51 (in Russ.). DOI: 10.32364/2587-6821-2022-6-1-45-51.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81278267","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 : 2022-01-01DOI: 10.32364/2587-6821-2022-6-9-509-515
A. Verbovoy, Y. Dolgikh, N. I. Verbovaya
Hypothyroidism is one of the most prevalent endocrine disorders, second only to diabetes. Hypothyroidism diagnosis can be difficult in view of its varied and non-specific symptoms. The reason is that thyroid hormones affect virtually every organ system in the body. At the same time, the severity of thyroid hormone deficiency may vary and does not always correlate with the changes in laboratory testing results. Clinical presentation of patients with hypothyroidism may include multiple symptoms and, as a result, it can be difficult to diagnose this disorder, especially in elderly and polymorbid individuals. In some patients, the prevailing symptoms indicate that only a particular system is affected. Thus, there are diseases known as the "masks" of hypothyroidism, and this review is focused on their clinical manifestations. Conditions that may be running under the "mask" of hypothyroidism include diastolic hypertension, dyslipidemia, hydropericardium, chronic constipation, biliary lithiasis, polyarthritis, alopecia, onycholysis, depression, dysfunctional uterine bleeding, infertility, anemia, etc. Due to a variety of clinical signs and symptoms, a patient with hypothyroidism may get an appointment with any medical specialist or receive a follow-up care provided in parallel by multiple specialists. Physicians should be aware of potential hypothyroidism and specific effects of the underactive thyroid on patient’s organs and systems. It is necessary to obtain a thorough medical history about comorbidities which would help to figure out that hypothyroidism is the cause of co-occurring conditions. KEYWORDS: autoimmune thyroiditis, hypothyroidism, subclinical hypothyroidism, euthyroidism, dyslipidemia, cardiovascular diseases, arterial hypertension FOR CITATION: Verbovoy A.F., Dolgikh Yu.A., Verbovaya N.I. Hypothyroidism is an interdisciplinary problem. Russian Medical Inquiry. 2022;6(9):509–515 (in Russ.). DOI: 10.32364/2587-6821-2022-6-9-509-515.
{"title":"Hypothyroidism is an interdisciplinary problem","authors":"A. Verbovoy, Y. Dolgikh, N. I. Verbovaya","doi":"10.32364/2587-6821-2022-6-9-509-515","DOIUrl":"https://doi.org/10.32364/2587-6821-2022-6-9-509-515","url":null,"abstract":"Hypothyroidism is one of the most prevalent endocrine disorders, second only to diabetes. Hypothyroidism diagnosis can be difficult in view of its varied and non-specific symptoms. The reason is that thyroid hormones affect virtually every organ system in the body. At the same time, the severity of thyroid hormone deficiency may vary and does not always correlate with the changes in laboratory testing results. Clinical presentation of patients with hypothyroidism may include multiple symptoms and, as a result, it can be difficult to diagnose this disorder, especially in elderly and polymorbid individuals. In some patients, the prevailing symptoms indicate that only a particular system is affected. Thus, there are diseases known as the \"masks\" of hypothyroidism, and this review is focused on their clinical manifestations. Conditions that may be running under the \"mask\" of hypothyroidism include diastolic hypertension, dyslipidemia, hydropericardium, chronic constipation, biliary lithiasis, polyarthritis, alopecia, onycholysis, depression, dysfunctional uterine bleeding, infertility, anemia, etc. Due to a variety of clinical signs and symptoms, a patient with hypothyroidism may get an appointment with any medical specialist or receive a follow-up care provided in parallel by multiple specialists. Physicians should be aware of potential hypothyroidism and specific effects of the underactive thyroid on patient’s organs and systems. It is necessary to obtain a thorough medical history about comorbidities which would help to figure out that hypothyroidism is the cause of co-occurring conditions. KEYWORDS: autoimmune thyroiditis, hypothyroidism, subclinical hypothyroidism, euthyroidism, dyslipidemia, cardiovascular diseases, arterial hypertension FOR CITATION: Verbovoy A.F., Dolgikh Yu.A., Verbovaya N.I. Hypothyroidism is an interdisciplinary problem. Russian Medical Inquiry. 2022;6(9):509–515 (in Russ.). DOI: 10.32364/2587-6821-2022-6-9-509-515.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86407883","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 : 2022-01-01DOI: 10.32364/2587-6821-2022-6-11-667-670
I. Sergeeva, Sh.Kh. Rakhimi
Botulism is a rare but serious condition characterized by long hospitalization and high lethality and therefore is considered an important problem of modern infectiology. Multiple diagnostic errors frequently occur in botulism, though the disease has highly distinctive clinical signs.The authors reviewed 27 patient medical records from 1992–2006: 15 records of the patients hospitalized with different preliminary diagnoses and later established diagnosis "botulism" and 12 records of the patients with initially diagnosed botulism which was not confirmed. The article highlights epidemiological and clinical criteria of botulism. While generating a differential diagnosis, it is necessary to recognize that botulism has different clinical manifestations, and that the disease severity may vary from mild to serious. Preventive measures for botulism play an important role and are aimed at enhancing the public awareness of the storage and consumption of mushroom, fish, and meat cans and products. KEYWORDS: botulism, botulinum toxin, Clostridium botulinum, early diagnosis, differential diagnosis, diagnostic errors. FOR CITATION: Sergeeva I.V., Rakhimi Sh.Kh. Diagnostic errors in botulism. Russian Medical Inquiry. 2022;6(11):667–670 (in Russ.). DOI: 10.32364/2587-6821-2022-6-11-667-670.
{"title":"Diagnostic errors in botulism","authors":"I. Sergeeva, Sh.Kh. Rakhimi","doi":"10.32364/2587-6821-2022-6-11-667-670","DOIUrl":"https://doi.org/10.32364/2587-6821-2022-6-11-667-670","url":null,"abstract":"Botulism is a rare but serious condition characterized by long hospitalization and high lethality and therefore is considered an important problem of modern infectiology. Multiple diagnostic errors frequently occur in botulism, though the disease has highly distinctive clinical signs.The authors reviewed 27 patient medical records from 1992–2006: 15 records of the patients hospitalized with different preliminary diagnoses and later established diagnosis \"botulism\" and 12 records of the patients with initially diagnosed botulism which was not confirmed. The article highlights epidemiological and clinical criteria of botulism. While generating a differential diagnosis, it is necessary to recognize that botulism has different clinical manifestations, and that the disease severity may vary from mild to serious. Preventive measures for botulism play an important role and are aimed at enhancing the public awareness of the storage and consumption of mushroom, fish, and meat cans and products. KEYWORDS: botulism, botulinum toxin, Clostridium botulinum, early diagnosis, differential diagnosis, diagnostic errors. FOR CITATION: Sergeeva I.V., Rakhimi Sh.Kh. Diagnostic errors in botulism. Russian Medical Inquiry. 2022;6(11):667–670 (in Russ.). DOI: 10.32364/2587-6821-2022-6-11-667-670.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89760422","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 : 2022-01-01DOI: 10.32364/2587-6821-2022-6-7-387-392
T. Tyulkova, T. Lugovkina, D. M. Kutuzova, N. Khabibullina
The authors analyzed 31 scientific publications, which highlighted modern methods to the diagnosis of bacteriologically unconfirmed pulmonary tuberculosis (PTB). In the article, such clinical cases are classified into two groups due to the absence of the tuberculosis causative agent. This approach can serve as a justification for choosing optimal and appropriate additional methods and techniques for diagnosing bacteriologically unconfirmed PTB. Given the fact that bacterial excretion is determined by traditional microbiological methods (microscopic and cultural) in sputum, the literature review presents data on additional measures for obtaining biological material for the etiological diagnosis of tuberculosis, using molecular genetic methods for detecting Mycobacterium tuberculosis DNA. Besides, the article shows the diagnostic significance of immunological and serological tests for the tuberculosis diagnosis, as well as modern methods to the X-ray results interpretation, using mathematical methods that evaluate the dynamic X-ray imaging. A special place in the bacteriologically unconfirmed PTB diagnosis is occupied by the description of biopsy material using artificial intelligence. That is, the integration of medicine and information technology achievements allows us having a source of additional information that should help the doctor diagnose tuberculosis in difficult clinical cases. KEYWORDS: tuberculosis, oligobacillar forms of tuberculosis, sputum smear-negative tuberculosis, diagnosis, bacteriologically unconfirmed, diagnostic material, immunological methods, radiation methods, mathematical methods. FOR CITATION: Tyulkova T.E., Lugovkina T.K., Kutuzova D.M., Khabibullina N.F. Diagnosis of bacteriologically unconfirmed pulmonary tuberculosis (literature review). Russian Medical Inquiry. 2022;6(7):387–392 (in Russ.). DOI: 10.32364/2587-6821-2022-6-7-387-392.
{"title":"Diagnosis of bacteriologically unconfirmed pulmonary tuberculosis (literature review)","authors":"T. Tyulkova, T. Lugovkina, D. M. Kutuzova, N. Khabibullina","doi":"10.32364/2587-6821-2022-6-7-387-392","DOIUrl":"https://doi.org/10.32364/2587-6821-2022-6-7-387-392","url":null,"abstract":"The authors analyzed 31 scientific publications, which highlighted modern methods to the diagnosis of bacteriologically unconfirmed pulmonary tuberculosis (PTB). In the article, such clinical cases are classified into two groups due to the absence of the tuberculosis causative agent. This approach can serve as a justification for choosing optimal and appropriate additional methods and techniques for diagnosing bacteriologically unconfirmed PTB. Given the fact that bacterial excretion is determined by traditional microbiological methods (microscopic and cultural) in sputum, the literature review presents data on additional measures for obtaining biological material for the etiological diagnosis of tuberculosis, using molecular genetic methods for detecting Mycobacterium tuberculosis DNA. Besides, the article shows the diagnostic significance of immunological and serological tests for the tuberculosis diagnosis, as well as modern methods to the X-ray results interpretation, using mathematical methods that evaluate the dynamic X-ray imaging. A special place in the bacteriologically unconfirmed PTB diagnosis is occupied by the description of biopsy material using artificial intelligence. That is, the integration of medicine and information technology achievements allows us having a source of additional information that should help the doctor diagnose tuberculosis in difficult clinical cases. KEYWORDS: tuberculosis, oligobacillar forms of tuberculosis, sputum smear-negative tuberculosis, diagnosis, bacteriologically unconfirmed, diagnostic material, immunological methods, radiation methods, mathematical methods. FOR CITATION: Tyulkova T.E., Lugovkina T.K., Kutuzova D.M., Khabibullina N.F. Diagnosis of bacteriologically unconfirmed pulmonary tuberculosis (literature review). Russian Medical Inquiry. 2022;6(7):387–392 (in Russ.). DOI: 10.32364/2587-6821-2022-6-7-387-392.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"77 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88019332","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 : 2022-01-01DOI: 10.32364/2587-6821-2022-6-11-608-611
R. Tlyustangelova, N. Pshenichnaya, S.S. Khaidarov
Aim: To assess the structure of acute intestinal infections (AIIs) over the period of 2017–2021 and characterize the etiology and clinical course of bacterial AIIs in adult patients in the Republic of Adygeya. Patients and Methods: this retrospective cohort study used the following resources: 1) official statistical reports on viral and bacterial AIIs over the period of 2017–2021 in the Republic of Adygeya to assess trends in the morbidity rates and 2) medical records of 50 patients with bacterial AIIs who received treatment in 2020–2021 in the Adygeya Republican Infectious Diseases Hospital to identify clinical and laboratory findings associated with the bacterial causes of diarrhea. A complete blood cell count, biochemistry blood test, stool analysis and stool culture test were performed in the studied patients. First, the stool samples were inoculated onto an enrichment medium, and then elective nutrient media were used for the detection of pathogens. Results: over the last five years, 4,474 AII cases were reported in the Republic, and in 3,317 (74.14%) of them the etiology was not determined. In 2017–2019, bowel infections of viral etiology prevailed in the structure of AIIs. In 2020 and 2021, amid a significant decline in AII morbidity rates, the percentage of viral and bacterial AIIs was similar: 7.14% and 7.71% in 2020 and 1.11% and 3.05% in 2021, respectively. The median age of patients with verified AIIs of bacterial etiology was 34.5 years, most of the patients were females. Salmonellosis caused by Salmonella entеritidis constituted the highest percentage of bacterial AIIs. Most of the patients had moderate illnesses with enterocolitis symptoms and prevailing secretory diarrhea. Conclusion: over the last five years, 4,474 AII cases were reported in the Republic of Adygeya, and in most patients the etiology was not determined. In 2020 and 2021, amid a significant decline in AII morbidity rates, the percentage of viral and bacterial AIIs was similar. Salmonellosis was dominating in the structure of AIIs (moderate illnesses with enterocolitis symptoms and prevailing secretory diarrhea). Biochemistry tests are necessary for patients with bacterial AIIs to identify pathogenetic mechanisms implicated in the development of post- infectious disease syndrome and gastrointestinal diseases. KEYWORDS: acute intestinal infections, bacterial intestinal infections, etiology, post-infectious disease syndrome, irritable bowel syndrome, gastrointestinal diseases. FOR CITATION: Tlyustangelova R.K., Pshenichnaya N.Yu., Khaidarov S.S. The etiology and clinical characteristics of bacterial intestinal infections in adult patients in the Republic of Adygeya. Russian Medical Inquiry. 2022;6(11):608–611 (in Russ.). DOI: 10.32364/2587-6821- 2022-6-11-608-611.
{"title":"The etiology and clinical characteristics of bacterial intestinal infections in adult patients in the Republic of Adygeya","authors":"R. Tlyustangelova, N. Pshenichnaya, S.S. Khaidarov","doi":"10.32364/2587-6821-2022-6-11-608-611","DOIUrl":"https://doi.org/10.32364/2587-6821-2022-6-11-608-611","url":null,"abstract":"Aim: To assess the structure of acute intestinal infections (AIIs) over the period of 2017–2021 and characterize the etiology and clinical course of bacterial AIIs in adult patients in the Republic of Adygeya. Patients and Methods: this retrospective cohort study used the following resources: 1) official statistical reports on viral and bacterial AIIs over the period of 2017–2021 in the Republic of Adygeya to assess trends in the morbidity rates and 2) medical records of 50 patients with bacterial AIIs who received treatment in 2020–2021 in the Adygeya Republican Infectious Diseases Hospital to identify clinical and laboratory findings associated with the bacterial causes of diarrhea. A complete blood cell count, biochemistry blood test, stool analysis and stool culture test were performed in the studied patients. First, the stool samples were inoculated onto an enrichment medium, and then elective nutrient media were used for the detection of pathogens. Results: over the last five years, 4,474 AII cases were reported in the Republic, and in 3,317 (74.14%) of them the etiology was not determined. In 2017–2019, bowel infections of viral etiology prevailed in the structure of AIIs. In 2020 and 2021, amid a significant decline in AII morbidity rates, the percentage of viral and bacterial AIIs was similar: 7.14% and 7.71% in 2020 and 1.11% and 3.05% in 2021, respectively. The median age of patients with verified AIIs of bacterial etiology was 34.5 years, most of the patients were females. Salmonellosis caused by Salmonella entеritidis constituted the highest percentage of bacterial AIIs. Most of the patients had moderate illnesses with enterocolitis symptoms and prevailing secretory diarrhea. Conclusion: over the last five years, 4,474 AII cases were reported in the Republic of Adygeya, and in most patients the etiology was not determined. In 2020 and 2021, amid a significant decline in AII morbidity rates, the percentage of viral and bacterial AIIs was similar. Salmonellosis was dominating in the structure of AIIs (moderate illnesses with enterocolitis symptoms and prevailing secretory diarrhea). Biochemistry tests are necessary for patients with bacterial AIIs to identify pathogenetic mechanisms implicated in the development of post- infectious disease syndrome and gastrointestinal diseases. KEYWORDS: acute intestinal infections, bacterial intestinal infections, etiology, post-infectious disease syndrome, irritable bowel syndrome, gastrointestinal diseases. FOR CITATION: Tlyustangelova R.K., Pshenichnaya N.Yu., Khaidarov S.S. The etiology and clinical characteristics of bacterial intestinal infections in adult patients in the Republic of Adygeya. Russian Medical Inquiry. 2022;6(11):608–611 (in Russ.). DOI: 10.32364/2587-6821- 2022-6-11-608-611.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86920227","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 : 2022-01-01DOI: 10.32364/2587-6821-2022-6-10-551-555
K.P. Tuzhikov, V. Voitenkov, E. Ekusheva
Background: the Five-Minute Cognitive Test (FCT) was designed in 2019 by the Chinese scientists to capture deficits in five domains of cognitive abilities, including episodic memory, language fluency, time orientation, visuospatial function, and executive function. Aim: to evaluate the efficiency of the Russian FCT version for identifying cognitive impairments (CI) in non-demented patients. Patients and Methods: according to the international requirements and standards, the FCT was translated and adapted and then evaluated in a focus group of non-demented patients (n=62, 60–75 years old) followed by the assessment of its psychometric properties. The FCT results were compared with the MMSE and Montreal Cognitive Assessment (MOCA) scores in two patient groups: the treatment group (n=30) consisting of patients with moderate CI, before after the cognitive rehabilitation course, and the comparison group, consisting of 32 individuals with normal cognitive functions. In addition, the correlation of the hippocampal volume with FCT/MMSE scores was assessed. Results: the average time to complete FCT was 5–6 min. The sensitivity and specificity of PCT for CI screening was 80.6% and 84.11%, respectively. As demonstrated by the study findings, FCT’s diagnostic performance was not inferior to that of other tests used for detecting CI. The neurovisualization data showed that there was a positive correlation between the hippocampal volume and the FCT/MMSE scores. Conclusion: the preliminary results suggest that the Russian FCT version is acceptable and promising for the use in clinical practice as a relevant screening test for identifying CI. KEYWORDS: mild cognitive impairments, moderate cognitive impairments, Alzheimer’s disease, brief cognitive test. FOR CITATION: Tuzhikov K.P., Voitenkov V.B., Ekusheva E.V. Evaluating the efficiency of a five-minute cognitive test for the use in non- demented patients with cognitive declines (a pilot study). Russian Medical Inquiry. 2022;6(10):551–555 (in Russ.). DOI: 10.32364/2587- 6821-2022-6-10-551-555
{"title":"Evaluating the efficiency of a five-minute cognitive test for the use in non-demented patients with cognitive declines (a pilot study)","authors":"K.P. Tuzhikov, V. Voitenkov, E. Ekusheva","doi":"10.32364/2587-6821-2022-6-10-551-555","DOIUrl":"https://doi.org/10.32364/2587-6821-2022-6-10-551-555","url":null,"abstract":"Background: the Five-Minute Cognitive Test (FCT) was designed in 2019 by the Chinese scientists to capture deficits in five domains of cognitive abilities, including episodic memory, language fluency, time orientation, visuospatial function, and executive function. Aim: to evaluate the efficiency of the Russian FCT version for identifying cognitive impairments (CI) in non-demented patients. Patients and Methods: according to the international requirements and standards, the FCT was translated and adapted and then evaluated in a focus group of non-demented patients (n=62, 60–75 years old) followed by the assessment of its psychometric properties. The FCT results were compared with the MMSE and Montreal Cognitive Assessment (MOCA) scores in two patient groups: the treatment group (n=30) consisting of patients with moderate CI, before after the cognitive rehabilitation course, and the comparison group, consisting of 32 individuals with normal cognitive functions. In addition, the correlation of the hippocampal volume with FCT/MMSE scores was assessed. Results: the average time to complete FCT was 5–6 min. The sensitivity and specificity of PCT for CI screening was 80.6% and 84.11%, respectively. As demonstrated by the study findings, FCT’s diagnostic performance was not inferior to that of other tests used for detecting CI. The neurovisualization data showed that there was a positive correlation between the hippocampal volume and the FCT/MMSE scores. Conclusion: the preliminary results suggest that the Russian FCT version is acceptable and promising for the use in clinical practice as a relevant screening test for identifying CI. KEYWORDS: mild cognitive impairments, moderate cognitive impairments, Alzheimer’s disease, brief cognitive test. FOR CITATION: Tuzhikov K.P., Voitenkov V.B., Ekusheva E.V. Evaluating the efficiency of a five-minute cognitive test for the use in non- demented patients with cognitive declines (a pilot study). Russian Medical Inquiry. 2022;6(10):551–555 (in Russ.). DOI: 10.32364/2587- 6821-2022-6-10-551-555","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"63 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86826645","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 : 2022-01-01DOI: 10.32364/2587-6821-2022-6-8-470-479
A.Yu. Tsinserling, V. Mazurov, I. Gaydukova, M. Petrova, O. Inamova, R. Bashkinov, N. Gonchar
Background: clinical and radiological studies on this issue remain unknown, despite the existing pathomorphological prerequisites, indicating the mutually potentiative effect of hyperuricemia (HU) on the radiographic progression (RP) in rheumatoid arthritis (RA). Aim: to study the association between the HU, the activity of RA, RP and the possibilities of their correction. Patients and Methods: among 967 patients included in the St. Petersburg City Register of HU from January 2011 to October 2021, 232 patients with RA and HU (uric acid (UA) level > 360 μmol/L) were selected, for which 232 patients of the comparison group with RA without HU were selected by random selection from the same register. A comparison of the demographic characteristics of patients (gender, age), their clinical, laboratory and radiological patterns and the ongoing treatment was conducted. Results: patients with RA and HU and without HU were comparable in age, gender, activity, disease course and the received baseline therapy. In patients with RA and HU, there was a higher (p=0.03) increase in the joint space narrowing (JSN) value of the feet. In patients with RA and HU, RP in all evaluated parameters (p<0,001) exceeded RP in patients with RA without HU. The article reveales direct correlations in the JSN of the feet and hands with the UA level, UA clearance, UA daily excretion, daily protein loss, as well as blood glucose and cholesterol levels, despite the well-known risk factors for the RA progression (age, disease duration, positivity according to RF and CCPA, elevated ESR and CRP level). Patients with HU and RP only reached the target UA levels in 27% of cases when treated with allopurinol, while patients without RP reached the target level in 80% of cases. Conclusion: HU in patients with RA is associated with RP, which indicates the need for its timely detection and correction. KEYWORDS: rheumatoid arthritis, asymptomatic hyperuricemia, radiographic progression, urate-lowering therapy, allopurinol. FOR CITATION: Tsinserling A.Yu., Mazurov V.I., Gaydukova I.Z. et al. Asymptomatic hyperuricemia and radiographic progression of rheumatoid arthritis. Russian Medical Inquiry. 2022;6(8):470–479 (in Russ.). DOI: 10.32364/2587-6821-2022-6-8-470-479.
{"title":"Asymptomatic hyperuricemia and radiographic progression of rheumatoid arthritis","authors":"A.Yu. Tsinserling, V. Mazurov, I. Gaydukova, M. Petrova, O. Inamova, R. Bashkinov, N. Gonchar","doi":"10.32364/2587-6821-2022-6-8-470-479","DOIUrl":"https://doi.org/10.32364/2587-6821-2022-6-8-470-479","url":null,"abstract":"Background: clinical and radiological studies on this issue remain unknown, despite the existing pathomorphological prerequisites, indicating the mutually potentiative effect of hyperuricemia (HU) on the radiographic progression (RP) in rheumatoid arthritis (RA). Aim: to study the association between the HU, the activity of RA, RP and the possibilities of their correction. Patients and Methods: among 967 patients included in the St. Petersburg City Register of HU from January 2011 to October 2021, 232 patients with RA and HU (uric acid (UA) level > 360 μmol/L) were selected, for which 232 patients of the comparison group with RA without HU were selected by random selection from the same register. A comparison of the demographic characteristics of patients (gender, age), their clinical, laboratory and radiological patterns and the ongoing treatment was conducted. Results: patients with RA and HU and without HU were comparable in age, gender, activity, disease course and the received baseline therapy. In patients with RA and HU, there was a higher (p=0.03) increase in the joint space narrowing (JSN) value of the feet. In patients with RA and HU, RP in all evaluated parameters (p<0,001) exceeded RP in patients with RA without HU. The article reveales direct correlations in the JSN of the feet and hands with the UA level, UA clearance, UA daily excretion, daily protein loss, as well as blood glucose and cholesterol levels, despite the well-known risk factors for the RA progression (age, disease duration, positivity according to RF and CCPA, elevated ESR and CRP level). Patients with HU and RP only reached the target UA levels in 27% of cases when treated with allopurinol, while patients without RP reached the target level in 80% of cases. Conclusion: HU in patients with RA is associated with RP, which indicates the need for its timely detection and correction. KEYWORDS: rheumatoid arthritis, asymptomatic hyperuricemia, radiographic progression, urate-lowering therapy, allopurinol. FOR CITATION: Tsinserling A.Yu., Mazurov V.I., Gaydukova I.Z. et al. Asymptomatic hyperuricemia and radiographic progression of rheumatoid arthritis. Russian Medical Inquiry. 2022;6(8):470–479 (in Russ.). DOI: 10.32364/2587-6821-2022-6-8-470-479.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"2016 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86300404","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 : 2022-01-01DOI: 10.32364/2587-6821-2022-6-10-596-599
É. A. Kulish, V. M. Frolova
Status epilepticus (SE) is one of the most common urgent neurological conditions in children. SE occurs as a result of the failure of the mechanisms responsible for stopping seizures, or of those that cause abnormally long seizures. The International League against Epilepsy recommends examining patients with epilepsy (including those with new-onset SE) using neuroimaging methods. In order to assess the informative value of neuroimaging methods in determining the causes of SE, we conducted a retrospective analysis of 44 medical records of pediatric patients with new-onset SE who were admitted in critical condition to the children’s intensive care unit for the period from 2000 to 2019. In the studied sample, only 32 patients were examined using neuroimaging methods (MRI, CT, EEG, video EEG monitoring). In 25% of cases, no changes were detected. The rest revealed epileptogenic (15.3%), conditionally epileptogenic (65.5%) and non-epileptogenic (19.2%) changes. To clarify the etiology of epilepsy in the latter case, it is recommended to conduct additional examination using other diagnostic methods. Thus, the use of neuroimaging methods is an important link in the patient management with new-onset SE. KEYWORDS: epilepsy, status epilepticus, children, brain, neuroimaging, magnetic resonance imaging, computed tomography. FOR CITATION: Kulish E.A., Frolova V.M. Neuroimaging in pediatric patients with new-onset status epilepticus. Russian Medical Inquiry. 2022;6(10):596–599 (in Russ.). DOI: 10.32364/2587-6821-2022-6-10-596-599.
{"title":"Neuroimaging in pediatric patients with new-onset status epilepticus","authors":"É. A. Kulish, V. M. Frolova","doi":"10.32364/2587-6821-2022-6-10-596-599","DOIUrl":"https://doi.org/10.32364/2587-6821-2022-6-10-596-599","url":null,"abstract":"Status epilepticus (SE) is one of the most common urgent neurological conditions in children. SE occurs as a result of the failure of the mechanisms responsible for stopping seizures, or of those that cause abnormally long seizures. The International League against Epilepsy recommends examining patients with epilepsy (including those with new-onset SE) using neuroimaging methods. In order to assess the informative value of neuroimaging methods in determining the causes of SE, we conducted a retrospective analysis of 44 medical records of pediatric patients with new-onset SE who were admitted in critical condition to the children’s intensive care unit for the period from 2000 to 2019. In the studied sample, only 32 patients were examined using neuroimaging methods (MRI, CT, EEG, video EEG monitoring). In 25% of cases, no changes were detected. The rest revealed epileptogenic (15.3%), conditionally epileptogenic (65.5%) and non-epileptogenic (19.2%) changes. To clarify the etiology of epilepsy in the latter case, it is recommended to conduct additional examination using other diagnostic methods. Thus, the use of neuroimaging methods is an important link in the patient management with new-onset SE. KEYWORDS: epilepsy, status epilepticus, children, brain, neuroimaging, magnetic resonance imaging, computed tomography. FOR CITATION: Kulish E.A., Frolova V.M. Neuroimaging in pediatric patients with new-onset status epilepticus. Russian Medical Inquiry. 2022;6(10):596–599 (in Russ.). DOI: 10.32364/2587-6821-2022-6-10-596-599.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87605097","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 : 2022-01-01DOI: 10.32364/2587-6821-2022-6-8-427-432
I. Leonova, O. Zakharova, S. Boldueva
Background: disorders of both endothelium-dependent and endothelium-independent vasodilation play a role in the pathogenesis of microvascular angina (MVA), the contribution of which may be different. Aim: to study the processes of endothelium-dependent vasodilation (EDV) in patients with primary MVA. Patients and Methods: an open prospective study included 60 patients (mean age 57.3±6.4 years) with MVA, confirmed clinical picture (chest pain), coronary angiography data (the absence of coronary artery stenosis), positive stress test (pain syndrome and/or ST segment depression by ≥2 mm by treadmill exercise stress test), positron emission tomography (PET) myocardial perfusion imaging (MPI) with tests (cold pressor test and with adenosine). Patients with diseases that can lead to secondary microvascular dysfunction were not included in the study. To evaluate the processes of EDV, all patients underwent the following evaluations: peripheral arterial tonometry (PAT), assessment of circulating endothelial cells (CEC), high-sensitivity C-reactive protein (hsCRP), endothelin-1 (ET-1), total antioxidant status. Adding that, the results of a cold pressor test during PET were analyzed. Results: the majority of the examined patients were women — 81.7%. Most of the female patients included in the study (93.9%) were postmenopausal. In all patients with MVA, according to the data of PET MPI with cold pressor test, signs of EDV disorder were detected as a decrease in coronary blood flow through the three coronary arteries. During PET, the index of reactive hyperemia was reduced (<1,67) in all examined patients and amounted to 1.43±0.15. According to the results of laboratory studies, there was an increase in the level of ET-1 and CEC — 3,335 [1,545; 3,952] fmol/L and 14±8 cells/3×105 leukocytes, respectively. The CRP level was 4,44 [1.02; 4.45] mg/L. The total antioxidant capacity was reduced in 53 (88%) patients, the average values of the indicator were 289,03±52,14 μmol/L. Conclusion: according to laboratory and instrumental studies, signs of endothelial dysfunction, namely disorders of EDV, were revealed in all examined patients with primary MVA. KEYWORDS: microvascular angina, peripheral arterial tonometry, endothelium-dependent vasodilation, positron emission tomography. FOR CITATION: Leonova I.A., Zakharova O.V., Boldueva S.A. Disorders of endothelium-dependent vasodilation in patients with microvascular angina. Russian Medical Inquiry. 2022;6(8):427–432 (in Russ.). DOI: 10.32364/2587-6821-2022-6-8-427-432.
{"title":"Disorders of endothelium-dependent vasodilation in patients with microvascular angina","authors":"I. Leonova, O. Zakharova, S. Boldueva","doi":"10.32364/2587-6821-2022-6-8-427-432","DOIUrl":"https://doi.org/10.32364/2587-6821-2022-6-8-427-432","url":null,"abstract":"Background: disorders of both endothelium-dependent and endothelium-independent vasodilation play a role in the pathogenesis of microvascular angina (MVA), the contribution of which may be different. Aim: to study the processes of endothelium-dependent vasodilation (EDV) in patients with primary MVA. Patients and Methods: an open prospective study included 60 patients (mean age 57.3±6.4 years) with MVA, confirmed clinical picture (chest pain), coronary angiography data (the absence of coronary artery stenosis), positive stress test (pain syndrome and/or ST segment depression by ≥2 mm by treadmill exercise stress test), positron emission tomography (PET) myocardial perfusion imaging (MPI) with tests (cold pressor test and with adenosine). Patients with diseases that can lead to secondary microvascular dysfunction were not included in the study. To evaluate the processes of EDV, all patients underwent the following evaluations: peripheral arterial tonometry (PAT), assessment of circulating endothelial cells (CEC), high-sensitivity C-reactive protein (hsCRP), endothelin-1 (ET-1), total antioxidant status. Adding that, the results of a cold pressor test during PET were analyzed. Results: the majority of the examined patients were women — 81.7%. Most of the female patients included in the study (93.9%) were postmenopausal. In all patients with MVA, according to the data of PET MPI with cold pressor test, signs of EDV disorder were detected as a decrease in coronary blood flow through the three coronary arteries. During PET, the index of reactive hyperemia was reduced (<1,67) in all examined patients and amounted to 1.43±0.15. According to the results of laboratory studies, there was an increase in the level of ET-1 and CEC — 3,335 [1,545; 3,952] fmol/L and 14±8 cells/3×105 leukocytes, respectively. The CRP level was 4,44 [1.02; 4.45] mg/L. The total antioxidant capacity was reduced in 53 (88%) patients, the average values of the indicator were 289,03±52,14 μmol/L. Conclusion: according to laboratory and instrumental studies, signs of endothelial dysfunction, namely disorders of EDV, were revealed in all examined patients with primary MVA. KEYWORDS: microvascular angina, peripheral arterial tonometry, endothelium-dependent vasodilation, positron emission tomography. FOR CITATION: Leonova I.A., Zakharova O.V., Boldueva S.A. Disorders of endothelium-dependent vasodilation in patients with microvascular angina. Russian Medical Inquiry. 2022;6(8):427–432 (in Russ.). DOI: 10.32364/2587-6821-2022-6-8-427-432.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87715394","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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