Pub Date : 2024-07-17DOI: 10.14739/2310-1210.2024.4.300534
O. O. Khaniukov, L. Sapozhnychenko, O. Smolianova
Aim. To describe a clinical case and analyze the challenges in diagnosing hypertrophic cardiomyopathy (HCM) in a patient with concomitant arterial hypertension (AH). Materials and methods. The article presents the clinical case of HCM in the patient with concomitant AH that was observed in an ambulatory setting in the Municipal Enterprise “Dnipropetrovsk Regional Clinical Center for Diagnostics and Treatment” of Dnipropetrovsk Regional Council. Results. A 66-year-old woman N., diagnosed by her family physician with coronary artery disease (CAD): stable angina FC II, grade 2 AH, chronic heart failure FC II NYHA, was referred to a cardiologist because of experiencing exertional dyspnea, chest pain, and uncontrolled blood pressure despite treatment compliance. Echocardiography identified concentric left ventricular hypertrophy with the left ventricular outflow tract (LVOT) obstruction (a mean gradient of 35 mmHg as per catheterization). Cardiac MRI confirmed the diagnosis and coronary angiography ruled out CAD. Adjustments to the treatment regimen, taking into account HCM with LVOT obstruction, effectively alleviated the patient’s symptoms and stabilized her blood pressure. Conclusions. It is especially important to follow the guidelines of AH management and perform echocardiography in all patients with high blood pressure, so as not to miss the signs of concomitant HCM, particularly with LVOT obstruction. In addition, in the case of HCM, it is necessary to timely detect, provide prevention and manage patients at risk for sudden cardiac death. Since HCM encompasses various diagnoses with different pathogenesis and distinct management, cardiac MRI, enzymatic or genetic testing may be needed according to guidelines. As HCM is a relatively common inherited cardiac disease, general practitioners could often encounter such patients in everyday clinical practice. Hence, they should have a certain suspicion of this diagnosis in persons with AH whose left ventricular mass meets the criteria for HCM.
目的描述一例临床病例，并分析诊断合并动脉高血压（AH）患者的肥厚型心肌病（HCM）所面临的挑战。文章介绍了在第聂伯罗彼得罗夫斯克州委员会市级企业 "第聂伯罗彼得罗夫斯克地区临床诊断和治疗中心 "门诊环境中观察到的合并动脉高血压患者的肥厚型心肌病临床病例。一名 66 岁的女性 N 经家庭医生诊断患有冠状动脉疾病（CAD）：稳定型心绞痛 FC II，2 级 AH，慢性心力衰竭 FC II NYHA，因出现劳累性呼吸困难、胸痛和血压无法控制而转诊至心脏科医生。心脏磁共振成像证实了诊断结果，冠状动脉造影排除了 CAD。考虑到 HCM 伴有 LVOT 阻塞，调整治疗方案后，患者的症状得到有效缓解，血压也趋于稳定。遵循 AH 管理指南并对所有高血压患者进行超声心动图检查尤为重要，以免错过并发 HCM（尤其是左心室出口梗阻）的征兆。此外，对于 HCM，有必要及时发现、预防和管理有心脏性猝死风险的患者。由于 HCM 包含多种诊断，发病机制各不相同，治疗方法也不尽相同，因此可能需要根据指南进行心脏磁共振成像、酶学或基因检测。由于 HCM 是一种较为常见的遗传性心脏病，普通医生在日常临床实践中经常会遇到此类患者，因此，对于左心室质量符合 HCM 标准的 AH 患者，他们应该对这一诊断有一定的怀疑。
{"title":"The challenges in diagnosing hypertrophic cardiomyopathy in the presence of arterial hypertension: a clinical case","authors":"O. O. Khaniukov, L. Sapozhnychenko, O. Smolianova","doi":"10.14739/2310-1210.2024.4.300534","DOIUrl":"https://doi.org/10.14739/2310-1210.2024.4.300534","url":null,"abstract":"Aim. To describe a clinical case and analyze the challenges in diagnosing hypertrophic cardiomyopathy (HCM) in a patient with concomitant arterial hypertension (AH).\u0000Materials and methods. The article presents the clinical case of HCM in the patient with concomitant AH that was observed in an ambulatory setting in the Municipal Enterprise “Dnipropetrovsk Regional Clinical Center for Diagnostics and Treatment” of Dnipropetrovsk Regional Council.\u0000Results. A 66-year-old woman N., diagnosed by her family physician with coronary artery disease (CAD): stable angina FC II, grade 2 AH, chronic heart failure FC II NYHA, was referred to a cardiologist because of experiencing exertional dyspnea, chest pain, and uncontrolled blood pressure despite treatment compliance.\u0000Echocardiography identified concentric left ventricular hypertrophy with the left ventricular outflow tract (LVOT) obstruction (a mean gradient of 35 mmHg as per catheterization). Cardiac MRI confirmed the diagnosis and coronary angiography ruled out CAD. Adjustments to the treatment regimen, taking into account HCM with LVOT obstruction, effectively alleviated the patient’s symptoms and stabilized her blood pressure.\u0000Conclusions. It is especially important to follow the guidelines of AH management and perform echocardiography in all patients with high blood pressure, so as not to miss the signs of concomitant HCM, particularly with LVOT obstruction. In addition, in the case of HCM, it is necessary to timely detect, provide prevention and manage patients at risk for sudden cardiac death. Since HCM encompasses various diagnoses with different pathogenesis and distinct management, cardiac MRI, enzymatic or genetic testing may be needed according to guidelines.\u0000As HCM is a relatively common inherited cardiac disease, general practitioners could often encounter such patients in everyday clinical practice. Hence, they should have a certain suspicion of this diagnosis in persons with AH whose left ventricular mass meets the criteria for HCM.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141831000","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 : 2024-07-17DOI: 10.14739/2310-1210.2024.4.298245
H. V. Haiko, V. M. Pidhaietskyi, O. Sulyma, V. M. Chornyi
Due to the growing scale of arthroplasty and the widening of indications for knee joint replacement, the durability of joint functioning has become a critical issue. Untimely diagnosis and inadequate treatment of patients with endoprosthesis component loosening leads to major bone defects. This problem arises from repeated joint interventions, large bone defects and duration of revision surgeries, that is fraught with catastrophic consequences for patients – revision prosthesis removal or even limb amputation. The project aims to improve the treatment for patients with instability of components after knee joint arthroplasty. The aim of the study is to analyze the results of revision knee arthroplasty and identify the causes of mistakes and complications of revision arthroplasty with the intention of prevention. Materials and methods. A retrospective analysis of 50 revision knee arthroplasties performed at the Centre for Arthroplasty of the State Institution “Institute of Traumatology and Orthopedics of the National Academy of Medical Sciences of Ukraine” was conducted. Clinical and radiological findings were evaluated for all patients. All revision prostheses used in this study were of the semi-constrained type. Cementation technique was used for all implants. In the revision of the septic complication group, a full cementation technique with antibiotics according to a sensitivity profile were used, while in the aseptic complication group, a surface cementation technique with antibiotics according to sensitivities were used. Results. The authors of the project have analyzed the results of treatment of 50 revision arthroplasty procedures performed between 2013 and 2022 for instability of the endoprosthesis components. The structure of complications has been examined and the causes of failure in revision knee arthroplasty have been identified. This study has shown promise in preventing complications and developing personalized approaches to revision arthroplasty. Conclusions. The analysis of revision knee arthroplasty failure has shown the prevalence of septic complications (56.0 %). In the case of septic complications after revision arthroplasty, Staphylococcus aureus prevailed (57.1 %), gram (-) microorganisms were causative agents in other cases. Factors resulting in aseptic complications included those associated with the surgical intervention (81.8 %), the patient (45.4 %) and the combination thereof (72.7 %). Significant causes of the femoral revision component loosening were residual valgus deformity, medial instability in the frontal plane; significant causes of the tibial component loosening were residual varus deformity and lateral instability in the frontal plane.
{"title":"Complications of revision knee arthroplasty","authors":"H. V. Haiko, V. M. Pidhaietskyi, O. Sulyma, V. M. Chornyi","doi":"10.14739/2310-1210.2024.4.298245","DOIUrl":"https://doi.org/10.14739/2310-1210.2024.4.298245","url":null,"abstract":"Due to the growing scale of arthroplasty and the widening of indications for knee joint replacement, the durability of joint functioning has become a critical issue. Untimely diagnosis and inadequate treatment of patients with endoprosthesis component loosening leads to major bone defects.\u0000This problem arises from repeated joint interventions, large bone defects and duration of revision surgeries, that is fraught with catastrophic consequences for patients – revision prosthesis removal or even limb amputation. The project aims to improve the treatment for patients with instability of components after knee joint arthroplasty.\u0000The aim of the study is to analyze the results of revision knee arthroplasty and identify the causes of mistakes and complications of revision arthroplasty with the intention of prevention.\u0000Materials and methods. A retrospective analysis of 50 revision knee arthroplasties performed at the Centre for Arthroplasty of the State Institution “Institute of Traumatology and Orthopedics of the National Academy of Medical Sciences of Ukraine” was conducted. Clinical and radiological findings were evaluated for all patients. All revision prostheses used in this study were of the semi-constrained type. Cementation technique was used for all implants. In the revision of the septic complication group, a full cementation technique with antibiotics according to a sensitivity profile were used, while in the aseptic complication group, a surface cementation technique with antibiotics according to sensitivities were used.\u0000Results. The authors of the project have analyzed the results of treatment of 50 revision arthroplasty procedures performed between 2013 and 2022 for instability of the endoprosthesis components. The structure of complications has been examined and the causes of failure in revision knee arthroplasty have been identified. This study has shown promise in preventing complications and developing personalized approaches to revision arthroplasty.\u0000Conclusions. The analysis of revision knee arthroplasty failure has shown the prevalence of septic complications (56.0 %). In the case of septic complications after revision arthroplasty, Staphylococcus aureus prevailed (57.1 %), gram (-) microorganisms were causative agents in other cases. Factors resulting in aseptic complications included those associated with the surgical intervention (81.8 %), the patient (45.4 %) and the combination thereof (72.7 %). Significant causes of the femoral revision component loosening were residual valgus deformity, medial instability in the frontal plane; significant causes of the tibial component loosening were residual varus deformity and lateral instability in the frontal plane.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141831493","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 : 2024-07-17DOI: 10.14739/2310-1210.2024.4.302924
M. Kurochkin, A. Davydova, O. M. Krupinova
Neonatal sepsis is a pathological process that occurs as a complication of any infectious processes and is a life-threatening condition for newborns. Aim. To inform practitioners with the case of neonatal sepsis, when timely diagnosis and intensive care helped to prevent the development of septic shock and multiple organ failure. Materials and methods. A child was treated in the Department of Anesthesiology and Intensive Care of Newborns of Zaporizhzhia City Pediatric Hospital No. 5. He underwent clinical and biochemical blood tests, microbiological, radiological and ultrasound examinations using the hospital equipment. Results. The child with a complicated prenatal history was born by emergency caesarean section for severe pre-eclampsia at 34 weeks’ gestation. On the tenth day of life, the infant developed a worsening intoxication syndrome and febrile temperature. X-ray examinations revealed right-sided pneumonia; clinical blood count showed leukocytosis with acute inflammatory changes, thrombocytopenia, and an elevated procalcitonin level. A day later, the inflammatory changes dramatically deteriorated, and the cerebrospinal fluid cytosis was increased up to 850 cells and dominated by neutrophils. Blood cultures tested positive for Enterobacter cloacae. The child was prescribed antibacterial therapy according to the de-escalation principle (meronem and vancomycin) with subsequent changes according to the results of microbiological examinations, infusion therapy with parenteral nutrition, immunosupportive (intravenous immunoglobulin) and antifungal therapy. As a result of intensive therapy, clinical blood count inflammatory abnormalities were regressed, cerebrospinal fluid was completely restored to health, procalcitonin and C-reactive protein levels were normalized, and pneumonia was resolved within a week. Positive laboratory changes were correlated with the general condition: normalization of body temperature, increased activity, and enteral feeding ability. Conclusions. Timely diagnosis and intensive care of neonatal sepsis caused by gram-negative flora helped to prevent the development of multiple organ failure and septic shock. The use of antibiotic therapy according to the de-escalation principle is justified in newborns at high risk of developing septicaemia.
新生儿败血症是任何感染过程的并发症，是一种危及新生儿生命的病理过程。向从业人员介绍一例新生儿败血症病例，及时诊断和重症监护有助于防止脓毒性休克和多器官功能衰竭的发生。扎波罗热市第五儿科医院麻醉科和新生儿重症监护室收治了一名患儿。他接受了医院设备提供的临床和生化血液化验、微生物学、放射学和超声波检查。患儿产前病史复杂，在妊娠 34 周时因重度先兆子痫紧急剖腹产。出生后第 10 天，婴儿出现中毒综合征和发热症状。X 射线检查显示婴儿患有右侧肺炎；临床血细胞计数显示白细胞增多并伴有急性炎症变化、血小板减少和降钙素原水平升高。一天后，炎症变化急剧恶化，脑脊液细胞增多至 850 个，以中性粒细胞为主。经血液培养，发现肠杆菌呈阳性。医生根据降级原则为患儿开出了抗菌治疗处方（美罗南和万古霉素），并根据微生物检查结果对处方进行了调整，同时还为患儿提供了肠外营养输液治疗、免疫抑制（静脉注射免疫球蛋白）和抗真菌治疗。经过强化治疗，临床血细胞计数炎症异常得到缓解，脑脊液完全恢复健康，降钙素原和 C 反应蛋白水平恢复正常，肺炎在一周内痊愈。实验室的积极变化与全身情况相关：体温恢复正常、活动增加、肠道喂养能力增强。由革兰阴性菌群引起的新生儿败血症的及时诊断和重症监护有助于防止多器官功能衰竭和脓毒性休克的发生。对于脓毒血症高危新生儿，根据降级原则使用抗生素治疗是合理的。
{"title":"A case of neonatal sepsis, early diagnosis and preventive intensive care","authors":"M. Kurochkin, A. Davydova, O. M. Krupinova","doi":"10.14739/2310-1210.2024.4.302924","DOIUrl":"https://doi.org/10.14739/2310-1210.2024.4.302924","url":null,"abstract":"Neonatal sepsis is a pathological process that occurs as a complication of any infectious processes and is a life-threatening condition for newborns.\u0000Aim. To inform practitioners with the case of neonatal sepsis, when timely diagnosis and intensive care helped to prevent the development of septic shock and multiple organ failure.\u0000Materials and methods. A child was treated in the Department of Anesthesiology and Intensive Care of Newborns of Zaporizhzhia City Pediatric Hospital No. 5. He underwent clinical and biochemical blood tests, microbiological, radiological and ultrasound examinations using the hospital equipment.\u0000Results. The child with a complicated prenatal history was born by emergency caesarean section for severe pre-eclampsia at 34 weeks’ gestation. On the tenth day of life, the infant developed a worsening intoxication syndrome and febrile temperature. X-ray examinations revealed right-sided pneumonia; clinical blood count showed leukocytosis with acute inflammatory changes, thrombocytopenia, and an elevated procalcitonin level. A day later, the inflammatory changes dramatically deteriorated, and the cerebrospinal fluid cytosis was increased up to 850 cells and dominated by neutrophils. Blood cultures tested positive for Enterobacter cloacae. The child was prescribed antibacterial therapy according to the de-escalation principle (meronem and vancomycin) with subsequent changes according to the results of microbiological examinations, infusion therapy with parenteral nutrition, immunosupportive (intravenous immunoglobulin) and antifungal therapy. As a result of intensive therapy, clinical blood count inflammatory abnormalities were regressed, cerebrospinal fluid was completely restored to health, procalcitonin and C-reactive protein levels were normalized, and pneumonia was resolved within a week. Positive laboratory changes were correlated with the general condition: normalization of body temperature, increased activity, and enteral feeding ability.\u0000Conclusions. Timely diagnosis and intensive care of neonatal sepsis caused by gram-negative flora helped to prevent the development of multiple organ failure and septic shock. The use of antibiotic therapy according to the de-escalation principle is justified in newborns at high risk of developing septicaemia.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141829327","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 : 2024-07-17DOI: 10.14739/2310-1210.2024.4.305572
V. K. Tashchuk, R. A. Bota
Aim. To study the relationship between myocardial contractility impairment in chronic coronary syndrome and the state of coronary flow reserve, the degree of systemic inflammation and endothelial dysfunction. Materials and methods. We examined 120 patients with stable angina pectoris (SAP) of functional class (FC) II–III, who were assigned into two groups: group 1 comprised 65 patients with left ventricular ejection fraction (LVEF) ≥55 %, and group 2 was composed of 55 patients with LVEF <55 %. Diagnostic methods included clinical and instrumental examination data, analyses of lipid profile, inflammation biomarkers, endothelial functional state, hemogram data, leukocyte inflammation markers, and questionnaires. Results. Compared to group 1, group 2 patients showed an increase in the left atrium (p < 0.001) and right ventricle (p = 0.027) sizes; significantly lower LVEF (50.16 ± 0.42 % vs 58.77 ± 0.41 %; p < 0.001); thickening of the intima-media complex in the right (p = 0.003) and left (p = 0.017) common carotid arteries; significantly lower load threshold values (p = 0.008), exercise tolerance (p = 0.004) and heart rate variability indicators – SDNN (standard deviation of normal-to-normal intervals over 24 hours; p = 0.046). Group 2 patients were characterized by more active low-grade chronic inflammation, as indicated by increased levels of leukocytes (p = 0.024), neutrophils (p < 0.001), and decreased lymphocyte levels (p = 0.021); significantly higher levels of leukocyte inflammation markers, in particular, the neutrophil-to-lymphocyte ratio (p < 0.001), platelet-to-lymphocyte ratio (p = 0.004), systemic immune-inflammation index (p < 0.001), systemic inflammation response index (p < 0.001), and aggregate index of systemic inflammation (p < 0.001) as compared to group 1 individuals. Patients with LVEF <55 % had higher levels of fibrinogen (p < 0.001), uric acid (p = 0.002), high-sensitivity C-reactive protein (p = 0.007), and endothelin-1 (p < 0.001) compared to those with LVEF ≥55 %. Conclusions. Group 2 patients need a more thorough monitoring and a more intensive treatment aimed at reducing the inflammatory process.
{"title":"Effect of impaired myocardial contractility on coronary flow reserve and inflammatory processes in chronic coronary syndrome","authors":"V. K. Tashchuk, R. A. Bota","doi":"10.14739/2310-1210.2024.4.305572","DOIUrl":"https://doi.org/10.14739/2310-1210.2024.4.305572","url":null,"abstract":"Aim. To study the relationship between myocardial contractility impairment in chronic coronary syndrome and the state of coronary flow reserve, the degree of systemic inflammation and endothelial dysfunction.\u0000Materials and methods. We examined 120 patients with stable angina pectoris (SAP) of functional class (FC) II–III, who were assigned into two groups: group 1 comprised 65 patients with left ventricular ejection fraction (LVEF) ≥55 %, and group 2 was composed of 55 patients with LVEF <55 %. Diagnostic methods included clinical and instrumental examination data, analyses of lipid profile, inflammation biomarkers, endothelial functional state, hemogram data, leukocyte inflammation markers, and questionnaires.\u0000Results. Compared to group 1, group 2 patients showed an increase in the left atrium (p < 0.001) and right ventricle (p = 0.027) sizes; significantly lower LVEF (50.16 ± 0.42 % vs 58.77 ± 0.41 %; p < 0.001); thickening of the intima-media complex in the right (p = 0.003) and left (p = 0.017) common carotid arteries; significantly lower load threshold values (p = 0.008), exercise tolerance (p = 0.004) and heart rate variability indicators – SDNN (standard deviation of normal-to-normal intervals over 24 hours; p = 0.046).\u0000Group 2 patients were characterized by more active low-grade chronic inflammation, as indicated by increased levels of leukocytes (p = 0.024), neutrophils (p < 0.001), and decreased lymphocyte levels (p = 0.021); significantly higher levels of leukocyte inflammation markers, in particular, the neutrophil-to-lymphocyte ratio (p < 0.001), platelet-to-lymphocyte ratio (p = 0.004), systemic immune-inflammation index (p < 0.001), systemic inflammation response index (p < 0.001), and aggregate index of systemic inflammation (p < 0.001) as compared to group 1 individuals. Patients with LVEF <55 % had higher levels of fibrinogen (p < 0.001), uric acid (p = 0.002), high-sensitivity C-reactive protein (p = 0.007), and endothelin-1 (p < 0.001) compared to those with LVEF ≥55 %.\u0000Conclusions. Group 2 patients need a more thorough monitoring and a more intensive treatment aimed at reducing the inflammatory process.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141829691","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 : 2024-07-17DOI: 10.14739/2310-1210.2024.4.306185
O. O. Lyulko, V. O. Morhuntsov
The aim of the work is to analyze the scientific literature data on the principles and state of rational antibiotic therapy use according to factors for the development of inflammatory changes in the urinary tract with the identification of the latter in the complex therapy for urolithiasis, taking into account the peculiarities of contact laser lithotripsy. The article presents the results of analytical processing of professional publications on current principles of rational antibiotic therapy in the surgical treatment for urolithiasis, taking into account factors that may influence the development of inflammatory changes in the urinary tract. It has been revealed that there is currently no clear understanding about chances of developing infectious processes during the treatment for urolithiasis of various localization, as well as the advisability and duration of using antibiotics in the comprehensive treatment of the disease. At the same time, antibiotic overuse has resulted in phenomena of resistance, side effects, and a number of other complicating factors needed to be addressed. Conclusions. An analysis of present approaches to antibacterial therapy, considering its rationality at different treatment stages, has been conducted concluding that clear criteria and indicators for the use of drugs have not been specified, but these data serve only as recommendations and have not been thoroughly examined. Data on searching for a solution to problematic aspects are also provided.
{"title":"Interrelations between factors in the development of inflammatory changes in the urinary tract in the comprehensive treatment of patients with urolithiasis","authors":"O. O. Lyulko, V. O. Morhuntsov","doi":"10.14739/2310-1210.2024.4.306185","DOIUrl":"https://doi.org/10.14739/2310-1210.2024.4.306185","url":null,"abstract":"The aim of the work is to analyze the scientific literature data on the principles and state of rational antibiotic therapy use according to factors for the development of inflammatory changes in the urinary tract with the identification of the latter in the complex therapy for urolithiasis, taking into account the peculiarities of contact laser lithotripsy.\u0000The article presents the results of analytical processing of professional publications on current principles of rational antibiotic therapy in the surgical treatment for urolithiasis, taking into account factors that may influence the development of inflammatory changes in the urinary tract.\u0000It has been revealed that there is currently no clear understanding about chances of developing infectious processes during the treatment for urolithiasis of various localization, as well as the advisability and duration of using antibiotics in the comprehensive treatment of the disease. At the same time, antibiotic overuse has resulted in phenomena of resistance, side effects, and a number of other complicating factors needed to be addressed.\u0000Conclusions. An analysis of present approaches to antibacterial therapy, considering its rationality at different treatment stages, has been conducted concluding that clear criteria and indicators for the use of drugs have not been specified, but these data serve only as recommendations and have not been thoroughly examined. Data on searching for a solution to problematic aspects are also provided.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141828485","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 : 2024-07-17DOI: 10.14739/2310-1210.2024.4.304800
O. H. Іvanko, A. V. Tovma, O. V. Solianyk, V. A. Deineha, M. V. Patsera, I. V. Pashchenko, V. Pidkova
The variety of causes, conditions and prognosis of sinus tachycardia (ST) had determined the study examining the quality of life, neurohumoral status as well as ST course in 17-year-old adolescents compared to their peers without heart rhythm disorders. The aim was to study neurohumoral status, quality of life and physical performance in adolescents of both sexes, aged 17 years with diagnosed ST during preventive examination using 24-hour ECG monitoring. Materials and methods. In the open prospective study, 165 adolescents (74 boys and 91 girls) with a mean age of 17.5 ± 0.5 years were enrolled. 24-hour ECG monitoring showed increased heart rate >90 bpm in 12 boys and 19 girls considered themselves healthy. All the children were examined according to a program including 24-hour blood pressure monitoring, heart rate variability, serum concentrations of the main hormones, endothelin and copeptin. Health-related quality of life was measured by the SF-36 questionnaire. A physical work capacity test (PWC170) on a bicycle ergometer was evaluated in an 8-month physical rehabilitation program. Results. Adolescents of both sexes with ST were hypersympathicotonic with humoral dysregulation of the sinoatrial node, grade I arterial hypertension, elevated blood levels of estradiol and osteocalcin and low renin in females. ST in adolescents was associated with reduced physical performance, the restoration of which was accompanied by ST termination. Conclusions. The examination of the 165 adolescents with the mean age of 17.5 years who considered themselves healthy has revealed 12 (16.6 %) males and 19 (22.9 %) females with ST and mean 24-hour heart rate >90 bpm. The children have been clinically diagnosed with inappropriate ST based on international classification, that were inadequate to healthy state. ST was accompanied by hypersympathicotonic type of sinoatrial node humoral dysregulation, grade I arterial hypertension in boys, abnormal pubertal development in girls with elevated blood levels of total estradiol and osteocalcin and low free renin levels, lowered levels of quality of life on role functioning of the SF-36 questionnaire. Adolescents with ST had lower performance in the PWC170 tests. The completion of the 8-week physical rehabilitation program via stationary cycling exercises has resulted in improved physical performance based on the PWC170 test from baseline levels of 8.6 ± 1.9 kgm/min per kg body weight to 12.8 ± 2.1 kgm /min per kg in girls (p = 0.08) and from 13.2 ± 1.5 kgm/min to 15.9 ± 1.6 kgm/min per kg body weight in boys (p > 0.1), that was accompanied by ST termination.
{"title":"Quality of life, neuro-humoral status and physical performance in adolescents with sinus tachycardia","authors":"O. H. Іvanko, A. V. Tovma, O. V. Solianyk, V. A. Deineha, M. V. Patsera, I. V. Pashchenko, V. Pidkova","doi":"10.14739/2310-1210.2024.4.304800","DOIUrl":"https://doi.org/10.14739/2310-1210.2024.4.304800","url":null,"abstract":"The variety of causes, conditions and prognosis of sinus tachycardia (ST) had determined the study examining the quality of life, neurohumoral status as well as ST course in 17-year-old adolescents compared to their peers without heart rhythm disorders.\u0000The aim was to study neurohumoral status, quality of life and physical performance in adolescents of both sexes, aged 17 years with diagnosed ST during preventive examination using 24-hour ECG monitoring.\u0000Materials and methods. In the open prospective study, 165 adolescents (74 boys and 91 girls) with a mean age of 17.5 ± 0.5 years were enrolled. 24-hour ECG monitoring showed increased heart rate >90 bpm in 12 boys and 19 girls considered themselves healthy. All the children were examined according to a program including 24-hour blood pressure monitoring, heart rate variability, serum concentrations of the main hormones, endothelin and copeptin. Health-related quality of life was measured by the SF-36 questionnaire. A physical work capacity test (PWC170) on a bicycle ergometer was evaluated in an 8-month physical rehabilitation program.\u0000Results. Adolescents of both sexes with ST were hypersympathicotonic with humoral dysregulation of the sinoatrial node, grade I arterial hypertension, elevated blood levels of estradiol and osteocalcin and low renin in females. ST in adolescents was associated with reduced physical performance, the restoration of which was accompanied by ST termination.\u0000Conclusions. The examination of the 165 adolescents with the mean age of 17.5 years who considered themselves healthy has revealed 12 (16.6 %) males and 19 (22.9 %) females with ST and mean 24-hour heart rate >90 bpm. The children have been clinically diagnosed with inappropriate ST based on international classification, that were inadequate to healthy state. ST was accompanied by hypersympathicotonic type of sinoatrial node humoral dysregulation, grade I arterial hypertension in boys, abnormal pubertal development in girls with elevated blood levels of total estradiol and osteocalcin and low free renin levels, lowered levels of quality of life on role functioning of the SF-36 questionnaire. Adolescents with ST had lower performance in the PWC170 tests. The completion of the 8-week physical rehabilitation program via stationary cycling exercises has resulted in improved physical performance based on the PWC170 test from baseline levels of 8.6 ± 1.9 kgm/min per kg body weight to 12.8 ± 2.1 kgm /min per kg in girls (p = 0.08) and from 13.2 ± 1.5 kgm/min to 15.9 ± 1.6 kgm/min per kg body weight in boys (p > 0.1), that was accompanied by ST termination.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141830079","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 : 2024-07-17DOI: 10.14739/2310-1210.2024.4.302749
O. Krichfalushii, M. Nemesh, Ya. I. Slyvka, Y. Savka, O. Palamarchuk, V. Feketa
The aim of the study is to examine the relationship between central hemodynamic parameters and body composition by considering baseline functional state of neuro-autonomic regulation according to the index of regulatory system activity (IRSA) in young men. Material and methods. A total of 44 male participants were divided into three groups based on the IRSA level. The first group included 26 men with an optimal IRSA level. The second and third groups, each of 9 men, with moderate and high IRSA levels, respectively. The functional state of cardiovascular system was assessed using a device “REOKOM” (Kharkiv). The measurement of body composition was performed by weight-scale “TANITA BC-601” (Japan). The functional state of autonomic nervous system was assessed using a device “CARDIOLAB” (Kharkiv). Results. Our results have demonstrated higher hemodynamic parameters in men with moderate and high level of IRSA. Men with elevated level of sympathetic activity had the highest indices of the pumping function of the heart, and those with the balance between parasympathetic and sympathetic branches had the lowest indices of the pumping heart function. As for the indicators of total peripheral resistance and specific peripheral resistance, another trend was seen, namely, individuals with a balanced state of autonomic nervous regulation had the highest parameters, and those with a predominance of sympathetic tone had the lowest ones. Close correlations have been found between increased levels of regulatory mechanism tension and cardiohemodynamic parameters. An indicator analysis of the body component composition has revealed a significant increase in body mass index, total and visceral fat content in the examined groups with moderate and severe regulatory system tension. In addition, correlations have been found between IRSA and constituting components of body composition. Conclusions. The group assignment of the examined individuals according to IRSA has shown that a high tension of the regulatory mechanisms increased the load on the cardiovascular system, as indicated by higher indicators of central hemodynamics. In individuals with an optimal level of regulatory system functioning, the cardiovascular system activity is optimal and less energy consuming.
{"title":"Relationship between central hemodynamic parameters and body composition and the functional state of neuro-autonomic regulation in young men","authors":"O. Krichfalushii, M. Nemesh, Ya. I. Slyvka, Y. Savka, O. Palamarchuk, V. Feketa","doi":"10.14739/2310-1210.2024.4.302749","DOIUrl":"https://doi.org/10.14739/2310-1210.2024.4.302749","url":null,"abstract":"The aim of the study is to examine the relationship between central hemodynamic parameters and body composition by considering baseline functional state of neuro-autonomic regulation according to the index of regulatory system activity (IRSA) in young men.\u0000Material and methods. A total of 44 male participants were divided into three groups based on the IRSA level. The first group included 26 men with an optimal IRSA level. The second and third groups, each of 9 men, with moderate and high IRSA levels, respectively. The functional state of cardiovascular system was assessed using a device “REOKOM” (Kharkiv). The measurement of body composition was performed by weight-scale “TANITA BC-601” (Japan). The functional state of autonomic nervous system was assessed using a device “CARDIOLAB” (Kharkiv).\u0000Results. Our results have demonstrated higher hemodynamic parameters in men with moderate and high level of IRSA. Men with elevated level of sympathetic activity had the highest indices of the pumping function of the heart, and those with the balance between parasympathetic and sympathetic branches had the lowest indices of the pumping heart function. As for the indicators of total peripheral resistance and specific peripheral resistance, another trend was seen, namely, individuals with a balanced state of autonomic nervous regulation had the highest parameters, and those with a predominance of sympathetic tone had the lowest ones. Close correlations have been found between increased levels of regulatory mechanism tension and cardiohemodynamic parameters.\u0000An indicator analysis of the body component composition has revealed a significant increase in body mass index, total and visceral fat content in the examined groups with moderate and severe regulatory system tension. In addition, correlations have been found between IRSA and constituting components of body composition.\u0000Conclusions. The group assignment of the examined individuals according to IRSA has shown that a high tension of the regulatory mechanisms increased the load on the cardiovascular system, as indicated by higher indicators of central hemodynamics. In individuals with an optimal level of regulatory system functioning, the cardiovascular system activity is optimal and less energy consuming.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141830937","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 : 2024-07-17DOI: 10.14739/2310-1210.2024.4.302524
O. Usachova, N. Vorobiova, E. Silina, T. B. Matvieieva
The aim – to summarize literature data on the pathogenetic mechanisms of the diarrheal syndrome development in children with rotavirus infection and to determine the role of carbohydrate malabsorption syndrome in it through a complex analysis of literature reviews and empirical studies. Rotavirus infection (RVI) remains the main cause of severe dehydrating gastroenteritis in children under five years of age. One of the most important pathogenetic links of rotavirus gastroenteritis is the development of osmotic diarrhea induced by carbohydrate malabsorption syndrome. Its development is associated with disaccharidase insufficiency and impaired absorption of monosaccharides in the small intestine. Carbohydrate malabsorption syndrome is found in 67.0–98.3 % of children with RVI. Its laboratory manifestations (an increase in levels of fecal carbohydrates and lactose) are observed starting from the first days of the disease, and the maximum indicators are recorded in the period from the fifth to the seventh day. Conclusions. Carbohydrate malabsorption syndrome is observed in the absolute majority of children with RVI, and its maximum severity is noted from the fifth to the seventh day of the disease, being realized mainly due to lactase deficiency. The severity of carbohydrate malabsorption syndrome can be influenced by concomitant pathological conditions, that lead to a decrease in the activity of disaccharidases in the small intestine, and the metabolic activity of the intestinal microbiota.
{"title":"The role of carbohydrate malabsorption syndrome in the pathogenesis of rotavirus diarrhea (a literature review)","authors":"O. Usachova, N. Vorobiova, E. Silina, T. B. Matvieieva","doi":"10.14739/2310-1210.2024.4.302524","DOIUrl":"https://doi.org/10.14739/2310-1210.2024.4.302524","url":null,"abstract":"The aim – to summarize literature data on the pathogenetic mechanisms of the diarrheal syndrome development in children with rotavirus infection and to determine the role of carbohydrate malabsorption syndrome in it through a complex analysis of literature reviews and empirical studies.\u0000Rotavirus infection (RVI) remains the main cause of severe dehydrating gastroenteritis in children under five years of age. One of the most important pathogenetic links of rotavirus gastroenteritis is the development of osmotic diarrhea induced by carbohydrate malabsorption syndrome. Its development is associated with disaccharidase insufficiency and impaired absorption of monosaccharides in the small intestine.\u0000Carbohydrate malabsorption syndrome is found in 67.0–98.3 % of children with RVI. Its laboratory manifestations (an increase in levels of fecal carbohydrates and lactose) are observed starting from the first days of the disease, and the maximum indicators are recorded in the period from the fifth to the seventh day.\u0000Conclusions. Carbohydrate malabsorption syndrome is observed in the absolute majority of children with RVI, and its maximum severity is noted from the fifth to the seventh day of the disease, being realized mainly due to lactase deficiency. The severity of carbohydrate malabsorption syndrome can be influenced by concomitant pathological conditions, that lead to a decrease in the activity of disaccharidases in the small intestine, and the metabolic activity of the intestinal microbiota.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141829998","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 : 2024-07-17DOI: 10.14739/2310-1210.2024.4.300129
O. M. Kiosov, A. V. Klymenko, M. B. Danyliuk, M. Kubrak
Achalasia is an esophageal motility disorder characterized by symptoms of dysphagia, regurgitation of undigested food, respiratory symptoms (nocturnal cough, recurrent aspiration, and pneumonia), chest pain, and weight loss. The aim: to evaluate the results of surgical treatment for achalasia cardia by the method of laparoscopic Heller’s cardiomyotomy in combination with Dor fundoplication. Materials and methods. To evaluate the treatment results of achalasia cardia by the method of laparoscopic Heller’s cardiomyotomy with Dor fundoplication, we analyzed 30 case histories of patients who were treated in the period from 2011 to 2022. Inclusion criteria were age 18 years or older, diagnosis of stage II, III cardia achalasia confirmed using instrumental examinations. Exclusion criterion was stage I achalasia. The mean age of the patients was 53.0 ± 15.3 years. In terms of sex, this group was almost equal, there were 14 (46.7 %) women and 16 (53.3 %) men. The average duration of the disease was 5.0 ± 1.2 years. To determine the degree of achalasia, we used the radiological classification of the distal esophageal morphology in achalasia and distinguished 4 stages. Based on this classification, stage II achalasia was detected in 24 (80.0 %) patients, and stage III – in 6 (20.0 %), p = 0.0007, U = 180.0. Results. All the patients were operated on as planned. The total duration of preoperative preparation in the hospital was 0.8 ± 0.2 days. The main method of treatment in this group was laparoscopic Heller’s cardiomyotomy with Dor fundoplication. Conclusions. Laparoscopic Heller’s cardiomyotomy with fundoplication is currently one of the most effective methods of treatment for achalasia cardia. Minimally invasive surgical treatment methods for achalasia are effective in most patients, however, recurrence of symptoms in the long term occurs in 10.0–20.0 %, leaving open the question of finding new effective methods for the treatment of this pathology.
{"title":"Laparoscopic Heller’s cardiomyotomy as the main method for treatment of achalasia cardia: an evaluation of treatment results","authors":"O. M. Kiosov, A. V. Klymenko, M. B. Danyliuk, M. Kubrak","doi":"10.14739/2310-1210.2024.4.300129","DOIUrl":"https://doi.org/10.14739/2310-1210.2024.4.300129","url":null,"abstract":"Achalasia is an esophageal motility disorder characterized by symptoms of dysphagia, regurgitation of undigested food, respiratory symptoms (nocturnal cough, recurrent aspiration, and pneumonia), chest pain, and weight loss.\u0000The aim: to evaluate the results of surgical treatment for achalasia cardia by the method of laparoscopic Heller’s cardiomyotomy in combination with Dor fundoplication.\u0000Materials and methods. To evaluate the treatment results of achalasia cardia by the method of laparoscopic Heller’s cardiomyotomy with Dor fundoplication, we analyzed 30 case histories of patients who were treated in the period from 2011 to 2022. Inclusion criteria were age 18 years or older, diagnosis of stage II, III cardia achalasia confirmed using instrumental examinations. Exclusion criterion was stage I achalasia. The mean age of the patients was 53.0 ± 15.3 years. In terms of sex, this group was almost equal, there were 14 (46.7 %) women and 16 (53.3 %) men. The average duration of the disease was 5.0 ± 1.2 years. To determine the degree of achalasia, we used the radiological classification of the distal esophageal morphology in achalasia and distinguished 4 stages. Based on this classification, stage II achalasia was detected in 24 (80.0 %) patients, and stage III – in 6 (20.0 %), p = 0.0007, U = 180.0.\u0000Results. All the patients were operated on as planned. The total duration of preoperative preparation in the hospital was 0.8 ± 0.2 days. The main method of treatment in this group was laparoscopic Heller’s cardiomyotomy with Dor fundoplication.\u0000Conclusions. Laparoscopic Heller’s cardiomyotomy with fundoplication is currently one of the most effective methods of treatment for achalasia cardia. Minimally invasive surgical treatment methods for achalasia are effective in most patients, however, recurrence of symptoms in the long term occurs in 10.0–20.0 %, leaving open the question of finding new effective methods for the treatment of this pathology.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141829311","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 : 2024-07-17DOI: 10.14739/2310-1210.2024.4.302379
T. Ashcheulova, N. Herasymchuk, O. A. Kochubiei, U. Herasymchuk
The COVID-19 epidemic has already come to be seen as an emergency of international concern. This relates not only to the wide occurrence of the infection, but also to a fairly high mortality rate, currently more than 6.5 million deaths in the world. The aim of this study was to analyze, generalize and systematize the currently available literary data on the study of the novel coronavirus infection pathogenesis in the human body and to determine key changes that occur after the SARS-CoV-2 penetration into cells. In this way to target physicians primarily based on the pathogenetic processes that occur in the human body, syndromes and symptom complexes that are observed in treatments. Results. The article presents a literature review demonstrating that the specific interaction between the virus and somatic cells is the triggering mechanism for the pathogenesis of coronavirus infection. The main route for SARS-CoV-2 entry into the body is the angiotensin-converting enzyme 2 (ACE2) receptor, which is expressed not only in type 2 alveolar epithelial cells, but also in cells of the kidney, heart, blood vessels and gastrointestinal tract, including endotheliocytes and pericytes. Expression of the ACE2 receptor has also been shown in various structures and parts of the brain, cells of the conjunctiva, limbus, cornea and cells of the substantia propria. A high expression of the ACE2 receptor has been found in the epithelial cells of the oral mucosa, salivary glands, tonsils and tongue. These factors explain a possible involvement of different organs and systems in the development of multiorgan failure. Conclusions. In the development of multiorgan disfunction, two components are important: first, direct cell tropism and viral load, that may be unique in each patient. Secondly, it is the development of immune-mediated reactions to infected cells. Under conditions of hyperimmune inflammation, that is, the development of cytokine storm, acute respiratory distress syndrome progresses, and multiple organ failure develops. Endothelial damage is directly involved in the pathophysiology of this process, that results in the development of endothelial dysfunction, disruption of microcirculation, as well as perivascular inflammation, which aggravates damage to the endothelium and can lead to thrombus formation. The use of modern knowledge about the immunopathogenesis of COVID-19 would help to estimate the risk for severe infection and the possible development of complications, allowing for the timely implementation of effective pathogenetic therapy.
{"title":"Etiological and immunopathogenetic aspects of multiorgan failure development in coronavirus disease (COVID-19)","authors":"T. Ashcheulova, N. Herasymchuk, O. A. Kochubiei, U. Herasymchuk","doi":"10.14739/2310-1210.2024.4.302379","DOIUrl":"https://doi.org/10.14739/2310-1210.2024.4.302379","url":null,"abstract":"The COVID-19 epidemic has already come to be seen as an emergency of international concern. This relates not only to the wide occurrence of the infection, but also to a fairly high mortality rate, currently more than 6.5 million deaths in the world.\u0000The aim of this study was to analyze, generalize and systematize the currently available literary data on the study of the novel coronavirus infection pathogenesis in the human body and to determine key changes that occur after the SARS-CoV-2 penetration into cells. In this way to target physicians primarily based on the pathogenetic processes that occur in the human body, syndromes and symptom complexes that are observed in treatments.\u0000Results. The article presents a literature review demonstrating that the specific interaction between the virus and somatic cells is the triggering mechanism for the pathogenesis of coronavirus infection. The main route for SARS-CoV-2 entry into the body is the angiotensin-converting enzyme 2 (ACE2) receptor, which is expressed not only in type 2 alveolar epithelial cells, but also in cells of the kidney, heart, blood vessels and gastrointestinal tract, including endotheliocytes and pericytes. Expression of the ACE2 receptor has also been shown in various structures and parts of the brain, cells of the conjunctiva, limbus, cornea and cells of the substantia propria. A high expression of the ACE2 receptor has been found in the epithelial cells of the oral mucosa, salivary glands, tonsils and tongue. These factors explain a possible involvement of different organs and systems in the development of multiorgan failure.\u0000Conclusions. In the development of multiorgan disfunction, two components are important: first, direct cell tropism and viral load, that may be unique in each patient. Secondly, it is the development of immune-mediated reactions to infected cells. Under conditions of hyperimmune inflammation, that is, the development of cytokine storm, acute respiratory distress syndrome progresses, and multiple organ failure develops. Endothelial damage is directly involved in the pathophysiology of this process, that results in the development of endothelial dysfunction, disruption of microcirculation, as well as perivascular inflammation, which aggravates damage to the endothelium and can lead to thrombus formation.\u0000The use of modern knowledge about the immunopathogenesis of COVID-19 would help to estimate the risk for severe infection and the possible development of complications, allowing for the timely implementation of effective pathogenetic therapy.","PeriodicalId":23832,"journal":{"name":"Zaporozhye Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141830170","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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