Almanac of Clinical Medicine最新文献

{"title":"Molecular genetic testing in colon cancer: clinical aspects","authors":"A. Martianov, E. Kuligina, A. Romanko, E. Imyanitov","doi":"10.18786/072-0505-2022-50-002","DOIUrl":"https://doi.org/10.18786/072-0505-2022-50-002","url":null,"abstract":"Molecular genetic diagnostics is an essential element to plan for management of colorectal cancer (CRC) patients. The choice of systemic treatment for CRC is impossible without molecular testing of the tumor. For instance, the assessment of the KRAS and NRAS genes is mandatory for consideration of anti-EGFR agents. Tumors with BRAF V600E mutation are characterized by aggressive behavior, the necessity of intensive cytostatic regimens, as well as by sensitivity to combination therapy with BRAF and EGFR inhibitors. Inactivation of the DNA mismatch repair, the MUTYH gene or DNA polymerase epsilon (POLE) leads to an excessive tumor mutational burden; these CRC types are highly immunogenic and therefore respond to immune checkpoint inhibitors. Some colorectal carcinomas are characterized by overexpression of the HER2 oncogene, which make them sensitive to corresponding target therapies. There are CRCs with clinical signs of hereditary predisposition, which require germline genetic testing. Nowadays the molecular diagnosis of CRC is being seriously modified due to worldwide implementation of the next-generation sequencing (NGS) and hypersensitive variants of polymerase chain reaction, for example, droplet digital polymerase chain reaction (ddPCR). Non-invasive liquid biopsy is an example of another highly useful innovation that has growing importance for CRC screening, control of surgical intervention efficacy and monitoring of the disease course.","PeriodicalId":7638,"journal":{"name":"Almanac of Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75648039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical features of the microRNA genes methylation in borderline ovarian tumors and depending on the histological structure in ovarian malignancies","authors":"S. Lukina, A. Burdennyy, E. Filippova, I. Pronina, T. Kazubskaya, D. N. Kushlinsky, D. O. Utkin, E. Braga, V. Loginov, N. Kushlinskii","doi":"10.18786/2072-0505-2022-50-001","DOIUrl":"https://doi.org/10.18786/2072-0505-2022-50-001","url":null,"abstract":"Background: Borderline ovarian tumors (BOT) belong to the intermediate type between benign and malignant ovarian neoplasms. Serous borderline tumors share common molecular and genetic characteristics with serous carcinomas. An increase in the methylation level of microRNA (miRNA) genes group has been previously shown during the development and progression of ovarian cancer. However, the study results are contradictory, and their number is not sufficient for a consensus. Current study is the first to search for aberrant methylated genes of the BOT-specific microRNA and for some histological subtypes of ovarian cancer. \u0000Materials and methods: The study was based on a set of 99 paired (tumor/healthy) ovarian tumor samples. Methylation analysis was carried out with quantitative methyl-specific polymerase chain reaction (PCR). Screening for BOT biomarkers was performed in 21 genes of miRNA. \u0000Results: We have found that some miRNA genes (MIR124-1, MIR125B-1, MIR129-2, MIR132, MIR148A, MIR193A, MIR203A, MIR107, MIR1258, MIR339) were characterized by a high methylation level in the patients with BOT, compared to that in the tissues of healthy women. At the same time, the methylation level in the patients with malignant ovarian tumors (MOT) either differed slightly or was even lower. For the MIR129-2, MIR132, MIR148A, MIR203, MIR107 and MIR1258 genes, a higher level of methylation was detected in the BOT patients, compared to the MOT patients. The methylation level of the MIR148A gene in the BOT patients was 4-fold higher than that in the MOT (31.3% vs 7.9%, p = 0.047, multiple two-sided Kruskal-Wallis test). The methylation levels of the miRNA genes MIR148A and MIR191 were significantly reduced in serous cystadenocarcinoma and increased in serous and endometrioid adenocarcinomas. \u0000Conclusion: Methylation of the miRNA MIR148A and MIR191 genes is significantly associated with various histological variants of ovarian cancer. We have shown an increased methylation level of a number of miRNA genes in BOT, compared to MOT. In general, epigenetic factors play a role in the clinical differences between histological forms of ovarian cancer and borderline tumors.","PeriodicalId":7638,"journal":{"name":"Almanac of Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74169241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential impact of viral skin diseases and other viral infections on the incidence and severity of COVID-19 in renal transplant patients","authors":"Anastasia D. Perlina, I. V. Alexandrov, E. Prokopenko, A. Terentyev, P. Kulikov","doi":"10.18786/2072-0505-2021-49-066","DOIUrl":"https://doi.org/10.18786/2072-0505-2021-49-066","url":null,"abstract":"Background: COVID-19 in solid organ transplant recipients is usually characterized by more severe disease course and is often associated with life-threatening complications. Identification of additional factors that may affect the risk and severity of the new coronavirus infection could have a significant impact on choosing a management strategy for renal graft recipients. \u0000Aim: To evaluate the possibility of cross-immunity between skin manifestations of viral etiology and COVID-19. \u0000Materials and methods: From May 2020 to February 2021 we examined 180 renal graft recipients with a history of transplantation from 2 months to 26.5 years. All patients were categorized into two groups: groupI (n=68), those who had confirmed moderate or severe COVID-19 disease and groupII (n=112), those without any history of clinical manifestations of the new coronavirus infection (including those with potentially asymptomatic disease). During the study period which lasted for 71 months on average (range, 2 to 318 months), laboratory workupwas performed in all patients (on average, twice): dermatological examination and detection of serum antibodies to herpes simplex virus 1, 2, cytomegalovirus, human papilloma virus (HPV), Epstein-Barr virus, SARS-CoV-2. \u0000Results: In recipients with HPV-associated skin manifestations, the incidence of COVID-19 was significantly lower than in recipients who did not have them 30.4% (34/112) and 50% (34/68), respectively (p=0.011). The incidence of new coronavirus infection did not differ in the groups of patients with cutaneous manifestations caused by herpes simplex viruses type 1 and 2, and without them. Among recipients with Epstein-Barr virus seropositivity, there were significantly fewer cases of COVID-19 compared to seronegative patients 26.2% (28/107) and 54.8% (40/73), respectively (p=0.0002). \u0000Conclusion: HPV-associated dermal manifestations or serum Epstein-Barr virus-seropositivity in renal graft recipients is associated with lower incidence of moderate and severe COVID-19. Further studies are needed to confirm the possibility of cross-immunity against SARS-CoV-2 with other infections.","PeriodicalId":7638,"journal":{"name":"Almanac of Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74377414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adult-onset of Langerhans cell histiocytosis: a clinical case","authors":"O. Chernysheva, O. Dorokhina, A. Khlebnikova, E. Selezneva","doi":"10.18786/2072-0505-2021-49-064","DOIUrl":"https://doi.org/10.18786/2072-0505-2021-49-064","url":null,"abstract":"Langerhans cell histiocytosis is mainly diagnosed in children, and its manifestation in adult age is quite uncommon. Skin rashes may be non-specific and mimic a number of dermatoses. Therefore, the clinical diagnosis is challenging and as a rule, such patients are misinterpreted and managed for other disorders by a dermatologist for some years. \u0000We present a clinical case of Langerhans cell histiocytosis with skin involvement in a 35-year female patient, who had been treated by a dermatologist for 2 years for pyoderma, seborrheic dermatitis, and skin fold candidiasis. Taking into account the clinical signs and symptoms and age of manifestation, we initially suspected familial benign pemphigus (Hailey-Hailey disease) or follicular dyskeratosis (Darier's disease). However, the histological assessment showed Langerhans cell histiocytosis confirmed by immunohistochemistry with anti-langerin, anti-CD1a, and anti-protein S-100 antibodies. The patient was referred to a hematologist for further work-upand specific treatment. \u0000In cases of any treatment resistant disorders, which do not respond to long-term conventional treatment, it is necessary to reconsider the diagnosis by means of histological investigation. It would allow for identification of a disease, which is uncommon in dermatology practice.","PeriodicalId":7638,"journal":{"name":"Almanac of Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88668726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A clinical case of Barraquer-Simons syndrome","authors":"T. Sedova, V. Elkin, M. Kobernik, E. Borodina","doi":"10.18786/2072-0505-2021-49-067","DOIUrl":"https://doi.org/10.18786/2072-0505-2021-49-067","url":null,"abstract":"Barraquer-Simons syndrome (SBS) belongs to the groupof lipodystrophy with complex etiology and pathophysiology and is characterized by progressive loss of subcutaneous fat, presumably related to autoimmune destruction of adipocytes. SBS is frequently associated with autoimmune disorders. Its first signs are found in childhood or puberty. It is characterized by gradual onset from the face with subsequent extension of the pathological process downwards without the involvement of the lower extremities. At the same time, there is a clear delimitation between the lipodystrophic and unaffected zones. The diagnosis of SBS is mainly based on clinical manifestations. Laboratory work-upis needed mostly to clarify any concomitant disorders. \u0000We describe a rare clinical case of the Barraquer-Simons syndrome in a 61-year-old woman, associated with chronic glomerulonephritis and C3-hypocomplementemia. The disease manifested at the age of 11 years with the fat loss in the face area. No familial history of SBS could be identified. Among the concomitant diseases, chronic glomerulonephritis and bilateral retinal angiopathy are of particular interest. The laboratory assessments showed proteinuria and microhematuria in the urine analysis and decreased C3 component of the complement in blood chemistry analysis. The skin pathology was represented by atrophy of the skin and soft tissues in the face, neck, upper limbs and trunk areas, with a clear delimitation in the upper third of the thighs, where normal subcutaneous fat was preserved. There was pronounced skin hypotrophy in the face area, with face disfiguration resembling a \"dead man's face\". To diagnose the Barraquer-Simons syndrome, in addition to the assessment of clinical manifestations, we used non-invasive diagnostic methods and the results of histological examination of a skin biopsy samples (the description of the specimen is given). \u0000Patients with SBS should be followed upwith the monitoring of their clinical and biochemical profiles and need an in-depth comprehensive examination by medical specialists to identify and treat their concomitant disorders.","PeriodicalId":7638,"journal":{"name":"Almanac of Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87440691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of narrowband phototherapy in the treatment of different forms of psoriasis with the predominant affection of palms and soles","authors":"M. Gureeva, A. Molochkov, G. E. Bagramova, Mikhail S. Sipkin, O. V. Karzanov","doi":"10.18786/2072-0505-2021-49-068","DOIUrl":"https://doi.org/10.18786/2072-0505-2021-49-068","url":null,"abstract":"Background: Palmar-plantar psoriasis is characterized by a torpid course and resistance to conventional systemic treatments. Phototherapy is usually considered as an adjuvant treatment of a patient with psoriasis. The potential use of phototherapy as a basic treatment strategy in limited psoriasis, including its plantar-palmar localization, could be of interest. \u0000Aim: To study the efficacy, safety and tolerability of the narrowband phototherapy (UVB 311 nm) in the treatment of different forms of psoriasis with predominant palmar-plantar involvement. \u0000Materials and methods: We retrospectively analyzed the results of treatment of 77 in-patients admitted to the Department of Dermatology for treatment of various types of psoriasis with prevailing palmar and plantar lesions. The main group consisted of 42 patients who were administered combination therapy including topical corticosteroids, hepatic protectors, antihistaminic agents and, in addition, the narrowband phototherapy with a phototherapy device Dermalight 500-1 (Dr. Hnle Medizintechnik GmbH, Germany). The initial radiation doses were set without the determination of the minimal erythema dose, depending on the patient's skin type, in accordance with the guidelines from the manufacturer. At each consecutive session, the dose was increased by 0.060.3 J/cm. The sessions were conducted 5 times a week with a total of 1421 sessions. The mean cumulative dose was 22.8 J/cm. The control group included 35 age-, gender- and psoriasis severity-matched patients who received the same treatments, except the narrowband phototherapy. The treatment efficacy was assessed by changes in the Palmoplantar Pustulosis Area and Severity Index (PPPASI). Clinical results of treatment were evaluated at day 10 after the treatment course had been completed. \u0000Results: No serious adverse events were registered during the treatment. In the patients with psoriasis vulgaris and predominant palmoplantar lesions, receiving the narrowband phototherapy, the PPPASI reduction was higher than in the patients who received only conventional treatment (U-test, p = 0.015). A PPPASI decrease of 50% was observed in 83.3% (25/30) and 60% (15/25) of the patients, respectively. Clinical efficacy criteria were achieved in 66.6% (8/12) of the patients with palmoplantar pustular psoriasis receiving the combination treatment with phototherapy and in 40% (4/10) of the conventionally treated patients in the control group; however, the difference in the distribution of remission achievement was non-significant (U-test, p = 0.123). \u0000Conclusion: The study has demonstrated the efficacy of UVB 311 nm narrowband phototherapy in the treatment of patients with psoriasis with predominant palmoplantar lesions. The results obtained make it possible to recommend the inclusion of the narrowband phototherapy UVB 311 nm at mean cumulative dose of 22.8 J/cm into the standardized set of treatments of patients with psoriasis vulgaris with predominant palmoplantar lesio","PeriodicalId":7638,"journal":{"name":"Almanac of Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77340144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A clinical case of familial enteropathic acrodermatitis caused by a new genetic mutation in exon 10 of the SLC39A4 gene","authors":"A. S. Stadnikova, O. Tamrazova, I. Zakharova, Y. Dmitrieva, A. V. Taganov, A. Yudina, G. E. Bagramova","doi":"10.18786/2072-0505-2021-49-069","DOIUrl":"https://doi.org/10.18786/2072-0505-2021-49-069","url":null,"abstract":"Enteropathic acrodermatitis is a rare form of genodermatoses, a group of hereditary disorders with prevailing skin lesions. The disease manifestation in children is associated with withdrawal of breastfeeding and switch to the cow milk-based products, which makes it difficult to differentiate enteropathic acrodermatitis from allergic dermatoses. We describe a familial case of enteropathic acrodermatitis in a 4-month old girl with advanced skin lesions and diarrhea. The familial history positive for enteropathic dermatitis made it possible to immediately suspect this diagnosis in the patient and to administer a zinc sulfate-containing agent before the genetic test results have become available. The response to therapy was obtained within a few days. Genetic testing of the patient identified a new mutation in exon 10 of the SLC39A4 gene. Proper collection of the past history and physician's vigilance to zinc-deficient conditions in acral dermatitis combined with alopecia and diarrhea in infants would allow for a timely and proper diagnosis and choice of a subsequent management strategy.","PeriodicalId":7638,"journal":{"name":"Almanac of Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74956490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antitumor efficacy of an isolated hind legperfusion with a pH-increased solution in thePliss’ lymphosarcoma graft rat model","authors":"A. Bogdanov, V. Egorenkov, N. Volkov, F. Moiseenko, M. S. Molchanov, N. Verlov, L. S. Gulina, V. Moiseyenko","doi":"10.18786/2072-0505-2021-49-070","DOIUrl":"https://doi.org/10.18786/2072-0505-2021-49-070","url":null,"abstract":"Background: The technique of regional isolated perfusion makes it possible to increase local levels of an anti-tumor agent, to perform the treatment procedure under hypothermia or hyperthermia, to reduce or even eliminate any systemic effect of a cytostatic on the patient. In this context, the use of isolated perfusion to modify the pH milieu of the tumor seems to be a promising strategy that could potentially ensure the anti-tumor effect. \u0000Aim: To evaluate the efficacy of a rat limb perfusion with 4% NaHCO3 solution in vivo in the Pliss' lymphosarcoma rat graft model. \u0000Materials and methods: The experiment was carried out in Wistar rats with Pliss' lymphosarcoma graft. The isolated limb was perfused with an isotonic sodium chloride solution (the control group) or a 4% sodium bicarbonate solution (the treatment group). The following parameters were assessed: tumor node growth over time, survival rate, hematology analysis at various time points of the experiment, and histological examination of autopsy samples from the tumor. \u0000Results: Median survival in the group perfused with 4% NaHCO3 (N = 6) was 17.2 days, whereas in the non-perfused group (the pathogenesis group) (N = 4) and in the group perfused with isotonic saline (N = 5) they were 13.2 and 13.6 days, respectively. The risk of death in the treatment group was lower compared to that in the control group (Cox regression model, hazard ratio 0.129; 95% confidence interval 0.0280.583; p = 0.0079). There were no significant differences in the tumor growth rate over time in the perfused groups. \u0000Conclusion: A single exposure of the tumor micro-milieu in the model with isolated perfusion of the limb with Pliss' lymphosarcoma graft does not lead to any changes in the tumor growth kinetics, but is associated with a change in the animal survival.","PeriodicalId":7638,"journal":{"name":"Almanac of Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84622058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A diaphragmatic tumor mimicking gastric neoplasm: a clinical case report","authors":"P. Burko, M. G. Fedorova, R. R. Iliasov, I. N. Mozhzhukhina","doi":"10.18786/2072-0505-2021-49-063","DOIUrl":"https://doi.org/10.18786/2072-0505-2021-49-063","url":null,"abstract":"The vast majority of patients with tumors arising from the diaphragm do not have any specific clinical symptoms, therefore, computed tomography (CT) and magnetic resonance imaging (MRI) are the techniques required for the diagnosis. This is particularly relevant when a  pathological mass has grown to an extent producing a “mass effect” on the adjacent organs. In some cases, clinical symptoms of arise due to the local invasion of the neoplasm to the adjacent tissues or distant metastases. We present a rare clinical case of a mesenchymal diaphragmatic tumor in a  34-year-old patient. After a  review of her clinical status and imaging of the abdomen, including CT and MRI, the preliminary diagnosis of the gastric neoplasm of uncertain behavior (D37.1) was made, despite the initial diagnostic assumption of the exogastric location of the mass based on MRI. After careful consideration of the diagnostic assessment results, a  multidisciplinary decision was made to perform laparoscopic resection of the mass. The intraoperative finding was a  tumor originating from the left diaphragmatic cupula with no involvement of the stomach. The patient's recovery was uneventful. Pathological examination revealed a solitary calcifying fibrous tumor of the diaphragm. This clinical case shows that a  mass arising from the diaphragm can mimic one arising from the gastric fundus, leading to an incorrect diagnosis and subsequent inappropriate management.","PeriodicalId":7638,"journal":{"name":"Almanac of Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83672661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunological aspects of determination of an adequate biological treatment sequence for inflammatory bowel diseases: the expert board statement (St. Petersburg, May 22, 2021)","authors":"E. Belousova, I. Kozlov, D. Abdulganieva, O. Alexeeva, I. Gubonina, A. Lishchinskaya, L. V. Tarasova, E. Chashkova, M. Shapina, O. Shifrin, O. Shchukina","doi":"10.18786/2072-0505-2021-49-060","DOIUrl":"https://doi.org/10.18786/2072-0505-2021-49-060","url":null,"abstract":"On May 22, 2021, the Expert Board met in St. Petersburg to discuss their position on immunological aspects of determination of an adequate biological treatment sequence for inflammatory bowel diseases (IBD). The Expert Board aimed at discussion of current strategies, development of a consensus on determination of an adequate biological treatment sequence for IBD. The main topics of the agenda were the contribution of immune system to the pathophysiology of Crohn's disease, ulcerative colitis and their complications, efficacy of genetically engineered biological agents (GEBA) at various stages of IBD management. Participation of the leading Russian experts in IBD, as well as involvement of other specialties, made it possible to consider the topic by a multidisciplinary team, with an in-depth analysis of IBD pathophysiology, to better understand the course of the disease in some contradictory situation, for instance, when clinical remission is not associated with an endoscopically confirmed remission. One of the expected effects of this Expert Board meeting would be an improvement of GEBA administration in clinical practice, mostly due to the modification of clinical guidelines. This would ascertain and confirm the algorithms for GEBA administration for IBD, including the optimal treatment sequence depending on an agent’s mechanism of action and the patient profile. The clarification of the optimal GEBA sequence in the clinical guidelines could lead to more frequent GEBA administration in local medical clinics and institutions in the regions, where GEBA are used insufficiently due to little experience and absence of their precise positioning in the clinical guidelines.","PeriodicalId":7638,"journal":{"name":"Almanac of Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90388276","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}