Consilium Medicum最新文献

{"title":"Scabies in dermatovenerologist practice: a clinical case of delayed diagnosis in a patient with chronic dermatosis. Case report","authors":"Marina A. Ufimceva, Yurii M. Bochkarev, K. Nikolaeva, Evgenia P. Gurkovskaya, Ekaterina S. Мylnikova, Oksana M. Podkorytova","doi":"10.26442/20751753.2023.12.202249","DOIUrl":"https://doi.org/10.26442/20751753.2023.12.202249","url":null,"abstract":"Despite the current approaches to diagnostics and treatment, regulatory documentation and guidelines, the diagnosis of scabies can often be delayed. The long-term scabies can mimic acute and chronic dermatoses which causes inadequate treatment. Physicians, including dermatovenerologists, misdiagnose scabies. Aim – to clarify historical aspects of scabies, present a clinical case of scabies complicated by allergic dermatitis and lymphoplasia in a patient with Darye's disease as an example of delayed diagnosis of scabies, errors in management tactics and features of treatment of scabies in a patient with chronic dermatosis.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140250882","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":"Comorbid functional pathology in gastroenterology. Possibilities and prospects for drug treatment: A review","authors":"A. M. Osadchuk, I. D. Loranskaya, M. A. Osadchuk","doi":"10.26442/20751753.2023.12.202529","DOIUrl":"https://doi.org/10.26442/20751753.2023.12.202529","url":null,"abstract":"Functional disorders of the gastrointestinal tract (FD GT) and their intersection are relevant due to their high prevalence in the population, decrease and, in some cases, loss of performance, low quality of life and treatment difficulties. Despite the large number of consensuses and clinical recommendations at the national and international level, the effectiveness of therapy for FD GT and their overlap does not exceed 30-50%. There is a high degree of comorbidity of these diseases, called “overlap syndromes,” due to common pathogenetic mechanisms. This predetermines the need to use drugs with a multi-target therapeutic effect in the treatment of such pathology. Such drugs include trimebutine (Trimedate®), probiotics and psychotropic drugs. Data obtained in recent years on the presence of anti-inflammatory, antimicrobial, regenerative effects in relation to nervous and epithelial tissue and anti-carcinogenic effects in trimebutine make it unique for the treatment of gastrointestinal diseases and their intersection. Currently, there is a search for new promising drugs for the treatment of both individual FD GT and their overlap, as well as improving the regimens of existing treatment methods. The review article is devoted to existing opportunities and new horizons for the treatment of FD GT and their overlap.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"43 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140249166","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":"Respiratory epithelial adenomatoid hamartoma in a child with nasal polyposis. Case report","authors":"K. K. Baranov, Elena N. Kotova, Eduard O. Vyazmenov, Mikhail M. Polunin, Ludmila V. Feniksova, Elizaveta V. Pavlova","doi":"10.26442/20751753.2023.12.202508","DOIUrl":"https://doi.org/10.26442/20751753.2023.12.202508","url":null,"abstract":"Benign and malignant formations of the nose and paranasal sinuses in the early stages of development are asymptomatic or manifest minor nonspecific signs, and therefore often remain unrecognized. Hamartoma is a tumor-like formation of a dysembriological nature, consisting of excessive tissues peculiar to the affected organ. Due to the rarity of the occurrence of hamartomas of the sinonasal region, especially in pediatric practice, their diagnosis may present certain difficulties, since they can mimic other formations, such as nasal polyps or inverted papilloma, may occur as an isolated formation in the nasal cavity, or in combination with chronic rhinosinusitis, nasal polyposis, allergic rhinosinusitis. Aim – to report a rare clinical case in pediatric practice of respiratory epithelial adenomatoid hamartoma associated with allergic rhinosinusitis and polyposis, display the relationship between the occurrence of respiratory epithelial adenomatoid hamartoma and chronic inflammation of the nasal cavity and paranasal sinuses, to carry out differential diagnosis with other exophytic aggressive lesions of the nasal cavity, combine and summarize available data on sinonasal hamartomas. The article describes a clinical case of respiratory epithelial adenomatoid hamartoma in a 17-year-old child with a previous 4-year follow-up with nasal cavity polyposis and a history of repeated polypotomy. The results of endoscopy and computed tomography of the nasal cavity and paranasal sinuses, the results of surgical intervention, as well as the conclusions of a histological examination of the tumor removed from the patient are presented. The authors analyzed the domestic and foreign literature, on the basis of which they presented a differential series of sinonasal hamartomas. Respiratory epithelial adenomatoid hamartoma is a rare pathological formation of the sinonasal region, which manifests itself as an isolated polypoid mass in the nasal cavity or as an accidental surgical finding in patients with chronic sinusitis. The association with nasal polyps supports the hypothesis that inflammation may be one of the inducing factors. Respiratory epithelial adenomatoid hamartoma, although rare, should be considered in the differential diagnosis of exophytic lesions of the nasal cavity. The tactics of treatment involves endoscopic removal of the formation within healthy tissues, which provides good long-term results, relapses are extremely rare.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"116 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140250779","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":"Development of polyresistance in microorganisms during antibiotic therapy in a multidisciplinary hospital during a pandemic COVID-19","authors":"N. Esaulenko, Olga V. Tkachenko, S. Kazakov, D.V. Davydov, A. Zaytsev, Sergey А. Chernov","doi":"10.26442/20751753.2023.12.202536","DOIUrl":"https://doi.org/10.26442/20751753.2023.12.202536","url":null,"abstract":"Background. Irrational and excessive use of antimicrobials drugs (AMD) creates conditions for the development of a global crisis of health systems around the world associated with antibiotic resistance. \u0000Aim. To conduct a retrospective study of the impact of the use of AMD on the change in the microbiological landscape and the sensitivity of microorganisms in the conditions of pandemic of the new coronavirus infection (COVID-19) in 2020–2021 in intensive care departments (ICD) of a multidisciplinary hospital. \u0000Materials and methods. In the course of the work, strains of microorganisms isolated from patients and from the surfaces of the hospital environment and changes in their sensitivity to significant groups of AMD in ICD for somatic and infectious patients with COVID-19 were compared. The sensitivity of the isolates was evaluated in accordance with the criteria of requirements of European Committee on Antimicrobial Susceptibility Testing – EUCAST, version 10.0, 2020. \u0000Results. A total of 1,394 isolates were studied, including 1,379 clinical and 15 isolates from the surfaces of the hospital environment. It was found that in all ICD in 2020–2021, gram-negative microorganisms prevailed in infectious loci in 70% of cases or more. In 2021, in the ICD in infectious patients with COVID-19, the persistent dominance of the Acinetobacter baumannii microorganism was revealed with an increase in the number of poly- and pan-resistant strains – 48.7%. While in the ICD for somatic patients Klebsiella Pneumoniae prevailed among gram-negative microorganisms – 37.5% in 2020 and 43.7% in 2021. It has been shown that in one department or in adjacent departments of the same medical institution, various nosocomial microorganisms with an unequal set of resistance genes and sensitivity to AMD may appear over time. \u0000Conclusion. The necessity of conducting constant microbiological monitoring and a passport of the medical department with mandatory registration of not only isolated strains of microorganisms, but also resistance genes in order to optimize the appointment of timely adequate empirical antimicrobial therapy is substantiated. The period of the latter should be as short as possible, and confirmed by convincing clinical signs of bacterial infection, and subsequently by the isolation of nosocomial flora from the biomaterial of critical loci from patients.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"116 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140250788","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":"Motivation of the patient to perform aesthetic rhinosurgical intervention, topical issues in identifying the true reasons: A review","authors":"I. I. Sarkisyan, A. A. Krivopalov, M. Korkmazov, Arsen M. Мусосович, Mohammed Abdulmalek Atef","doi":"10.26442/20751753.2023.12.202511","DOIUrl":"https://doi.org/10.26442/20751753.2023.12.202511","url":null,"abstract":"From time immemorial, people have sought to improve their body and appearance by resorting to various medical, non-drug and surgical interventions. The most advanced direction in this context has been and remains facial cosmetic surgery, which, being a kind of standard that allows you to achieve perfection, encourages people to change their appearance in an operative way, which is not always justified. The most common and sought after desire of people when visiting a plastic surgeon is to change the shape of the nose. The main motive for rhinoplasty is low self-esteem, dissatisfaction with the shape and size of the nose, which, in their opinion, prevents them from achieving success in their personal lives, building a career, etc. As a rule, most of these people are people of ethnic groups who seek to “Europeanize” their nose and face according to modern aesthetic canons, people with dysmorphophobia, young girls and boys. Often there are cases when patients, having not received the desired result, make claims to surgeons and embark on litigation. Therefore, when planning rhinoplasty, it is necessary to find out several important questions: the main psychological reasons that motivated rhinoplasty; whether the patient has mental deviations what are the external influences and internal deviations. Patients presenting with the following features are at high risk and should give surgeons reason to reconsider their rhinoplasty.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"135 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140249671","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":"Glucocorticosteroids for community-acquired pneumonia (execution cannot be pardoned): A review","authors":"A. Zaytsev","doi":"10.26442/20751753.2023.12.202509","DOIUrl":"https://doi.org/10.26442/20751753.2023.12.202509","url":null,"abstract":"The publication discusses the use of glucocorticosteroids in community -acquired pneumonia. A critical analysis of the appropriateness of their application is given, the results of clinical studies devoted to systemic steroids in community-acquired pneumonia, modern recommendations for their use in a number of clinical situations.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"92 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140250307","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 and economic analysis of the application of the method of three-dimensional reconstruction of lung tissue in the practice of tuberculosis institution","authors":"Aleksey G. Naumov, Alexander S. Shprykov, Natalya Yu. Borodina","doi":"10.26442/20751753.2023.12.202542","DOIUrl":"https://doi.org/10.26442/20751753.2023.12.202542","url":null,"abstract":"Background. The use of clinical and economic analysis in practical healthcare allows for a more rational use of the resources allocated by the state and contributes to the achievement of optimal indicators in terms of the quality of disease identification and the effectiveness of its treatment. \u0000Aim. To conduct a clinical and economic analysis of the prospects for introducing the 3D lung reconstruction method into tuberculosis practice, which is used to correct the level of adherence, reduce the severity of symptoms of anxiety and depression, and increase the effectiveness of chemotherapy. \u0000Materials and methods. In this scientific work, the results of treatment (more than 90 people) of newly diagnosed patients with destructive pulmonary tuberculosis, which were observed in the Nizhny Novgorod Regional Clinical Tuberculosis Dispensary, were used. The patients were divided into two groups. For the 1st group of patients, tactile lung models were made, among them a questionnaire was conducted using the MMAS-4 questionnaire and the HADS scale. For patients of the 2nd group, lung models were not made, and no survey was conducted. Each group was assessed the effectiveness of chemotherapy. Clinical and economic analysis of the cost of introducing the method of three-dimensional lung reconstruction into tuberculosis practice was carried out on the basis of two evaluation criteria «cost – effectiveness» and «cost-effectiveness increment» with additional mathematical calculations of the necessary indicators. The results obtained were compared with the existing known method of increasing adherence to tuberculosis treatment - the issuance of food packages. \u0000Results. Based on the results of the study, it was proved that the use of tactile models of the lungs in phthisiatric practice is more than 8 times cheaper than the method of issuing food kits with, in fact, comparable results of treatment effectiveness. If there is a need to increase the effectiveness of the treatment of tuberculosis patients by increasing the subsidy of food packages, the cost of one additional percent of efficiency is not economically viable. \u0000Conclusion. The clinical and economic analysis of the prospects for introducing the method of three-dimensional lung reconstruction into phthisiatric practice presented in the paper looks promising, which is confirmed by the performed mathematical calculations and comparisons, and can be recommended for use in the routine practice of phthisiatricians to correct the level of adherence of tuberculosis patients to chemotherapy, reduce the severity symptoms of anxiety and depression, as well as an increase in the effectiveness of treatment.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"112 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140250695","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":"Microbiota of the upper respiratory tract in children with chronic adenoiditis","authors":"I. Andriyanova, Natalya A. Ilyenkova, S. G. Vakhrushev, Natalia Iu. Romanova","doi":"10.26442/20751753.2024.12.202570","DOIUrl":"https://doi.org/10.26442/20751753.2024.12.202570","url":null,"abstract":"Background. Routine application of the GC-MS method to assess the URT microbiota can potentially improve the efficacy and safety of treatment for chronic respiratory diseases. \u0000Aim. To perform a comparative analysis of the microbiota from the surface of the pharyngeal tonsil, from the deep parts of the nose, and saliva in children with chronic adenoiditis. \u0000Materials and methods. The study included 90 patients with chronic adenoiditis (CA) and/or pharyngeal tonsil hypertrophy (PTH). All study participants had swabs taken from the surface of the pharyngeal tonsil, from the deep parts of the nasal cavity, and saliva as a biological fluid of the oral cavity. Microorganisms were identified by specific fatty acids using GC-MS to assess the composition of the microbial community on the surface of the pharyngeal tonsil. \u0000Results. The study showed that the microbiota of the nasopharynx is identical in its qualitative composition to microorganisms from the deep parts of the nose. However, according to the results of the analysis of microbial markers of saliva, the oral microbiota showed significant differences in the quantitative and qualitative composition of microorganisms compared with the nasopharyngeal microbiota. \u0000Conclusion. The introduction of the GC-MS method for assessing the URT microbiota enables its monitoring in clinical practice for the treatment of chronic respiratory system diseases without disturbing the ecology of the mucous membranes and the whole body.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"119 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140250494","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":"Psycho-emotional state during pregnancy and one year after childbirth in mothers of children with functional gastrointestinal disorders","authors":"E. I. Griaznova, Maria I. Dubrovskaya, A. Turchinskaya, Alexandra S. Botkina, Tatiana A. Kovtun","doi":"10.26442/20751753.2023.12.202534","DOIUrl":"https://doi.org/10.26442/20751753.2023.12.202534","url":null,"abstract":"Aim. To determine the relationship between the incidence of functional gastrointestinal disorders in children up to 1 year of age and the psycho-emotional state of their mothers during pregnancy and after childbirth. \u0000Materials and methods. A survey of 1203 mothers of children under 4 years of age was conducted using a questionnaire of functional gastrointestinal disorders according to the Rome IV criteria (2016). The questionnaire contained domains on general issues (the age of the mother at the time of the child's birth, the data of obstetric and gynecological anamnesis, the type of child's nutrition at the time of the survey), psycho-emotional state (retrospectively, the psychological component of the gestational dominant – PСGD – during pregnancy, Beck's anxiety and Beck's depression questionnaires) and questions on functional disorders in infants and young children. \u0000Results. Questionnaires of 487 mothers of children of the 1st year of life were analyzed. Only in 34.4% of cases, mothers' responses lacked anxious and depressive PCGD. In mothers with anxious PСGD, the risk of regurgitation in their children was statistically significantly 2-fold higher compared to mothers with depressive PСGD. In mothers with optimal PСGD, the rate of colic in their children was statistically significantly 2-fold lower compared to mothers with anxious and depressive PСGD. After childbirth, anxiety was noted in 17% mothers and signs of depression in 59% mothers. Significant and severe depression was diagnosed in 10% mothers; the children of these mothers had persistent regurgitation.. In the absence of depression in mothers, the probability of no regurgitation and colic in their children was statistically significantly 2-fold higher compared to the children of mothers with depression. \u0000Conclusion. The incidence of functional gastrointestinal disorders in a child up to 1 year of age is associated with maternal anxiety during pregnancy and maternal depression after childbirth.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"51 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140249056","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":"Vegetative disorders in anxiety disorder: A review","authors":"Vladislav Y. Marchenko, D. Petelin","doi":"10.26442/20751753.2023.11.202486","DOIUrl":"https://doi.org/10.26442/20751753.2023.11.202486","url":null,"abstract":"Vegetative disorders are characteristic of patients with anxiety disorders, which are becoming more common and negatively affect the quality of life of both the patients themselves and their environment. Almost 20% of the population suffers from anxiety disorders, and women are more prone to these diseases than men. Anxiety disorders include panic disorder, generalized anxiety disorder, and other disorders. In most cases, anxiety disorders are accompanied by vegetative symptoms, such as palpitations, sweating, trembling, changes in appetite and others. Vegetative disorders often mimic somatic and neurological disorders in patients with anxiety disorders, therefore they create problems for diagnosis. In our country, a significant part of patients with anxiety disorders are observed by neurologists with a diagnosis of somatoform dysfunction of the autonomic nervous system or autonomic dystonia. The therapy of the underlying disease, which includes lifestyle optimization, psychotherapy and medications, is of leading importance in reducing vegetative disorders.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"103 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140260971","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}