Clinical Medicine (Russian Journal)最新文献

{"title":"Idiopathic thrombocytopenic purpura","authors":"T. I. Avdeeva, A. V. Koloskov","doi":"10.30629/0023-2149-2024-102-4-309-314","DOIUrl":"https://doi.org/10.30629/0023-2149-2024-102-4-309-314","url":null,"abstract":"The review presents a modern understanding of the pathophysiology and mechanisms leading to thrombocytopenia, as well as emerging treatment methods for.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"133 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141811388","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":"Bloodcoagulation. Modern state","authors":"I. N. Bokarev","doi":"10.30629/0023-2149-2024-102-4-285-290","DOIUrl":"https://doi.org/10.30629/0023-2149-2024-102-4-285-290","url":null,"abstract":"The article provides information on historical issues — the discovery of blood clotting factors, anticoagulant and thrombolytic therapy, on modern understanding, diagnosis and treatment of arterial and venous thrombosis, atherothrombosis, venous thromboembolism, intravascular microthrombosis syndrome, hemophilias and immunothrombosis. Assumptions about the development of atherosclerosis are presented.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"69 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141813001","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":"Hemorrhagic complications of emergency endovascular interventions","authors":"B. S. Sukovatykh, N. V. Bolomatov, D. V. Sidorov, M. B. Sukovatykh","doi":"10.30629/0023-2149-2024-102-4-315-322","DOIUrl":"https://doi.org/10.30629/0023-2149-2024-102-4-315-322","url":null,"abstract":"The article provides a systematic review of data from domestic and international literature on the issue of hemorrhagic complications that can occur during emergency endovascular interventions. It provides a generalized classifi cation of these complications and highlights the frequency of major and minor hemorrhages in diff erent locations, depending on their underlying cause. Various factors, causes, and mechanisms related to the development of hemorrhaging are discussed, including those associated with surgical access, vessel dissection, rupture, anticoagulation, anti-platelet therapy, and thrombolysis. Methods for preventing and treating these complications following endovascular procedures are also described in detail.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"77 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141812813","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":"Gut microbiome: new diagnostic and treatment options","authors":"I. V. Mayev, S. Lyamina","doi":"10.30629/0023-2149-2024-102-4-297-308","DOIUrl":"https://doi.org/10.30629/0023-2149-2024-102-4-297-308","url":null,"abstract":"The gut microbiome is of undeniable contribution to the functioning of numerous human organ systems, including higher nervous activity and behavioral reactions, and largely determines the activity of the immune system. To date, a large amount of knowledge has been accumulated about the importance of the composition, diversity and functional properties of the gut microbiota both for maintaining the human body in a state of health and for the development of pathology. Changes in the human organism are inevitably accompanied by changes in species composition and microbiome diversity. Certain patterns of changes in the human gut microbiome throughout life, as well as changes in its functional activity under the infl uence of external factors and food preferences. This research is based on search results in databases and electronic libraries PubMed (MEDLINE), Embase, Cochrane Library, Google Scholar, eLibrary in the period from 2012 to 2023. The review is devoted to the analysis of gut microbiome as a marker and predictor of chronic socially signifi cant non-communicable diseases, as well as an integral component of health gain in the context of a personalized approach of modern therapeutic strategies.  ","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"90 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141812594","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":"Rare forms of thyrotoxicosis: thyrotropin-secreting pituitary adenomas","authors":"M. A. Telegina, Zhanna Evgen'evna Belaya","doi":"10.30629/0023-2149-2024-102-4-291-296","DOIUrl":"https://doi.org/10.30629/0023-2149-2024-102-4-291-296","url":null,"abstract":"Thyrotoxicosis most often occurs due to autoimmune diseases of the thyroid gland or a multi-nodular toxic goiter, but it can also be caused by TSH-secreting pituitary adenomas. In the presence of these adenomas, the levels of circulating free T3 and T4 increase in the absence of suppression, even with elevated TSH levels. Incorrect interpretation of results from studies that only measure TSH can lead to erroneous diagnoses and management strategies for patients, including unnecessary surgery or radioactive iodine therapy. This can contribute to the growth of pituitary tumors. Various tests have been used to try to diagnose them, but none have proven to be eff ective. Only laboratory tests in combination with MRI of the pituitary can accurately diagnose and prescribe treatment. When choosing a treatment for TSH-producing pituitary adenomas, preference is given to the surgical method of transsphenoidal adenomectomy. If surgery is not possible or eff ective, the method used to normalize TSH levels is to prescribe somatostatin analogs. In some cases, it is possible to use somatostatin analog therapy before neurosurgery. In exceptional circumstances, radiation therapy may be used, as with other types of adenomas.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141813013","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":"First experience of distal hybrid surgery on lower limb arteries with port-system installation","authors":"A. G. Vaganov, M. S. Nochnoy, D. A. Lisitsky, A. V. Gavrilenko","doi":"10.30629/0023-2149-2024-102-2-133-138","DOIUrl":"https://doi.org/10.30629/0023-2149-2024-102-2-133-138","url":null,"abstract":"   Cases of occlusive lesions of the arteries of the lower leg occupy a special place in the treatment of critical lower limb ischemia. In this regard, performing open reconstructive interventions is unpromising. A new era in the treatment of occlusions of the arteries of the lower leg has become endovascular surgery. However, due to extensive occlusive lesions of the arteries of the lower leg, direct endovascular revascularization is often impossible. Currently, vascular surgeons adhere to the angiosome principle, according to which the goal of balloon angioplasty is to restore blood supply to the artery supplying the angiosome with purulent-trophic changes. In the clinical example provided, the universality of the angiosome theory is questioned, and clinical success achieved due to the discovery of collateral blood fl ow is demonstrated. The patient underwent surgery with the use of an original hybrid operation technique with the installation of a port system followed by active therapeutic-diagnostic measures on an outpatient basis for 30 days. As a result of the treatment, epithelialization of the trophic defect and cessation of critical ischemic phenomena were noted.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":" 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140995473","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":"Assessment of pharmacotherapy efficacy for the treatment of exacerbations of chronic obstructive pulmonary disease associated with viral infection","authors":"L. A. Shpagina, O. Kotova, I. Shpagin, G. V. Kuznetsova, E. Loktin, A. Rukavitsyna, S. Karmanovskaya, L. Panacheva, E. Anikina","doi":"10.30629/0023-2149-2024-102-2-152-162","DOIUrl":"https://doi.org/10.30629/0023-2149-2024-102-2-152-162","url":null,"abstract":"   Justification. Knowledge of the differences in response to therapy between phenotypes of exacerbations of chronic obstructive pulmonary disease (COPD) is necessary to improve treatment outcomes.   Objective: to determine the most effective additional pharmacological methods for virus-associated exacerbations of COPD.   Material and methods. The study included patients hospitalized with exacerbations of COPD with viral (n = 60) and viral-bacterial (n = 60) infections, and a comparison group with exacerbations of COPD with bacterial infection (n = 60). The diagnosis of COPD was based on spirometric criteria, viral infection — according to the results of PCR-RV of sputum for RNA of respiratory viruses. Treatment was carried out in real clinical practice. The groups were comparable in the use of systemic glucocorticoids, short-acting bronchodilators. Dyspnea was assessed using the TDI index (primary endpoint), lung function (spirometry, diffusion capacity for carbon monoxide), exercise tolerance (6-minute walk test), length of hospital stay (secondary endpoints). The сorrelations were determined with the use of Cox proportional hazards model.   Results. In the groups with virus-associated and viral-bacterial exacerbations, unlike bacterial exacerbations, the following types of treatment were associated with achieving TDI +1 (odds ratio — OR, 95 % confidence interval — CI): fixed triple combination (OR 2.69; 95 % CI 1.48–4.90; p = 0.010 and OR 2.74; 95 % CI 1.29–3.80; p = 0.031), inhalation of 3 % sodium chloride solution (OR 3.64; 95 % CI 1.45–5.42; p = 0.001 and OR 3.23; 95 % CI 2.15–5.43; p = 0.042), antiviral drugs (OR 2.91; 95 % CI 1.15–3.62; p = 0.009 and OR 2.76; 95 % CI 1.31–3.90; p = 0.008). As a result of treatment, an increase in DLco/Va, SpO2 after a 6-minute walk, and a decrease in the length of hospital stay were observed.   Conclusion. Detection of virus-associated infections is a promising marker for determining indications for prescribing long-acting anticholinergic drugs and beta-adrenomimetics, inhaled corticosteroids, inhalations of hypertonic sodium chloride solution, and antiviral drugs for exacerbations of COPD.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":" 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140995827","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":"Dynamics of clinical and echocardiographic parameters of patients with cardiovascular diseases 3, 12 and 26 months after COVID-19 pneumonia","authors":"E. Yaroslavskaya, V. Garanina, N. Е. Shirokov, D. Krinochkin, N. A. Osokina, I. O. Korovina, A. V. Migacheva, A. D. Sapozhnikova, T. I. Petelina","doi":"10.30629/0023-2149-2024-102-2-139-146","DOIUrl":"https://doi.org/10.30629/0023-2149-2024-102-2-139-146","url":null,"abstract":"   Aim: to study the dynamics of clinical and echocardiographic parameters in patients with cardiovascular diseases (CVD) at 3, 12, and 26 months after COVID-19 pneumonia.   Material and methods. The dynamics of clinical and echocardiographic parameters were studied in 130 patients with CVD at 3, 12, and 26 months after COVID-19 pneumonia (57 ± 8 years old, 46.9 % males).   Results. Between the 1st and 2nd visits, body mass index (BMI) increased (30.6 ± 5.1 kg/m2 vs. 31.4 ± 5.4 kg/m2, p < 0.001), the number of patients with obesity of grades 2 –3 increased (14.6 % vs. 23.1 %, p < 0.001). Early diastolic septal mitral annular velocity decreased from the 2nd to the 3rd visit (7.0 [6.0; 8.0] cm/s vs. 6.0 [5.0; 8.0] cm/s, p = 0.023), as did the maximum diastolic lateral tricuspid annular velocity (12.0 [11.0; 14.0] cm/s vs. 8.0 [6.0; 9.0] cm/s, p < 0.001). Between the 2nd and 3rd visits, the average global longitudinal strain of the left ventricle increased ( –19.3 ± 2.6 % vs. –19.8 ± 2.2 %, p = 0.034), the frequency of detecting its reduced values decreased (34.9 % vs. 17.4 %, p = 0.003).   Conclusion. In the long term after COVID-19 pneumonia, patients with CVD show an increase in BMI accompanied by worsening of diastolic ventricular function parameters without signifi cant progression in the frequency and severity of CVD.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":" 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140994877","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":"Aviation and medicine. Doctors of the aviation units of the Russian Im- perial Army in the First World War","authors":"P. E. Krynyukov, V. G. Abashin, I. I. Velichko","doi":"10.30629/0023-2149-2024-102-2-183-187","DOIUrl":"https://doi.org/10.30629/0023-2149-2024-102-2-183-187","url":null,"abstract":"   Data on the first aviation and aeronautical units of the Russian Imperial Army in the First World War are presented. Biographical information about the first air medical offi cers of these military units is given.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":" 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140996778","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 experience of using a high-intensity erbium laser for the treatment of chronic wounds","authors":"A. E. Zaitsev, O. N. Asanov, E. Z. Sandalov, A. V. Zaitseva","doi":"10.30629/0023-2149-2024-102-2-147-151","DOIUrl":"https://doi.org/10.30629/0023-2149-2024-102-2-147-151","url":null,"abstract":"   Chronic wounds are a common surgical pathology. Some types of laser radiation allow for eff ective debridement of wounds and stimulation of healing processes. High-intensity erbium laser can comprehensively aff ect tissues in all phases of the wound process, leading to accelerated healing of chronic wounds.   The aim of the study was to evaluate the eff ectiveness of using high-intensity erbium laser for treating patients with chronic wounds of various origins compared to traditional treatment.   Material and methods: An analysis of the treatment of 144 patients with chronic wounds was conducted in two groups. In the 1st group (n = 71), a high-intensity erbium laser and dressings with water-soluble ointments were used. In the 2nd group (n = 73), standard surgical treatment with similar dressings was performed. Results were evaluated using visual assessment of wound defects, planimetry, bacteriological and cytological studies, assessment of procedure tolerability, and pain intensity before and after treatment.   Results: рatients in the 1st group showed signs of healing signifi cantly earlier and more frequently achieved complete epithelialization of wounds. Laser treatment contributed to more effective decontamination of wound defects, and signs of tissue regeneration were more frequently observed in cytological images. Patients tolerated erbium laser treatment better than surgical treatment, although pain intensity after treatment did not differ between groups.   Conclusion: The study confi rmed the effectiveness of using high-intensity erbium laser for treating chronic wounds. This method can be recommended for use in surgical practice alongside other technical and pharmacological tools.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":" 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140996911","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}