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COVID-19 in Patients with Primary Biliary Cholangitis 原发性胆道胆管炎患者的COVID-19
Q3 Medicine Pub Date : 2022-08-18 DOI: 10.22416/1382-4376-2022-32-3-29-34
М. К. Prashnova, K. Raikhelson, N. V. Marchenko, S. Zakharenko
The aim of the study. To analyze the course of COVID-19 infection in patients with primary biliary cholangitis (PBC).Materials and methods. In a single-center retrospective study, survey and analysis of medical records of 144 patients with PBC was carried out.Results. All patients (n = 144) received basic therapy with ursodeoxycholic acid (UDCA), 5 of them received fibrates as well. Response to therapy (EASL criteria) was obtained in 30 people. Between March 2020 and March 2021, 50 patients (34.7 %) suffered COVID-19, with mean age of 58.8 ± 10.7 years, 16 of which were diagnosed with liver cirrhosis. Mild COVID-19 was observed in 34 (68 %) people, moderate course — in 14 (28 %), severe — in 2 (4 %), cases of extremely severe course were not recorded. 12 patients were hospitalized, 8 of which received oxygen therapy due to a decrease in SpO2 < 94 %, there was no need for the use of other methods of oxygen therapy in any case. The duration of hospitalization was 11.4 ± 5.7 days. There was a higher initial activity of serum alkaline phosphatase (1.8 ± 1.0 versus 1.7 ± 1.4 times of the upper limit of normal, M ± SD, p = 0.04) in patients with COVID-19 infection and lack of UDCA therapy effectiveness was more prominent (40 % vs. 19.1 % of cases, p = 0.04) compared with patients who did not have COVID-19. There were no significant differences in characteristics of the course of PBC (stage, response to therapy) and age in correlation with severity of the course of COVID-19. Among hospitalized patients and those in need of oxygen support, large proportion were older patients (58.3 % and 62.5 %, respectively) and patients with concomitant diseases (62.5 % and 75 %, respectively). Patients who hadn`t previously responded to UDCA therapy were more likely to require oxygen support compared to patients responding to basic therapy (p < 0.01).Conclusion. PBC is not a risk factor for severe COVID-19. A protective effect of UDCA in SARS-CoV-2 infection is possible, which requires further investigation.
研究的目的。目的:分析原发性胆道胆管炎(PBC)患者的COVID-19感染过程。材料和方法。在一项单中心回顾性研究中,对144例PBC患者的病历进行了调查和分析。144例患者均接受熊去氧胆酸(UDCA)基础治疗,其中5例患者同时接受贝特类药物治疗。30例患者获得治疗反应(EASL标准)。2020年3月至2021年3月,50例(34.7%)患者感染COVID-19,平均年龄58.8±10.7岁,其中16例诊断为肝硬化。34人(68%)出现轻度COVID-19, 14人出现中度病程(28%),2人出现重度病程(4%),未记录极重度病程病例。12例患者住院,其中8例因SpO2下降< 94%而接受氧疗,均无需使用其他氧疗方法。住院时间11.4±5.7 d。与未感染COVID-19的患者相比,感染COVID-19的患者血清碱性磷酸酶的初始活性更高(1.8±1.0比1.7±1.4倍正常上限,M±SD, p = 0.04), UDCA缺乏治疗效果更突出(40%比19.1%,p = 0.04)。PBC病程特征(分期、治疗反应)和年龄与COVID-19病程严重程度相关无显著差异。在住院患者和需要氧支持的患者中,老年患者(分别为58.3%和62.5%)和合并疾病患者(分别为62.5%和75%)所占比例较大。与接受基础治疗的患者相比,先前未接受UDCA治疗的患者更有可能需要氧支持(p < 0.01)。PBC不是严重COVID-19的危险因素。UDCA可能对SARS-CoV-2感染有保护作用,这需要进一步调查。
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引用次数: 0
Technologically-Treated Polyclonal Affinity-Purified Antibodies to the Tumor Necrosis Factor-α, Brain Specific S-100 Protein and Histamine in Treatment of Functional Dyspepsia: Results of the Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial 技术处理的肿瘤坏死因子-α、脑特异性S-100蛋白和组胺多克隆亲和纯化抗体治疗功能性消化不良:多中心、随机、双盲、安慰剂对照试验的结果
Q3 Medicine Pub Date : 2022-08-11 DOI: 10.22416/1382-4376-2022-32-3-40-51
Y. Shulpekova, I. Maev, V. Grinevich, I. Khlynov, Y. Shvarts, V. Ivashkin
The aim of the study was to evaluate the efficacy and safety of Kolofort® (a complex medicine containing technologically processed forms of antibodies to S-100 protein, tumor necrosis factor-α and histamine) in the management of functional dyspepsia (FD) in outpatient clinical practice.Methods: Outpatients (N = 309) at the age of 18–45 in whom FD was diagnosed according to the Rome IV criteria were enrolled in a multicenter, double-blind, placebo-controlled, randomized clinical trial. Patients were randomized in two groups receiving Kolofort® or placebo 2 tablets tid for 8 weeks. The primary endpoint of the study was a change in the FD symptoms severity score according to the Gastrointestinal symptom score (GIS) at week 8. ITT and [PP] analysis were performed.Results: at week 8 the reduction in GIS sum score was observed in Kolofort® group and placebo group (by 7.2 ± 3.3 [7.2 ± 3.4] and 6.3 ± 4.6 [6.2 ± 4.5], respectively, p = 0.041 [0.039]). The proportion of cases with GIS score reduction by ≥4 was 88,1 % [88.6 %] and 79.1 % [79.6 %] in Kolofort® group and placebo group, respectively (p = 0.046 [p = 0.051]). None of the patients in Kolofort® group had progression of FD symptoms or required additional therapy. There were 29 adverse events (AEs) recorded in 25 patients including 16 cases in 13 (8.6 %) patients in Kolofort® group and 13 AEs in 12 (7.6 %) patients in placebo group.Conclusion: the clinical trial demonstrates the positive effect of Kolofort® in FD with a favorable safety profile. 
该研究的目的是评估Kolofort®(一种含有S-100蛋白、肿瘤坏死因子-α和组胺抗体的复合药物)在门诊临床实践中治疗功能性消化不良(FD)的疗效和安全性。方法:采用多中心、双盲、安慰剂对照、随机临床试验,选取年龄在18-45岁、经Rome IV标准诊断为FD的门诊患者309例。患者被随机分为两组,每天服用Kolofort®或安慰剂2片,持续8周。研究的主要终点是根据胃肠道症状评分(GIS)在第8周FD症状严重程度评分的变化。进行ITT和[PP]分析。结果:在第8周,Kolofort®组和安慰剂组的GIS总分分别下降了7.2±3.3[7.2±3.4]和6.3±4.6[6.2±4.5],p = 0.041[0.039])。Kolofort®组和安慰剂组GIS评分降低≥4分的比例分别为88%、1%[88.6%]和79.1% [79.6%](p = 0.046 [p = 0.051])。Kolofort®组患者无FD症状进展或需要额外治疗。25例患者共发生29例不良事件(ae),其中Kolofort®组13例16例(8.6%),安慰剂组12例13例(7.6%)。结论:临床试验表明Kolofort®在FD中的积极作用,具有良好的安全性。
{"title":"Technologically-Treated Polyclonal Affinity-Purified Antibodies to the Tumor Necrosis Factor-α, Brain Specific S-100 Protein and Histamine in Treatment of Functional Dyspepsia: Results of the Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial","authors":"Y. Shulpekova, I. Maev, V. Grinevich, I. Khlynov, Y. Shvarts, V. Ivashkin","doi":"10.22416/1382-4376-2022-32-3-40-51","DOIUrl":"https://doi.org/10.22416/1382-4376-2022-32-3-40-51","url":null,"abstract":"The aim of the study was to evaluate the efficacy and safety of Kolofort® (a complex medicine containing technologically processed forms of antibodies to S-100 protein, tumor necrosis factor-α and histamine) in the management of functional dyspepsia (FD) in outpatient clinical practice.Methods: Outpatients (N = 309) at the age of 18–45 in whom FD was diagnosed according to the Rome IV criteria were enrolled in a multicenter, double-blind, placebo-controlled, randomized clinical trial. Patients were randomized in two groups receiving Kolofort® or placebo 2 tablets tid for 8 weeks. The primary endpoint of the study was a change in the FD symptoms severity score according to the Gastrointestinal symptom score (GIS) at week 8. ITT and [PP] analysis were performed.Results: at week 8 the reduction in GIS sum score was observed in Kolofort® group and placebo group (by 7.2 ± 3.3 [7.2 ± 3.4] and 6.3 ± 4.6 [6.2 ± 4.5], respectively, p = 0.041 [0.039]). The proportion of cases with GIS score reduction by ≥4 was 88,1 % [88.6 %] and 79.1 % [79.6 %] in Kolofort® group and placebo group, respectively (p = 0.046 [p = 0.051]). None of the patients in Kolofort® group had progression of FD symptoms or required additional therapy. There were 29 adverse events (AEs) recorded in 25 patients including 16 cases in 13 (8.6 %) patients in Kolofort® group and 13 AEs in 12 (7.6 %) patients in placebo group.Conclusion: the clinical trial demonstrates the positive effect of Kolofort® in FD with a favorable safety profile. ","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"151 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85614291","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}
引用次数: 0
The Association of High COVID-19 Cases and Mortality with Anomalous High Surface Ozone Concentration in Moscow City in Summer 2021 2021年夏季莫斯科市高COVID-19病例和死亡率与异常高地表臭氧浓度的关系
Q3 Medicine Pub Date : 2022-08-11 DOI: 10.22416/1382-4376-2022-32-3-18-22
E. Stepanov, V. Andreev, D. Chuprov, V. Ivashkin
Aim: to compare statistical data on the frequency of COVID-19 and deaths from it with the ozone content in the surface atmosphere of Moscow in the summer of 2021.Materials and methods. We used data on the frequency of daily COVID-19 cases and mortality from COVID-19 in Moscow in 2020–2021 published by Rospotrebnadzor. Data on the ozone content in the surface layer of the atmosphere were obtained by an automatic monitoring station using a chemiluminescent analyzer.Results. The waves of high frequency of COVID-19 cases and mortality from COVID-19 in Moscow in the summer of 2021 were compared with abnormally high concentrations of ozone in the surface atmosphere of the megalopolis. Variations of these parameters were found to be markedly correlated. The coefficients of correlation of the COVID-19 cases and mortality with the concentration of ground-level ozone were 0,59 (p < 0.01) and 0.60 (p < 0.01), respectively.Conclusion. The observed noticeable relationship may be due to the combined pathological effect of high concentrations of ozone and the SARS-CoV-2 on the respiratory and circulatory organs, which can lead to both easier transmission of infection and a more severe course of the disease with increased mortality.
目的:比较2021年夏季莫斯科地面大气臭氧含量与2019冠状病毒病发病频率和死亡人数的统计数据。材料和方法。我们使用了Rospotrebnadzor公布的2020-2021年莫斯科每日COVID-19病例频率和COVID-19死亡率数据。利用化学发光分析仪自动监测站获得了大气表层臭氧含量的数据。将2021年夏季莫斯科新冠肺炎病例和死亡率的高频率与大都市地面大气中异常高浓度的臭氧进行了比较。这些参数的变化被发现是显著相关的。新冠肺炎病例数和死亡率与地面臭氧浓度的相关系数分别为0、59 (p < 0.01)和0.60 (p < 0.01)。观察到的明显关系可能是由于高浓度臭氧和SARS-CoV-2对呼吸和循环器官的综合病理影响,这既可能导致感染更容易传播,也可能导致病程更严重,死亡率增加。
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引用次数: 0
Modern Approaches to Vaccination of Patients with Chronic Liver Diseases and Inflammatory Bowel Diseases against a Novel Coronavirus Infection 慢性肝病和炎症性肠病患者预防新型冠状病毒感染的现代方法
Q3 Medicine Pub Date : 2022-08-09 DOI: 10.22416/1382-4376-2022-32-3-7-11
A. Sheptulin, V. Ivashkin
Aim. To analyze the literature data on the peculiarities of vaccination of patients with chronic liver diseases (CLD) and inflammatory bowel diseases (IBD) against COVID-19 infection.Key findings. It has been shown that many patients with CLD (cirrhosis of the liver, non-alcoholic fatty liver disease) have a higher risk of severe course of a novel coronavirus infection, which necessitates their vaccination. IBD patients are also subject to vaccination, although the immunomodulatory drugs which they take may reduce its effectiveness. In addition, the correct timing of the vaccine administration is of great importance. Vaccination of patients with CLD and IBD is safe, and the frequency of side effects during its implementation does not differ from that in the general population.Conclusion. Analysis of literature data shows that patients with CLD and IBD are subject to vaccination against COVID-19 infection, which is effective and safe. 
的目标。目的:分析慢性肝病(CLD)和炎症性肠病(IBD)患者预防COVID-19感染疫苗接种的特点。关键的发现。研究表明,许多CLD(肝硬化,非酒精性脂肪性肝病)患者发生新型冠状病毒严重感染的风险较高,因此需要接种疫苗。IBD患者也需要接种疫苗,尽管他们服用的免疫调节药物可能会降低疫苗的有效性。此外,接种疫苗的正确时机也非常重要。CLD和IBD患者接种疫苗是安全的,在接种过程中发生副作用的频率与一般人群没有差异。文献资料分析表明,CLD和IBD患者接种COVID-19感染疫苗是有效和安全的。
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引用次数: 0
Vaccination and Mortality of Patients with a Novel Coronavirus Infection (COVID-19): A Global Approach 新型冠状病毒感染(COVID-19)患者的疫苗接种和死亡率:一种全球方法
Q3 Medicine Pub Date : 2022-08-09 DOI: 10.22416/1382-4376-2022-32-3-23-28
N. Benuni, A. Kotusov, F. S. Adzhieva, A. Kucher, K. A. Tolmacheva, V. N. Dushuk, R. Maslennikov
Aim. The aim is to study the correlation between the vaccination rate (VR) and mortality rate of patients with COVID-19 (MpCOV).Methods. The countries with gross domestic product per capita corrected for purchasing power parity (GDP PPP) over $-10,000 were selected for an ecologic study. The city-states and countries with a population of 1,000,000 were excluded. The number of patients who died from COVID-19 within a week was divided by the number of patients diagnosed with COVID-19 within a week 20 days earlier to calculate MpCOV.Results. We included 85 countries. VR (r = –0.604; p < 0.001) and GDPpcPPP level (p = 0.202), is an independent determinant of MpCOV. There was no significant difference in MpCOV between groups of countries with VR < 20 % and 20–39 % (1.96 [1.21; 4.67] vs. 1.96 [1.01; 3.36] %; p = 0.464). MpCOV was higher in countries where VR were lower when groups of countries with VR of 20–39 %, 40–59 %, 60–79 %, and ≥80 % were compared (1.96 [1.01; 3.36] vs. 1.11 [0.76; 1.64] vs. 0.50 [0.39; 1.00] vs. 0.16 [0.10; 0.21]; p = 0.003; p = 0.020, and p = 0.008).Conclusions. An increase in VR correlates with a decrease in MpCOV.
的目标。目的探讨新型冠状病毒肺炎(MpCOV)疫苗接种率(VR)与患者死亡率的相关性。经购买力平价修正的人均国内生产总值(GDP PPP)超过-10,000美元的国家被选中进行生态研究。城市国家和人口超过100万的国家被排除在外。将一周内死于COVID-19的患者数除以20天前一周内确诊为COVID-19的患者数,计算mpcov。我们包括了85个国家。VR (r = -0.604;p < 0.001)和GDPpcPPP水平(p = 0.202),是MpCOV的独立决定因素。在VR < 20%和20 - 39%的国家组中,MpCOV无显著差异(1.96;4.67] vs. 1.96 [1.01;3.36) %;P = 0.464)。当将VR为20 - 39%、40 - 59%、60 - 79%和≥80%的国家组进行比较时,MpCOV在VR较低的国家较高(1.96 [1.01;3.36] vs. 1.11 [0.76;1.64] vs. 0.50 [0.39;1.00] vs. 0.16 [0.10;0.21);P = 0.003;p = 0.020, p = 0.008)。VR的增加与MpCOV的减少相关。
{"title":"Vaccination and Mortality of Patients with a Novel Coronavirus Infection (COVID-19): A Global Approach","authors":"N. Benuni, A. Kotusov, F. S. Adzhieva, A. Kucher, K. A. Tolmacheva, V. N. Dushuk, R. Maslennikov","doi":"10.22416/1382-4376-2022-32-3-23-28","DOIUrl":"https://doi.org/10.22416/1382-4376-2022-32-3-23-28","url":null,"abstract":"Aim. The aim is to study the correlation between the vaccination rate (VR) and mortality rate of patients with COVID-19 (MpCOV).Methods. The countries with gross domestic product per capita corrected for purchasing power parity (GDP PPP) over $-10,000 were selected for an ecologic study. The city-states and countries with a population of 1,000,000 were excluded. The number of patients who died from COVID-19 within a week was divided by the number of patients diagnosed with COVID-19 within a week 20 days earlier to calculate MpCOV.Results. We included 85 countries. VR (r = –0.604; p < 0.001) and GDPpcPPP level (p = 0.202), is an independent determinant of MpCOV. There was no significant difference in MpCOV between groups of countries with VR < 20 % and 20–39 % (1.96 [1.21; 4.67] vs. 1.96 [1.01; 3.36] %; p = 0.464). MpCOV was higher in countries where VR were lower when groups of countries with VR of 20–39 %, 40–59 %, 60–79 %, and ≥80 % were compared (1.96 [1.01; 3.36] vs. 1.11 [0.76; 1.64] vs. 0.50 [0.39; 1.00] vs. 0.16 [0.10; 0.21]; p = 0.003; p = 0.020, and p = 0.008).Conclusions. An increase in VR correlates with a decrease in MpCOV.","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80886139","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}
引用次数: 0
Features of Medical Care Providing to Patients with Digestive Diseases in the Krasnodar Region during the COVID-19 Pandemic 新冠肺炎大流行期间克拉斯诺达尔地区消化系统疾病患者医疗服务特点
Q3 Medicine Pub Date : 2022-08-09 DOI: 10.22416/1382-4376-2022-32-3-12-17
N. Korochanskaya, V. M. Durleshter, S. A. Gabriel’, O. V. Kovalevskaya, S. N. Serikova, M. A. Basenko
The aim of the study: optimization the medical care provision to patients with diseases of the digestive system (DD) in the Krasnodar Region during the COVID-19 pandemic.Material and methods. The analysis of the features of the DD course in the Krasnodar Region was carried out according to the data of form C 51 “Distribution of the dead by sex, age groups and causes of death” of the Territorial Federal State Statistics Service in the Krasnodar Region, as well as monitoring the quality of medical care for patients with DD for the period from 2019 to 2021 years.Results. During the COVID-19 pandemic, the routing of gastroenterological patients, dispensary observation and preventive measures have undergone some changes. In the structure of total mortality in the Krasnodar Region, mortality from DD was 21.6 % in 2020 and 4.0 % in 2021. The decrease in the growth of mortality rate, including from DD, in the second year of the pandemic is associated with the completed healthcare systems reformatting. The increase in hospital mortality in patients with gastric and duodenal ulcers, ulcerative colitis, and diverticular disease had a significant impact on mortality rates from DD. The decreasing number of hospitalizations was explained due to the conversion of a number of hospitals into hospitals for the treatment of patients with COVID-19. The hospitalization was mainly carried out for emergency indications and patients with a more severe course of the disease. The pandemic has increased the need for telemedicine: 378 tele-consultations on the gastroenterological profile was carried out in the Krasnodar Region in 2021.Conclusion. Healthcare system workload in the Krasnodar Region increased significantly during the coronavirus pandemic that required a number of structural adjustments. In recent times, the regional health care is returning to the planned mode of providing medical care. 
该研究的目的是:在COVID-19大流行期间,优化克拉斯诺达尔地区消化系统疾病(DD)患者的医疗服务。材料和方法。根据克拉斯诺达尔地区联邦国家统计局的C - 51表格“按性别、年龄组和死亡原因分列的死亡人数分布”数据,对克拉斯诺达尔地区DD病程特征进行了分析,并对2019年至2021年期间DD患者的医疗质量进行了监测。2019冠状病毒病大流行期间,胃肠病学患者路线、药房观察和预防措施发生了一些变化。在克拉斯诺达尔州的总死亡率结构中,2020年DD死亡率为21.6%,2021年为4.0%。在大流行的第二年,死亡率(包括DD)增长率的下降与完成了卫生保健系统的改革有关。胃和十二指肠溃疡、溃疡性结肠炎和憩室疾病患者住院死亡率的增加对DD死亡率有显著影响。住院人数减少的原因是一些医院改为治疗COVID-19患者的医院。住院治疗主要针对急诊指征和病程较重的患者。大流行增加了对远程医疗的需求:2021年在克拉斯诺达尔地区开展了378次关于胃肠病学的远程会诊。在冠状病毒大流行期间,克拉斯诺达尔地区的卫生保健系统工作量显著增加,需要进行一些结构调整。近年来,区域卫生保健正在回归到提供医疗保健的计划模式。
{"title":"Features of Medical Care Providing to Patients with Digestive Diseases in the Krasnodar Region during the COVID-19 Pandemic","authors":"N. Korochanskaya, V. M. Durleshter, S. A. Gabriel’, O. V. Kovalevskaya, S. N. Serikova, M. A. Basenko","doi":"10.22416/1382-4376-2022-32-3-12-17","DOIUrl":"https://doi.org/10.22416/1382-4376-2022-32-3-12-17","url":null,"abstract":"The aim of the study: optimization the medical care provision to patients with diseases of the digestive system (DD) in the Krasnodar Region during the COVID-19 pandemic.Material and methods. The analysis of the features of the DD course in the Krasnodar Region was carried out according to the data of form C 51 “Distribution of the dead by sex, age groups and causes of death” of the Territorial Federal State Statistics Service in the Krasnodar Region, as well as monitoring the quality of medical care for patients with DD for the period from 2019 to 2021 years.Results. During the COVID-19 pandemic, the routing of gastroenterological patients, dispensary observation and preventive measures have undergone some changes. In the structure of total mortality in the Krasnodar Region, mortality from DD was 21.6 % in 2020 and 4.0 % in 2021. The decrease in the growth of mortality rate, including from DD, in the second year of the pandemic is associated with the completed healthcare systems reformatting. The increase in hospital mortality in patients with gastric and duodenal ulcers, ulcerative colitis, and diverticular disease had a significant impact on mortality rates from DD. The decreasing number of hospitalizations was explained due to the conversion of a number of hospitals into hospitals for the treatment of patients with COVID-19. The hospitalization was mainly carried out for emergency indications and patients with a more severe course of the disease. The pandemic has increased the need for telemedicine: 378 tele-consultations on the gastroenterological profile was carried out in the Krasnodar Region in 2021.Conclusion. Healthcare system workload in the Krasnodar Region increased significantly during the coronavirus pandemic that required a number of structural adjustments. In recent times, the regional health care is returning to the planned mode of providing medical care. ","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"2012 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86428122","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}
引用次数: 0
Prevalence of Small Intestinal Bacterial Overgrowth Syndrome in Patients with Irritable Bowel Syndrome who Have Suffered COVID-19 患有COVID-19的肠易激综合征患者中小肠细菌过度生长综合征的患病率
Q3 Medicine Pub Date : 2022-08-07 DOI: 10.22416/1382-4376-2022-32-3-35-39
A. V. Nalyotov, N. P. Guz
Aim. To study the prevalence of the small intestinal bacterial overgrowth syndrome in patients with irritable bowel syndrome with diarrhea who have had COVID-19 infection.Materials and methods. 60 patients with irritable bowel syndrome with diarrhea were examined. In 30 patients, irritable bowel syndrome was diagnosed after COVID-19 infection (main group). The comparison group consisted of 30 patients with classical stress-induced irritable bowel syndrome. The small intestinal bacterial overgrowth syndrome was diagnosed using a hydrogen breath test with lactulose loading in all patients.Results. In main group the small intestinal bacterial overgrowth syndrome was diagnosed in 93.3 % patients, which was statistically significantly higher (p < 0.01) relative to the comparison group — 60.0 % patientsConclusion. Irritable bowel syndrome in patients who have undergone COVID-19 occurs against the background of the small intestinal bacterial overgrowth syndrome development.
的目标。目的研究COVID-19感染的肠易激综合征伴腹泻患者小肠细菌过度生长综合征的患病率。材料和方法。对60例肠易激综合征伴腹泻患者进行了检查。30例患者在COVID-19感染后诊断为肠易激综合征(主组)。对照组由30例典型应激性肠易激综合征患者组成。所有患者均采用乳果糖负荷氢呼气试验诊断小肠细菌过度生长综合征。主组小肠细菌过度生长综合征检出率为93.3%,高于对照组60.0%,差异有统计学意义(p < 0.01)。感染COVID-19的患者的肠易激综合征是在小肠细菌过度生长综合征发展的背景下发生的。
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引用次数: 1
Practical Recommendation of the Scientific Сommunity for Human Microbiome Research (CHMR) and the Russian Gastroenterological Association (RGA) on Small Intestinal Bacterial Overgrowth in Adults 科学Сommunity人类微生物组研究(CHMR)和俄罗斯胃肠病学协会(RGA)关于成人小肠细菌过度生长的实用建议
Q3 Medicine Pub Date : 2022-07-29 DOI: 10.22416/1382-4376-2022-32-3-68-85
V. Ivashkin, I. Maev, D. Abdulganieva, O. P. Alekseeva, S. Alekseenko, O. Zolnikova, N. Korochanskaya, O. Medvedev, E. Poluektova, V. Simanenkov, A. Trukhmanov, I. Khlynov, V. Tsukanov, O. Shifrin, K. Ivashkin, T. Lapina, R. Maslennikov, M. Fadeeva, A. Ulyanin
Aim. To optimize the choice of treatment strategies by physicians and gastroenterologists to improve treatment and prevention of small intestinal bacterial overgrowth (SIBO) in adults.Key points. SIBO is a condition characterized by an increased amount and/or abnormal composition of the microbiota in the small intestine. Clinically, the syndrome is manifested by nonspecific gastroenterological complaints and the development of malabsorption syndrome. Most often, SIBO is associated with various chronic non- infectious diseases (both diseases of the gastrointestinal tract, and the cardiovascular system and the neuromuscular apparatus) and can affect the severity of their symptoms. Specific methods for diagnosing SIBO are the culture method and breath tests. The main approaches to the treatment of SIBO include the elimination of the underlying cause of its occurrence, the use of antibacterial drugs and adherence to dietary recommendations (elemental diet).Conclusion. Small intestinal bacterial overgrowth is common in patients with various diseases, but has non-specific manifestations, so proper diagnosis of this condition is required. SIBO therapy involves prescription of antibacterial agents, the most studied of which is the non-absorbable antibiotic rifaximin-α.
的目标。优化医生和胃肠病学家的治疗策略选择,以改善成人小肠细菌过度生长(SIBO)的治疗和预防。要点。SIBO是一种以小肠微生物群数量增加和/或组成异常为特征的疾病。临床上,该综合征表现为非特异性胃肠疾病和发展为吸收不良综合征。大多数情况下,SIBO与各种慢性非传染性疾病(胃肠道疾病、心血管系统疾病和神经肌肉器官疾病)有关,并可影响其症状的严重程度。诊断SIBO的具体方法有培养法和呼吸试验。SIBO的主要治疗方法包括消除其发生的根本原因,使用抗菌药物和遵守饮食建议(元素饮食)。小肠细菌过度生长在各种疾病的患者中都很常见,但没有特异性的表现,因此需要正确的诊断。SIBO治疗涉及抗菌药物的处方,其中研究最多的是不可吸收的抗生素利福昔明-α。
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引用次数: 4
Patient with Jaundice, Dyspnea and Hyperferritinemia after COVID-19 新冠肺炎后黄疸、呼吸困难及高铁蛋白血症患者
Q3 Medicine Pub Date : 2022-07-12 DOI: 10.22416/1382-4376-2022-32-3-57-67
V. R. Grechishnikova, P. Tkachenko, M. Zharkova, T. Nekrasova, V. Ivashkin
The aim: to highlight the importance of considering hemophagocytic lymphohistiocytosis in patients with jaundice of unclear origin and systemic inflammatory manifestations after coronavirus infection.Key points. A 64-y.o. patient was admitted to the hospital with jaundice, pruritus, fatigue, weight loss. The complaints occurred 2 weeks after discharge from the hospital for treatment of patients with coronavirus infection. Laboratory tests revealed signs of hepatic insufficiency, markers of cholestasis and inflammation persisted in time. Upon instrumental examination no signs of hepatosplenomegaly, biliary tree changes, intra- and extrahepatic obstruction were found. S. aureus was identified in blood cultures, CT scan of the facial skull bones showcased the focus of infection in the area of the roots of teeth 2.4 and 2.5. Therefore, antibiotics were prescribed. Subsequently, the patient's condition was complicated by the development of two episodes of acute respiratory distress syndrome, which occurred during the withdrawal of glucocorticosteroid therapy. Liver biopsy was performed, morphological study revealed signs of “vanishing bile duct” syndrome, excessive activation of macrophages and hemosiderosis of sinusoidal cells. Identified lesions can be found in hemophagocytic lymphohistiocytosis (HLH), a life-threatening complication of coronavirus infection. Glucocorticosteroids therapy, transfusions of human immunoglobulin, albumin, and parenteral nutrition have led to patient's condition improvement.Conclusion. COVID-19 provokes the development of secondary HLH 10 times more often than other respiratory viral infections. The possibility of hemophagocytic syndrome development should be considered, including cases of overlap syndrome with sepsis, in patients with unresolved jaundice, hyperferritinemia after coronavirus infection. Routinely used scales and criteria for diagnosis of HLH (H-score, HLH 2004) in such cases lacks sensitivity, therefore, careful analysis of clinical picture and exclusion of other causes of jaundice are required.
目的:强调在冠状病毒感染后来源不明的黄疸和全身性炎症表现的患者中考虑噬血细胞淋巴组织细胞增多症的重要性。要点。64年有着专一。患者入院时伴有黄疸、瘙痒、乏力、体重减轻。投诉发生在收治冠状病毒感染患者出院后2周。实验室检查显示肝功能不全、胆汁淤积和炎症持续存在的迹象。仪器检查未发现肝脾肿大、胆道改变、肝内和肝外梗阻等征象。血培养中发现金黄色葡萄球菌,面部颅骨CT扫描显示感染的焦点在牙根2.4和2.5区域。因此,医生开了抗生素。随后,患者的病情因急性呼吸窘迫综合征的两次发作而复杂化,这两次发作发生在糖皮质激素治疗的停药期间。肝活检,形态学检查显示“胆管消失”综合征,巨噬细胞过度活化,窦细胞含铁血黄素沉着。可在噬血细胞性淋巴组织细胞增多症(HLH)中发现确诊病变,这是冠状病毒感染的一种危及生命的并发症。糖皮质激素治疗、输注人免疫球蛋白、白蛋白和肠外营养可使患者病情改善。COVID-19引发继发性HLH的频率是其他呼吸道病毒感染的10倍。冠状病毒感染后黄疸、高铁蛋白血症未解决的患者应考虑发生噬血细胞综合征的可能性,包括合并败血症的重叠综合征。在此类病例中,常规用于诊断HLH的量表和标准(H-score, HLH 2004)缺乏敏感性,因此需要仔细分析临床表现并排除黄疸的其他原因。
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引用次数: 0
Severe Diverticulitis Associated to Clostridioides difficile Infection in a 91 Year Old Patient (Clinical Case) 91岁高龄艰难梭菌感染合并重度憩室炎1例临床分析
Q3 Medicine Pub Date : 2022-07-12 DOI: 10.22416/1382-4376-2022-32-2-93-98
A. A. Makushina, L.N. Androsova, K. Puzakov, A. Okhlobystin, M. A. Tatarkina, O. Shifrin
Aim. To present a clinical case of a 91-year-old patient with a severe course of diverticulitis combined with the development of Clostridioides difficile-associated disease.Key points. On admission the patient complained of pain in the left iliac region, increased body temperature, constipation and bloating. The medical history showed that constipation increased on the background of prolonged bed rest and discontinuation of psyllium. According to the laboratory and instrumental examinations, the patient had signs of acute diverticulitis, antibacterial therapy was corrected twice, positive dynamics of the condition was noted. However, a few days later, the patient developed a clinic of C. difficile-associated disease, which required the prescription of anticlostridial therapy (vancomycin), until the laboratory confirmation of the accession of this infection was obtained. Combined therapy of exacerbation of diverticular disease and C. difficile-associated disease made it possible to achieve a steady improvement of the condition.Conclusion. The exclusion of possible development of C. difficile-associated disease on the background or prior antibiotic therapy is an important condition for correct and adequate management of a patient with exacerbation of diverticular disease. If the patient develops a clinical picture of C. difficile-associated disease, treatment may be initiated before laboratory confirmation.
的目标。报告一位91岁高龄的重症憩室炎合并难辨梭菌相关疾病的临床病例。要点。入院时患者主诉左髂疼痛、体温升高、便秘和腹胀。病史显示,在长期卧床休息和停用车前草的背景下,便秘增加。根据实验室和仪器检查,患者有急性憩室炎的迹象,抗菌治疗纠正了两次,注意到病情的积极动态。然而,几天后,患者临床出现难辨梭菌相关疾病,需要处方抗梭菌治疗(万古霉素),直到实验室确认该感染的加入。憩室病加重与难治性梭菌相关疾病联合治疗,可使病情稳步改善。排除因背景或既往抗生素治疗而可能发生的艰难梭菌相关疾病是对憩室疾病恶化患者进行正确和充分管理的重要条件。如果患者出现难辨梭菌相关疾病的临床表现,可在实验室确认之前开始治疗。
{"title":"Severe Diverticulitis Associated to Clostridioides difficile Infection in a 91 Year Old Patient (Clinical Case)","authors":"A. A. Makushina, L.N. Androsova, K. Puzakov, A. Okhlobystin, M. A. Tatarkina, O. Shifrin","doi":"10.22416/1382-4376-2022-32-2-93-98","DOIUrl":"https://doi.org/10.22416/1382-4376-2022-32-2-93-98","url":null,"abstract":"Aim. To present a clinical case of a 91-year-old patient with a severe course of diverticulitis combined with the development of Clostridioides difficile-associated disease.Key points. On admission the patient complained of pain in the left iliac region, increased body temperature, constipation and bloating. The medical history showed that constipation increased on the background of prolonged bed rest and discontinuation of psyllium. According to the laboratory and instrumental examinations, the patient had signs of acute diverticulitis, antibacterial therapy was corrected twice, positive dynamics of the condition was noted. However, a few days later, the patient developed a clinic of C. difficile-associated disease, which required the prescription of anticlostridial therapy (vancomycin), until the laboratory confirmation of the accession of this infection was obtained. Combined therapy of exacerbation of diverticular disease and C. difficile-associated disease made it possible to achieve a steady improvement of the condition.Conclusion. The exclusion of possible development of C. difficile-associated disease on the background or prior antibiotic therapy is an important condition for correct and adequate management of a patient with exacerbation of diverticular disease. If the patient develops a clinical picture of C. difficile-associated disease, treatment may be initiated before laboratory confirmation.","PeriodicalId":33798,"journal":{"name":"Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76483840","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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Rossiiskii zhurnal gastroenterologii gepatologii koloproktologii
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