Consilium Medicum最新文献

{"title":"Features of the motor function of the gastrointestinal tract at the cross-functional pathology","authors":"A. E. Lychkova, A. Samsonov, D. N. Andreev, E. I. Kuznetsova","doi":"10.26442/20751753.2023.5.202210","DOIUrl":"https://doi.org/10.26442/20751753.2023.5.202210","url":null,"abstract":"Aim. To identify the role of impaired motor function of the gastrointestinal tract (GIT) in the overlap of functional disorders (FD). \u0000Materials and methods. Thirty-two abdominal FD patients were followed up, with a predominance of women aged 33.76.1 years (75%). Men aged 31.85.6 years were 25%. All patients had symptoms of GIT FD established according to the Rome IV criteria, endoscopy, and abdominal ultrasound. In addition, patients underwent 2-hour pH-metry and electromyography of the abdominal organs using bipolar silver electrodes with a surface area of 0.50.6 cm2. The amplitude-frequency characteristics of slow waves and spikes and the power of phase and tonic contractions were analyzed using the Canon M hardware and software complex with a transmission frequency of 0.1 to 10 Hz and a noise level of 15 W. \u0000Results. Overlapping clinical symptoms of motor disorders in gastrointestinal tract functional disorders are observed at a young age, mainly in women. The abnormal ratio of the gallbladder and common bile duct motility in overlapping GIT FD was 1:1.08, with a pronounced increase in contractions of the common bile duct, which could lead to an increase in pressure in the biliary system, pain, and insufficient flow of bile to the duodenum, disrupting the digestion and worsening the dyspepsia. \u0000Conclusion. The study showed a tendency for higher incidence of functional disorders in young women. Patients with overlapping disorders also have more severe pain than those with isolated disorders.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44285222","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":"Outcomes of the use of the glycosaminoglycan-peptide complex as monotherapy and in combination with diacerein for the treatment of knee osteoarthritis in real-world practice","authors":"A. Karateev, E. Polishchuk, A. Potapova, E. V. Matyanova, E. Filatova, S. Glukhova, A. Lila","doi":"10.26442/20751753.2023.2.202135","DOIUrl":"https://doi.org/10.26442/20751753.2023.2.202135","url":null,"abstract":"Background. Slow-acting symptomatic agents (chondroprotectors) in osteoarthritis (OA) combined therapy is a promising approach. \u0000Aim. To compare the real-world results of combined therapy with glycosaminoglycan-peptide complex (GPC) and diacerein with GPC monotherapy in treating knee OA. \u0000Materials and methods. Statistical analysis of the data obtained during the observational, non-interventional study was conducted. The study group included 9190 patients with OA, 69.0% females, age 60.911.4, with moderate/severe pain (4 using a 010 numerical rating scale). Of these, 6199 received a combination of GPC (Rumalon, at least 20 intramuscular injections per course) + diacerein (Diaflex Rompharm) 100 mg/day, and 2991 patients received GPC monotherapy. The following indicators were evaluated: the change of pain during movement, at rest, and at night, the overall health assessment (using a 010 numerical rating scale), the number of patients with a pain reduction of 50% from the baseline, the patient's assessment of the treatment result using a 05 scale, a decrease in the need for non-steroidal anti-inflammatory drugs 2 months after the start of therapy. \u0000Results. The improvement of clinical indicators was more significant in patients who received a combination of GPC + diacerein, compared with GPC monotherapy: the decrease in pain during movement was 3.11.5 and 2.61.3, at rest 1 [0; 2] and 1 [0; 1], at night 2 [1; 4] and 2 [1; 3], the overall health assessment was 3.71.7 and 3.21.8, respectively (for all indicators p0.001). The percentage of patients with a 50% reduction in pain was 66.0 and 60.0% (p0.001), the assessment of treatment results was \"good\" or \"excellent\" in 62.1 and 42.9% (p0.001), a decrease in the need for non-steroidal anti-inflammatory drugs was reported in 60.9 and 57.1% (p=0.001) of patients, respectively. \u0000Conclusion. The therapeutic effect of the combination of GPC + diacerein in patients with OA is significantly higher than that of GPC monotherapy.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49134456","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":"Torsion dystonia type 30. Clinical observation. Case report","authors":"Artur Sh. Latypov, S. Kotov, E. Proskurina, O. Sidorova, E. S. Novikova, I. Vasilenko, Darya V. Cassina","doi":"10.26442/20751753.2023.2.202222","DOIUrl":"https://doi.org/10.26442/20751753.2023.2.202222","url":null,"abstract":"A 58-year-old patient with type 30 dystonia (OMIM619291) detected by genome-wide sequencing was described. A variant of rs778751388, not previously described in the literature, has been identified in the heterozygous state in exon 2 of 24 of the VPS16 gene, leading to the amino acid substitution of P.Cys36A4rg. DNA change (HG38)(protein change) 20:g.2859771TC ENST00000380445.8:c.106TC ENSP00000369810.3:p.Cys36Arg. The patient's disease began quite late, in the 4th decade of life, with spastic torticollis. Subsequently, the spread of the pathological process involving the muscles of the neck, the right upper limb, then the right lower limb, myoclonia of the right hand and tremor of the right lower limb was noted. Secondary mitochondrial disorders were revealed in the form of an increase in the level of lactate in the blood before and after loading with carbohydrates. A decrease in the activity of mitochondrial enzymes in peripheral blood lymphocytes was also revealed: succinate dehydrogenase, an enzyme of the mitochondrial respiratory chain complex II; -glycerophosphate dehydrogenase involved in mitochondrial fat metabolism; glutamate dehydrogenase (amino acid metabolism in mitochondria). The level of lactate dehydrogenase in peripheral blood lymphocytes in the patient was elevated. The identified secondary mitochondrial disorders may be an indication for the appointment of energotropic medicines along with levodopa drugs and dopaminergic receptor agonists. In the presented observation, it can be argued about autosomal dominant inheritance, since the patient has a characteristic clinical picture of the disease and a mutation in the heterozygous state in the VPS16 gene was detected.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42752280","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":"Baker's cyst: etiopathogenesis, clinical picture, differential diagnosis of complications: A review","authors":"V. V. Lyalina, E. A. Skripnichenko, S. Borisovskaya, Ruslan N. Obyedkov, F. L. Lazko, Roman Iu. Yudin, Victoria G. Saltykova, I. Nikitin","doi":"10.26442/20751753.2023.2.202139","DOIUrl":"https://doi.org/10.26442/20751753.2023.2.202139","url":null,"abstract":"Bakers cyst (BC) is a common condition and can be caused by both inflammatory and non-inflammatory disorders. Small BCs are usually asymptomatic and accidentally revealed. Large BCs present with pain and discomfort in the posterior knee as well as certain limitations of mobility. Large BCs may rupture resulting the fluid efflux down into the calf, which in turn presents with acute pain and number of potential thrombotic and neural complications. On another note, BC rupture requires differentiation with some urgent conditions such as venosus or arterial thrombosis, soft tissue infections etc. In this article we present some aspects of the etiopathogenesis, clinical signs and course of the BC. We also discuss the problematic issues of assessment and diagnostic work-up in case of BC ruptures.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46164489","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":"Group B vitamins: prospective for multidisciplinary application: A review","authors":"Liubov A. Kuzina, Gulnaz S. Kaishibaeva","doi":"10.26442/20751753.2023.2.202239","DOIUrl":"https://doi.org/10.26442/20751753.2023.2.202239","url":null,"abstract":"Group B vitamins are used in various fields of medicine, most commonly in treating diseases of the peripheral and central nervous system, especially in treating pain. Group B vitamins are neurotropic agents; they play an essential role in the functioning of cells, acting as coenzymes in a wide range of catabolic and anabolic enzymatic reactions. They play a role in numerous processes of nervous tissue functioning, including energy production, DNA/RNA synthesis/repair, genomic and non-genomic methylation, and synthesis of many neurochemicals and signaling molecules, which ensures the normal functioning of the central and peripheral nervous system. Among all the B vitamins, these properties are most inherent in thiamine (B1), pyridoxine (B6), and cyanocobalamin (B12).","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45079147","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":"Cognitive disorders in patients with atrial fibrillation: A review","authors":"V. A. Parfenov","doi":"10.26442/20751753.2023.2.202220","DOIUrl":"https://doi.org/10.26442/20751753.2023.2.202220","url":null,"abstract":"Cognitive disorders (CD) represent one of the leading causes of disability among the elderly. Atrial fibrillation (AF) is an independent and corrected risk factor for CD and dementia. The development of CD with AF is associated with the occurrence of cerebral infarcts, silent infarcts, cerebral micro and macro hemorrhages, a cerebral small vessels disease, cerebral hypoperfusion, and comorbid neurodegenerative disease. The prevention of the first and recurrent ischemic stroke (IS) is the leading importance in preventing the development and progression of the CD in AF, which include the use of the vitamin K antagonists (VKA) and new oral anticoagulants (the NOACs apixaban, dabigatran, rivaroxaban, edoxaban), control of arterial pressure and other methods of prevention. The use of the NOACs is more effective than using VKA, reduces the risk of CD and dementia. The use of individual NOACs, various methods for the prevention of CD and Alzheimer's disease in patients with AF are discussed.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41780034","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":"New therapeutic opportunities in management of patients with joint hypermobility syndrome and synovitis. Clinical example: A review","authors":"Yulia S. Filatova, Alexey M. Gruzdev, V. R. Gauert","doi":"10.26442/20751753.2023.2.202211","DOIUrl":"https://doi.org/10.26442/20751753.2023.2.202211","url":null,"abstract":"The article describes the issues of diagnosis and treatment of joint hypermobility syndrome. Starting from its historical aspects, ending with the modern possibilities of therapy. The article discusses the risks of developing early osteoarthritis against the background of joint hypermobility syndrome. On a clinical example, the issues of diagnosis according to the Beighton scale and the Brighton criteria are analyzed, and the possibilities of therapy and prevention of early osteoarthritis are presented, according to the clinical recommendations for connective tissue dysplasia, within which this syndrome is considered.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48598490","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":"Combination of cortical-subcortical infarction with lobar microbleeds as a specific MRI pattern in patients with infective endocarditis","authors":"D. A. Demin, A. Kulesh, E. Nikolaeva, E. I. Shaposhnikova, Marina V. Lezhikova, P. Astanin","doi":"10.26442/20751753.2023.2.202230","DOIUrl":"https://doi.org/10.26442/20751753.2023.2.202230","url":null,"abstract":"Background. Ischemic stroke (IS) and cerebral microbleeds (CMB) are the most common types of neurological complications of infective endocarditis (IE), while their combination is poorly understood. \u0000Aim. To evaluate the pattern of combination of cortical-subcortical infarction with lobar CMB or subarachnoid hemorrhage (SAH) in patients with left-sided IE. \u0000Materials and methods. A retrospective case-control study was conducted, including patients with IE who received cardiac surgery at the Federal Center for Cardiovascular Surgery. Inclusion criteria: age of patients 18 years; definite or possible (Duke criteria) IE of the left heart (aortic and/or mitral valves). The control group included patients without IE, with non-lacunar (likely embolic) IS. In both groups, the pattern of combination of cortical-subcortical infarction with lobar CMB or SAH was assessed. Differences between groups of patients were assessed using the 2 test, Fisher's exact test and the MannWhitney test. Additionally, odds ratios for binary features were calculated. To assess the information content of the studied pattern, classical classification quality metrics were calculated: accuracy, sensitivity, and specificity. \u0000Results. In patients with IS, infarcts corresponded to the main characteristics of cardioembolism: involvement of multiple cerebral arterial territories (84%), multiple infarcts (88%), cortical-subcortical localization (100%), and a high incidence of hemorrhagic transformation (44%). CMB was detected in 64% of cases (in 93.8%, CMB localization was lobar), SAH in 28% of patients (with CMB in 6 out of 7 cases). The pattern of combination of cortical-subcortical infarction with lobar CMB or SAH was observed in 64% in the IE group (in the control group in 12%). Odds ratio for the presence of IE was 13.0 (95% confidence interval 3.0455.9; p0.001). The accuracy of the sign was 76%, specificity 71%, sensitivity 84%. \u0000Conclusion. The combination of cortical-subcortical infarcts with lobar CMB or SAH may be a sign characteristic of IE-associated stroke.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42050967","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":"Impact of stress on hemostasis: A review","authors":"V. Salukhov, M. Kharitonov, N. A. Varavin, Alisa S. Krasovskaya, Alexander A. Santakov","doi":"10.26442/20751753.2023.2.202183","DOIUrl":"https://doi.org/10.26442/20751753.2023.2.202183","url":null,"abstract":"The article presents an overview of current views of changes in the hemostasis system in response to stress. Stress-induced neurohormonal responses activate the clotting system and inhibit the fibrinolysis system, leading to hypercoagulation. An evolutionary interpretation of such responses is that hypercoagulation under stress protects a healthy body from excessive bleeding in case of trauma in fight-or-flight situations. Acute psychological stress can cause significant hemoconcentration and prothrombotic changes in the blood, which can have potentially harmful effects on the cardiovascular system.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43288709","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":"Impact of COVID-19 on the occurrence and exacerbation of cutaneous forms of lupus erythematosus: A review","authors":"Eleonora S. Mikheeva, I. M. Golubeva, E.E. Radionova, O. Zhukova, I. Korsunskaya","doi":"10.26442/20751753.2023.2.202142","DOIUrl":"https://doi.org/10.26442/20751753.2023.2.202142","url":null,"abstract":"The article addresses the impact of the new coronavirus infection on the occurrence of cutaneous forms of lupus erythematosus (LE). Since the beginning of the COVID-19 pandemic, there has been an increase in the incidence of cutaneous LE worldwide, the emergence of new cases, and exacerbation and aggravation of the severity of existing ones. The pathogenesis of cutaneous LE, and the role of viral infections in its occurrence, mainly COVID-19, is reviewed. The need for the SARS-CoV-2 vaccination and its potential as a possible trigger is described. It is necessary to note the importance of clinicians in diagnosing LE since it is essential for the dermatologist to know the features of its course and be able to suspect and diagnose even the rarest forms of this disease. Proper awareness and correct diagnosis determine the optimal drug therapy and patient health in the future.","PeriodicalId":10550,"journal":{"name":"Consilium Medicum","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47242535","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}