Al''manah Kliniceskoj Mediciny最新文献

{"title":"Clinical particulars of acute coronary syndrome course in patients with COVID-19","authors":"Nadezhda V. Izmozherova, Artem A. Popov, Andrey I. Tsvetkov, Leonid I. Kadnikov, Vladislav E. Ispavskii, Muraz A. Shambatov","doi":"10.18786/2072-0505-2023-51-033","DOIUrl":"https://doi.org/10.18786/2072-0505-2023-51-033","url":null,"abstract":"Background: Cardiovascular complications of COVID-19 result in challenges for differential diagnosis, patients referral and treatment, which negatively affect the outcomes.
 Aim: To identify clinical particulars of various types acute coronary syndrome course in patients with COVID-19.
 Materials and methods: This retrospective cross-sectional study included 202 patients with COVID-19 and acute coronary syndrome (ACS) admitted to a primary vascular medicine center from September to December 2020. Their medical records were used for the analysis of ACS and COVID-19 clinical course, including physical and history data, laboratory and instrumental work-up. For the analysis, the patient sampling was divided into three study groups: 50 patients with unstable angina (UA), 107 patients with acute myocardial infarction with ST segment elevation (STEMI), and 45 patients with acute myocardial infarction without ST segment elevation (non-STEMI).
 Results: There were no differences in clinical manifestations of ACS in the study groups. As far as clinical manifestations of coronavirus infections are concerned, the patients differed significantly as per prevalence of fever and dry cough. Fever was present in 22 (44%) UA patients, 18 (17%) of STEMI patients and in 10 (22%) of non-STEMI patients (p 0.001 for comparison of 3 groups, Kruskall-Wallis test), whereas dry cough was present in 18 (36%), 19 (18%), and 14 (31%) patients, respectively (p = 0.029). Paired comparison (Mann-Whitney test with Bonferroni adjustment) showed significant differences between US and STEMI groups for both symptoms. The number of involved vessels (median [25%; 75%]) in UA patients was 0 [0; 2], in STEMI and non-STEMI patients 2 [1; 3] (p 0.001). A left coronary artery stenosis was detected in 2 (6%) of the UA patients, 13 (14%) of the STEMI and 4 (13%) of the non-STEMI patients (p = 0.452); left anterior descending artery stenosis, in 12 (36%), 67 (72%) and 23 (72%) patients, respectively (p 0.001). In the pairwise comparison, there were differences between UA and STEMI groups and between UA and non-STEMI groups. A left circumflex artery stenosis was found in 7 (21%) of the UA patients, 45 (48%) of the STEMI and 18 (56%) of the non-STEMI patients (p = 0.008); the pairwise comparisons showed the difference between UA and non-STEMI study groups. A right coronary artery stenosis was identified in 9 (27%), 64 (69%) and 18 (56%) of the study patients, respectively (p 0.001); in the pairwise comparison the difference was found between the UA and STEMI group. There were significant differences in the percentage of the right descendent and right coronary artery stenosis: the right descending artery stenosis was 70% [45; 80] in the UA patients, 90% [70; 100] in the STEMI and 95% [70; 100] in the non-STEMI patients (p = 0.013), whereas the right coronary artery stenosis was 50% [45; 80], 90% [70; 100], 90% [60; 100], respectively (p = 0.018). In the pairwise comparison, the diff","PeriodicalId":31492,"journal":{"name":"Al''manah Kliniceskoj Mediciny","volume":"4 8","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135141745","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}

{"title":"Central diabetes insipidus after transnasal adenomectomy:trends in development and recovery, clinical and laboratory characteristics","authors":"Daria S. Mikhaylova, Larisa K. Dzeranova, Olga Y. Rebrova, Ekaterina A. Pigarova, Liudmila Y. Rozhinskaya, Vilen N. Azizyan, Oksana V. Ivashchenko, Andrey Y. Grigoriev","doi":"10.18786/2072-0505-2023-51-032","DOIUrl":"https://doi.org/10.18786/2072-0505-2023-51-032","url":null,"abstract":"Background: Currently, there is an increase in the incidence of chiasmosellar neoplasms and respective neurosurgical interventions. The postoperative period may be complicated by vasopressin synthesis and secretion disorders. Both the development and abortion of the fluid and electrolyte disorders can be delayed. Due to a tendency for an earlier discharge of the patients, a proportion of the disorders remain unaddressed. There is no data on the evolution and time to regress of transient abnormalities in the published studies with a long-term postoperative follow-up.
 Aim: To assess the incidence, evolution and regression trends, clinical and laboratory characteristic of postoperative central diabetes insipidus (CDI).
 Materials and methods: The single center retrospective comparative study included 150 patients who had undergone transnasal adenomectomy for Cushings disease, acromegaly, prolactinomas, and hormonally inactive pituitary adenomas. Clinical and laboratory assessments were performed pre- and postoperatively. In the event of CDI, treatment with desmopressin was administered. Ninety six (96) patients aged 20 to 65 years (median age 43 [35; 54] years) were followed for at least 60 months after the procedure.
 Results: Median time to the onset of permanent CDI (pCDI) was Day 5 [1; 9.5] after surgery, that of transient CDI (tCDI) Day 1 [1; 4.5] with its remission by Day 30 [1.5; 199]. The maximally delayed onset was on Day 86 for the pCDI and Day 61 for tCDI; that to the remission of tCDI, 738 days. At discharge from the hospital, postoperative CDI was present in 34/150 patients (23%; 95% CI 1730), and in 25/150 of the patients (16%; 95% CI 1224) the disorder resolved. At 5 to 7 years after surgery, the prevalence of pCDI was 16% (95% CI 1024), that of tCDI 35% (95% CI 2745), 49% (95% CI 3959) of the patients had no abnormalities (respective absolute patient numbers being 15, 34, and 47 of 96 followed for at least 60 months). At Days 1 to 7 after surgery, the patients with pCDI and tCDI had more frequent complaints of dry mouth and thirst than those without the disorder. These complaints were verified by higher 24-hour fluid intake and diuresis at the day of surgery and Days 5 to 7 thereafter, compared to those in the patients without the disorders. At Days 57 after surgery, urine sodium and urine specific gravity were significantly lower, as was urine osmolality at all postoperative stages, compared to those in the patients without the disorders.
 Conclusion: Within 2 years after transnasal adenomectomy, the incidence of postoperative CDI is gradually decreasing (from 23% to 16%). Due to potentially delayed manifestation of water and electrolyte imbalance, it is recommended that these parameters should be monitored at least for 2,5 months after the discharge from hospital. Due to potentially delayed remission (12 months and more), follow-up and monitoring for 1.5 years is reasonable, with periodic assessment of sodium l","PeriodicalId":31492,"journal":{"name":"Al''manah Kliniceskoj Mediciny","volume":"297 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135474926","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}

{"title":"Characteristics of the basal psychoautonomous indicators in patients after coronary artery stent placement at various stages of rehabilitation","authors":"Ruslan A. Mirzoev, Svetlana V. Malchikova, Mikhail A. Sherman","doi":"10.18786/2072-0505-2023-51-031","DOIUrl":"https://doi.org/10.18786/2072-0505-2023-51-031","url":null,"abstract":"Background: Clinically significant psychoautonomous syndrome, along with other modifiable factors (obesity, dyslipidemia, low physical activity, smoking, arterial hypertension, etc.) increases the risk of development and progression of coronary artery disease (CAD). In particular, patients who have undergone coronary interventions and have a higher anxiety level are prone to the development of CAD complications.
 Aim: To characterize the basal parameters of clinically significant psychoautonomous syndrome and their changes over time under combination therapy, including anxiolytics, at various stages of rehabilitation of the patients after endovascular myocardial revascularization.
 Materials and methods: This open-label randomized controlled prospective study included 60 patients aged 45 to 75 years admitted to our in-patient department for rehabilitation treatment after coronary stent placement. The patients from the intervention group (n = 30), in addition to basic treatment for CAD, were administered anxiolytic therapy (alimemazine tartrate at daily dose of 12.5 to 25 mg i. m. at the early rehabilitation step and at 5 to 10 mg during their out-patient follow-up). The in-patient study period included 3 study visits (at admittance, i. e., Day 1, at Days 5 or 6, and at discharge at Day 10 to 14). Two further study visits were performed during the out-patient rehabilitation period at Days 30 and 60. At each visit, the emotional state, sleep quality, subjective signs of autonomous dysregulation, autonomous background and suprasegmental vegetative regulation, including temporal and spectral indicators of heart rate variability, were evaluated.
 Results: After endovascular myocardial revascularization (the in-patient study period, Day 1) patients of the intervention and control groups (n = 30 in both groups) demonstrated comparable moderate levels of state anxiety (median [Q1; Q3]: 42 [40; 46] and 42 [36; 43], respectively) and trait anxiety (45 [41; 48] and 42 [40; 46], associated with insomnia (PSQI score: 8 [6; 12] and 6 [3; 9]) and autonomous imbalance (SDNN: 73 [61; 89] and 70 [44; 95]) with a shift to sympathetic hyperactivity. Addition of an anxiolytic initiated the regression of psychoautonomous abnormalities already by the end of the early in-patient rehabilitation period) (Days 10 to 14), with a subsequent decrease in state anxiety to 36 [33; 39] and trait anxiety to 33 [32; 37] (p 0.001), regression of insomnia according to PSQI to 2 [2; 4] (p 0.001), and an improvement of autonomous balance (SDNN) to 113 [81; 132] (p 0.001) at days 45 to 60 of the outpatient follow-up. The only adverse event in the patients receiving the treatment for psychoautonomous dysfunction was increased sleepiness at daytime, which was registered in most of them at initiation of the therapy for 2 to 3 days and did not require any dose modification. There were no other clinically significant adverse events, including cardiovascular.
 Conclusion: ","PeriodicalId":31492,"journal":{"name":"Al''manah Kliniceskoj Mediciny","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135888482","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}

{"title":"Diagnostic algorithms for acute ankle injury imaging","authors":"Gennadii E. Trufanov, Viktoria Y. Aleksandrovich, Irina S. Menkova","doi":"10.18786/2072-0505-2023-51-030","DOIUrl":"https://doi.org/10.18786/2072-0505-2023-51-030","url":null,"abstract":"Ankle trauma is the most prevalent low extremity injury among urgent referral patients. Up to 85% of acute ankle traumas lead to an isolated ligament injury, with up to 50% of these patients would have chronic pain syndrome in the future, related to inaccurate diagnosis and resulting inappropriate treatment strategy and rehabilitation term.
 We analyzed publications on the state-of-the-art aspects of radiation diagnostics of acute ankle injury available from PubMed/MEDLINE databases and in the Russian Index of Scientific Citation (Elibrary.ru) for the last ten years; some earlier essential publications on certain aspects were also considered.
 Up to now, there have been no unified guidelines on the radiation diagnosis of ankle injury depending on the trauma type, mechanism, and severity. The Ottawa ankle rules (1994) are the basic guidelines for selection of the patients with acute trauma who should be offered X-rays. Primary X-ray would allow for the choice of the treatment strategy or further diagnostic assessment of the patient. Computed tomography is done for multi-fragment intra-articular fractures and for the control after their reposition. Computed tomography is used in patients with severe pain syndrome and other absolute and relative contraindications for magnetic resonance imaging. The latter allows for the imaging of all injured structures within a single assessment procedure and by such to make the diagnosis of ligament and tendon ruptures, to visualize osteochondral injuries, hidden and stress fractures and many other acute ankle injuries. Ultrasound assessment can considerably add to clinical understanding of the patient during acute trauma, if magnetic resonance imaging is contraindicated.
 Based on the analysis performed, we propose the algorithms for diagnostic assessment in various clinical situations.","PeriodicalId":31492,"journal":{"name":"Al''manah Kliniceskoj Mediciny","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135994102","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}

{"title":"The diagnosis of retroperitoneal tumors from a radiologist perspective: a case report of a giant intramuscular hemangioma in a 23-year old patient","authors":"Vladimir G. Aznaurov, Anastasia A. Kovalenko, Vadim S. Shirokov, Grigory G. Karmazanovsky","doi":"10.18786/2072-0505-2023-51-029","DOIUrl":"https://doi.org/10.18786/2072-0505-2023-51-029","url":null,"abstract":"Primary retroperitoneal tumors are a heterogeneous group of neoplasms with a prevalence of 0.02 to 1%. The results of diagnostic visualization of such tumors are usually ambiguous due to their diversity and similar radiological semiotics of malignant and benign tumor types. The paper describes a rare case of the diagnosis and management of a patient with one of retroperitoneal tumor, i. e. a giant intramuscular hemangioma.
 A 23-year old male patient was referred with complaints of episodic pains in the right inguinal area for 78 years. The multiaxial computed tomography showed a mass of 145 125 125 mm located in the trunk and pelvis, and spreading to the right thigh. The tumor structure was markedly heterogeneous and contained calcinates, adipose tissue, soft tissue and vascular components. The mass showed a heterogeneous contrast accumulation, with predominant delayed-phase enhancement. The tumor was surgically resected, with the histological investigation characteristic of intramuscular hemangioma.
 Rare retroperitoneal tumors are always challenging in the interpretation of the results of diagnostic visualization. Since their various types have similar radiological semiotics, the differential diagnosis is often impossible. Therefore, the main diagnostic issue should be the exact localization of the neoplasm, identification of the feeding vessels, and the assessment of the adjacent tissue abnormalities.","PeriodicalId":31492,"journal":{"name":"Al''manah Kliniceskoj Mediciny","volume":"214 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135351481","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}

{"title":"A clinical case of pyoderma gangrenosum as a severe extraintestinal manifestation of Crohn’s disease","authors":"Irina V. Gubonina, Vladimir B. Grinevich, Silviya R. Ramazanova, Sergey A. Petrachkov, Yaroslav L. Butrin","doi":"10.18786/2072-0505-2023-51-028","DOIUrl":"https://doi.org/10.18786/2072-0505-2023-51-028","url":null,"abstract":"Pyoderma gangrenosum is a rare neutrophilic dermatosis associated with a number of immune-mediated disorders, most frequently with inflammatory bowel disease and rheumatoid arthritis. Despite significant success in the treatment in inflammatory bowel disease, the problem of multidisciplinary management of patients with extraintestinal manifestations in routine medical practice remains unsolved. The paper presents a clinical case of a 32-year old female patient with a life-threatening extraintestinal manifestation of Crohn's disease, i. e. pyoderma gangrenosum. Late diagnosis of Crohn's disease, underestimation of the inflammation activity in the gut and respective lack of disease-modifying treatment were the reasons for the occurrence of pyoderma gangrenosum and its uncontrolled course. The untimely diagnosis of the skin purulent wound as an extraintestinal manifestation of Crohn's disease has led to delay in the immunosuppressive therapy required. The patient needed an intensive course of systemic glucocorticosteroids, prompt addition of a tumor necrosis factor-alpha inhibitor and surgery as a circulatory autodermoplasty.","PeriodicalId":31492,"journal":{"name":"Al''manah Kliniceskoj Mediciny","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135352541","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}

{"title":"Pegylated interferon in the treatment of chronic delta hepatitis: the experience from real-world clinical practice","authors":"Saniyat A. Magomedova, Saida K. Bilalova, Khatuna D. Peradze, Olga V. Isaeva, Vera S. Kichatova, Elena Y. Malinnikova, Liudmila Y. Ilchenko, Karen K. Kyuregyan, Vasiliy G. Akimkin, Mikhail M. Mikhailov","doi":"10.18786/2072-0505-2023-51-027","DOIUrl":"https://doi.org/10.18786/2072-0505-2023-51-027","url":null,"abstract":"Rationale: The high prevalence of hepatitis D virus (HDV) infection in the Republic of Dagestan, significantly exceeding that in the European part of the Russian Federation, as well as the limited choice of therapeutic options, have led to the need to analyze the accumulated experience of interferon therapy in the real clinical practice to further select possible treatment regimens.
 Aim: To evaluate the efficacy of pegylated interferon alpha (Peg-IFN-) in patients with chronic hepatitis D (CHD) in real world clinical practice.
 Materials and methods: In a retrospective study, the efficacy, safety and tolerability of Peg-IFN- were analyzed in 34 patients with CHD living in the Republic of Dagestan. Main virological parameters (anti-HDV antibodies (anti-HDV), HDV RNA and HBV DNA), alanine aminotransferase levels, changes over time in liver density by elastometry, and clinical parameters (hematology and urine tests, clinical chemistry, thyroid function tests) were assessed at 24 and 48 weeks of therapy, as well as at 48 weeks after its completion.
 Results: The treatment with Peg-IFN- for 48 weeks resulted in a virological response, defined as a HDV RNA decrease by more than 2 lg copies/mL, in 32% (11/34) of the patients. A sustained virological response, defined as undetectable HDV RNA at 48 weeks after the end of therapy, was not observed in any case. Treatment with interferon was associated with a decrease in liver density by average 4.1 kPa by week 48 on therapy. Normalization of alanine aminotransferase levels after 48 weeks of treatment was observed in 59% (20/34) of the patients; however, sustained biochemical response was achieved in none of them. Serious adverse events of high or moderate severity that resulted in the discontinuation of therapy were observed in 12% (4/34) of the cases.
 Conclusion: The results obtained indicate low efficacy of Peg-IFN- in the treatment of CHD in the Dagestan patients. Further research is needed to refine optimal interferon therapy regimens, to search for predictors of treatment response, and to evaluate the impact of interferon treatment regimens on the risk of hepatic complications, clinical outcomes, and patient survival. However, the most obvious solution to the problem of CHD therapy is the development and implementation of interferon-free treatment regimens.","PeriodicalId":31492,"journal":{"name":"Al''manah Kliniceskoj Mediciny","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135302458","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}

{"title":"Causes for the absence of thrombocytopenia in patients with liver cirrhosis and portal vein thrombosis: A case-control study","authors":"Maria Y. Nadinskaia, Khava B. Kodzoeva, Kseniya A. Gulyaeva, Mariia-Doris E. Khen, Diana I. Koroleva, Vladimir T. Ivashkin","doi":"10.18786/2072-0505-2023-51-025","DOIUrl":"https://doi.org/10.18786/2072-0505-2023-51-025","url":null,"abstract":"Background: Complications of liver cirrhosis (LC), such as thrombocytopenia and portal vein thrombosis (PVT), have similar pathophysiology. However, the association between PVT and platelet count in LC patients is contradictory.
 Aim: To assess factors affecting the platelet count in patients with LC and PVT.
 Materials and methods: This was a retrospective case-control study. The cases were 114 patients with LC of various etiologies and newly diagnosed PVT unrelated to invasive hepatocellular carcinoma. From the database of LC patients without PVT, 228 controls were randomly selected with stratification by gender, age and etiology of cirrhosis. The patients from both groups were divided into subgroups with thrombocytopenia ( 150 109/L) and without thrombocytopenia ( 150 109/L). We analyzed the LC etiology, portal hypertension severity (ascites, hepatic encephalopathy, gastroesophageal varices and associated bleedings, the spleen length, and portal vein diameter), laboratory parameters (white blood cell counts, neutrophils, lymphocytes, hemoglobin levels, total protein, albumin, total bilirubin, fibrinogen, neutrophil-to-lymphocyte ratio, and prothrombin); also, the rates of newly diagnosed malignant tumors was assessed. The statistical analysis included calculation of odds ratios (OR) and 95% confidence intervals (CI), logistic regression models with assessment of the model accuracy, and the area under the ROC curve (AUC).
 Results: There were no differences in the severity of thrombocytopenia between the case and control groups: thrombocytopenia was severe in 15.8% (18 patients) vs 13.6% (31 patients, p = 0.586); moderate, in 41.2% (47 patients) vs 46.1% (105 patients, p = 0.398) and mild, in 31.6% (36 patients) vs 24.5% (56 patients, p = 0.168). The proportion of the patients without thrombocytopenia was 11.4% (13 patients) in the case group and 15.8% (36 patients) in the control group, with the between-group difference being non-significant (p = 0.276). In the subgroups of patients without thrombocytopenia (both in the cases and in the controls), the proportion alcoholic etiology of LC, white blood cells counts, neutrophils, lymphocytes, and fibrinogen concentrations were significantly higher (p 0.05) than in those with thrombocytopenia. The model based on the outcome \"absence of thrombocytopenia\" included white blood cells counts, hemoglobin and albumin levels, the presence of newly diagnosed malignant tumors in the case group (model accuracy 90.4%, AUC 0.873), and neutrophil counts and spleen length in the control group (model accuracy 86.4%, AUC 0.855). In the patients with PVT and platelet counts of 150 109/L, the OR for all newly diagnosed malignant tumors was 26.3 (95% CI 7.3793.97, р 0.0001), for newly diagnosed hepatocellular carcinoma without portal vein invasion 17.42 (95% CI 4.8462.65, р 0.0001).
 Conclusion: In LC patients, the prevalence and severity of thrombocytopenia are not different depending on the PVT p","PeriodicalId":31492,"journal":{"name":"Al''manah Kliniceskoj Mediciny","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135303046","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}

{"title":"The results of real-world practice with glecaprevir/pibrentasvir for the treatment of chronic hepatitis C virus infection genotypes 1 and 3 in adolescents aged 12 to 17 years in the Moscow region","authors":"Elena R. Meskina, Elena E. Tselipanova, Lidiya A. Galkina","doi":"10.18786/2072-0505-2023-51-026","DOIUrl":"https://doi.org/10.18786/2072-0505-2023-51-026","url":null,"abstract":"Rationale: The first direct anti-viral agents (DAVA) for the treatment of adolescents with chronic hepatitis C virus (HCV) infection have been approved quite recently, i. e. in 2017 worldwide and in 2019 in Russia. Currently, only few adolescents are treated worldwide, their proportion in the Russian Federation not exceeding 9 to 15%. The results of real-world practice with various DAVA regiments in adolescents aged 12 to 17 years could be useful to choose the strategies for local healthcare bodies.
 Aim: To evaluate the efficacy and safety of the fixed combination of glecaprevir and pibrentasvir (GLE/PIB) in adolescents aged 12 to 17 years with HCV infection genotypes (GT) 1 and 3 in the Moscow region.
 Materials and methods: We retrospectively analyzed the results of treatment of 32 adolescents (gender ratio 1:1) who were treated for HCV infection (GT1, 49.9% of the cases, GT3, 53.1%; F1 fibrosis according to the METAVIR scale, 37.5% of the patients, F2, 9.4%) with GLE/PIB during 2019 to 2022 within the Program of State-guaranteed free medical care to the citizens of the Moscow region. The treatment course lasted for 8 weeks in 31 treatment-nave patients and 16 weeks in one patient who had failed on interferon treatment. The information was extracted from medical files of the patients treated on the outpatient basis and from discharge letters from the day care unit. Concomitant diseases were diagnosed in 75% of the adolescents.
 Results: At week 4 of GLE/PIB treatment, HCV RNA was undetectable in 90.6% (95% confidence interval (CI) 75.098.0) of the patients, and alanine aminotransferase activity reached the reference interval in all patients (100%). The rate of sustained viral response at 12 week of therapy was 96.9% (95% CI 83.899.9), including 100% (95% CI 78.2100) in the GT1 patients and 94.1% (95% CI 71.399.9) in the GT3 patients. At week 24 after the GLE/PIB treatment had been finished, the rate of liver fibrosis according to METAVIR decreased from 46.9% to 12.5% (p 0.001). The lack of response to GLE/PIB in one patient with GT1 HCV appeared to be due to missed doses of the drug. GLE/PIB-related adverse events (headache, fatigue, nausea, and diarrhea) were rare and were recorded in 9.4% (95% CI 1.925.0) of the patients, whereas unrelated adverse events (acute respiratory infection symptoms) in 15.6% (95% CI 5.332.8) of the patients. All adverse events were mild, occurred at 23 weeks of the treatment and did not require additional pharmacological intervention.
 Conclusion: The results obtained indicate a high efficacy and safety profile of GLE/PIB for the treatment of chronic HCV infection in adolescents aged 12 to 17 years. They can be used by local healthcare authorities to choose the treatment regimens effective for all genotypes and most suitable for children.","PeriodicalId":31492,"journal":{"name":"Al''manah Kliniceskoj Mediciny","volume":"298 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135304237","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}

{"title":"Retraction of the article “Intraoperative computed tomography perfusion navigation for maximal resection of high grade gliomas: a prospective non-randomized trial”","authors":"","doi":"10.18786/2072-0505-2023-51-023","DOIUrl":"https://doi.org/10.18786/2072-0505-2023-51-023","url":null,"abstract":"The editors (publisher) have retracted the article by R.S.Talybov, T.N.Trofimova, V.V.Mochalov, I.V.Shvetsov, V. V.Spasennikov. Intraoperative computed tomography perfusion navigation for maximal resection of high grade gliomas: aprospective non-randomized trial. Almanac of Clinical Medicine. 2023;51. doi: 10.18786/2072-0505-2023-51-012. Received 14 April 2023; revised 15 May 2023; accepted 5 June 2023; published online 15 June 2023.
 The retraction reason: research ethics violation by the authors in terms of submission of misinformation on the ethics approval for the study and on the signing of the informed consent by the patients for participation in the study. The authors have been informed on the decision.","PeriodicalId":31492,"journal":{"name":"Al''manah Kliniceskoj Mediciny","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135209097","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}