Pub Date : 2024-07-23DOI: 10.29413/abs.2024-9.3.11
A. Sumin, A. V. Starovoytova, A. V. Shcheglova, E. V. Gorbunova
Background. Despite the high evidence level of the currently existing international recommendations on stable coronary heart disease (CHD) and chronic coronary syndrome, their implementation in domestic clinical practice is insufficient.The aim of the work. To analyze the choice of diagnostic tactics (non-invasive and invasive) in patients with suspected obstructive coronary heart disease in real clinical practice.Methods. The study included outpatients with suspected obstructive CHD, in whom the pre-test probability (PTP) of obstructive CHD was determined; if PTP = 5–15 %, clinical probability was assessed based on CHD risk factors. Based on the results of coronary angiography, the following groups were identified: group I – obstructive lesion of the coronary arteries (≥ 70 %) (n = 50); group II – non-obstructive lesion of the coronary arteries (< 70 %) (n = 32); group III – intact coronary arteries (n = 40). Results. According to the results of coronary angiography, the frequency of detection of obstructive lesion of the coronary arteries was 42 % (in patients without past medical history of myocardial infarction – 31 %). Before performing coronary angiography, non-invasive tests were performed in 2.5 % of cases. Pain in the chest was represented by typical angina in 74 % of patients, with no difference in frequency in all groups. PTP values were statistically significantly higher in the group with obstructive CHD (median – 32 %), however, in the other two groups, PTP values corresponded to a high risk of obstructive CHD (median – 27 % and 21 %, respectively). PTP was an independent predictor for obstructive CHD and subsequent myocardial revascularization.Conclusion. In the cohort of outpatients with suspected coronary heart disease we examined during invasive coronary angiography, the frequency of obstructive lesion of the coronary arteries remains low. Non-invasive tests were performed in isolated cases, while PTP was an independent predictor for obstructive CHD and subsequent myocardial revascularization. To increase the frequency of detection of obstructive coronary heart disease, we should adhere to the diagnostic algorithms of the European Society of Cardiology and make wider use of non-invasive imaging tests.
{"title":"Contemporary algorithms for diagnosing obstructive coronary artery disease in real clinical practice","authors":"A. Sumin, A. V. Starovoytova, A. V. Shcheglova, E. V. Gorbunova","doi":"10.29413/abs.2024-9.3.11","DOIUrl":"https://doi.org/10.29413/abs.2024-9.3.11","url":null,"abstract":"Background. Despite the high evidence level of the currently existing international recommendations on stable coronary heart disease (CHD) and chronic coronary syndrome, their implementation in domestic clinical practice is insufficient.The aim of the work. To analyze the choice of diagnostic tactics (non-invasive and invasive) in patients with suspected obstructive coronary heart disease in real clinical practice.Methods. The study included outpatients with suspected obstructive CHD, in whom the pre-test probability (PTP) of obstructive CHD was determined; if PTP = 5–15 %, clinical probability was assessed based on CHD risk factors. Based on the results of coronary angiography, the following groups were identified: group I – obstructive lesion of the coronary arteries (≥ 70 %) (n = 50); group II – non-obstructive lesion of the coronary arteries (< 70 %) (n = 32); group III – intact coronary arteries (n = 40). Results. According to the results of coronary angiography, the frequency of detection of obstructive lesion of the coronary arteries was 42 % (in patients without past medical history of myocardial infarction – 31 %). Before performing coronary angiography, non-invasive tests were performed in 2.5 % of cases. Pain in the chest was represented by typical angina in 74 % of patients, with no difference in frequency in all groups. PTP values were statistically significantly higher in the group with obstructive CHD (median – 32 %), however, in the other two groups, PTP values corresponded to a high risk of obstructive CHD (median – 27 % and 21 %, respectively). PTP was an independent predictor for obstructive CHD and subsequent myocardial revascularization.Conclusion. In the cohort of outpatients with suspected coronary heart disease we examined during invasive coronary angiography, the frequency of obstructive lesion of the coronary arteries remains low. Non-invasive tests were performed in isolated cases, while PTP was an independent predictor for obstructive CHD and subsequent myocardial revascularization. To increase the frequency of detection of obstructive coronary heart disease, we should adhere to the diagnostic algorithms of the European Society of Cardiology and make wider use of non-invasive imaging tests.","PeriodicalId":505136,"journal":{"name":"Acta Biomedica Scientifica","volume":"137 29","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141810905","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 : 2024-07-23DOI: 10.29413/abs.2024-9.3.18
V. Kocherova, N. G. Popova, V. A. Shcherbak
The aim. To study the predisposing factors for the development and timing of development of intraventricular hemorrhage (IVH) in extremely premature newborns.Materials and methods. We carried out retrospective analysis of 32 case histories of children born at a gestational age of less than 32 weeks. The children were divided into three groups: group 1 (n = 13) – children death was caused by non-traumatic IVH; group 2 (n = 12) – surviving infants with IVH; group 3 (comparison group; n = 7) – premature infants without IVH. We assessed risk factors for the development of IVH, their severity, and main indicators predisposing to death in newborns of these groups.Results. Children of the group 1 had statistically significantly low values of body weight – 670 [640–860] g (р1–2 = 0.007; р1–3 = 0.012), head circumference – 23 [22–24] cm (р1–2 = 0.008; р1–3 = 0.049), gestational age – 24.5 [23.5–25.5] weeks (р1–2 = 0.002; р1–3 = 0.007). Gender differences were revealed: in the group 1, there were 92.3 % of boys, in the group 2 – 33.3 % (p1–2 = 0.008). Maternal smoking increased the risk of fatal IVH by 3.5 ± 0.15 times, polyhydramnios – by 3.3 ± 0.37 times, chorioamnionitis – by 12.8 ± 0.47 times, placenta previa – by 3.2 ± 0.15 times. In newborns of the group 1, seizures developed on the day 1 of life in 84.6 % (more often than in group 2; p = 0.00001), and shock in the first 3 hours of life was recorded in 46.1 % of cases (р1–2 = 0.034), which increased the risk of death by 4.3 ± 0.47 times. In newborns of group 1, compared with newborns of groups 2 and 3, pulmonary hypertension was more often detected (60.8 [50.1–69.2] mm Hg; p1–2 = 0.028; p1–3 = 0.047).Conclusion. Confirmed infectious diseases in the mother, clinical manifestation of convulsions, pulmonary hypertension, development of multiple organ failure and shock in extremely premature newborns increase the risk of intraventricular hemorrhage and the frequency of deaths.
{"title":"Causes of intraventricular hemorrhages in extremely premature newborns and features of their early outcomes","authors":"V. Kocherova, N. G. Popova, V. A. Shcherbak","doi":"10.29413/abs.2024-9.3.18","DOIUrl":"https://doi.org/10.29413/abs.2024-9.3.18","url":null,"abstract":"The aim. To study the predisposing factors for the development and timing of development of intraventricular hemorrhage (IVH) in extremely premature newborns.Materials and methods. We carried out retrospective analysis of 32 case histories of children born at a gestational age of less than 32 weeks. The children were divided into three groups: group 1 (n = 13) – children death was caused by non-traumatic IVH; group 2 (n = 12) – surviving infants with IVH; group 3 (comparison group; n = 7) – premature infants without IVH. We assessed risk factors for the development of IVH, their severity, and main indicators predisposing to death in newborns of these groups.Results. Children of the group 1 had statistically significantly low values of body weight – 670 [640–860] g (р1–2 = 0.007; р1–3 = 0.012), head circumference – 23 [22–24] cm (р1–2 = 0.008; р1–3 = 0.049), gestational age – 24.5 [23.5–25.5] weeks (р1–2 = 0.002; р1–3 = 0.007). Gender differences were revealed: in the group 1, there were 92.3 % of boys, in the group 2 – 33.3 % (p1–2 = 0.008). Maternal smoking increased the risk of fatal IVH by 3.5 ± 0.15 times, polyhydramnios – by 3.3 ± 0.37 times, chorioamnionitis – by 12.8 ± 0.47 times, placenta previa – by 3.2 ± 0.15 times. In newborns of the group 1, seizures developed on the day 1 of life in 84.6 % (more often than in group 2; p = 0.00001), and shock in the first 3 hours of life was recorded in 46.1 % of cases (р1–2 = 0.034), which increased the risk of death by 4.3 ± 0.47 times. In newborns of group 1, compared with newborns of groups 2 and 3, pulmonary hypertension was more often detected (60.8 [50.1–69.2] mm Hg; p1–2 = 0.028; p1–3 = 0.047).Conclusion. Confirmed infectious diseases in the mother, clinical manifestation of convulsions, pulmonary hypertension, development of multiple organ failure and shock in extremely premature newborns increase the risk of intraventricular hemorrhage and the frequency of deaths.","PeriodicalId":505136,"journal":{"name":"Acta Biomedica Scientifica","volume":"77 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141812576","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 : 2024-07-23DOI: 10.29413/abs.2024-9.3.17
A. Chuprov, S. Notova, O. Marshinskaia, T. Kazakova
Background. Cataract is one of the main causes of decreased visual acuity in the world, and therefore scientists are continuing researches on the mechanisms of development of this ophthalmic pathology.The aim. To study metabolic changes in a cloudy lens using an experimental model.Materials and methods. The study was carried out on adult male Wistar rats (n = 60), which were divided into control (n = 30) and experimental (n = 30) groups. Experimental cataract were simulated by daily ultraviolet irradiation (λ = 300–350 nm) during 6 months for 20 minutes. At the months 2, 4 and 6 of the study, we carried out a biomicroscopic examination of the anterior eye of animals using a slit lamp to monitor the development of cataract. Lenses were collected to determine the content of stearoyl-coenzyme-A desaturases and melatonin using enzyme immunoassay.Results. At the stage of initial cataract, the content of the stearoyl-coenzyme A desaturase was statistically significantly lower than the control values by 38 %; at the stage of immature cataract – by 30 %; at the stage of mature cataract – by 15.4 %. It was revealed that at the month 6 of the study, the concentration of melatonin in lens homogenates was 17 % lower when compared with the control. A statistically significant correlation was established between stearoyl-coenzyme A desaturase and melatonin (r = 0.32).Conclusion. Melatonin and stearoyl-coenzyme A desaturase play an important role in a number of biochemical processes that ensure the proper functioning of the visual analyzer. Changes in the concentration of these biological molecules can play a key role in the pathogenesis of cataract and a number of other ophthalmic diseases
{"title":"Metabolic changes in the eye lens in the progression of cataract","authors":"A. Chuprov, S. Notova, O. Marshinskaia, T. Kazakova","doi":"10.29413/abs.2024-9.3.17","DOIUrl":"https://doi.org/10.29413/abs.2024-9.3.17","url":null,"abstract":"Background. Cataract is one of the main causes of decreased visual acuity in the world, and therefore scientists are continuing researches on the mechanisms of development of this ophthalmic pathology.The aim. To study metabolic changes in a cloudy lens using an experimental model.Materials and methods. The study was carried out on adult male Wistar rats (n = 60), which were divided into control (n = 30) and experimental (n = 30) groups. Experimental cataract were simulated by daily ultraviolet irradiation (λ = 300–350 nm) during 6 months for 20 minutes. At the months 2, 4 and 6 of the study, we carried out a biomicroscopic examination of the anterior eye of animals using a slit lamp to monitor the development of cataract. Lenses were collected to determine the content of stearoyl-coenzyme-A desaturases and melatonin using enzyme immunoassay.Results. At the stage of initial cataract, the content of the stearoyl-coenzyme A desaturase was statistically significantly lower than the control values by 38 %; at the stage of immature cataract – by 30 %; at the stage of mature cataract – by 15.4 %. It was revealed that at the month 6 of the study, the concentration of melatonin in lens homogenates was 17 % lower when compared with the control. A statistically significant correlation was established between stearoyl-coenzyme A desaturase and melatonin (r = 0.32).Conclusion. Melatonin and stearoyl-coenzyme A desaturase play an important role in a number of biochemical processes that ensure the proper functioning of the visual analyzer. Changes in the concentration of these biological molecules can play a key role in the pathogenesis of cataract and a number of other ophthalmic diseases","PeriodicalId":505136,"journal":{"name":"Acta Biomedica Scientifica","volume":"121 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141811855","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 : 2024-07-23DOI: 10.29413/abs.2024-9.3.19
A. Y. Lazutkina
Background. Coronary heart disease (CHD) ranks first among the causes of death, morbidity, and disablement. The development of innovative methods for predicting CHD will reduce these losses.The aim of the work. To assess the quality of the screening test for predictors of coronary heart disease using statistical quality control of a verifiable diagnostic test (with binary outcomes).Materials and methods. In 2008–2013, 70 cases of CHD were registered in a groupof 7959 initially healthy men 18–66 years old who were the members of locomotive crews. Statistical analysis identified CHD predictors: arterial hypertension; psychosocial stress; hyperglycemia; dyslipidemia; excessive alcohol consumption; obesity of degree I–III; age 34–66 years; microalbuminuria; thickening of the intima- media complex/atherosclerotic plaque (IMC/ASP); pulse wave velocity (PWV) > 12 m/s; left ventricular hypertrophy; grade I–II retinopathy; atherosclerosis of aorta. DiagStat (Russian Federation) software determined their predictive ability when used in screening tests to predict CHD. We demonstrated the use of this method to assess the predictive ability of risk factors for any disease.Results. CHD predictors have high to moderate specificity for the absence of CHD in individuals who test negative for the above-listed factors. IMC/ASP, microalbuminuria, PWV > 12 m/s, grade III obesity moderately increase the posterior odds of developing CHD versus its absence in comparison with the prior odds after receiving a positive result of the verifiable diagnostic test for these factors. Age 34–66 years moderately increases the posterior odds in favor of the absence of CHD versus its occurrence compared with the prior odds after receiving a negative result of the verifiable diagnostic test.Conclusion. When assessing the result of the verifiable diagnostic test, we should focus on both the probability of occurrence and the absence of CHD in the presence or absence of a predictor in the patient. Since the determination of PWV > 12 m/s, atherosclerosis of aorta, microalbuminuria, stress, and excessive alcohol consumption among workers of locomotive crews is not mandatory, it is necessary to conduct a targeted search for them
{"title":"Quality assessment of the screening test for predictors of coronary heart disease","authors":"A. Y. Lazutkina","doi":"10.29413/abs.2024-9.3.19","DOIUrl":"https://doi.org/10.29413/abs.2024-9.3.19","url":null,"abstract":"Background. Coronary heart disease (CHD) ranks first among the causes of death, morbidity, and disablement. The development of innovative methods for predicting CHD will reduce these losses.The aim of the work. To assess the quality of the screening test for predictors of coronary heart disease using statistical quality control of a verifiable diagnostic test (with binary outcomes).Materials and methods. In 2008–2013, 70 cases of CHD were registered in a groupof 7959 initially healthy men 18–66 years old who were the members of locomotive crews. Statistical analysis identified CHD predictors: arterial hypertension; psychosocial stress; hyperglycemia; dyslipidemia; excessive alcohol consumption; obesity of degree I–III; age 34–66 years; microalbuminuria; thickening of the intima- media complex/atherosclerotic plaque (IMC/ASP); pulse wave velocity (PWV) > 12 m/s; left ventricular hypertrophy; grade I–II retinopathy; atherosclerosis of aorta. DiagStat (Russian Federation) software determined their predictive ability when used in screening tests to predict CHD. We demonstrated the use of this method to assess the predictive ability of risk factors for any disease.Results. CHD predictors have high to moderate specificity for the absence of CHD in individuals who test negative for the above-listed factors. IMC/ASP, microalbuminuria, PWV > 12 m/s, grade III obesity moderately increase the posterior odds of developing CHD versus its absence in comparison with the prior odds after receiving a positive result of the verifiable diagnostic test for these factors. Age 34–66 years moderately increases the posterior odds in favor of the absence of CHD versus its occurrence compared with the prior odds after receiving a negative result of the verifiable diagnostic test.Conclusion. When assessing the result of the verifiable diagnostic test, we should focus on both the probability of occurrence and the absence of CHD in the presence or absence of a predictor in the patient. Since the determination of PWV > 12 m/s, atherosclerosis of aorta, microalbuminuria, stress, and excessive alcohol consumption among workers of locomotive crews is not mandatory, it is necessary to conduct a targeted search for them","PeriodicalId":505136,"journal":{"name":"Acta Biomedica Scientifica","volume":"62 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141813191","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 : 2024-07-23DOI: 10.29413/abs.2024-9.3.13
L. V. Poskotinova, E. Krivonogova, O. Krivonogova, A. Kudryavtsev
Background. Setting of norms for the parameters of P300 cognitive auditory evoked potentials (EP) in elderly people with intact cognitive functions considering their residence in certain climatic and geographical regions is an urgent problem.The aim of the study. To determine age-related parameters of P300 cognitive auditory evoked potentials in elderly people aged 60–69 and 70–74 years, living in the European North of Russia (using the example of Arkhangelsk).Methods. The parameters of P300 auditory EP were determined in randomly selected urban residents in the age groups of 60–69 years (n = 284) and 70–74 years (n = 115) with normal scores on the Montreal Cognitive Assessment Scale (MoCA), without depression (according to Beck Depression Inventory), with preserved ability to work and/or social functions. We calculated the 5th–95th percentile values (P5– P95) of the P300 EP parameters and assessed the relationships of these parameters with socio-demographic characteristics, lifestyle and the results on the MoCA scale and Beck Depression Inventory.Results. Statistically significant differences in latency indicators of P300 EP were determined between groups of 60–69 and 70–74 years (P25–P90) in all studied brain regions (frontal, central). In the group of 60–69 years, the range of P25–P75 values of P300 EP latencies was 342.5–401 ms, in the group of 70–74 years – 358.5–443 ms. Age differences in P300 EP amplitudes were minimal with an interquartile range of 4–13 μV in the total sample. Participants who smoked had higher latency scores and lower amplitude scores; former smokers had higher latency scores compared to never-smokers.Conclusion. Latency above 400 ms at the age of 60–65 years and above 443 ms at 70–74 years can be considered as a criterion for reduced cognitive reserve and an increased risk of developing cognitive disorders in elderly people living in the European North of Russia.
{"title":"Agerelated parameters of P300 auditory evoked potentials in elderly persons in the context of cognitive health: A study in the European North of Russia","authors":"L. V. Poskotinova, E. Krivonogova, O. Krivonogova, A. Kudryavtsev","doi":"10.29413/abs.2024-9.3.13","DOIUrl":"https://doi.org/10.29413/abs.2024-9.3.13","url":null,"abstract":"Background. Setting of norms for the parameters of P300 cognitive auditory evoked potentials (EP) in elderly people with intact cognitive functions considering their residence in certain climatic and geographical regions is an urgent problem.The aim of the study. To determine age-related parameters of P300 cognitive auditory evoked potentials in elderly people aged 60–69 and 70–74 years, living in the European North of Russia (using the example of Arkhangelsk).Methods. The parameters of P300 auditory EP were determined in randomly selected urban residents in the age groups of 60–69 years (n = 284) and 70–74 years (n = 115) with normal scores on the Montreal Cognitive Assessment Scale (MoCA), without depression (according to Beck Depression Inventory), with preserved ability to work and/or social functions. We calculated the 5th–95th percentile values (P5– P95) of the P300 EP parameters and assessed the relationships of these parameters with socio-demographic characteristics, lifestyle and the results on the MoCA scale and Beck Depression Inventory.Results. Statistically significant differences in latency indicators of P300 EP were determined between groups of 60–69 and 70–74 years (P25–P90) in all studied brain regions (frontal, central). In the group of 60–69 years, the range of P25–P75 values of P300 EP latencies was 342.5–401 ms, in the group of 70–74 years – 358.5–443 ms. Age differences in P300 EP amplitudes were minimal with an interquartile range of 4–13 μV in the total sample. Participants who smoked had higher latency scores and lower amplitude scores; former smokers had higher latency scores compared to never-smokers.Conclusion. Latency above 400 ms at the age of 60–65 years and above 443 ms at 70–74 years can be considered as a criterion for reduced cognitive reserve and an increased risk of developing cognitive disorders in elderly people living in the European North of Russia.","PeriodicalId":505136,"journal":{"name":"Acta Biomedica Scientifica","volume":"37 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141813336","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 : 2024-07-23DOI: 10.29413/abs.2024-9.3.15
L. M. Tibekina, O. A. Al-Sahli, V. V. Flud
Despite the wide choice of antiepileptic drugs (AEDs), a third of patients remain resistant to the effects of modern AEDs. Drug-resistant epilepsy (DRE) is characterized by the inability to control seizures in a patient when using at least two adequate AED regimens at an effective daily dose as monotherapy or in combination. In this case, the mechanisms responsible for drug resistance are mainly either increased excretion of AEDs by transporters from epileptogenic tissue (the multidrug transporter hypothesis) or a decrease in the sensitivity of drug receptors in epileptogenic brain tissue. It is assumed that there are other mechanisms, but they remain understudied. A number of factors are associated with the risk of DRE developing in patients with diagnosed epilepsy, including genetic, iatrogenic, brain malformations, and others. Patients with DRE have a higher probability of developing psychopathological disorders (depression, anxiety, psychosis), the proportion of which is significantly higher than in the general population. They have a 10-fold increased risk of death due to injury, cognitive decline, and sudden unexpected death in epilepsy (SUDEP). The priority treatment method for DRE is surgery. Early identification of DRE is critical for identifying potential treatment alternatives and determining whether a patient is a surgical candidate. Analysis of data from clinical and instrumental research of operated patients with DRE in the early and late postoperative period will allow us to identify factors of unfavorable outcome and to increase the effectiveness of treatment for this category of patients.The aim was to study and to summarize literature data on the pathogenesis and risk factors of drug resistance to antiepileptic drugs in patients with epilepsy, justifying the need for timely identification of drug resistance and referral of patients with drugresistant epilepsy to specialized centers for possible surgical treatment.
尽管有多种抗癫痫药物（AEDs）可供选择，但仍有三分之一的患者对现代 AEDs 产生耐药性。耐药性癫痫（DRE）的特点是，患者在单药或联合用药的情况下，以有效的日剂量使用至少两种适当的 AED 治疗方案，仍无法控制癫痫发作。在这种情况下，导致耐药性的机制主要是致痫组织的转运体对 AEDs 的排泄增加（多药转运体假说）或致痫脑组织中药物受体的敏感性降低。据推测还有其他机制，但这些机制仍未得到充分研究。确诊癫痫患者发生 DRE 的风险与多种因素有关，包括遗传、先天性因素、脑部畸形等。DRE 患者出现精神病理障碍（抑郁、焦虑、精神病）的概率较高，其比例明显高于普通人群。他们因受伤、认知能力下降和癫痫猝死（SUDEP）而死亡的风险增加了 10 倍。DRE 的优先治疗方法是手术。早期识别 DRE 对于确定潜在的替代治疗方法和确定患者是否适合手术治疗至关重要。对术后早期和晚期DRE手术患者的临床和仪器研究数据进行分析，将使我们能够识别不利于治疗结果的因素，并提高这类患者的治疗效果。目的是研究和总结有关癫痫患者抗癫痫药物耐药性的发病机制和风险因素的文献数据，证明及时识别耐药性和将耐药性癫痫患者转诊到专业中心进行可能的手术治疗的必要性。
{"title":"Drug-resistant epilepsy: Current concepts, pathogenesis, risk factors, outcomes of surgical treatment","authors":"L. M. Tibekina, O. A. Al-Sahli, V. V. Flud","doi":"10.29413/abs.2024-9.3.15","DOIUrl":"https://doi.org/10.29413/abs.2024-9.3.15","url":null,"abstract":"Despite the wide choice of antiepileptic drugs (AEDs), a third of patients remain resistant to the effects of modern AEDs. Drug-resistant epilepsy (DRE) is characterized by the inability to control seizures in a patient when using at least two adequate AED regimens at an effective daily dose as monotherapy or in combination. In this case, the mechanisms responsible for drug resistance are mainly either increased excretion of AEDs by transporters from epileptogenic tissue (the multidrug transporter hypothesis) or a decrease in the sensitivity of drug receptors in epileptogenic brain tissue. It is assumed that there are other mechanisms, but they remain understudied. A number of factors are associated with the risk of DRE developing in patients with diagnosed epilepsy, including genetic, iatrogenic, brain malformations, and others. Patients with DRE have a higher probability of developing psychopathological disorders (depression, anxiety, psychosis), the proportion of which is significantly higher than in the general population. They have a 10-fold increased risk of death due to injury, cognitive decline, and sudden unexpected death in epilepsy (SUDEP). The priority treatment method for DRE is surgery. Early identification of DRE is critical for identifying potential treatment alternatives and determining whether a patient is a surgical candidate. Analysis of data from clinical and instrumental research of operated patients with DRE in the early and late postoperative period will allow us to identify factors of unfavorable outcome and to increase the effectiveness of treatment for this category of patients.The aim was to study and to summarize literature data on the pathogenesis and risk factors of drug resistance to antiepileptic drugs in patients with epilepsy, justifying the need for timely identification of drug resistance and referral of patients with drugresistant epilepsy to specialized centers for possible surgical treatment.","PeriodicalId":505136,"journal":{"name":"Acta Biomedica Scientifica","volume":"80 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141810169","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 : 2024-07-23DOI: 10.29413/abs.2024-9.3.16
V. A. Zaika, T. Iureva, D. B. Danzandorzhieva
The problem of the structural and functional effectiveness of episcleral and endovitreal treatment methods of rhegmatogenous retinal detachment remains open to this day.The aim of the study. To assess the clinical effectiveness of surgical treatment of rhegmatogenous retinal detachment using episcleral and endovitreal methods.Material and methods. An analysis of the electronic database and a detailed assessment of the treatment of 285 patients with rhegmatogenous retinal detachment for 2005–2022 were carried out. A comparative analysis was made in two groups: group 1 – patients after episcleral surgery (n = 155); group 2 – patients after endovitreal surgery (n = 130). The initial condition and the extent of surgery were comparable. Results. From 2005 to 2009 in 65.9 % of cases, episcleral buckling predominated; from 2009 to 2021 – posterior closed vitrectomy (in 64.8–88.7 % of cases). The incidence of primary retinal reattachment was 74.2 % and 71.5 %. The number of relapses after vitreoretinal surgery slightly exceeded the values in the group 1 – 28.4 % versus 25.7 %, and in 20% of cases the first relapse occurred before silicone aspiration as a result of subsilicone proliferation. The total number of surgical interventions per person, taking into account mandatory silicone aspiration, in the group 1 was 1.3, in the group 2 – 2.25 for the entire observation period. The visual acuity of patients in group 1 was 2 times higher than that of the comparison group – 0.21 ± 0.02 and 0.1 ± 0.03, respectively (p < 0.05).Conclusion. Episcleral treatment methods of rhegmatogenous retinal detachment are characterized by better anatomical, reconstructive and functional effects with fewer re-operations
{"title":"Choosing the optimal method for surgical treatment of rhegmatogenous retinal detachment","authors":"V. A. Zaika, T. Iureva, D. B. Danzandorzhieva","doi":"10.29413/abs.2024-9.3.16","DOIUrl":"https://doi.org/10.29413/abs.2024-9.3.16","url":null,"abstract":"The problem of the structural and functional effectiveness of episcleral and endovitreal treatment methods of rhegmatogenous retinal detachment remains open to this day.The aim of the study. To assess the clinical effectiveness of surgical treatment of rhegmatogenous retinal detachment using episcleral and endovitreal methods.Material and methods. An analysis of the electronic database and a detailed assessment of the treatment of 285 patients with rhegmatogenous retinal detachment for 2005–2022 were carried out. A comparative analysis was made in two groups: group 1 – patients after episcleral surgery (n = 155); group 2 – patients after endovitreal surgery (n = 130). The initial condition and the extent of surgery were comparable. Results. From 2005 to 2009 in 65.9 % of cases, episcleral buckling predominated; from 2009 to 2021 – posterior closed vitrectomy (in 64.8–88.7 % of cases). The incidence of primary retinal reattachment was 74.2 % and 71.5 %. The number of relapses after vitreoretinal surgery slightly exceeded the values in the group 1 – 28.4 % versus 25.7 %, and in 20% of cases the first relapse occurred before silicone aspiration as a result of subsilicone proliferation. The total number of surgical interventions per person, taking into account mandatory silicone aspiration, in the group 1 was 1.3, in the group 2 – 2.25 for the entire observation period. The visual acuity of patients in group 1 was 2 times higher than that of the comparison group – 0.21 ± 0.02 and 0.1 ± 0.03, respectively (p < 0.05).Conclusion. Episcleral treatment methods of rhegmatogenous retinal detachment are characterized by better anatomical, reconstructive and functional effects with fewer re-operations","PeriodicalId":505136,"journal":{"name":"Acta Biomedica Scientifica","volume":"71 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141812963","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}
I. E. Pleshchev, V. Nikolenko, E. Achkasov, Y.I. Preobrazhenskiy, L. A. Gridin, A. N. Shkrebko, M. V. Tsoller
The aim of the review. To analyze the prevalence of sarcopenic obesity among elderly and senile people, to assess its causes, and to present modern methods for its prevention and physical rehabilitation.This review article discusses the most recent evidence on age-related changes in fat and muscle tissue, and on calorie restriction and exercise that have positive effect on physical performance in older people with sarcopenic obesity. In addition, potential gaps in clinical practice guidelines that merit attention in future research are identified and analyzed.Search strategy. We used the following key words to define participation in the review:“sarcopenic obesity”, “sarcopenia with obesity”, “sarcopenia”, “elderly/old age”. Inclusion and exclusion criteria. The review included original research results (reviews, meta-analyses). Editorials, proceeding of the conferences, and research protocols were excluded. The study sample included women and men of any race aged ≥ 60 years with a diagnosis of sarcopenic obesity and with preserved locomotion function. Articles involving hospital patients were also excluded. Non-human studies and studies that did not report precise intervention criteria (e. g., nutrition, exercise, duration, etc.) were excluded.The literature search was conducted in four electronic databases: PubMed, Cochrane Library, Springer, Scopus, for the period from 2013 to August 1, 2023. There were no restrictions on the language of the publication.
{"title":"The effect of exercise and nutritional support on elderly and senile patients with sarcopenic obesity","authors":"I. E. Pleshchev, V. Nikolenko, E. Achkasov, Y.I. Preobrazhenskiy, L. A. Gridin, A. N. Shkrebko, M. V. Tsoller","doi":"10.29413/abs.2024-9.3.2","DOIUrl":"https://doi.org/10.29413/abs.2024-9.3.2","url":null,"abstract":"The aim of the review. To analyze the prevalence of sarcopenic obesity among elderly and senile people, to assess its causes, and to present modern methods for its prevention and physical rehabilitation.This review article discusses the most recent evidence on age-related changes in fat and muscle tissue, and on calorie restriction and exercise that have positive effect on physical performance in older people with sarcopenic obesity. In addition, potential gaps in clinical practice guidelines that merit attention in future research are identified and analyzed.Search strategy. We used the following key words to define participation in the review:“sarcopenic obesity”, “sarcopenia with obesity”, “sarcopenia”, “elderly/old age”. Inclusion and exclusion criteria. The review included original research results (reviews, meta-analyses). Editorials, proceeding of the conferences, and research protocols were excluded. The study sample included women and men of any race aged ≥ 60 years with a diagnosis of sarcopenic obesity and with preserved locomotion function. Articles involving hospital patients were also excluded. Non-human studies and studies that did not report precise intervention criteria (e. g., nutrition, exercise, duration, etc.) were excluded.The literature search was conducted in four electronic databases: PubMed, Cochrane Library, Springer, Scopus, for the period from 2013 to August 1, 2023. There were no restrictions on the language of the publication.","PeriodicalId":505136,"journal":{"name":"Acta Biomedica Scientifica","volume":"9 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141814614","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}
E. D. Kazantseva, M. Darenskaya, L. V. Rychkova, A. Petrova, N. V. Semеnova, N. Kurashova, L. Grebenkina, L. I. Kolesnikova
Introduction. Influenza remains a serious viral infection in children and has consequences for the organism.The aim of the study. To analyze the lipid peroxidation products and antioxidant defense (AOD) components level in children of two age groups with seasonal influenza.Materials and methods. We examined 141 children aged from 1 month to 6 years with a diagnosis of influenza (subgroup 1 – 1 month – 2.11 years (n = 78); subgroup 2 – 3–6 years (n = 63)), 47 children of control group (subgroup 3 – 1 month – 2.11 years (n = 17); subgroup 4 – 3–6 years (n = 30)). Spectrophotometric, fluorometric and statistical methods were used.Results. In subgroup 1 of children with influenza, there were higher levels of compounds with double bonds (p = 0.001), conjugated dienes (CDs) (p < 0.0001), ketodienes and conjugated trienes (KD and CT) (p = 0.004); in subgroup 2 of children with influenza – increased values of CDs (p < 0.0001), KD and CT (p < 0.0001) and thiobarbituric acid reactants (p < 0.0001) compared to the control. The AOD system in subgroup 1 was characterized by a decrease in the level of α-tocopherol (p < 0.0001), retinol (p < 0.0001) and higher oxidized glutathione (GSSG) values (p = 0.002) compared to the control. Children of subgroup 2 had lower values of the level of α-tocopherol (p < 0.001), retinol (p = 0.012) and total antioxidant activity (p < 0.0001) and higher values of GSSG (p = 0.035) compared to the control.Conclusion. In children with influenza, regardless of age, there is a higher level of production of lipid peroxidation indicators, a lack of fat-soluble vitamins and higher values of oxidized glutathione than in healthy children
{"title":"Lipid peroxidation – antioxidant defense system in children with seasonal influenza","authors":"E. D. Kazantseva, M. Darenskaya, L. V. Rychkova, A. Petrova, N. V. Semеnova, N. Kurashova, L. Grebenkina, L. I. Kolesnikova","doi":"10.29413/abs.2024-9.3.9","DOIUrl":"https://doi.org/10.29413/abs.2024-9.3.9","url":null,"abstract":"Introduction. Influenza remains a serious viral infection in children and has consequences for the organism.The aim of the study. To analyze the lipid peroxidation products and antioxidant defense (AOD) components level in children of two age groups with seasonal influenza.Materials and methods. We examined 141 children aged from 1 month to 6 years with a diagnosis of influenza (subgroup 1 – 1 month – 2.11 years (n = 78); subgroup 2 – 3–6 years (n = 63)), 47 children of control group (subgroup 3 – 1 month – 2.11 years (n = 17); subgroup 4 – 3–6 years (n = 30)). Spectrophotometric, fluorometric and statistical methods were used.Results. In subgroup 1 of children with influenza, there were higher levels of compounds with double bonds (p = 0.001), conjugated dienes (CDs) (p < 0.0001), ketodienes and conjugated trienes (KD and CT) (p = 0.004); in subgroup 2 of children with influenza – increased values of CDs (p < 0.0001), KD and CT (p < 0.0001) and thiobarbituric acid reactants (p < 0.0001) compared to the control. The AOD system in subgroup 1 was characterized by a decrease in the level of α-tocopherol (p < 0.0001), retinol (p < 0.0001) and higher oxidized glutathione (GSSG) values (p = 0.002) compared to the control. Children of subgroup 2 had lower values of the level of α-tocopherol (p < 0.001), retinol (p = 0.012) and total antioxidant activity (p < 0.0001) and higher values of GSSG (p = 0.035) compared to the control.Conclusion. In children with influenza, regardless of age, there is a higher level of production of lipid peroxidation indicators, a lack of fat-soluble vitamins and higher values of oxidized glutathione than in healthy children","PeriodicalId":505136,"journal":{"name":"Acta Biomedica Scientifica","volume":"14 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141816984","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}
T. Sorokovikova, A. Morozov, A. Kryukova, S. Naumova, A. V. Mitropolskaya
Background. Fatal familial insomnia is a rare genetically determined neurodegenerative disorder from the group of prion diseases. Its main cause is the autosomal dominant D178N mutation of the PRNP gene, which leads to the synthesis of the pathological prion protein PrP.The aim. Using the example of a clinical case to describe an example of the early onset of fatal familial insomnia in a teenager, a clinical example of its management.Materials and methods. Female patient V., 16 years old, of hyposthenic constitution, undernourished, with negative family history (multiple sclerosis in her paternal grandmother) for the first time consulted a neurologist in Tver for the complaints of superficial sleep, shortened to 4–5 hours, unspecific pain all over the body, periodic numbness in the upper limbs. Six months later, retardation of speech and movements, changes in gait, and intentional tremor occurred; sleep was shortened to 2 hours. In the future, the teenager lost the ability to independently maintain the vertical body position, the ability to walk without assistance, speech was reduced to syllable answers to questions. In order to verify the diagnosis and to carry out differential diagnosis with other neurodegenerative diseases, the girl underwent auxiliary research methods: detection of antibodies to nuclear antigens, magnetic resonance imaging, computer electroencephalography, polyexomal genome sequencing.Results. Based on the anamnesis, complaints, clinical picture and results of genetic research the final diagnosis of fatal familial insomnia was made. Due to the lack of etiological and pathogenetic therapy, the patient was subsequently provided with palliative medical care. The fatal outcome occurred 19 months after the onset of the disease.Conclusions. The presented clinical case reflects the complexity of managing patients with rare genetic diseases, confirms the need for mandatory polyexomal genome sequencing in order to verify the diagnosis, which allows timely palliative care
{"title":"Genetic prion disease – fatal familial insomnia (clinical case)","authors":"T. Sorokovikova, A. Morozov, A. Kryukova, S. Naumova, A. V. Mitropolskaya","doi":"10.29413/abs.2024-9.3.8","DOIUrl":"https://doi.org/10.29413/abs.2024-9.3.8","url":null,"abstract":"Background. Fatal familial insomnia is a rare genetically determined neurodegenerative disorder from the group of prion diseases. Its main cause is the autosomal dominant D178N mutation of the PRNP gene, which leads to the synthesis of the pathological prion protein PrP.The aim. Using the example of a clinical case to describe an example of the early onset of fatal familial insomnia in a teenager, a clinical example of its management.Materials and methods. Female patient V., 16 years old, of hyposthenic constitution, undernourished, with negative family history (multiple sclerosis in her paternal grandmother) for the first time consulted a neurologist in Tver for the complaints of superficial sleep, shortened to 4–5 hours, unspecific pain all over the body, periodic numbness in the upper limbs. Six months later, retardation of speech and movements, changes in gait, and intentional tremor occurred; sleep was shortened to 2 hours. In the future, the teenager lost the ability to independently maintain the vertical body position, the ability to walk without assistance, speech was reduced to syllable answers to questions. In order to verify the diagnosis and to carry out differential diagnosis with other neurodegenerative diseases, the girl underwent auxiliary research methods: detection of antibodies to nuclear antigens, magnetic resonance imaging, computer electroencephalography, polyexomal genome sequencing.Results. Based on the anamnesis, complaints, clinical picture and results of genetic research the final diagnosis of fatal familial insomnia was made. Due to the lack of etiological and pathogenetic therapy, the patient was subsequently provided with palliative medical care. The fatal outcome occurred 19 months after the onset of the disease.Conclusions. The presented clinical case reflects the complexity of managing patients with rare genetic diseases, confirms the need for mandatory polyexomal genome sequencing in order to verify the diagnosis, which allows timely palliative care","PeriodicalId":505136,"journal":{"name":"Acta Biomedica Scientifica","volume":"21 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141817220","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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