Clinical Medicine (Russian Journal)最新文献

{"title":"Hormonal contraception and cervical cancer: does the correlation exist?","authors":"I. Zakharov, A. A. Schmidt, I. A. Pronsky, S. V. Beskrovny, V. G. Abashin","doi":"10.30629/0023-2149-2023-101-4-5-194-197","DOIUrl":"https://doi.org/10.30629/0023-2149-2023-101-4-5-194-197","url":null,"abstract":"The article presents a systematic analysis of scientifi c publications concerning the eff ect of combined hormonal contraceptives on the risk of the development of cervical cancer. The following databases were used for literary search: PubMed, Cochrane, Google Scholar, elibrary.ru. Key words and their combinations were: “cervical cancer”, “cervical intraepithelial neoplasia”, “human papillomavirus”, “contraception”, “combined oral contraceptives”, “hormonal contraceptives”. 147 scientifi c publications have been analyzed, and 10 of them have been selected with the use of I/E criteria. Based on the analyzed literature, a conclusion was made. Long-term use of combined oral contraceptives against the background of persistence of the human papillomavirus increases the risk of developing cervical cancer.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86139287","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":"Features of hematological and immune reactions in patients with autoimmune thyroiditis living in the Аrctic region of the Russian Federation","authors":"K. V. Vereshchagina, A. Samodova, L. Dobrodeeva","doi":"10.30629/0023-2149-2023-101-4-5-216-222","DOIUrl":"https://doi.org/10.30629/0023-2149-2023-101-4-5-216-222","url":null,"abstract":"Objective. To identify the features of hematological and immune reactions in patients with autoimmune thyroiditis, living in the Arctic region of the Russian Federation.Material and methods. The study involved 84 people aged 21–55, including 35 patients with AIT and 49 practically healthy ones at the time of examination. The study included estimating of erythrocyte aggregation, platelets, neutrophil granulocytes, lymphocytes, hemogram, neutrophil phagocytic activity, immunoperoxidase reaction, fl ow cytometry, enzyme immunoassay (EIA).Results. In patients with AIT living in the Arctic, an increase in the aggregation of erythrocytes (82.86% vs. 65.31%) and platelets (11.43% vs. 2.04%), an increase in the number of monocytes with vacuolization of cytoplasm and nucleus (5.71% vs. 2.04%) and neutrophils with azurophilic granularity (14.28 vs. 10.20%) was found. Pathological processes in AIT are combined with a high frequency of neutropenia incidence (34.28% vs. 18.37%) and a defi ciency of phagocytic protection (34.28% vs. 4.08%). The compensatory reaction in neutropenia is manifested in a high level of monocytosis registration (48.57%) and eosinophilia (17.14%). In patients with AIT, a decrease in the total content of lymphocytes was revealed mainly with CD3+, CD3–CD16+CD56+, CD71+, CD25+, CD54+ receptors, as well as the level of sCD25, sCD54 against the background of an increase in the concentration of IFN-γ, IL-6, IgA, M, G.Conclusion. The pathogenetic mechanism of tissue damage and infl ammation exacerbation in patients with autoimmune thyroiditis (AIT) living in the Arctic is a combination of increased levels of erythrocyte and platelet aggregation, degranulation of neutrophil granulocytes with the release of azurophilic granules, and vacuolization of monocyte cytoplasm and nucleus. Reduction in cell-mediated cytotoxicity alongside an increase in humoral reactions refl ects the risk of autoimmune processes formation. ","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85661655","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":"Features of the relationship between the levels of regulation of hemodynamics and the activity of immune reactions in healthy and patients with coronary heart disease residents of the European North and the Arctic of the Russian Federation","authors":"L. Dobrodeeva, A. Samodova, S. N. Balashova, K. O. Pashinskaya","doi":"10.30629/0023-2149-2023-101-2-3-116-122","DOIUrl":"https://doi.org/10.30629/0023-2149-2023-101-2-3-116-122","url":null,"abstract":"Objective. To establish the features and interrelation of the levels of hemodynamics and the activity of immune reactions regulation in practically healthy people and patients with coronary heart disease living in the European North and the Arctic of the Russian Federation.Material and methods. The study included 430 people aged 21 to 55, 274 women and 156 men, living in Arkhangelsk region (Arkhangelsk, settlements of the Konosha district; 60° N.L., 40° E.L.), Murmansk region (settlements of Revda and Lovozero; 67° N.L., 34° E.L.) and the Spitsbergen archipelago (Barentsburg; 80° N.L., 10° E.L.). 244 of those were practically healthy at the time of the examination and 186 patients were diagnosed with coronary heart disease. The research included the study of hemogram, content of phenotypes of CD3+, CD4+, CD8+, CD16+, CD71+ lymphocytes, concentrations of sCD71, transferrin, IL-1β, epinephrine, norepinephrine, dopamine, Nt-pro-BNP, endothelin-1, total NO, endogenous NO2, nitrate NO3, cGMP, cAMP, antibodies to cardiolipin, antibodies to phospholipids, CEC IgM.Results. It was found that practically healthy residents of the Arctic, compared to people living in more favorable climatic conditions, are 2–2.5 times more likely to have elevated concentrations of transferrin, sCD71, dopamine, cortisol, endothelin-1 and Nt-pro-BNP, as well as autoantibodies to cardiolipids and IgM CIC in the plasma of venous peripheric blood. In patients with coronary heart disease, the frequency of elevated levels of trasferrin, endothelin-1, and cortisol in the blood is 1.5–2 times higher, and concentrations of natriuretic peptide, antiphospholipids, CIC and a free pool of transferrin receptors are 4–5 times higher than those in healthy people. The strongest correlations of all these factors with the concentration of the cardiomyocyte damage marker were found in sCD71, which confi rms the involvement of elevated concentrations of the serum transferrin receptor in the mechanisms of tissue damage.Conclusion. Hyperfunction of the cardiovascular system is provided by elevated reactions. A systematic increase in the levels of hemodynamic reactions, intercellular interactions, and integration of homeostasis regulation mechanisms provide correction of a certain stage of regulation and may lead to a reduction in reserve regulatory capabilities and excessive severity of adaptive processes.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75281026","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":"Prevalence of cardiovascular pathology and relationship of left ventricular global longitudinal strain three months after COVID-19","authors":"D. Krinochkin, E. Yaroslavskaya, N. Shirokov, E. Gorbatenko, E. Gultyaeva, I. R. Krinochkina, I. O. Korovina, V. Garanina, N. Osokina, A. V. Migacheva","doi":"10.30629/0023-2149-2023-101-2-3-123-130","DOIUrl":"https://doi.org/10.30629/0023-2149-2023-101-2-3-123-130","url":null,"abstract":"Purpose: To study the prevalence of cardiovascular diseases and the correlations of left ventricle global longitudinal strain (LV GLS) in patients 3 months after proven COVID-19 pneumonia.Material and methods. 369 patients with proven COVID-19 pneumonia underwent a comprehensive clinical examination and echocardiography (EchoCG) after 3 months ± 3 weeks after their discharge from the hospital. Mean age of the patients was 54 [46; 61]; 50.9% of them were women. LV GLS was studied in 284 (77%) of patients with optimal visualization quality during echocardiography. LV GLS was considered reduced in the limit of > –18%. Study Registration: ClinicalTrials.gov ID: NCT04501822.Results. 3 months after discharge, obesity was noted in 46.5% of patients, cardiovascular diseases were diagnosed in 73.4%, including de novo in 8.4%. Arterial hypertension occurred in 71.5% of patients, coronary artery disease — in 22.5%. The average left ventricle (LV) ejection fraction was 67.8 ± 5.0%, the average LV GLS was –19.5 ± 2.3%. LV GLS was reduced in 24.4% of the patients. LV GLS showed no correlation with the patient age, NYHA functional class and LV ejection fraction. Reduced LV GLS was independently associated with male sex (OR 1.399; 95% CI 1.239–1.580; p < 0.001), obesity (OR 1.268; 95% CI 1.132–1.421; p < 0.0001), diabetes mellitus (OR 1.204; 95 % CI 1.017–1.425; p = 0.031) and hypertension (OR 1.120; 95% CI 1.002–1.252; p = 0.046). LV GLS showed moderate positive correlations with echocardiographic parameters of right ventricle (RV): the length (r = 0.346), diastolic (r = 0.333) and systolic area (r = 0.326), width at the basal (r = 0.358) and midlevel (r = 0.321), as well as with the dimension of the proximal RV outfl ow tract (r = 0.302, all p < 0.001). LV GLS showed a weak correlation with the severity of lung lesions during hospitalization (r = 0.184; p = 0.002).Conclusions. 3 months after COVID-19 pneumonia, cardiovascular diseases were diagnosed in 73.4%. Reduced LV GLS was observed in 24.4% of survivors and was associated with male sex, obesity, diabetes mellitus, arterial hypertension and linear and planimetric RV dimensions.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"2014 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82615569","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":"Features of etiology, clinical picture, diagnosis and treatment of travelers’ diarrhea","authors":"A. Sheptulin, S. Kardasheva, A. Kurbatova","doi":"10.30629/0023-2149-2023-101-2-3-137-140","DOIUrl":"https://doi.org/10.30629/0023-2149-2023-101-2-3-137-140","url":null,"abstract":"The article discusses the issues of epidemiology, etiology, clinical manifestations, diagnosis, treatment and prevention of travelers’ diarrhea (TD). This disease most often has a bacterial nature, but can also be caused by viruses and protozoa. TD usually has a favorable course and ends with self-healing. In mild forms of TD, rehydration therapy is suffi  cient, as well as the appointment of loperamide or bismuth subsalicylate. In moderately severe and severe forms, the use of antibiotics (fl uoroquinolones, azithromycin, rifaximin) is necessary. Prevention of TD is reduced to compliance with hygienic measures. The appointment of antibiotics for this purpose — taking into account the growing resistance to them — is carried out only for special indications.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81587812","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":"Modern approaches to the management of patients with osteoarthritis in real clinical practice","authors":"A. Lila, L. Alekseeva","doi":"10.30629/0023-2149-2023-101-2-3-141-146","DOIUrl":"https://doi.org/10.30629/0023-2149-2023-101-2-3-141-146","url":null,"abstract":"Osteoarthritis (OA) is a heterogeneous condition, which is based on low-intensity infl ammation that aff ects all tissues of the joint, and allows it to be considered as an organ pathology, that is, a disease of the whole organ — the joint. The article presents algorithms for managing a patient with OA, including non-drug, pharmacological treatment and surgical interventions. Drug treatment consists of three stages of sequential prescription of medications. The early use of symptomatic slow-acting drugs in osteoarthritis (SYSADOA) is emphasized. It increases the eff ectiveness of treatment, reduces pain, improves joint function, and thereby improves the quality of life of patients.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88563992","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":"Lung lesion in a patient with systemic lupus erythematosus","authors":"E. Pravkina, A. S. Baranova, S. P. Filonenko, S. A. Molchanov","doi":"10.30629/0023-2149-2023-101-2-3-147-155","DOIUrl":"https://doi.org/10.30629/0023-2149-2023-101-2-3-147-155","url":null,"abstract":"Systemic lupus erythematosus is a chronic rheumatic autoimmune disease characterized by polysystemic lesions and a variety of clinical manifestations. This disease often aff ects the respiratory system, represented mainly by pleurisy or pulmonary hypertension. However, this publication describes a clinical case in which lung damage in a patient who has had systemic lupus erythematosus for over than 25 years, manifested itself as interstitial lung disease (ILD), which is more typical for other rheumatic diseases, such as  diff use scleroderma, Sjogren disease. ILD manifested with an atypically bright clinical picture, progressed and required the prescription of genetically engineered biological drugs. Their use was complicated by recurrent urinary tract infection, and therefore these drugs were withheld. A peculiar feature of ILD is its blurred clinical picture, which causes additional diffi  culties in diff erential diagnosis, especially during the period of widespread new coronavirus infection, taking into account similar clinical manifestations and changes detected by computed tomography of the lungs, so it leads to a late start of pathogenetic therapy. In this regard, the episode of recrudescence of the patient’s condition manifested by a clinical picture and a pattern of changes on a CT scan, similar to both progressive IPL and pneumonia associated with a new coronavirus infection, which complicated diff erential diagnosis and management tactics, deserves special attention.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75056615","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":"Distal radial access for endovascular interventions","authors":"Y. Mikheeva, D. Kurtasov, N. D. Kisliy, A. G. Koledinsky","doi":"10.30629/0023-2149-2023-101-2-3-111-115","DOIUrl":"https://doi.org/10.30629/0023-2149-2023-101-2-3-111-115","url":null,"abstract":"This article, based on the guidelines of the European Society of Cardiology (ESC), Russian clinical recommendations and large randomized trials, summarizes information about traditional radial access used in X-ray endovascular interventions. We present a description and characteristics of a new distal radial approach. It is a puncture of the deep palmar branch of the radial artery (DLV LA) and catheterization of the radial artery distal to its bifurcation to the superfi cial and deep palmar arches.The aim of this study is to present real time data about distal radial access as current clinical guidelines do not contain information about this new method; to evaluate its advantages and disadvantages, and to assess the frequency of complications. Analysis of references showed that the new distal radial approach is safe, eff ective, competitive and it may be the method of choice for endovascular interventions.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"83 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77622427","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":"Organizers of the medical service of fl eets during the Great Patriotic War","authors":"M. Knopov","doi":"10.30629/0023-2149-2023-101-2-3-168-174","DOIUrl":"https://doi.org/10.30629/0023-2149-2023-101-2-3-168-174","url":null,"abstract":"The article presents brief characteristics of the activities of the Directors of Medical and Sanitary Services of the fl eets during the Great Patriotic War, who developed plans for organizing medical defense of the fl eets during the war years.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80296287","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":"Kupriyanov is an outstanding military field surgeon (on the 130th anniversary of his birth)","authors":"V. Simonenko, M. Knopov","doi":"10.30629/0023-2149-2023-101-2-3-163-167","DOIUrl":"https://doi.org/10.30629/0023-2149-2023-101-2-3-163-167","url":null,"abstract":"The article presents the facts concerning the life and career development of an outstanding organizer of military fi eld surgery, an excellent clinician, a wonderful teacher, a well-known public fi gure, academician of the USSR Academy of Medical Sciences, Honored Scientist of the RSFSR, Lenin Prize laureate, Hero of Socialist Labor, lieutenant general of the medical service Pyotr Andreyevich Kupriyanov.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"126 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77021983","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}