Pub Date : 2023-12-22DOI: 10.26442/00403660.2023.11.202480
Nail R. Yamoldinov, M. V. Dudarev, D. S. Sarksyan, V. V. Maleev
Heart rhythm disorders are one of the most common complications of coronavirus infection. Heart rhythm disorders can develop in 6–17% of hospitalized patients, and in convalescents, COVID-19 can manifest itself up to 12 months after the completion of the acute phase of the disease. Among the mechanisms for the development of cardiac arrhythmias, there are a direct cytopathic effect of SARS-CoV-2 on the myocardium, systemic inflammatory response syndrome, electrolyte imbalance, hypoxia, the use of antibacterial, antimalarial and antiviral drugs, exudative pericarditis, autonomic dysfunction. The main COVID-19-mediated heart rhythm disorders are sinus tachycardia and bradycardia, atrial fibrillation, ventricular tachycardia, long QT syndrome. Despite a significant amount of research, the literature data on the prevalence of certain types of cardiac arrhythmias (especially in COVID-19 convalescents), as well as methods for their correction, are somewhat contradictory and need to be clarified. Taking into account the impact of arrhythmia on the quality of life and mortality, active monitoring of convalescents of coronavirus infection, identification and development of approaches to the treatment of heart rhythm disorders in patients who have had COVID-19, seem to be relevant and promising areas in modern cardiology.
{"title":"Сardiac arrhythmias in people who have had a coronavirus infection COVID-19: A review","authors":"Nail R. Yamoldinov, M. V. Dudarev, D. S. Sarksyan, V. V. Maleev","doi":"10.26442/00403660.2023.11.202480","DOIUrl":"https://doi.org/10.26442/00403660.2023.11.202480","url":null,"abstract":"Heart rhythm disorders are one of the most common complications of coronavirus infection. Heart rhythm disorders can develop in 6–17% of hospitalized patients, and in convalescents, COVID-19 can manifest itself up to 12 months after the completion of the acute phase of the disease. Among the mechanisms for the development of cardiac arrhythmias, there are a direct cytopathic effect of SARS-CoV-2 on the myocardium, systemic inflammatory response syndrome, electrolyte imbalance, hypoxia, the use of antibacterial, antimalarial and antiviral drugs, exudative pericarditis, autonomic dysfunction. The main COVID-19-mediated heart rhythm disorders are sinus tachycardia and bradycardia, atrial fibrillation, ventricular tachycardia, long QT syndrome. Despite a significant amount of research, the literature data on the prevalence of certain types of cardiac arrhythmias (especially in COVID-19 convalescents), as well as methods for their correction, are somewhat contradictory and need to be clarified. Taking into account the impact of arrhythmia on the quality of life and mortality, active monitoring of convalescents of coronavirus infection, identification and development of approaches to the treatment of heart rhythm disorders in patients who have had COVID-19, seem to be relevant and promising areas in modern cardiology.","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"10 12","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138946038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-22DOI: 10.26442/00403660.2023.11.202477
S. S. Kozlov, L. A. Ermakova, Y. Lobzin, S. A. Nagorny, I. Kornienko, V. O. Telicheva, Mariia A. Kaliuzhina, N. Pshenichcnaya
The differential diagnosis of neoplasms of various localizations is the primary task in clinical practice of all physicians. We present a description of the case of invasion with Dirofilaria repens in the lung of a 68-year-old patient. In 2016 the patient was diagnosed with cancer of the left kidney and underwent a left-sided nephrectomy. During the dynamic observation in 2019, a lump was found in the left lung, which was regarded as a metastasis. An atypical SIX resection of the left lung was performed. Microscopy of the removed lump revealed the presence of a nematode of the genus Dirofilaria, presumably D. repens. The species identity of D. repens was confirmed by polymerase chain reaction using species-specific primers. It is known that the morphological identification of parasites up to the species in the surgical material presents certain difficulties and requires high professional training of the researcher. Therefore, the diagnosis of dirofilariasis in atypical localizations of nematodes in the human body is of great importance in the differentiation of malignant and benign formations, and the use of the polymerase chain reaction method can significantly increase the accuracy in establishing the final diagnosis.
对不同部位的肿瘤进行鉴别诊断是所有医生在临床实践中的首要任务。我们在此介绍一例68岁患者肺部感染狄氏丝虫的病例。2016 年，患者被诊断为左肾癌，并接受了左侧肾切除术。在2019年的动态观察中，发现左肺有肿块，被认为是转移灶。进行了左肺非典型 SIX 切除术。对切除的肿块进行显微镜检查后发现了一种 Dirofilaria 属线虫，推测为 D. repens。通过使用物种特异性引物进行聚合酶链反应，确认了 D. repens 的物种身份。众所周知，对手术材料中的寄生虫进行形态学鉴定直至确定其种类存在一定的困难，对研究人员的专业素养要求很高。因此，在人体内线虫的非典型定位中诊断双鞭毛虫病对于区分恶性和良性病变非常重要，而使用聚合酶链反应方法可以大大提高最终诊断的准确性。
{"title":"A case of pleuropulmonary dirofilariasis caused by Dirofilaria repens. Case report","authors":"S. S. Kozlov, L. A. Ermakova, Y. Lobzin, S. A. Nagorny, I. Kornienko, V. O. Telicheva, Mariia A. Kaliuzhina, N. Pshenichcnaya","doi":"10.26442/00403660.2023.11.202477","DOIUrl":"https://doi.org/10.26442/00403660.2023.11.202477","url":null,"abstract":"The differential diagnosis of neoplasms of various localizations is the primary task in clinical practice of all physicians. We present a description of the case of invasion with Dirofilaria repens in the lung of a 68-year-old patient. In 2016 the patient was diagnosed with cancer of the left kidney and underwent a left-sided nephrectomy. During the dynamic observation in 2019, a lump was found in the left lung, which was regarded as a metastasis. An atypical SIX resection of the left lung was performed. Microscopy of the removed lump revealed the presence of a nematode of the genus Dirofilaria, presumably D. repens. The species identity of D. repens was confirmed by polymerase chain reaction using species-specific primers. It is known that the morphological identification of parasites up to the species in the surgical material presents certain difficulties and requires high professional training of the researcher. Therefore, the diagnosis of dirofilariasis in atypical localizations of nematodes in the human body is of great importance in the differentiation of malignant and benign formations, and the use of the polymerase chain reaction method can significantly increase the accuracy in establishing the final diagnosis.","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"37 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138946686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-22DOI: 10.26442/00403660.2023.11.202455
A. V. Gurov, Andrey I. Kriukov, Georgy B. Shadrin, G. Izotova, P. K. Zotova
Aim. To study the structure of the microbial landscape in patients with acute otitis externa, as well as to evaluate the efficacy and safety of the combined drug chloramphenicol/clotrimazole/beclomethasone/lidocaine (Candibiotic) as an empirical therapy of this disease.Materials and methods. In this retrospective study of real clinical practice, outpatient records of 963 patients who applied to the KDO of the Sverzhevsky Research Clinical Institute of Otorhinolaryngology with symptoms of otitis externa in the period from 2017 to 2022 were selected. Additional analysis was carried out on the clinical records of patients who received the combined drug Candibiotic. The endpoints of this analysis included data on the clinical and microbiological efficacy of therapy, as well as safety information.Results. According to microbiological testing, 60.6% of microorganisms belonged to bacterial flora, 26% were bacterial-fungal associations, 11.6% were monofungal flora, in 1.8% of cases there was no growth of microorganisms. The most frequently isolated microorganisms were: Pseudomonas spp (n=291; 29.16%), Staphylococcus spp. (n=214; 21.4%), Candida spp. (n=194; 19.4%), Aspergillus spp. (n=133; 13.3%). Most of the patients (71.0%) received Candibiotic. In 69.7% of patients, the resolution of the clinical symptoms of otitis externa occurred within 7 days of therapy with Candibiotic. Complete eradication of microorganisms occurred in 87% of cases. Adverse events were recorded only in 3 (0.04%) cases.Conclusion. The study demonstrated an extremely high level of clinical efficacy and safety of therapy in patients with acute external infectious otitis who received the Candibiotic, which can be used as an initial empirical therapy in patients with otitis externa.
{"title":"Efficacy and safety of topical combination therapy in patients with acute otitis externa","authors":"A. V. Gurov, Andrey I. Kriukov, Georgy B. Shadrin, G. Izotova, P. K. Zotova","doi":"10.26442/00403660.2023.11.202455","DOIUrl":"https://doi.org/10.26442/00403660.2023.11.202455","url":null,"abstract":"Aim. To study the structure of the microbial landscape in patients with acute otitis externa, as well as to evaluate the efficacy and safety of the combined drug chloramphenicol/clotrimazole/beclomethasone/lidocaine (Candibiotic) as an empirical therapy of this disease.Materials and methods. In this retrospective study of real clinical practice, outpatient records of 963 patients who applied to the KDO of the Sverzhevsky Research Clinical Institute of Otorhinolaryngology with symptoms of otitis externa in the period from 2017 to 2022 were selected. Additional analysis was carried out on the clinical records of patients who received the combined drug Candibiotic. The endpoints of this analysis included data on the clinical and microbiological efficacy of therapy, as well as safety information.Results. According to microbiological testing, 60.6% of microorganisms belonged to bacterial flora, 26% were bacterial-fungal associations, 11.6% were monofungal flora, in 1.8% of cases there was no growth of microorganisms. The most frequently isolated microorganisms were: Pseudomonas spp (n=291; 29.16%), Staphylococcus spp. (n=214; 21.4%), Candida spp. (n=194; 19.4%), Aspergillus spp. (n=133; 13.3%). Most of the patients (71.0%) received Candibiotic. In 69.7% of patients, the resolution of the clinical symptoms of otitis externa occurred within 7 days of therapy with Candibiotic. Complete eradication of microorganisms occurred in 87% of cases. Adverse events were recorded only in 3 (0.04%) cases.Conclusion. The study demonstrated an extremely high level of clinical efficacy and safety of therapy in patients with acute external infectious otitis who received the Candibiotic, which can be used as an initial empirical therapy in patients with otitis externa.","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"23 12","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138947773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-22DOI: 10.26442/00403660.2023.11.202487
A. Shuldyakov, A. N. Smagina, Kristina Kh. Ramazanova, E. Lyapina, Yusef R. Chabbarov, N.A. Sheshina, Alena A. Zhuk
The adverse outcomes in patients with COVID-19 in the initial phase of the disease are often due to the development of cytokine storm, endothelial dysfunction, shifts in the hemostasis system, microangiopathy, angiocentric inflammation, and pathological angiogenesis, which require targeted therapy. Unfortunately, to date, there is still no drug with proven high efficacy. This review is to analyse the literature data on the pathogenesis of vascular homeostasis lesions and possible ways to correct the existing shifts in patients with COVID-19. When the oxygen content in the tissue decreases, one of the most important mechanisms of adaptation is the activation of the succinate oxidase pathway, but under conditions of prolonged hypoxia and intoxication, the succinate reserve is rapidly depleted. That is why exogenous of succinic acid can enhance the adaptive capabilities of the organism and improve the prognosis in patients with COVID-19. Succinic acid preparations contribute to normalization of energy exchange and reduction of oxidative stress, especially in combination with inosine, nicotinamide and riboflavin and are widely used in clinical practice in various nosological forms. Taking into account the analysis of data on the mechanisms of clinical effects of succinate-containing preparations, this group of drugs can be considered as promising with regard to the correction of vascular disorders in COVID-19.
{"title":"Pathogenetic approaches to the correction of vascular homeostasis in patients with COVID-19: A review","authors":"A. Shuldyakov, A. N. Smagina, Kristina Kh. Ramazanova, E. Lyapina, Yusef R. Chabbarov, N.A. Sheshina, Alena A. Zhuk","doi":"10.26442/00403660.2023.11.202487","DOIUrl":"https://doi.org/10.26442/00403660.2023.11.202487","url":null,"abstract":"The adverse outcomes in patients with COVID-19 in the initial phase of the disease are often due to the development of cytokine storm, endothelial dysfunction, shifts in the hemostasis system, microangiopathy, angiocentric inflammation, and pathological angiogenesis, which require targeted therapy. Unfortunately, to date, there is still no drug with proven high efficacy. This review is to analyse the literature data on the pathogenesis of vascular homeostasis lesions and possible ways to correct the existing shifts in patients with COVID-19. When the oxygen content in the tissue decreases, one of the most important mechanisms of adaptation is the activation of the succinate oxidase pathway, but under conditions of prolonged hypoxia and intoxication, the succinate reserve is rapidly depleted. That is why exogenous of succinic acid can enhance the adaptive capabilities of the organism and improve the prognosis in patients with COVID-19. Succinic acid preparations contribute to normalization of energy exchange and reduction of oxidative stress, especially in combination with inosine, nicotinamide and riboflavin and are widely used in clinical practice in various nosological forms. Taking into account the analysis of data on the mechanisms of clinical effects of succinate-containing preparations, this group of drugs can be considered as promising with regard to the correction of vascular disorders in COVID-19.","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"16 4","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138944565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-22DOI: 10.26442/00403660.2023.11.202471
K. V. Zhdanov, O. V. Maltsev, K. Kasyanenko, K. Kozlov, V. Sukachev, Nikolai I. Lvov, V. V. Sharabkhanov, Alexander A. Litvinov
Aim. To evaluate the clinical efficacy and safety of antiviral drug riamilovir in patients with acute respiratory viral infections (ARVI) of non-coronavirus (SARS-CoV-2) etiology with different dosing regimens. Materials and methods. The study included 150 patients with ARVI aged 18–27 years (50 patients received riamilovir in the regimen of 250 mg 3 times a day for 5 days, 50 patients received riamilovir in the off label regimen of 250 mg 5 times a day for 5 days, 50 patients received only pathogenetic treatment). Results. The use of riamilovir in both treatment regimens led to a reduction in the duration of inpatient treatment. The shortest periods of hospitalization were noted in patients who received the study drug at higher daily dosages. The use of riamilovir reduced the duration and severity of general infectious manifestations of the disease, while the shortest total duration of fever and a number of respiratory tract syndromes was registered among people who received riamilovir in the regimen of 1250 mg per day for 5 days, no adverse events were registered, additionally, 100% elimination of ARVI pathogens was noted in 1250 mg per day group. Conclusion. Riamilovir has shown clinical efficacy and a good safety profile in in both treatment regimens. The dosage regimen of 1250 mg per day led to more significant clinical effects and to 100% elimination of ARVI pathogens in the study group by the 6th day of hospitalization.
{"title":"Clinical efficiency and safety of riamilovir under various dosage regimens for treatment of acute respiratory viral infections in adults","authors":"K. V. Zhdanov, O. V. Maltsev, K. Kasyanenko, K. Kozlov, V. Sukachev, Nikolai I. Lvov, V. V. Sharabkhanov, Alexander A. Litvinov","doi":"10.26442/00403660.2023.11.202471","DOIUrl":"https://doi.org/10.26442/00403660.2023.11.202471","url":null,"abstract":"Aim. To evaluate the clinical efficacy and safety of antiviral drug riamilovir in patients with acute respiratory viral infections (ARVI) of non-coronavirus (SARS-CoV-2) etiology with different dosing regimens. \u0000Materials and methods. The study included 150 patients with ARVI aged 18–27 years (50 patients received riamilovir in the regimen of 250 mg 3 times a day for 5 days, 50 patients received riamilovir in the off label regimen of 250 mg 5 times a day for 5 days, 50 patients received only pathogenetic treatment). \u0000Results. The use of riamilovir in both treatment regimens led to a reduction in the duration of inpatient treatment. The shortest periods of hospitalization were noted in patients who received the study drug at higher daily dosages. The use of riamilovir reduced the duration and severity of general infectious manifestations of the disease, while the shortest total duration of fever and a number of respiratory tract syndromes was registered among people who received riamilovir in the regimen of 1250 mg per day for 5 days, no adverse events were registered, additionally, 100% elimination of ARVI pathogens was noted in 1250 mg per day group. \u0000Conclusion. Riamilovir has shown clinical efficacy and a good safety profile in in both treatment regimens. The dosage regimen of 1250 mg per day led to more significant clinical effects and to 100% elimination of ARVI pathogens in the study group by the 6th day of hospitalization.","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"57 4","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138945835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-22DOI: 10.26442/00403660.2023.11.202468
A. M. Osadchuk, Nina A. Fadeeva, Nuriya A. Dashkina, I. D. Loranskaya, Sergey G. Khomeriki
Currently, there is an increase in the incidence of microscopic colitis. There are difficulties in diagnosing this disease due to the variability of histological signs, variability of morphological changes in the mucous membrane of the colon in different parts of the colon, and the combination in one patient of not only various forms of microscopic colitis, but also other intestinal diseases. The article describes the differential diagnosis, an example of its staging and successful treatment of various forms of microscopic colitis with budesonide (two clinical cases presented).
{"title":"Clinical cases of microscopic colitis: Diagnosis and treatment issues. Case report","authors":"A. M. Osadchuk, Nina A. Fadeeva, Nuriya A. Dashkina, I. D. Loranskaya, Sergey G. Khomeriki","doi":"10.26442/00403660.2023.11.202468","DOIUrl":"https://doi.org/10.26442/00403660.2023.11.202468","url":null,"abstract":"Currently, there is an increase in the incidence of microscopic colitis. There are difficulties in diagnosing this disease due to the variability of histological signs, variability of morphological changes in the mucous membrane of the colon in different parts of the colon, and the combination in one patient of not only various forms of microscopic colitis, but also other intestinal diseases. The article describes the differential diagnosis, an example of its staging and successful treatment of various forms of microscopic colitis with budesonide (two clinical cases presented).","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"27 4","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138947182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-22DOI: 10.26442/00403660.2023.11.202476
A. Pokrovskaya, Anna A. Popova
The article presents a clinical case of hepatitis C treatment with repeated reinfection in an HIV-positive patient. Despite the possibility of hepatitis C cure with modern antiviral drugs and long-term duration and quality of patients’ life, remains the risk of reinfection. It is necessary to intensify prevention and regular laboratory screening for viral hepatitis among all population in order to start treatment in time and prevent new cases of hepatitis.
{"title":"A clinical case of three times treatment of hepatitis C with repeated infection in HIV-positive patient. Case Report","authors":"A. Pokrovskaya, Anna A. Popova","doi":"10.26442/00403660.2023.11.202476","DOIUrl":"https://doi.org/10.26442/00403660.2023.11.202476","url":null,"abstract":"The article presents a clinical case of hepatitis C treatment with repeated reinfection in an HIV-positive patient. Despite the possibility of hepatitis C cure with modern antiviral drugs and long-term duration and quality of patients’ life, remains the risk of reinfection. It is necessary to intensify prevention and regular laboratory screening for viral hepatitis among all population in order to start treatment in time and prevent new cases of hepatitis.","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"13 8","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138944466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-22DOI: 10.26442/00403660.2023.11.202473
M. S. Nozhkin, D. A. Lioznov, T. V. Antonova, Olga V. Gorchakova, Edward M. Goldstein, M. O. Popova, Tatyana V. Shneyder
The study evaluated the impact of HCV infection on the prognosis in patients with hematological malignancies. A total of 96 patients with anti-HCV antibodies were enrolled, with the age of 37.8 (3.0–81.0) years old, 39.6% had non-Hodgkin’s lymphoma. Chronic hepatitis C (CHC) was diagnosed in 46.9% patients prior to malignancy development, in 38.5% patients simultaneously with malignancy, and in 14.6% patients during malignancy treatment. Clinical and biochemical signs of HCH were mild in most of the patients, minimal liver fibrosis (F0–1 by METAVIR system) was discovered in 47.3% patients, severe fibrosis or cirrhosis (F3–4) was diagnosed in 40% of participants. Only 20 (20.8%) of patients received antiviral therapy against HCV prior to enrollment. Regression analysis demonstrated that age 55 years old, late onset of antiviral therapy, and poor nutritional status were significant predictors of death from hematological malignancy. Survey conducted among physicians of hematological oncology hospitals in Saint-Petersburg revealed gaps in knowledge on presentation and risks of HCV infection, as well as on opportunities of modern antiviral therapy.
{"title":"Prognostic factors in patients with hematological malignancies and concomitant chronic hepatitis C","authors":"M. S. Nozhkin, D. A. Lioznov, T. V. Antonova, Olga V. Gorchakova, Edward M. Goldstein, M. O. Popova, Tatyana V. Shneyder","doi":"10.26442/00403660.2023.11.202473","DOIUrl":"https://doi.org/10.26442/00403660.2023.11.202473","url":null,"abstract":"The study evaluated the impact of HCV infection on the prognosis in patients with hematological malignancies. A total of 96 patients with anti-HCV antibodies were enrolled, with the age of 37.8 (3.0–81.0) years old, 39.6% had non-Hodgkin’s lymphoma. Chronic hepatitis C (CHC) was diagnosed in 46.9% patients prior to malignancy development, in 38.5% patients simultaneously with malignancy, and in 14.6% patients during malignancy treatment. Clinical and biochemical signs of HCH were mild in most of the patients, minimal liver fibrosis (F0–1 by METAVIR system) was discovered in 47.3% patients, severe fibrosis or cirrhosis (F3–4) was diagnosed in 40% of participants. Only 20 (20.8%) of patients received antiviral therapy against HCV prior to enrollment. Regression analysis demonstrated that age 55 years old, late onset of antiviral therapy, and poor nutritional status were significant predictors of death from hematological malignancy. Survey conducted among physicians of hematological oncology hospitals in Saint-Petersburg revealed gaps in knowledge on presentation and risks of HCV infection, as well as on opportunities of modern antiviral therapy.","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"55 17","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138946299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-22DOI: 10.26442/00403660.2023.11.202474
O. Savushkina, P. Astanin, G. Nekludova, S. Avdeev, A. Zaytsev
Background. Impulse oscillometry (IOS) is an effort independent method of studying lung mechanics.Aim. To study the diagnostic significance of IOS in assessing lung mechanics after COVID-19.Materials and methods. Spirometry, body plethysmography, diffusion test (DLco), IOS parameters were analyzed in 315 patients (the median age 48 years), the median period from the beginning of COVID-19 to the study was 50 days. Statistical analysis included descriptive statistics, correlation analysis and one-dimensional logistic regression analysis with an assessment of odds ratios.Results. In general group, spirometry and body plethysmography parameters were in normal values, while DLCO was reduced in 61% of patients. Parameters of IOS were analyzed in the general group and between the groups, depending on the value of DLco and total lung capacity (TLC): normal or reduced. In general group, reactance area (AX), hererogeneity of resistance Rrs5–Rrs20, resistance at 5 Hz (Rrs5), reactance at 5 Hz (ΔXrs5) were increased in 29.8%, 17.8%, 6%, 4.8% of patients, respectively, and were statistically significantly higher in the group with reduced TLC, whereas in the group with reduced DLco AX, Rrs5–Rrs20 were statistically significantly higher. Logistic regression analysis showed that patients with Rrs5-Rrs200.07 kPa×sec/l or AX0.32 kPa/l had a 1.99-fold and 2.24-fold increased risk for decrease DLco, respectively, while the risk of decrease in TLC was 2.25-fold (p=0.012) and 3.16-fold (p0.001) higher, respectively.Conclusion. IOS allow to detect both dysfunction of small airways (if AX or Rrs5–Rrs20 are increased) and the risk of restrictive pattern and lung diffusion impairment after COVID-19.
{"title":"The possibilities of impulse oscillometry in the diagnosis of the lung function disorders after COVID-19","authors":"O. Savushkina, P. Astanin, G. Nekludova, S. Avdeev, A. Zaytsev","doi":"10.26442/00403660.2023.11.202474","DOIUrl":"https://doi.org/10.26442/00403660.2023.11.202474","url":null,"abstract":"Background. Impulse oscillometry (IOS) is an effort independent method of studying lung mechanics.Aim. To study the diagnostic significance of IOS in assessing lung mechanics after COVID-19.Materials and methods. Spirometry, body plethysmography, diffusion test (DLco), IOS parameters were analyzed in 315 patients (the median age 48 years), the median period from the beginning of COVID-19 to the study was 50 days. Statistical analysis included descriptive statistics, correlation analysis and one-dimensional logistic regression analysis with an assessment of odds ratios.Results. In general group, spirometry and body plethysmography parameters were in normal values, while DLCO was reduced in 61% of patients. Parameters of IOS were analyzed in the general group and between the groups, depending on the value of DLco and total lung capacity (TLC): normal or reduced. In general group, reactance area (AX), hererogeneity of resistance Rrs5–Rrs20, resistance at 5 Hz (Rrs5), reactance at 5 Hz (ΔXrs5) were increased in 29.8%, 17.8%, 6%, 4.8% of patients, respectively, and were statistically significantly higher in the group with reduced TLC, whereas in the group with reduced DLco AX, Rrs5–Rrs20 were statistically significantly higher. Logistic regression analysis showed that patients with Rrs5-Rrs200.07 kPa×sec/l or AX0.32 kPa/l had a 1.99-fold and 2.24-fold increased risk for decrease DLco, respectively, while the risk of decrease in TLC was 2.25-fold (p=0.012) and 3.16-fold (p0.001) higher, respectively.Conclusion. IOS allow to detect both dysfunction of small airways (if AX or Rrs5–Rrs20 are increased) and the risk of restrictive pattern and lung diffusion impairment after COVID-19.","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"23 11","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138946028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-22DOI: 10.26442/00403660.2023.11.202479
V. V. Nikiforov, V. A. Petrov, A. Stremoukhov., M. Avdeeva, Y. Shvarts, Irina E. Kravchenko, Irina V. Nikolaeva, S. E. Ushakova, Oksana N. Belousova, Natal'ia A. Eremina, S. V. Teplykh, Ekaterina V. Mel'nikova, Natal'ia E. Kostinа
Aim. The search for etiopathogenetic agents to prevent the development of severe and extremely severe COVID-19 remains relevant. A placebo-controlled randomized clinical trial was conducted to evaluate the efficacy and safety of the antibody-based biological drug (Raphamin).Materials and methods. 785 outpatients 18–75 y.o. with laboratory confirmed mild COVID-19 were included within 24 hours from the disease onset. 771 patients were randomized to the group Raphamin (n=382) and the Placebo group (n=389). The study drug/placebo was prescribed for 5 days. The rate of progression to a more severe degree of COVID-19 by day 28 as well as the time to sustained clinical recovery and the frequency of hospitalization were evaluated. Safety was assessed taking into account adverse events, vital signs and laboratory parameters.Results. The number of cases of progression to a more severe degree of COVID-19 in participants receiving Raphamin was 59 (15.5%) [52 (14.6%)] versus placebo – 89 (22.9%) [85 (23.7%)], ITT and [PP] analysis data are presented. The odds ratio between groups was OR=0.6157 [OR=0.5494], 95% confidence interval 0.4276–0.8866 [0.3750–0.8048], which meant a reduction in the chance of progression to a more severe degree by 38.4% [45.1%] or 1.48 [1.62] times; p=0.0088 [p=0.0019]. The time to sustained recovery in the Raphamin group was 4.5±2.4 [4.6±2.4] days, versus placebo – 5.8±4.7 [6.0±4.8] days; p=0.0025 [p=0.0036]. No adverse events with a certain relationship were registered.Conclusion. Raphamin reduces the risk of progression to a more severe degree of the COVID-19 and significantly shortens the duration of clinical symptoms.
{"title":"The effect of etiopathogenetic therapy of COVID-19 on the severity of the disease: results of a multicenter double-blind placebo-controlled randomized trial","authors":"V. V. Nikiforov, V. A. Petrov, A. Stremoukhov., M. Avdeeva, Y. Shvarts, Irina E. Kravchenko, Irina V. Nikolaeva, S. E. Ushakova, Oksana N. Belousova, Natal'ia A. Eremina, S. V. Teplykh, Ekaterina V. Mel'nikova, Natal'ia E. Kostinа","doi":"10.26442/00403660.2023.11.202479","DOIUrl":"https://doi.org/10.26442/00403660.2023.11.202479","url":null,"abstract":"Aim. The search for etiopathogenetic agents to prevent the development of severe and extremely severe COVID-19 remains relevant. A placebo-controlled randomized clinical trial was conducted to evaluate the efficacy and safety of the antibody-based biological drug (Raphamin).Materials and methods. 785 outpatients 18–75 y.o. with laboratory confirmed mild COVID-19 were included within 24 hours from the disease onset. 771 patients were randomized to the group Raphamin (n=382) and the Placebo group (n=389). The study drug/placebo was prescribed for 5 days. The rate of progression to a more severe degree of COVID-19 by day 28 as well as the time to sustained clinical recovery and the frequency of hospitalization were evaluated. Safety was assessed taking into account adverse events, vital signs and laboratory parameters.Results. The number of cases of progression to a more severe degree of COVID-19 in participants receiving Raphamin was 59 (15.5%) [52 (14.6%)] versus placebo – 89 (22.9%) [85 (23.7%)], ITT and [PP] analysis data are presented. The odds ratio between groups was OR=0.6157 [OR=0.5494], 95% confidence interval 0.4276–0.8866 [0.3750–0.8048], which meant a reduction in the chance of progression to a more severe degree by 38.4% [45.1%] or 1.48 [1.62] times; p=0.0088 [p=0.0019]. The time to sustained recovery in the Raphamin group was 4.5±2.4 [4.6±2.4] days, versus placebo – 5.8±4.7 [6.0±4.8] days; p=0.0025 [p=0.0036]. No adverse events with a certain relationship were registered.Conclusion. Raphamin reduces the risk of progression to a more severe degree of the COVID-19 and significantly shortens the duration of clinical symptoms.","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"74 21","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138945376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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