Pub Date : 2022-01-01DOI: 10.32364/2587-6821-2022-6-5-244-251
M. Livzan, O. Gaus, S. Mozgovoi
According to the prevalence, chronic biliary gastritis is among the most common etiological variants of chronic gastritis along with Helicobacter pylori associated gastritis and NSAID gastropathy. This review has been prepared to systematize data on the causes, pathogenetic mechanisms and methods of the diagnosis and therapy of chronic biliary gastritis. The widespread prevalance of biliary gastritis in clinical practice with insufficient understanding of the pathogenesis, the lack of diagnostic standards and unified treatment methods make the coverage of this problem very relevant. The review also systematizes known information about risk factors and pathogenetic mechanisms of biliary gastritis, discusses methods of the diagnosis and treatment of this disease, in particular, the use of ursodeoxycholic acid and cytoprotectors as pathogenetic therapy. The authors note that the treatment of biliary gastritis should be comprehensive and aimed not only at relieving dyspeptic symptoms and improving the life quality of patients, but also at preventing and inhibiting atrophic changes in the gastric mucosa. KEYWORDS: biliary gastritis, duodenogastric reflux, reactive gastritis, bile reflux gastropathy, reactive gastropathy, ursodeoxycholic acid, cytoprotectors. FOR CITATION: Livzan M.A., Gaus O.V., Mozgovoi S.I., Telyatnikova L.I. Biliary gastritis: modern methods of diagnosis and therapy. Russian Medical Inquiry. 2022;6(5):244–251 (in Russ.). DOI: 10.32364/2587-6821-2022-6-5-244-251.
{"title":"Biliary gastritis: modern methods of diagnosis and therapy","authors":"M. Livzan, O. Gaus, S. Mozgovoi","doi":"10.32364/2587-6821-2022-6-5-244-251","DOIUrl":"https://doi.org/10.32364/2587-6821-2022-6-5-244-251","url":null,"abstract":"According to the prevalence, chronic biliary gastritis is among the most common etiological variants of chronic gastritis along with Helicobacter pylori associated gastritis and NSAID gastropathy. This review has been prepared to systematize data on the causes, pathogenetic mechanisms and methods of the diagnosis and therapy of chronic biliary gastritis. The widespread prevalance of biliary gastritis in clinical practice with insufficient understanding of the pathogenesis, the lack of diagnostic standards and unified treatment methods make the coverage of this problem very relevant. The review also systematizes known information about risk factors and pathogenetic mechanisms of biliary gastritis, discusses methods of the diagnosis and treatment of this disease, in particular, the use of ursodeoxycholic acid and cytoprotectors as pathogenetic therapy. The authors note that the treatment of biliary gastritis should be comprehensive and aimed not only at relieving dyspeptic symptoms and improving the life quality of patients, but also at preventing and inhibiting atrophic changes in the gastric mucosa. KEYWORDS: biliary gastritis, duodenogastric reflux, reactive gastritis, bile reflux gastropathy, reactive gastropathy, ursodeoxycholic acid, cytoprotectors. FOR CITATION: Livzan M.A., Gaus O.V., Mozgovoi S.I., Telyatnikova L.I. Biliary gastritis: modern methods of diagnosis and therapy. Russian Medical Inquiry. 2022;6(5):244–251 (in Russ.). DOI: 10.32364/2587-6821-2022-6-5-244-251.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87768517","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: 10.32364/2587-6821-2022-6-10-589-595
V. Korotaeva, Y. Kushnir, O. Kudyasheva, A. Polushin, V. Krasnov
POEMS syndrome (Polyneuropathy, Organomegaly, Endocrinopathy, M-protein, Skin changes) is a rare paraneoplastic disease associated with plasma cell dyscrasias, the pathogenesis of which is currently not fully understood. The diagnosis of POEMS syndrome is commonly confirmed after an extended period of time from the disease onset, since the syndrome is rare and can be mistaken for other neurological diseases, for instance, chronic inflammatory demyelinating polyneuropathy (CIDP). The article describes a clinical case of the disease in a young male patient with the onset of neurological disorders in the form of the CIDP clinical phenotype, refractory to first-line therapy, and further systemic clinical and laboratory comorbidities of POEMS syndrome. The necessary laboratory and radiological studies were performed to confirm the diagnosis. The diagnosis was established based on the presence of 2 major, 1 additional major and 4 minor criteria of POEMS syndrome in the patient. Then the patient was discharged for further observation of hematologists to initiate basic therapy of POEMS syndrome. Early detection of the POEMS syndrome "red flags" in patients with the CIDP allows for timely treatment initiation, prevention of further disease progression and the development of persistent disabling disorders. KEYWORDS: POEMS-syndrome, chronic inflammatory demyelinating polyneuropathy, paraprotein, monoclonal gammopathy of undetermined significance. FOR CITATION: Korotaeva V.V., Kushnir Ya.B., Kudyasheva O.V. et al. POEMS-syndrome with the disease onset in the form of сhronic dysimmune neuropathy. Russian Medical Inquiry. 2022;6(10):589–595 (in Russ.). DOI: 10.32364/2587-6821-2022-6-10-589-595.
{"title":"POEMS-syndrome with the disease onset in the form of сhronic dysimmune neuropathy","authors":"V. Korotaeva, Y. Kushnir, O. Kudyasheva, A. Polushin, V. Krasnov","doi":"10.32364/2587-6821-2022-6-10-589-595","DOIUrl":"https://doi.org/10.32364/2587-6821-2022-6-10-589-595","url":null,"abstract":"POEMS syndrome (Polyneuropathy, Organomegaly, Endocrinopathy, M-protein, Skin changes) is a rare paraneoplastic disease associated with plasma cell dyscrasias, the pathogenesis of which is currently not fully understood. The diagnosis of POEMS syndrome is commonly confirmed after an extended period of time from the disease onset, since the syndrome is rare and can be mistaken for other neurological diseases, for instance, chronic inflammatory demyelinating polyneuropathy (CIDP). The article describes a clinical case of the disease in a young male patient with the onset of neurological disorders in the form of the CIDP clinical phenotype, refractory to first-line therapy, and further systemic clinical and laboratory comorbidities of POEMS syndrome. The necessary laboratory and radiological studies were performed to confirm the diagnosis. The diagnosis was established based on the presence of 2 major, 1 additional major and 4 minor criteria of POEMS syndrome in the patient. Then the patient was discharged for further observation of hematologists to initiate basic therapy of POEMS syndrome. Early detection of the POEMS syndrome \"red flags\" in patients with the CIDP allows for timely treatment initiation, prevention of further disease progression and the development of persistent disabling disorders. KEYWORDS: POEMS-syndrome, chronic inflammatory demyelinating polyneuropathy, paraprotein, monoclonal gammopathy of undetermined significance. FOR CITATION: Korotaeva V.V., Kushnir Ya.B., Kudyasheva O.V. et al. POEMS-syndrome with the disease onset in the form of сhronic dysimmune neuropathy. Russian Medical Inquiry. 2022;6(10):589–595 (in Russ.). DOI: 10.32364/2587-6821-2022-6-10-589-595.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82463530","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: 10.32364/2587-6821-2022-6-5-213-220
I. Pirogova, I.V. Ufimtseva
Aim: to evaluate the effect of ursodeoxycholic acid (UDCA) on hepatic fibrosis and steatosis, dyslipidemia, carbohydrate metabolism, and litholysis of cholesterol gallstones in patients with a combination of non-alcoholic fatty liver disease (NAFLD) and gallstone disease (GD). Patients and Methods: a prospective monocenter study was conducted, which included patients with NAFLD and GD at the age of 19 to 65 years. The diagnosis was established on the basis of clinical, laboratory, ultrasound and radiological data. The nature and incidence of comorbid pathology were assessed. The degree of hepatic fibrosis and steatosis was determined according to the abdominal MSCT and serum tests of liver fibrosis (FIB 4, APRI) and hepatic steatosis (FLI), as well as liver elastography. All patients received UDCA at a dose of 15 mg/kg for 6 months. Results: 85 patients were included in the study, 59 (70%) of them were female, the mean age was 49.3±9 years. Gallstones of low density (up to 75 HU) were detected in 45 (52%) patients who made up the group 1, of high density (75–120 HU) — in 40 (48%) patients included in the group 2. 42 (49%) patients had comorbidity. In group 2, comorbid pathology was significantly more common and the degree of hepatic steatosis and fibrosis was higher. During treatment with UDCA, the positive trend in group 1 was expressed in a significant decrease in the gallstone density and size, normalization of liver density, cytolysis and cholestasis indicators, improvement of carbohydrate metabolism, and regression of hepatic steatosis according to MSCT and elastography. In group 2, there was a decrease in bile density and gallstone size according to MSCT, as well as a positive trend of lipidogram, HOMA-IR index, hepatic density and steatosis according to MSCT and elastography.Conclusion: the use of UDCA in patients with NAFLD and GD as pathogenetic therapy has a positive effect on hepatic fibrosis and steatosis, dyslipidemia, carbohydrate metabolism, and provides litholysis of cholesterol stones, mainly with a density of less than 75 HU. KEYWORDS: comorbidity, non-alcoholic fatty liver disease, cholelithiasis, cholesterol stones, litholysis, hepatic steatosis. FOR CITATION: Pirogova I.Yu., Ufimtseva I.V. Clinical study of the URSosan Forte in patients with non-alcoholic fatty liver disease and cholelithiasis (KURS study). Russian Medical Inquiry. 2022;6(5):213–220 (in Russ.). DOI: 10.32364/2587-6821-2022-6-5-213-220.
{"title":"Clinical study of the URSosan Forte in patients with non-alcoholic fatty liver disease and cholelithiasis (KURS study)","authors":"I. Pirogova, I.V. Ufimtseva","doi":"10.32364/2587-6821-2022-6-5-213-220","DOIUrl":"https://doi.org/10.32364/2587-6821-2022-6-5-213-220","url":null,"abstract":"Aim: to evaluate the effect of ursodeoxycholic acid (UDCA) on hepatic fibrosis and steatosis, dyslipidemia, carbohydrate metabolism, and litholysis of cholesterol gallstones in patients with a combination of non-alcoholic fatty liver disease (NAFLD) and gallstone disease (GD). Patients and Methods: a prospective monocenter study was conducted, which included patients with NAFLD and GD at the age of 19 to 65 years. The diagnosis was established on the basis of clinical, laboratory, ultrasound and radiological data. The nature and incidence of comorbid pathology were assessed. The degree of hepatic fibrosis and steatosis was determined according to the abdominal MSCT and serum tests of liver fibrosis (FIB 4, APRI) and hepatic steatosis (FLI), as well as liver elastography. All patients received UDCA at a dose of 15 mg/kg for 6 months. Results: 85 patients were included in the study, 59 (70%) of them were female, the mean age was 49.3±9 years. Gallstones of low density (up to 75 HU) were detected in 45 (52%) patients who made up the group 1, of high density (75–120 HU) — in 40 (48%) patients included in the group 2. 42 (49%) patients had comorbidity. In group 2, comorbid pathology was significantly more common and the degree of hepatic steatosis and fibrosis was higher. During treatment with UDCA, the positive trend in group 1 was expressed in a significant decrease in the gallstone density and size, normalization of liver density, cytolysis and cholestasis indicators, improvement of carbohydrate metabolism, and regression of hepatic steatosis according to MSCT and elastography. In group 2, there was a decrease in bile density and gallstone size according to MSCT, as well as a positive trend of lipidogram, HOMA-IR index, hepatic density and steatosis according to MSCT and elastography.Conclusion: the use of UDCA in patients with NAFLD and GD as pathogenetic therapy has a positive effect on hepatic fibrosis and steatosis, dyslipidemia, carbohydrate metabolism, and provides litholysis of cholesterol stones, mainly with a density of less than 75 HU. KEYWORDS: comorbidity, non-alcoholic fatty liver disease, cholelithiasis, cholesterol stones, litholysis, hepatic steatosis. FOR CITATION: Pirogova I.Yu., Ufimtseva I.V. Clinical study of the URSosan Forte in patients with non-alcoholic fatty liver disease and cholelithiasis (KURS study). Russian Medical Inquiry. 2022;6(5):213–220 (in Russ.). DOI: 10.32364/2587-6821-2022-6-5-213-220.","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":"91085353","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: 10.32364/2587-6821-2022-6-2-67-71
E. Markelova, M. S. Tulupova, T. Nevezhkina, L. S. Matyushkina, M. Chernikova, S. Knysh
Papillomaviruses are a group of DNA viruses belonging to the Papillomavirida family. These viruses provoke pathological conditions manifesting with inflammation, exophytic masses, carcinogenesis, reproductive and perinatal disorders. Immune status is an essential factor de-termining the severity and duration of inflammatory diseases, the course of latent viral infections, including papillomavirus infection (PVI). The human immune system prevents the persistence, reactivation, and development of PVI clinical presentations. The cellular immune response is realized under the control of interferons (IFNs). Today, no complex studies on type 1, 2, or 3 IFNs in the cervical mucus of women with PVI associated with herpesvirus and chlamydia infec-tions are available. Aim: to compare IFN profile of mucosal immunity in women with PVI associated with herpesvirus and chlamydia infections. Patients and Methods: this study enrolled 149 women aged 25–44. Women were divided into four groups. Group 1 included women with PVI only (n=21). Group 2 included women with PVI and herpesvirus infection (n=47). Group 3 included women with PVI and chlamydia infec-tions (n=39). Group 4 included controls (n=30). Complex outpatient clinical laboratory examina-tion included clinical functional, biochemical, and immunological tests to detail pathophysiolog-ical mechanisms of urogenital PVIs. IFN (IFN-β, IFN-γ, IFN-λ1/IL-29, IFN-λ3/IL-28B) levels in the cervical mucus were measured by ELISA. Results: in all groups, IFN-λ3 and IFN-γ deficiencies were detected. In PVI, IFN-γ deficiency prevailed. In PVI associated with herpesvirus infection, IFN-λ3 deficiency prevailed. In PVI associated with chlamydia infection, a severe IFN-β deficiency was revealed. Conclusion: these patterns demonstrate a relevant role of the interferon arm of the im-mune response in the pathogenesis of isolated PVI and PVI associated with herpesvirus and chlamydia infections. These alterations in mucosal immunity support the prescription of immu-notherapy for these infections. KEYWORDS: human papillomavirus, herpesvirus infection, chlamydia infection, interferons, immune system, cervical mucus, mucosal immunity. FOR CITATION: Markelova E.V., Tulupova M.S., Nevezhkina T.A. et al. Interferon profile of the mucosal immunity in women with papillomavirus infection. Russian Medical Inquiry. 2022;6(2):67–71 (in Russ.). DOI: 10.32364/2587-6821-2022-6-2-67-71.
{"title":"Interferon profile of the mucosal immunity in women with papillomavirus infection","authors":"E. Markelova, M. S. Tulupova, T. Nevezhkina, L. S. Matyushkina, M. Chernikova, S. Knysh","doi":"10.32364/2587-6821-2022-6-2-67-71","DOIUrl":"https://doi.org/10.32364/2587-6821-2022-6-2-67-71","url":null,"abstract":"Papillomaviruses are a group of DNA viruses belonging to the Papillomavirida family. These viruses provoke pathological conditions manifesting with inflammation, exophytic masses, carcinogenesis, reproductive and perinatal disorders. Immune status is an essential factor de-termining the severity and duration of inflammatory diseases, the course of latent viral infections, including papillomavirus infection (PVI). The human immune system prevents the persistence, reactivation, and development of PVI clinical presentations. The cellular immune response is realized under the control of interferons (IFNs). Today, no complex studies on type 1, 2, or 3 IFNs in the cervical mucus of women with PVI associated with herpesvirus and chlamydia infec-tions are available. Aim: to compare IFN profile of mucosal immunity in women with PVI associated with herpesvirus and chlamydia infections. Patients and Methods: this study enrolled 149 women aged 25–44. Women were divided into four groups. Group 1 included women with PVI only (n=21). Group 2 included women with PVI and herpesvirus infection (n=47). Group 3 included women with PVI and chlamydia infec-tions (n=39). Group 4 included controls (n=30). Complex outpatient clinical laboratory examina-tion included clinical functional, biochemical, and immunological tests to detail pathophysiolog-ical mechanisms of urogenital PVIs. IFN (IFN-β, IFN-γ, IFN-λ1/IL-29, IFN-λ3/IL-28B) levels in the cervical mucus were measured by ELISA. Results: in all groups, IFN-λ3 and IFN-γ deficiencies were detected. In PVI, IFN-γ deficiency prevailed. In PVI associated with herpesvirus infection, IFN-λ3 deficiency prevailed. In PVI associated with chlamydia infection, a severe IFN-β deficiency was revealed. Conclusion: these patterns demonstrate a relevant role of the interferon arm of the im-mune response in the pathogenesis of isolated PVI and PVI associated with herpesvirus and chlamydia infections. These alterations in mucosal immunity support the prescription of immu-notherapy for these infections. KEYWORDS: human papillomavirus, herpesvirus infection, chlamydia infection, interferons, immune system, cervical mucus, mucosal immunity. FOR CITATION: Markelova E.V., Tulupova M.S., Nevezhkina T.A. et al. Interferon profile of the mucosal immunity in women with papillomavirus infection. Russian Medical Inquiry. 2022;6(2):67–71 (in Russ.). DOI: 10.32364/2587-6821-2022-6-2-67-71.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78419068","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: 10.32364/2587-6821-2022-6-7-367-375
T. Bilichenko
In COVID-19 of moderate to severe degree, there are significant inflammatory changes in the lungs and other organs involved in the pathological process with corresponding symptoms and functional disorders lasting longer than 12 weeks. They are designated as postcovid syndrome (PCS) and require further treatment. The article presents the pathogenetic mechanism of PCS, in which organ damage has the systemic nature. Special attention is paid to the changes in the organs of the respiratory system (atelectasis in the alveoli within the lungs, remodeling of the bronchial epithelium, hyaluronan deposition in the lumen of alveoli, bronchi and perialveolar interstitial with the formation of connective tissue), which in the long term lead to fibrous changes, especially in patients with severe COVID-19 and concomitant respiratory diseases. This, in turn, makes oxygen and carbon dioxide to pass through the alveoli wall with difficulties, decreases exercise tolerance and life quality, and increases mortality in elderly patients. The article also outlines the main directions of pathogenetically conditioned therapy of patients with respiratory disorder in the outpatient settings, providing a decrease in rehabilitation period and improving the patients condition. KEYWORDS: postcovid syndrome, alveolar epithelium, atelectasis, comorbidity, rehabilitation. FOR CITATION: Bilichenko T.N. Postcovid syndrome: risk factors, pathogenesis, diagnosis and treatment of patients with respiratory damage after COVID-19 (overview). Russian Medical Inquiry. 2022;6(7):367–375 (in Russ.). DOI: 10.32364/2587-6821-2022-6-7-367-375.
{"title":"Postcovid syndrome: risk factors, pathogenesis, diagnosis and treatment of patients with respiratory damage after COVID-19 (overview)","authors":"T. Bilichenko","doi":"10.32364/2587-6821-2022-6-7-367-375","DOIUrl":"https://doi.org/10.32364/2587-6821-2022-6-7-367-375","url":null,"abstract":"In COVID-19 of moderate to severe degree, there are significant inflammatory changes in the lungs and other organs involved in the pathological process with corresponding symptoms and functional disorders lasting longer than 12 weeks. They are designated as postcovid syndrome (PCS) and require further treatment. The article presents the pathogenetic mechanism of PCS, in which organ damage has the systemic nature. Special attention is paid to the changes in the organs of the respiratory system (atelectasis in the alveoli within the lungs, remodeling of the bronchial epithelium, hyaluronan deposition in the lumen of alveoli, bronchi and perialveolar interstitial with the formation of connective tissue), which in the long term lead to fibrous changes, especially in patients with severe COVID-19 and concomitant respiratory diseases. This, in turn, makes oxygen and carbon dioxide to pass through the alveoli wall with difficulties, decreases exercise tolerance and life quality, and increases mortality in elderly patients. The article also outlines the main directions of pathogenetically conditioned therapy of patients with respiratory disorder in the outpatient settings, providing a decrease in rehabilitation period and improving the patients condition. KEYWORDS: postcovid syndrome, alveolar epithelium, atelectasis, comorbidity, rehabilitation. FOR CITATION: Bilichenko T.N. Postcovid syndrome: risk factors, pathogenesis, diagnosis and treatment of patients with respiratory damage after COVID-19 (overview). Russian Medical Inquiry. 2022;6(7):367–375 (in Russ.). DOI: 10.32364/2587-6821-2022-6-7-367-375.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76633414","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: 10.32364/2587-6821-2022-6-7-352-359
E. Volchkova, Y. Alexandrovich, O. Titova, N. Kuzubova, V. Volchkov, D. Piskunov, M. N. Bakholdina, F. Bitakova
Aim: to evaluate the effect of pulmonary surfactant therapy in the complex treatment of severe community-acquired pneumonia caused by the SARS-CoV-2 on the disease course and outcome and to determine the possibility of using the level of surfactant protein D (surfactant protein D, SP-D) in blood serum as a criterion for the treatment efficacy. Patients and Methods: a prospective randomized study included 60 patients. Inclusion criteria confirmed SARS-CoV-2; bilateral pneumonia with at least grade 3 of lesion according to CT; SpO2 less than 92%. Patients were divided into two groups: group 1 (n=30) received surfactant therapy in addition to standard therapy, group 2 (n=30) received only standard therapy. Surfactant was administered by inhalation at a dose of 150–300 mg/day. The duration of surfactant therapy was 10 days. Arterial blood gas values, clinical parameters and SP-D levels were analyzed before and after treatment. Results: 48 hours after the therapy start, a statistically significant increase in SpO2 was registered in patients from group 1 versus an increase in patients from group 2 (p=0.048). On the 10th day of treatment, group 1 versus group 2 showed a statistically significant increase in the oxygenation index (PaO2/FiO2) (266.82±10.5 mmHg vs. 199.67±11.7 mmHg, respectively, p=0.001), a decrease in the frequency of artificial lung ventilation (ALV) (27% vs. 67%, respectively, p=0.002), length of hospital stay (21.0 (15;25) days vs. 27.0 (15;35) days, respectively, p=0.05). The fatal outcome was registered in 8 (27%) patients from group 1 and 18 (60%) patients from group 2 (p=0.001). Among patients from group 1 who had a favorable disease outcome, in 84% of cases surfactant therapy was prescribed in a shorter period from the disease onset versus patients whose treatment was ineffective (3±1.5 days vs. 7±2.0 days). A stable, reliable correlation was established between SP-D and PaO2 (r= 420, p=0.001), between SP-D and PaO2/FiO2 (r=460, p=0.001). Conclusion: the major effects of surfactant therapy are a faster recovery of the arterial blood gas, a decrease in the frequency of ALV, the length of hospital stay, and mortality. The success of surfactant therapy is associated with its early prescription. Surfactant therapy can be considered as an additional pathogenetically justified component in the complex treatment of severe pneumonia caused by the SARS-CoV-2. Significantly higher levels of SP-D were observed in patients with severe pneumonia associated with COVID-19, with the disease progression and adverse outcome. KEYWORDS: SARS-CoV-2, COVID-19, pneumonia, surfactant, artificial lung ventilation, respiratory failure, surfactant protein D, SP-D. FOR CITATION: Volchkova E.V., Alexandrovich Yu.S., Titova O.N. et al. Pulmonary surfactant in the complex treatment of severe pneumonia associated with COVID-19. Efficacy markers. Russian Medical Inquiry. 2022;6(7):352–359 (in Russ.). DOI: 10.32364/2587-6821-2022-6-7-352-359.
{"title":"Pulmonary surfactant in the complex treatment of severe pneumonia associated with COVID-19. Efficacy markers","authors":"E. Volchkova, Y. Alexandrovich, O. Titova, N. Kuzubova, V. Volchkov, D. Piskunov, M. N. Bakholdina, F. Bitakova","doi":"10.32364/2587-6821-2022-6-7-352-359","DOIUrl":"https://doi.org/10.32364/2587-6821-2022-6-7-352-359","url":null,"abstract":"Aim: to evaluate the effect of pulmonary surfactant therapy in the complex treatment of severe community-acquired pneumonia caused by the SARS-CoV-2 on the disease course and outcome and to determine the possibility of using the level of surfactant protein D (surfactant protein D, SP-D) in blood serum as a criterion for the treatment efficacy. Patients and Methods: a prospective randomized study included 60 patients. Inclusion criteria confirmed SARS-CoV-2; bilateral pneumonia with at least grade 3 of lesion according to CT; SpO2 less than 92%. Patients were divided into two groups: group 1 (n=30) received surfactant therapy in addition to standard therapy, group 2 (n=30) received only standard therapy. Surfactant was administered by inhalation at a dose of 150–300 mg/day. The duration of surfactant therapy was 10 days. Arterial blood gas values, clinical parameters and SP-D levels were analyzed before and after treatment. Results: 48 hours after the therapy start, a statistically significant increase in SpO2 was registered in patients from group 1 versus an increase in patients from group 2 (p=0.048). On the 10th day of treatment, group 1 versus group 2 showed a statistically significant increase in the oxygenation index (PaO2/FiO2) (266.82±10.5 mmHg vs. 199.67±11.7 mmHg, respectively, p=0.001), a decrease in the frequency of artificial lung ventilation (ALV) (27% vs. 67%, respectively, p=0.002), length of hospital stay (21.0 (15;25) days vs. 27.0 (15;35) days, respectively, p=0.05). The fatal outcome was registered in 8 (27%) patients from group 1 and 18 (60%) patients from group 2 (p=0.001). Among patients from group 1 who had a favorable disease outcome, in 84% of cases surfactant therapy was prescribed in a shorter period from the disease onset versus patients whose treatment was ineffective (3±1.5 days vs. 7±2.0 days). A stable, reliable correlation was established between SP-D and PaO2 (r= 420, p=0.001), between SP-D and PaO2/FiO2 (r=460, p=0.001). Conclusion: the major effects of surfactant therapy are a faster recovery of the arterial blood gas, a decrease in the frequency of ALV, the length of hospital stay, and mortality. The success of surfactant therapy is associated with its early prescription. Surfactant therapy can be considered as an additional pathogenetically justified component in the complex treatment of severe pneumonia caused by the SARS-CoV-2. Significantly higher levels of SP-D were observed in patients with severe pneumonia associated with COVID-19, with the disease progression and adverse outcome. KEYWORDS: SARS-CoV-2, COVID-19, pneumonia, surfactant, artificial lung ventilation, respiratory failure, surfactant protein D, SP-D. FOR CITATION: Volchkova E.V., Alexandrovich Yu.S., Titova O.N. et al. Pulmonary surfactant in the complex treatment of severe pneumonia associated with COVID-19. Efficacy markers. Russian Medical Inquiry. 2022;6(7):352–359 (in Russ.). DOI: 10.32364/2587-6821-2022-6-7-352-359.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74051396","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: 10.32364/2587-6821-2022-6-4-164-170
A. Chernookov, M. R. Kuznetsov, S. Kandyba, A. Atayan, Yu. N. Lebedeva, A. A. Ramazanov
Aim: to substantiate the feasibility of concurrent surgeries in patients with varicose vein disease and anterior abdominal wall hernias (ventral hernias). Patients and Methods: the paper presents the treatment results of 82 patients with ventrial hernias and lower limb varicose vein disease. The method choice and the scope of surgical intervention were determined on the basis of clinical and instrumental examination data. Commonly, Lichtenstein tension-free hernia repair in combination with crossectomy, endovasal laser coagulation (EVLC), varicose veins radiofrequency ablation (VVRFA) were performed. The long-term results were analyzed 1–2 years after the use of concurrent surgeries. The life quality before surgery and a year after was determined by the SF-36 questionnaire. Results: the patients consisted of 45 (54.9%) men and 37 (45.1%) women aged 19 to 69 years. In 20 (24.4%) of the admitted patients, work was associated with physical activity, and 56 (68.3%) patients were at the most capable age: 19 to 50 years. Upon admission to the clinic, 78 patients had complaints. Commonly, they had a combination of varicose vein disease with inguinal or umbilical hernias. After the use of concurrent surgeries, no specific complications were observed in this patient cohort, as well as complications associated with both diseases concomitantly. In the long-term period, patients noted an improvement in their general health by 23.2%. In the preoperative period, the indicator of physical functioning was 41.27 points; after the operation, there was an increase in this indicator according to patients’ estimates by 1.6 times — to 67.32 points. After surgery, the greatest positive trend of vital activity (42.8%) and role limitations due to emotional state (57.3%) were observed. There was an increase in all indicators of life quality by 18.2–53.9% in patients who underwent concurrent surgeries. Conclusion: the obtained results demonstrated the safety and high efficacy of concurrent surgeries in patients with varicose vein disease and ventral hernias. Thus, the use of concurrent surgeries is considered to be an alternative to the staged treatment of patients with varicose vein disease and ventral hernias KEYWORDS: concurrent surgeries, varicose vein disease, ventral hernias, life quality, postoperative complications. FOR CITATION: Chernookov A.I., Kuznetsov M.R., Kandyba S.I. et al. Concurrent surgeries in patients with varicose vein disease and ventral hernias. Russian Medical Inquiry. 2022;6(4):164–170 (in Russ.). DOI: 10.32364/2587-6821-2022-6-4-164-1.
{"title":"Concurrent surgeries in patients with varicose vein disease and ventral hernias","authors":"A. Chernookov, M. R. Kuznetsov, S. Kandyba, A. Atayan, Yu. N. Lebedeva, A. A. Ramazanov","doi":"10.32364/2587-6821-2022-6-4-164-170","DOIUrl":"https://doi.org/10.32364/2587-6821-2022-6-4-164-170","url":null,"abstract":"Aim: to substantiate the feasibility of concurrent surgeries in patients with varicose vein disease and anterior abdominal wall hernias (ventral hernias). Patients and Methods: the paper presents the treatment results of 82 patients with ventrial hernias and lower limb varicose vein disease. The method choice and the scope of surgical intervention were determined on the basis of clinical and instrumental examination data. Commonly, Lichtenstein tension-free hernia repair in combination with crossectomy, endovasal laser coagulation (EVLC), varicose veins radiofrequency ablation (VVRFA) were performed. The long-term results were analyzed 1–2 years after the use of concurrent surgeries. The life quality before surgery and a year after was determined by the SF-36 questionnaire. Results: the patients consisted of 45 (54.9%) men and 37 (45.1%) women aged 19 to 69 years. In 20 (24.4%) of the admitted patients, work was associated with physical activity, and 56 (68.3%) patients were at the most capable age: 19 to 50 years. Upon admission to the clinic, 78 patients had complaints. Commonly, they had a combination of varicose vein disease with inguinal or umbilical hernias. After the use of concurrent surgeries, no specific complications were observed in this patient cohort, as well as complications associated with both diseases concomitantly. In the long-term period, patients noted an improvement in their general health by 23.2%. In the preoperative period, the indicator of physical functioning was 41.27 points; after the operation, there was an increase in this indicator according to patients’ estimates by 1.6 times — to 67.32 points. After surgery, the greatest positive trend of vital activity (42.8%) and role limitations due to emotional state (57.3%) were observed. There was an increase in all indicators of life quality by 18.2–53.9% in patients who underwent concurrent surgeries. Conclusion: the obtained results demonstrated the safety and high efficacy of concurrent surgeries in patients with varicose vein disease and ventral hernias. Thus, the use of concurrent surgeries is considered to be an alternative to the staged treatment of patients with varicose vein disease and ventral hernias KEYWORDS: concurrent surgeries, varicose vein disease, ventral hernias, life quality, postoperative complications. FOR CITATION: Chernookov A.I., Kuznetsov M.R., Kandyba S.I. et al. Concurrent surgeries in patients with varicose vein disease and ventral hernias. Russian Medical Inquiry. 2022;6(4):164–170 (in Russ.). DOI: 10.32364/2587-6821-2022-6-4-164-1.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74236951","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: 10.32364/2587-6821-2022-6-7-404-410
A. V. Gurov, A. V. Muzhichkova
In recent years, there has been an increased number of calls to ENT specialists concerning otitis externa. These conditions are characterized by antibiotic resistance of key pathogens, as well as the presence of significant pain symptoms. In 60–98% of cases, inflammation in the external auditory canal has a bacterial etiology. Pseudomonas aeruginosa occupies a leading place in the microbial landscape — up to 78% on average, while Staphylococcus aureus is sown only in 9–27% of cases. Rational therapy of otitis externa is one of the urgent problems of otorhinolaryngology, despite the large variety of treatment methods. It is necessary to use complex therapy of external otitis, including a direct effect on the etiological factor, as well as pain relief. In the vast majority of cases, the frontline empirical therapy of otitis externa should be topical antimicrobial agents. The following combined drug is successfully used for the treatment of otitis externa: ear drops containing a combined antibiotic (aminoglycoside neomycin + cyclic polypeptide polymyxin B + topical anesthetic lidocaine). Early therapy of otitis externa with a combined antibiotic is the key to a fast and reliable clinical result. KEYWORDS: otitis externa, bacterial otitis, ear drops, combined antibiotic, aminoglycoside, cyclic polypeptide, topical anesthetics, neomycin, polymyxin B, lidocaine. FOR CITATION: Gurov A.V., Muzhichkova A.V. Rational approach to the treatment of otitis externa. Russian Medical Inquiry. 2022;6(7):404– 410 (in Russ.). DOI: 10.32364/2587-6821-2022-6-7-404-410.
{"title":"Rational approach to the treatment of otitis externa","authors":"A. V. Gurov, A. V. Muzhichkova","doi":"10.32364/2587-6821-2022-6-7-404-410","DOIUrl":"https://doi.org/10.32364/2587-6821-2022-6-7-404-410","url":null,"abstract":"In recent years, there has been an increased number of calls to ENT specialists concerning otitis externa. These conditions are characterized by antibiotic resistance of key pathogens, as well as the presence of significant pain symptoms. In 60–98% of cases, inflammation in the external auditory canal has a bacterial etiology. Pseudomonas aeruginosa occupies a leading place in the microbial landscape — up to 78% on average, while Staphylococcus aureus is sown only in 9–27% of cases. Rational therapy of otitis externa is one of the urgent problems of otorhinolaryngology, despite the large variety of treatment methods. It is necessary to use complex therapy of external otitis, including a direct effect on the etiological factor, as well as pain relief. In the vast majority of cases, the frontline empirical therapy of otitis externa should be topical antimicrobial agents. The following combined drug is successfully used for the treatment of otitis externa: ear drops containing a combined antibiotic (aminoglycoside neomycin + cyclic polypeptide polymyxin B + topical anesthetic lidocaine). Early therapy of otitis externa with a combined antibiotic is the key to a fast and reliable clinical result. KEYWORDS: otitis externa, bacterial otitis, ear drops, combined antibiotic, aminoglycoside, cyclic polypeptide, topical anesthetics, neomycin, polymyxin B, lidocaine. FOR CITATION: Gurov A.V., Muzhichkova A.V. Rational approach to the treatment of otitis externa. Russian Medical Inquiry. 2022;6(7):404– 410 (in Russ.). DOI: 10.32364/2587-6821-2022-6-7-404-410.","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":"83261778","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: 10.32364/2587-6821-2022-6-9-528-533
K. Zherebchikova, Y. Sych, M. V. Amosova, M. Sekacheva, V. Fadeev, A.A. Vilensky
Immune checkpoint inhibitors are monoclonal antibodies directed against the molecules blocking immune response, such as cytotoxic T-lymphocyte- associated protein 4 (CTLA-4), programmed cell death protein-1 (PD1) and its ligand, which enhance anti-tumor immunity. Immune checkpoint inhibitors have demonstrated high efficacy in cancer treatment, including the most common types of cancer and helped to increase recurrence- free and overall survival of cancer patients. At the same time, the use of checkpoint inhibitors is associated with a high risk of immune-related adverse events (irAEs) — autoimmune conditions that occur in multiple organs and tissues, including endocrinopathies. Endocrine irAEs can affect the thyroid, pituitary gland, adrenal glands, and pancreas. These events are unique when compared with other irAEs because the manifestations are often irreversible. The awareness of clinicians of potential irAEs, including endocrinopathies caused by agents from the group of immune checkpoint inhibitors will improve their timely identification and treatment. Thus, it will promote the safe use of highly effective anti-tumor therapy. KEYWORDS: checkpoint inhibitors, CTLA-4, PD1, PDL1, immune-related adverse events, hypothyroidism, thyrotoxicosis, thyroiditis, hypophysitis, adrenal insufficiency. FOR CITATION: Zherebchikova K.Yu., Sych Yu.P., Amosova M.V. et al. Endocrine adverse events in patients with malignant neoplasms receiving treatment with immune checkpoint inhibitors. Russian Medical Inquiry. 2022;6(9):528–533 (in Russ.). DOI: 10.32364/2587-6821- 2022-6-9-528-533.
{"title":"Endocrine adverse events in patients with malignant neoplasms receiving treatment with immune checkpoint inhibitors","authors":"K. Zherebchikova, Y. Sych, M. V. Amosova, M. Sekacheva, V. Fadeev, A.A. Vilensky","doi":"10.32364/2587-6821-2022-6-9-528-533","DOIUrl":"https://doi.org/10.32364/2587-6821-2022-6-9-528-533","url":null,"abstract":"Immune checkpoint inhibitors are monoclonal antibodies directed against the molecules blocking immune response, such as cytotoxic T-lymphocyte- associated protein 4 (CTLA-4), programmed cell death protein-1 (PD1) and its ligand, which enhance anti-tumor immunity. Immune checkpoint inhibitors have demonstrated high efficacy in cancer treatment, including the most common types of cancer and helped to increase recurrence- free and overall survival of cancer patients. At the same time, the use of checkpoint inhibitors is associated with a high risk of immune-related adverse events (irAEs) — autoimmune conditions that occur in multiple organs and tissues, including endocrinopathies. Endocrine irAEs can affect the thyroid, pituitary gland, adrenal glands, and pancreas. These events are unique when compared with other irAEs because the manifestations are often irreversible. The awareness of clinicians of potential irAEs, including endocrinopathies caused by agents from the group of immune checkpoint inhibitors will improve their timely identification and treatment. Thus, it will promote the safe use of highly effective anti-tumor therapy. KEYWORDS: checkpoint inhibitors, CTLA-4, PD1, PDL1, immune-related adverse events, hypothyroidism, thyrotoxicosis, thyroiditis, hypophysitis, adrenal insufficiency. FOR CITATION: Zherebchikova K.Yu., Sych Yu.P., Amosova M.V. et al. Endocrine adverse events in patients with malignant neoplasms receiving treatment with immune checkpoint inhibitors. Russian Medical Inquiry. 2022;6(9):528–533 (in Russ.). DOI: 10.32364/2587-6821- 2022-6-9-528-533.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74460990","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: 10.32364/2587-6821-2022-6-2-85-91
S. Petrova, V. Albanova
Extensive trials have identified a close relationship between atopic dermatitis (AD) and alopecia areata (AA). This review paper summarizes and analyzes available data on the immunological pattern of AD-associated AA. The analysis of scientific findings suggests that epidermal barrier dysfunction in AD promotes AA in the presence of target genes contributing to its development. Both pathological entities negatively affect each other. The results are the reduction in regulatory T cell (Treg) suppression activity and an increase in inflammatory and autoimmune activity of Th-17 cells. Hyperergic Th2 response affects AD-associated AA clinical presentations. The regression of bald patches after IL-4, IL-13, and histamine receptors blockage further establishes the association between AA and AD. The possibility of atopic alopecia requires both skin and hair care products in AD. Dry peeling skin vulnerable to infections should be treated to reduce the risk of autoimmunity in AA. The presence of two family lines of genetic predisposition (atopy and AA) results in severe combined manifestations of these disorders in progeny. Therefore, attention should be paid to early AD signs in children in these families to commence treatment timely. KEYWORDS: atopic dermatitis, аlopecia areata, genetics, autoimmunity, epidermal barrier, regulatory T cells, immune privilege, hair follicle, T helper 17 cells, mast cells. FOR CITATION: Petrova S.Yu., Albanova V.I. Alopecia areata in atopic dermatitis: coincidence or regularity? Russian Medical Inquiry. 2022;6(2):85–91 (in Russ.). DOI: 10.32364/2587-6821-2022-6-2-85-91.
{"title":"Alopecia areata in atopic dermatitis: coincidence or regularity?","authors":"S. Petrova, V. Albanova","doi":"10.32364/2587-6821-2022-6-2-85-91","DOIUrl":"https://doi.org/10.32364/2587-6821-2022-6-2-85-91","url":null,"abstract":"Extensive trials have identified a close relationship between atopic dermatitis (AD) and alopecia areata (AA). This review paper summarizes and analyzes available data on the immunological pattern of AD-associated AA. The analysis of scientific findings suggests that epidermal barrier dysfunction in AD promotes AA in the presence of target genes contributing to its development. Both pathological entities negatively affect each other. The results are the reduction in regulatory T cell (Treg) suppression activity and an increase in inflammatory and autoimmune activity of Th-17 cells. Hyperergic Th2 response affects AD-associated AA clinical presentations. The regression of bald patches after IL-4, IL-13, and histamine receptors blockage further establishes the association between AA and AD. The possibility of atopic alopecia requires both skin and hair care products in AD. Dry peeling skin vulnerable to infections should be treated to reduce the risk of autoimmunity in AA. The presence of two family lines of genetic predisposition (atopy and AA) results in severe combined manifestations of these disorders in progeny. Therefore, attention should be paid to early AD signs in children in these families to commence treatment timely. KEYWORDS: atopic dermatitis, аlopecia areata, genetics, autoimmunity, epidermal barrier, regulatory T cells, immune privilege, hair follicle, T helper 17 cells, mast cells. FOR CITATION: Petrova S.Yu., Albanova V.I. Alopecia areata in atopic dermatitis: coincidence or regularity? Russian Medical Inquiry. 2022;6(2):85–91 (in Russ.). DOI: 10.32364/2587-6821-2022-6-2-85-91.","PeriodicalId":21378,"journal":{"name":"Russian Medical Inquiry","volume":"105 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77679831","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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