Consilium Medicum最新文献

{"title":"Experience in using Aterixen® in clinical practice. Results of the \"SUPRA\" observation program","authors":"Irina T. Kulagina, Madina I. Bagaeva","doi":"10.26442/20751753.2023.9.202401","DOIUrl":"https://doi.org/10.26442/20751753.2023.9.202401","url":null,"abstract":"Background. The new medical product Aterixen (XC221GI) has appeared on the pharmaceutical market in 2022. It was revealed, at preclinical stage, that the main anti-inflammatory drug's effect was assured by its effect on production of anti-inflammatory cytokines IL-6, IL-8 and chemokines IP-10 (CXCL10), MIG (CXCL9). The results of double-blind randomized placebo-controlled studies have shown high efficacy of the drug in the management of patients with new coronavirus infection (COVID-19) of different severity.
 Aim. To evaluate experience of Atherixen practical use among physicians and general practitioners.
 Materials and methods. The observational program included patients aged from 18 to 60 years with confirmed diagnosis of mild COVID-19. All patients have signed voluntary informed consent to participate in the study. The study consisted of 2 periods: screening period and drug administration period. All patients received Aterixen (100 mg tablets), 1 tablet 2 times per day for 14 days within the standard therapy outlined in the Temporary methodological recommendations on prevention, diagnosis, and treatment of COVID-19. Efficacy was assessed by mean disease duration and physician and patient treatment satisfaction via five-point Likert scale.
 Results. The average disease duration did not exceed 9.5 days. It indicates the ability of Aterixen to prevent the transition of the disease to moderate and severe forms. The degree of physician and patient treatment satisfaction via five-point Likert scale in the vast majority of cases corresponded to the highest grades. Moreover, no adverse events were reported during the study and all patients had high tolerability.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"126 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135803716","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":"Functional and organic dysphonia in voice professionals (lecture)","authors":"Julia E. Stepanova","doi":"10.26442/20751753.2023.9.202387","DOIUrl":"https://doi.org/10.26442/20751753.2023.9.202387","url":null,"abstract":"An urgent task of otorhinolaryngology (phoniatry) is the diagnosis and treatment of disorders of voice function in voice professionals or persons of voice-speech professions. An undiagnosed laryngeal disease worsens the quality of life of patients, creates difficulties in communication and can even lead to professional unfitness, because the patient does not withstand the necessary vocal load. The leading role in the modern diagnosis of laryngeal diseases belongs to endoscopic research methods video endoscopy and video endostroboscopy. All disorders of voice function are classified as functional and organic. Recent studies have shown that from 30.5 to 40% of voice professionals who have applied for phoniatric care suffer from functional disorders. Functional changes are understood to mean changes in which laryngoscopic examination does not always reveal any visible pathology. But with the help of special research methods, such as stroboscopy (videostroboscopy), spectral analysis of the voice, pathognomonic changes can be determined, and the patient presents characteristic complaints. More often than others, hypotonic and hypo-hypertonic dysphonia are diagnosed. Organic laryngeal diseases are characteristic of 69.5% of patients with dysphonia. They are represented by various nosological forms. Certain difficulties arise in the diagnosis of professional laryngitis and vascular pathology of the larynx. The lecture presents pathognomonic clinical changes of the larynx in voice professionals, knowledge of which is necessary for practical doctors to make a diagnosis.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135803526","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":"Exacerbation of chronic obstructive pulmonary disease: discussion of controversies. A review","authors":"Andrey A. Zaytsev","doi":"10.26442/20751753.2023.9.202393","DOIUrl":"https://doi.org/10.26442/20751753.2023.9.202393","url":null,"abstract":"The paper discusses the controversial issues of infectious exacerbation of chronic obstructive pulmonary disease. Researchers and practitioners share a common understanding of rational patient management, which involves the evolution of exacerbation terminology, the impact of viral infection and air pollutants, the significance of biomarkers, and the appropriate antibiotic therapy regimens. Clinical reflections on the current causes of chronic obstructive pulmonary disease exacerbations and modern therapeutic options are presented.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135803697","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":"Differentiated approach to diagnosis and treatment to combined pathology of the pharynx, larynx and rhino-orbital zone: interdisciplinary interaction","authors":"Konstantin K. Baranov, Elena N. Kotova, Eduard O. Vyazmenov, Artem A. Protasov","doi":"10.26442/20751753.2023.9.202416","DOIUrl":"https://doi.org/10.26442/20751753.2023.9.202416","url":null,"abstract":"Background. The main complaint of patients with inflammatory diseases of the pharynx is a sore throat; rhino-orbital pathology, in turn, is manifested by symptoms associated with impaired nasal breathing, lacrimal drainage and other ophthalmological disorders. With pathology of the larynx, dysphonia is often present. As a rule, such patients initially fall into the hands of general practitioners, therapists and pediatricians, less often otolaryngologists, however, periodically the clinical situation requires the involvement of other specialists and additional laboratory and instrumental studies. The article presents a number of clinical observations of patients with combined pathology of the pharynx, larynx and rhino-orbital zone, who initially turned to an otolaryngologist, who subsequently required a team approach from various specialists.
 Aim. Demonstration of a differentiated approach to the diagnosis and treatment of combined pathology of the pharynx, larynx and rhino-orbital zone within the framework of interdisciplinary interaction of specialists based on clinical observations of patients.
 Materials and methods. We observed 5 patients who initially sought consultation with an otorhinolaryngologist with complaints of pain or discomfort in the throat, impaired nasal breathing, lacrimal drainage, itching in the eye area, and dysphonia.
 Results. The article presents clinical cases of syphilis, leptotrichosis of the oropharynx, herpesvirus infection type VI, infectious mononucleosis, infectious-toxic paresis of the larynx, the diagnosis and treatment of which was carried out through interdisciplinary interaction of otorhinolaryngologists with doctors of other specialties. The presented observations demonstrate that, despite the reason for treatment, patients with combined pathology of the pharynx, larynx and rhino-orbital zone require the help of not only otolaryngologists, but also other specialists, primarily infectious disease specialists.
 Conclusion. In order to improve the quality of diagnosis, routing and treatment of patients with combined pathology of the pharynx and rhino-orbital zone, it is necessary to develop interdisciplinary interaction and create conditions for expanding the professional erudition of doctors dealing with the problems of pathology of the same anatomical areas.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135803704","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":"Comparative analysis of methods for creating virtual three-dimensional models of the lungs from computed tomography images in the practice of a tuberculosis organization using Materialise software","authors":"Aleksey G. Naumov, Alexander S. Shprykov, Dina A. Sutyagina, Evgenii S. Grinin","doi":"10.26442/20751753.2023.9.202386","DOIUrl":"https://doi.org/10.26442/20751753.2023.9.202386","url":null,"abstract":"Background. One of the important conditions for the final victory over tuberculosis is not only the prevention of its development and early detection, but also the provision of high-quality personalized medical care to the patient. Additive technologies and virtualization technologies are ways to fully reveal this principle in phthisiatric practice.
 Aim. Demonstrate the possibilities and evaluate the labor costs (time spent on virtualization and the size of the final digital files of models) while working with the Mimics inPrint 2.0.0.159 and Mimics Medical 21.0.0.406 software systems in the aspect of virtual reconstruction of the lungs of a patient with a destructive form of tuberculosis.
 Materials and methods. A comparative analysis of methods for creating virtual three-dimensional models of the lungs from CT images was carried out at the Nizhny Novgorod Regional Clinical Tuberculosis Dispensary. The study involved one patient with a destructive form of tuberculosis of the upper lobe of the left lung. Virtual three-dimensional models were made according to a specially developed algorithm. The time spent for the formation of virtual lung models was analyzed using the built-in function in the \"Log\" software. The analysis of the size of the obtained virtual lung models in the STL format was carried out using the operating system function from the Windows family \"Properties\", section \"General\", subsection \"Size\".
 Results. The most practical software package for virtual lung reconstructions turned out to be Mimics inPrint 2.0.0.159 with the result of the time spent on creating a model of 2 minutes (Mimics Medical 21.0.0.406 7 minutes 17 seconds) and a model size of 125 megabytes (Mimics Medical 21.0.0.406 26.1 megabyte). The technical nuances and algorithms of lung reconstruction covered in the article using the Mimics inPrint 2.0.0.159 and Mimics Medical 21.0.0.406 software packages will allow the interested person not to make a mistake in realizing their scientific and practical interests in the process of providing personalized care to the patient. The article focuses on the main advantages of the Mimics inPrint 2.0.0.159 software package in comparison with Mimics Medical 21.0.0.406. A brief description of similar programs is given.
 Conclusion. The studied software systems successfully coped with the goal assigned to them, which concerned the demonstration of their capabilities and the assessment of labor costs for virtualization. Mimics inPrint 2.0.0.159 turned out to be the most understandable and promising software and application complex for use in everyday clinical practice.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"234 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135803872","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":"Therapy of tonsillopharyngitis: advantages of an integrated approach. A review","authors":"Sergey V. Ryazantsev, Galina S. Maltseva, Svetlana S. Vysockaya","doi":"10.26442/20751753.2023.9.202407","DOIUrl":"https://doi.org/10.26442/20751753.2023.9.202407","url":null,"abstract":"The problem of pain in the pharynx continues to be the focus of attention of scientists and practitioners for many decades. Despite the emergence of modern methods of diagnosis and treatment, the problem of pharyngoalgia is far from being solved. It has now been established that more than 500 possible etiological factors can be the cause of pharyngoalgia, but the leading place is occupied by inflammatory diseases of the pharynx and palatine tonsils. Taking into account the wide distribution of this nosology among the population and the high risk of complications, especially in childhood, the issues related to the search for effective therapeutic regimens and ways to prevent the development of complications are still relevant. Definitely, the treatment should be safe, comprehensive, justified and individually selected in each case. Adequate therapy started in time allows avoiding the development of adverse effects, reducing the treatment time and improving the patient's quality of life. And for a doctor, it is extremely important to know the differences in the clinical picture of pharyngoalgia caused by different types of microorganisms: bacteria, viruses or fungal flora, since these differences will be decisive in the further tactics of treating the patient. This article is devoted to highlighting the issues of the complex use of the lysine salt of ketoprofen in local and systemic form. The parameters of the analgesic and anti-inflammatory action of the lysine salt of ketoprofen are characterized, and a new scheme for the treatment of inflammatory diseases of the pharynx within a single molecule is proposed. The article also pays attention to the prevention of complications and relapses, and discusses the advantages of the drug pidotimod in immunomodulatory therapy.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"2011 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135803834","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":"Microsurgery of chronic laryngeal diseases using fiber optic lasers. A review","authors":"Aleksandr A. Krivopalov, Polina A. Shamkina, Alexandra I. Glushchenko","doi":"10.26442/20751753.2023.9.202418","DOIUrl":"https://doi.org/10.26442/20751753.2023.9.202418","url":null,"abstract":"Background. The treatment of chronic diseases of the larynx is an urgent issue. Chronic larynx masses account for up to 5570% of the upper respiratory tract proliferative diseases. The incidence of vocal apparatus disorders is stable due to increased load on the vocal apparatus, neuro-emotional stress, non-compliance with voice hygiene (smoking, alcohol consumption), nasal and pharyngeal inflammatory diseases, sensibilization, and gastrointestinal disorders. Dysphonia, voice timbre changes, and vocal fatigue are presented in 712% of otorhinolaryngologist patients. Delayed treatment of chronic larynx diseases can lead to upper respiratory obstruction, reduced exercise and self-care tolerance, and disablement in people with voice and speech professions.
 Aim. To address current treatment methods for chronic diseases of the larynx. Modern surgical and non-surgical treatments of chronic larynx diseases aim to restore voice quality and respiratory function. Over the past 50 years, laser-assisted phonosurgery has gained popularity due to the many benefits of biological tissue exposure to electromagnetic energy and low rates of intra- and postoperative complications.
 Materials and methods. The literature review was performed using electronic medical libraries and professional printed papers. According to local and foreign data, laryngeal laser surgery is highly precise, minimally invasive, associated with no blood loss, and highly effective. Historically, CO2 laser has been used for the longest time in laryngeal surgery. Modern medical technology has recently introduced surgical systems with novel technicalities for clinical use. In such devices, the laser energy is transmitted through a flexible optical fiber instead of a mirror system, as in the CO2 laser, which has made new surgical high-energy systems more affordable for equipping medical institutions. Currently, the following fiber-optic laser systems are most often used to treat chronic diseases of the larynx: potassium-titanyl-phosphate, diode laser, and \"blue\" laser with a wavelength of 445 nm.
 Results. The literature review and analysis of surgical treatment outcomes using fiber-optic laser devices in patients with chronic larynx diseases showed high safety and effectiveness of modern treatments, providing fast recovery of voice and respiratory function.
 Conclusion. The development of laser devices, including domestic ones, with new wavelengths, makes it possible to work in contact mode in an inert gas environment, which opens up new opportunities for phonosurgery.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135803986","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":"Radical surgery on the middle ear in the treatment of cholesteatoma: history or reality? A review","authors":"Vadim S. Isachenko, Vladimir V. Dvorianchikov, Sergey Y. Ognetov, Kseniya I. Sotnikova, Dolgorma A. Tsydypova","doi":"10.26442/20751753.2023.9.202417","DOIUrl":"https://doi.org/10.26442/20751753.2023.9.202417","url":null,"abstract":"Radical surgery on the middle ear is primarily associated with such pathology as cholesteatoma and ear neoplasms. And if in the case of tumors radicalism in ear surgery is justified, then in the surgery of the cholesteatomic process there is a need to discuss this issue. The existence of acquired cholesteatoma was recognized more than three centuries ago. Without timely detection and intervention, cholesteatomas can increase to gigantic sizes and lead to numerous intracranial and extracranial complications. Due to its aggressive growth, invasive nature and potentially fatal consequences of intracranial complications, acquired cholesteatoma remains the cause of morbidity and death in those who do not have access to advanced medical care. Currently, there are no effective non-surgical methods of treatment. The article provides a brief overview of the main issues related to acquired middle ear cholesteatoma, and discusses the practical","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"87 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135803833","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":"Community-acquired pneumonia: antibiotic therapy approach after the COVID-19 pandemic. A review","authors":"Andrey A. Zaytsev, Igor A. Guchev","doi":"10.26442/20751753.2023.9.202408","DOIUrl":"https://doi.org/10.26442/20751753.2023.9.202408","url":null,"abstract":"Pneumonia is clearly differentiated from other focal inflammatory lung diseases of non-infectious origin. A patient with community-acquired pneumonia (CAP) should receive antibacterial drugs no later than 4 hours after the diagnosis. Initial antibacterial therapy in CAP should be based on factors affecting the potential causative agents and the risk of drug-resistant microorganisms. Rational use of amoxicillin in terms of dose and frequency in CAP patients without severe comorbidities and risk factors for PES pathogens, the use of -lactam in combination with a macrolide or moxifloxacin monotherapy in high-risk groups of patients is the most effective strategy of empirical antibacterial therapy.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"81 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135803835","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":"Rational mucolytic therapy with ambroxol: controversial and indisputable. A review","authors":"Sergey L. Babak, Marina V. Gorbunova, Andrey G. Malyavin","doi":"10.26442/20751753.2023.9.202405","DOIUrl":"https://doi.org/10.26442/20751753.2023.9.202405","url":null,"abstract":"Many years of experience in the use of ambroxol is based on its ability to regulate the basic mechanisms of physiological production and transport of bronchial mucus. The main indication for ambroxol is the mucolytic therapy of acute and chronic bronchopulmonary diseases associated with hypersecretion and impaired mucus transport. Ambroxol has a number of the following properties: high secretolytic activity (promotes mucus clearance, facilitates expectoration of sputum, reduces productive cough); anti-inflammatory and antioxidant activity; local analgesic (anesthetic) effect through the blockade of sodium channels of cell membranes. The effect of anesthesia of the mucous membranes is attributed to the new pharmacological action of ambroxol, useful in the treatment of acute respiratory tract infections. The efficacy and safety of ambroxol in clinical practice has been confirmed by half a century of experience in its administration. The purpose of this publication was an up-to-date assessment of the controversial and indisputable chemical, pharmacological, clinical data on the properties of ambroxol in the concept of modern recovery mucolytic therapy that can improve the therapy and prognosis of patients with tracheobronchial secretion hypersecretion, impaired mucociliary clearance and unproductive cough.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135803532","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}