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Primary adrenal insufficiency 原发性肾上腺功能不全
Pub Date : 2024-06-02 DOI: 10.30629/0023-2149-2024-102-3-264-267
T. I. Kalenchits, S. Kabak, N. S. Didenko, I. V. Glushko
Due to the non-specificity of a number of clinical manifestations of Addison’s disease, the diagnosis of primary adrenal insufficiency in general therapeutic profile hospitals causes certain difficulties. The article presents a clinical case of diagnosing primary adrenal insufficiency in combination with autoimmune thyroiditis and hypogonadism as a manifestation of autoimmune polyglandular syndrome. Signs of Addison’s disease included hyperpigmentation of the skin and mucous membranes of the oral cavity, as well as low cortisol levels and an increase in adrenocorticotropic hormone(ACTH) concentration, detected in the blood serum antibodies to thyroperoxidase — a specific marker of autoimmune thyroid gland damage. A positive result of the test for autoantibodies to steroid-producing cells indicated functional ovarian insufficiency.
由于阿狄森氏病的一些临床表现不具有特异性,在一般治疗型医院诊断原发性肾上腺功能不全存在一定的困难。本文介绍了一例诊断原发性肾上腺功能不全合并自身免疫性甲状腺炎和性腺功能减退症的临床病例,这是自身免疫性多腺体综合征的一种表现。阿狄森病的症状包括皮肤和口腔黏膜色素沉着,皮质醇水平低,促肾上腺皮质激素(ACTH)浓度升高,血清中检测到甲状腺过氧化物酶抗体--这是自身免疫性甲状腺损伤的特异性标志物。类固醇生成细胞自身抗体的检测结果呈阳性,表明存在功能性卵巢功能不全。
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引用次数: 0
Military doctors in the elimination of the Manchurian plague epidemic 消灭满洲鼠疫的军医
Pub Date : 2024-06-02 DOI: 10.30629/0023-2149-2024-102-3-273-278
P. E. Krynyukov, V. G. Abashin, V. B. Simonenko, P. Dulin
The article provides information about the last plague epidemic in history, which occurred in Manchuria in 1910 along the Chinese Eastern Railway. The main focus of this publication is on the biographical data of Russian doctors from anti-plague units.
文章提供了有关历史上最后一次鼠疫流行的信息,这次流行发生在 1910 年中国东部铁路沿线的满洲里。本出版物的重点是抗鼠疫部队的俄罗斯医生的传记资料。
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引用次数: 0
Syncope in children and adolescents in sports medicine 运动医学中的儿童和青少年晕厥
Pub Date : 2024-06-02 DOI: 10.30629/0023-2149-2024-102-3-268-272
L. A. Balykova, S. A. Ivyanskiy, Y. Soldatov, T. S. Shablinova, M. V. Shirmankina, T. M. Duvayarova, D. V. Durnaikina, Yu. S. Shabunina
The clinical case of a neuro-mediated syncope episode in a sports-active adolescent is presented. The differential diagnosis included the following conditions: cardiomyopathy induced by physical factors, sinus node dysfunction, and sinus node weakness syndrome. After conducting necessary laboratory and instrumental investigations (ECG, echocardiography, 24-hour ECG monitoring, and exercise stress test), these conditions were excluded. The patient was discharged to outpatient care with recommendations for non-pharmacological syncope prevention. 
本病例是一名热爱运动的青少年因神经介导的晕厥发作而导致的临床病例。鉴别诊断包括以下几种情况:物理因素诱发的心肌病、窦房结功能障碍和窦房结无力综合征。在进行了必要的实验室和仪器检查(心电图、超声心动图、24小时心电图监测和运动负荷试验)后,这些病症被排除。患者出院后在门诊接受了非药物性晕厥预防建议。
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引用次数: 0
Study of respiratory function of the lungs in smokers and patients with chronic obstructive pulmonary disease 吸烟者和慢性阻塞性肺病患者肺部呼吸功能研究
Pub Date : 2024-06-02 DOI: 10.30629/0023-2149-2024-102-3-241-246
A. I. Mikhailovicheva, V. V. Smirnov, P. V. Struchkov, N. S. Nosenko, A. G. Sotnikova, E. O. Dyachkova, T. I. Divakova, Yu. A. Bazhenova-Bessonova, I. Manichev
The article discusses the use of methods for assessing lung respiratory function in patients with chronic obstructive pulmonary disease (COPD) and smokers.The aim of the study is a comparative evaluation of the informative value of capnometry, spirometry, multiple breath nitrogen washout method, and diffusion test in patients with COPD, as well as an early detection of respiratory function impairment in smokers.Results. Three groups of patients were examined: 1st — 30 patients with moderately severe COPD, average age 50.6 ± 4.3 years, 2nd — 30 smokers, average age 45.6 ± 2.4 years, 3rd (control group) — 30 practically healthy non-smokers, average age 45.6 ± 2.4 years. Capnometry showed a statistically significant increase in the slope of the alveolar phase in patients with COPD compared to the control group and smokers at rest, both before and after bronchodilator use. Significant differences between smokers and control groups were detected during forced exhalation. According to spirometry data, the FEV1/FVC ratio in patients with COPD was statistically significantly lower compared to the control group and smokers, both before and after bronchodilator use. Diffusion capacity was significantly lower in patients with COPD and smokers compared to the control group. The lung clearance index was significantly higher in the COPD group compared to the other two groups.Conclusions. All the mentioned methods were informative in patients with COPD, but capnometry and lung diffusion capacity assessment were sensitive methods in smokers, revealing uneven distribution of ventilation-perfusion ratios in the lungs and impaired gas exchange function.
文章讨论了慢性阻塞性肺疾病(COPD)患者和吸烟者肺部呼吸功能评估方法的使用。研究的目的是比较评估慢性阻塞性肺疾病患者的肺活量测定法、肺活量测定法、多次呼气氮冲洗法和二重灌注试验的信息价值,以及早期发现吸烟者的呼吸功能损伤。对三组患者进行了检查:第一组--30 名中重度慢性阻塞性肺病患者,平均年龄(50.6 ± 4.3)岁;第二组--30 名吸烟者,平均年龄(45.6 ± 2.4)岁;第三组(对照组)--30 名身体健康的非吸烟者,平均年龄(45.6 ± 2.4)岁。肺活量测定显示,与对照组和吸烟者相比,慢性阻塞性肺疾病患者在静息状态下的肺泡期斜率在使用支气管扩张剂之前和之后都有显著增加。在用力呼气时,吸烟者和对照组之间也存在明显差异。根据肺活量数据,与对照组和吸烟者相比,慢性阻塞性肺病患者的FEV1/FVC比值在使用支气管扩张剂之前和之后都明显偏低。与对照组相比,慢性阻塞性肺病患者和吸烟者的肺灌注能力明显较低。慢性阻塞性肺病组的肺清除指数明显高于其他两组。所有上述方法对慢性阻塞性肺病患者都有参考价值,但对吸烟者来说,肺活量测定和肺灌注容量评估是敏感的方法,可显示肺部通气-灌注比率分布不均和气体交换功能受损。
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引用次数: 0
Forgotten faces of the First World War: Alexandra Petrovna Filippova 第一次世界大战中被遗忘的面孔:亚历山德拉-彼得罗夫娜-菲利波娃
Pub Date : 2024-06-02 DOI: 10.30629/0023-2149-2024-102-3-279-280
V. G. Abashin, P. Dulin
The article reveals the identity of the senior sister of mercy of the Community of Sisters of Mercy named after M.P. Kaufman, Alexandra Petrovna Filippova, depicted in the photograph of 1915.
这篇文章揭示了以 M.P. 考夫曼的名字命名的仁慈修女团体的高级仁慈修女亚历山德拉-彼得罗夫娜-菲利波娃的身份,她在 1915 年的照片中被描绘出来。
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引用次数: 0
COVID-19 and diabetes: health risks COVID-19 与糖尿病:健康风险
Pub Date : 2024-06-02 DOI: 10.30629/0023-2149-2024-102-3-252-256
E. S. Sokolova, M. Palamarenko, A. A. Osipov, A. Chaulin, E. V. Eliseeva, E. S. Koryakin
During the COVID-19 pandemic, many familiar processes had to be adapted due to various restrictions and high workload on healthcare workers. In particular, to reduce the risk of coronavirus infection, remote patient care technologies have been used more frequently. This study aims to analyze the impact of the COVID-19 pandemic and related restrictions on access to free educational courses on diabetes, disease dynamics, and patient awareness of necessary treatment methods. Changes in patient satisfaction with online learning compared to traditional face-to-face formats were studied, as well as changes in medication adherence with regular education and consultations. The authors described possible reasons for changes in the effectiveness of education and proposed measures to optimize treatment processes and patient information in Russia. The study showed that the COVID-19 pandemic led to a decrease in patient participation in educational programs on diabetes. This could have been due to fear of infection, lack of awareness of such programs, and socio-economic inequality.
在 COVID-19 大流行期间,由于各种限制和医护人员的高工作量,许多熟悉的流程不得不进行调整。特别是,为了降低冠状病毒感染的风险,远程病人护理技术被更频繁地使用。本研究旨在分析 COVID-19 大流行和相关限制对糖尿病免费教育课程的获取、疾病动态和患者对必要治疗方法的认识的影响。研究了与传统的面对面形式相比,患者对在线学习满意度的变化,以及对定期教育和咨询的用药依从性的变化。作者描述了教育效果变化的可能原因,并提出了优化俄罗斯治疗流程和患者信息的措施。研究表明,COVID-19大流行导致患者参与糖尿病教育计划的人数减少。这可能是由于对感染的恐惧、对此类计划缺乏了解以及社会经济不平等造成的。
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引用次数: 0
Comparative characteristics of the nasal airflow aerodynamic parameters in patients with nasal septum deformation and healthy participants 鼻中隔变形患者与健康人鼻气流空气动力学参数的比较特征
Pub Date : 2024-06-02 DOI: 10.30629/0023-2149-2024-102-3-247-251
N. S. Sagandykova, M. Baurzhan, M. I. Shbair, N. M. Papulova, D. S. Kasenova, B. K. Aigozhina
Surgical treatment of nasal septum deviation or deformity (NSD) is a common method of treatment. The quality of treatment is assessed visually with rhinoscopy, taking into account subjective patient sensations. However, there are still no objective criteria for assessing nasal airflow improvement, which complicates the evaluation of patient breathing after treatment. We used a novel CFD modeling method to create a virtual airflow model and determine flow parameters in the nasal cavity in normal and pathological conditions.Objective: to compare the aerodynamic characteristics of airflow in patients with NSD and healthy nasal cavities.Material and methods: the study used electronic files of computed tomography scans of the nasal sinuses of 60 patients with NSD and 21 healthy participants. Specific software (3D slicer, Ansys Fluent) was used to obtain airflow parameters; 3D models of the nasal cavity airflow were created, and CFD flow modeling was conducted.Results: in patients with NSD, flow velocity ranged from 5.17 to 15.63 m/s, in healthy individuals from 1.1 to 2.0 m/s; pressure force on the nasal walls ranged from 2.20 to 10.20 Pa in patients with NSD, in healthy individuals from 0.60 to 1.00 Pa; flow temperature ranged from 26.45 to 36.80 °C in patients with NSD, in healthy individuals from 20.14 to 24.40 °C; flow partial pressure ranged from –120.60 to –0.01 Pa in patients with NSD, in healthy individuals from 2.00 to –4.80 Pa, p < 0.0001. Conclusion: Aerodynamic characteristics of nasal cavity airflow in patients with nasal septum deviation significantly differ from those in healthy individuals. The application of CFD modeling of nasal airflow will assist clinicians in objectively assessing nasal breathing in NSD, as well as surgical treatment outcomes and quality assessment in otorhinolaryngological practice.
手术治疗鼻中隔偏曲或畸形(NSD)是一种常见的治疗方法。治疗质量通过鼻内镜直观评估,同时考虑患者的主观感觉。然而,目前仍没有评估鼻气流改善情况的客观标准,这使得治疗后的患者呼吸评估变得更加复杂。我们使用一种新型的 CFD 建模方法创建了一个虚拟气流模型,并确定了正常和病理情况下鼻腔内的气流参数。目的:比较 NSD 患者和健康鼻腔内气流的空气动力学特征。材料和方法:研究使用了 60 名 NSD 患者和 21 名健康参与者的鼻窦计算机断层扫描电子文件。结果:NSD 患者的气流速度为 5.17 至 15.63 m/s,健康人为 1.1 至 2.0 m/s;鼻腔壁上的压力力为 2.20 至 10.20 Pa。20至10.20帕,健康人为0.60至1.00帕;NSD患者的气流温度为26.45至36.80 °C,健康人为20.14至24.40 °C;NSD患者的气流分压为-120.60至-0.01帕,健康人为2.00至-4.80帕,P < 0.0001。结论鼻中隔偏曲患者鼻腔气流的空气动力学特征与健康人有显著差异。鼻腔气流CFD模型的应用将有助于临床医生客观评估鼻中隔偏曲患者的鼻腔呼吸情况,以及耳鼻喉科的手术治疗效果和质量评估。
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引用次数: 0
Diagnosis and treatment of community-acquired pneumonia in military personnel (Guidelines) 军人社区获得性肺炎的诊断和治疗(指南)
Pub Date : 2024-06-01 DOI: 10.30629/0023-2149-2023-101-11-212-229
A. A. Zaitsev, A. M. Makarevich, M. B. Patsenko, A. I. Sinopalnikov, A. A. Sergoventsev, E. V. Kryukov
Community-acquired pneumonia is a relevant issue for the medical service of the Armed Forces of the Russian Federation. The article presents the main points of modern clinical guidelines for managing patients with community-acquired pneumonia. It discusses diagnostic possibilities, prognostic scoring systems, criteria for transferring patients to intensive care units, antibiotic prescribing regimens, etc. These guidelines should be used in the training of military doctors and in the professional activities of healthcare workers at all levels of the medical service.
社区获得性肺炎是俄罗斯联邦武装部队医疗服务的一个相关问题。文章介绍了管理社区获得性肺炎患者的现代临床指南要点。文章讨论了诊断的可能性、预后评分系统、将患者转入重症监护室的标准、抗生素处方方案等。这些指南应在军医培训和各级医疗服务机构医护人员的专业活动中使用。
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引用次数: 0
Cerebral small vessel disease — new ideas about chronic cerebral ischemia 脑小血管疾病--关于慢性脑缺血的新观点
Pub Date : 2024-06-01 DOI: 10.30629/0023-2149-2024-102-3-205-211
E. A. Shirokov, О. A. Sapronenkova
Cerebral small vessel disease (CSVD) is a heterogeneous disease of the microcirculatory vessel bed, leading to the development of cognitive impairments, lacunar strokes, and intracerebral hemorrhages. The pathogenesis of CSVD is characterized by disturbances in the structure of the intercellular matrix of the vessel wall, resulting in the accumulation of pathological proteins, hyalinosis, necrosis, and increased permeability of the blood-brain barrier. Disease progression is associated with a decrease in the area of the microvascular bed, inflammatory processes, atrophy, and demyelination. The article presents a pathogenetic classification of CSVD, discusses principles of diagnosis and treatment. Special attention is given to promising approaches for managing patients with chronic small artery pathology. Principles for the use of vasodilators from various pharmaceutical groups are proposed and justified, along with discussions on the prospects of using systemic proteolytic enzymes and platelet anti-aggregants.
脑小血管病(CSVD)是微循环血管床的一种异质性疾病,可导致认知障碍、腔隙性中风和脑内出血。CSVD 的发病机制以血管壁细胞间基质结构紊乱为特征,导致病理蛋白堆积、透明质酸化、坏死和血脑屏障通透性增加。疾病进展与微血管床面积缩小、炎症过程、萎缩和脱髓鞘有关。文章介绍了 CSVD 的病理分类,讨论了诊断和治疗原则。文章特别关注了治疗慢性小动脉病变患者的有效方法。文章提出并论证了使用不同制药集团的血管扩张剂的原则,还讨论了使用全身蛋白水解酶和血小板抗聚集剂的前景。
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引用次数: 0
Achievements of rheumatology in the XXI century: contribution of Russian rheumatology 二十一世纪风湿病学的成就:俄罗斯风湿病学的贡献
Pub Date : 2024-06-01 DOI: 10.30629/0023-2149-2023-102-3-197-204
I. L. Nasonov, A. Lila
Rheumatology is one of the most rapidly developing medical specialties, which effectively adapts achievements and contributes to the progress of the world fundamental and clinical medical science [1]. Such immuno-inflammatory rheumatic diseases (IVRS) both rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) are not only the most severe chronic inflammatory human diseases, but also “models” for studying the fundamental mechanisms of pathogenesis and approaches to pharmacotherapy of other diseases associated with the development of autoimmunity and/or auto-inflammation. The relevance of the problem of IVR for modern medicine is determined by their high prevalence in the population, the difficulty of early diagnosis, the rapid development of disability and an unfavorable life prognosis. Deciphering the mechanisms of immunopathogenesis, improving diagnostics, molecular taxonomy, developing approaches to prevention, searching for new “targets” of IVR therapy based on “omix” technologies and artificial intelligence are among the priority areas of biology and medicine of the XXI century.
风湿病学是发展最迅速的医学专科之一,它有效地吸收了世界基础和临床医学科学的成就并为其进步做出了贡献[1]。类风湿性关节炎(RA)和系统性红斑狼疮(SLE)这类免疫炎症性风湿病(IVRS)不仅是人类最严重的慢性炎症性疾病,也是研究与自身免疫和/或自身炎症发展相关的其他疾病的基本发病机制和药物治疗方法的 "模型"。IVR问题与现代医学的相关性是由其在人群中的高发病率、早期诊断的困难性、残疾的快速发展和不利的生命预后决定的。破译免疫发病机制、改进诊断、分子分类、开发预防方法、寻找基于 "omix "技术和人工智能的 IVR 治疗新 "靶点",这些都是二十一世纪生物学和医学的优先领域。
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引用次数: 0
期刊
Clinical Medicine (Russian Journal)
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