The Bulletin of Contemporary Clinical Medicine最新文献

{"title":"ВЕСТНИК СОВРЕМЕННОЙ КЛИНИЧЕСКОЙ МЕДИЦИНЫ 2024 Том 17, вып. 1 23ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ IMMUNE STATUS CHARACTERISTICS OF GLOMERULONEPHRITIS PATIENTS WITH REFRACTORY NEPHROTIC SYNDROME","authors":"S. I. Kudryashov, Marina A. Stenina, L. M. Karzakova, Evgeniya V. Sokolova, I. A. Sidorov, L. V. Borisova, Tatyana R. Vozyakova","doi":"10.20969/vskm.2024.17(1).22-28","DOIUrl":"https://doi.org/10.20969/vskm.2024.17(1).22-28","url":null,"abstract":"Abstract. Introduction. Research in the issues related to glomerulonephritis with nephrotic syndrome is an important problem of modern medicine due to their prevalence among the global population and mainly in the younger age group, with a significant proportion of patients with refractory nephrotic syndrome (frequent relapses, persistent course). Currently, there are no ways to predict the development of glomerulonephrites with refractory nephrotic syndrome. Due to the immunological nature of glomerulonephrites, it seems advisable to search for predictors of refractory nephrotic syndrome among the indicators characterizing the patient’s immune status. Aim of the study was to study the characteristic features of the immune status and their prognostic value in glomerulonephritis with refractory nephrotic syndrome. Materials and Methods. We examined 136 glomerulonephritis patients with active nephrotic syndrome, hospitalized in the nephrology department in 2015-2021. Along with conventional examinations, humoral and T-cell immunity indicators were tested in the patients. The end point of the study was in 2022 where the the clinical course of the disease was assessed in patients, and patients with nephrotic syndrome who showed refractory to steroid therapy were placed into one group, while those with non–refractory nephrotic syndrome were placed into another one. Within the selected groups of patients, we performed the comparative study of demographic, clinical and laboratory parameters, the indicators of humoral and T-cell immunity, and the ROC analysis of indicators correlating with the nephrotic syndrome recurrence frequency. Results and Discussion. In the group of patients with a refractory course of the disease, an increase was detected in the number of T helper phenotype cells and of the activated T cells carrying activation markers, HLA-DR and CD38, on their surfaces. At the same time, the relative content of regulatory T cells (Treg) among T helper cells decreased. The B system was characterized by an increase in the number of B lymphocytes, an increase in the levels of circulating immune complexes and IgM, and a decrease in IgG levels. The changes detected in the parameters of humoral and T-cell immunity may be essential to the development of refractory nephrotic syndrome. In the refractory nephrotic syndrome pathogenesis, the most important is the decrease in the number of Tregs, which correlated most closely with the nephrotic syndrome recurrence frequency. Conclusions. An association was found between refractory nephrotic syndrome and the pronounced activation of humoral immunity, and a significant imbalance was detected between various immunoregulatory and activated T-lymphocyte subpopulations. The Treg content in the blood can be a prognostic indicator: Treg content values of under 1.9% indicate a high probability of developing refractory nephrotic syndrome.","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"231 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140468846","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 THE PREVIOUS 2019 NOVEL CORONAVIRUS INFECTION ON THE STRUCTURAL AND FUNCTIONAL PARAMETERS OF THE RIGHT HEART AND ON PULMONARY HEMODYNAMICS IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE","authors":"E. Kulik, V. Pavlenko, A. Bakina, S. Naryshkina","doi":"10.20969/vskm.2024.17(1).15-21","DOIUrl":"https://doi.org/10.20969/vskm.2024.17(1).15-21","url":null,"abstract":"Abstract. Introduction. This paper presents the interim results of a prospective clinical study, in which we studied the long-term influence of 2019 novel coronavirus infection (2019-nCoV) on pulmonary-cardiac relationships in patients with chronic obstructive pulmonary disease. Aim: Studying the effect provided by the previous 2019-nCoV on the structural and functional parameters of the right ventricle of the heart and on pulmonary hemodynamics in patients with chronic obstructive pulmonary disease. Materials and Methods. Over the years 2021-2023, we examined 43 patients with stable chronic obstructive pulmonary disease, having a history of 2019-nCoV by transthoracic echocardiography. The study consisted of two control points: on day 8-12 in the hospital and the follow-up visit to the clinic 12 months after 2019-nCoV. The study included a control group of 30 stable chronic obstructive pulmonary disease patients having no 2019-nCoV history. Results and Discussion. We found that the structural and functional strains of the right heart are aggravated in the acute period of 2019-nCoV in patients with chronic obstructive pulmonary disease. Thus, as compared to the control group, the maximum right atrium width (p<0.05), right ventricle anterior wall thickness (p<0.05), and basal right ventricle diameter values were significantly higher. Echocardiographic signs of right ventricle diastolic dysfunction Type 1 were found in 36,3% of cases and Type 2 in 23.3%. Pulmonary artery diameter and mean pulmonary artery pressure were higher than in those of the control group, as well. In 44% of patients, the value of pulmonary artery acceleration time was less than 105 ms (χ2 = 4.59; p<0.05). Persistently high linear and volumetric right atrium and right ventricle indicators were registered in patients after 12 months of follow-up. Signs of the Type 1 diastolic dysfunction were found in 62.7% of patients. There was a tendency to decrease the mean pulmonary artery pressure and pulmonary artery acceleration time values. Conclusions. Thus, according to echocardiography, the combination of chronic obstructive pulmonary disease and 2019-nCoV leads to the aggravation of right ventricle diastolic dysfunction and the progression of pulmonary hypertension. These signs persisted for a long time (12 months).","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"131 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140463789","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 STATE OF ENDOTHELIUM IN PATIENTS WITH PSORIASIS","authors":"Renata M. Arslanova, E. G. Mutalova, Zarema R. Khismatullina, Albina E. Nigmatullina, Velena R. Galyautdinova, Gulnara J. Kamaltdinova, Gulnara V. Asadullina, Liana I. Samigullina, Z. Y. Rustyamova, R. I. Sadikova, Svetlana A. Frid, Eldar R. Kamaltdinov, Flarisa S. Musina","doi":"10.20969/vskm.2024.17(1).7-14","DOIUrl":"https://doi.org/10.20969/vskm.2024.17(1).7-14","url":null,"abstract":"Abstract. Introduction. Psoriasis is an independent risk factor for cardiovascular diseases, accompanied by an increased risk of mortality from cardiovascular diseases, as compared with the population, which is mainly associated with chronic systemic inflammation (increased levels of C-reactive protein, fibrinogen, and homocysteine) and with the accumulation of conventional cardiovascular risk factors, such as dyslipidemia, obesity, decreased physical activity, and arterial hypertension. There are only few studies evaluating the link between psoriasis, inflammation, and cardiovascular disease. Our aim was to study the relationship between pro-inflammatory mediators and the endothelium functional state indicators of the in patients with psoriasis. Materials and Methods. We examined 116 patients with verified psoriasis, aged 19-62 years. The control group consisted of 25 comparably aged and practically healthy individuals. The diagnosis was made considering the psoriasis clinical form, stage, seasonality, type, and severity. All patients underwent a standard laboratory and instrumental examination. The levels of pro-inflammatory markers (IL-6, VEGF,CRPvh) were determined by enzyme-linked immunosorbent assay using commercial ELISA-BEST kits manufactured by OOO Vector-Best, Novosibirsk, Russia. The endothelial function was assessed by using the Biomedical ENDOTELIN test system by BioKhimMak JSC to measure the quantitative content of endothelin-1, a characteristic of the vasomotor function of endothelium, determined by ultrasound according to the method proposed by Celermajer D. et al. Results and Discussion. The study revealed a high incidence of the disease in people of working age and a slight predominance among male patients. In 55.2% of patients, classic atherosclerosis risk factors were identified: Arterial hypertension, smoking, low physical activity, alcohol abuse, and improper nutrition. 33.6% of patients were overweight; 24.1% had obesity I-II degree, and 39.7% with abdominal obesity. According to the findings of the study of pro-inflammatory markers in the blood serum, there is a significant increase in their levels as compared with the control group indicators, which correlates with the severity of psoriasis and a decrease in the ratio of IL-6/CRPvh. Endothelial dysfunction was characterized by a statistically significant increase in endothelin-1 and a significant increase in the content of vascular endothelial growth factor (VEGF) in the blood serum of psoriasis patients. Percentage increase in the brachial artery diameter on the endothelium-dependent stimulus was reduced and averaged 9.14% in the group of patients with psoriasis. Conclusion. A high comorbidity of psoriasis and cardiovascular diseases has been established. A significant increase in the levels of systemic immune inflammation mediators IL-6 and C-RBhv and a decrease in the ratio of IL-6/C-RPhvh were identified, which correlates with the severity of the disease and the presence of cardiova","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"1124 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140467209","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":"RELATIONSHIP BETWEEN THE ANNEXIN A5 LEVEL AND THE REGRESSION OF PULMONARY COMPLICATIONS IN PATIENTS WITH SARS-COV-2- ASSOCIATED PNEUMONIA AT THE OUTPATIENT STAGE","authors":"A.S. Kurmaeva, Olga A. Bashkina, T. Prokofyeva, O. S. Polunina, E. Polunina","doi":"10.20969/vskm.2024.17(1).29-34","DOIUrl":"https://doi.org/10.20969/vskm.2024.17(1).29-34","url":null,"abstract":"Abstract. Introduction. To date, there are still some questions regarding the novel coronavirus infection. One of them concerns the long-term post-COVID-19 effects and the regression of complications that have developed during the acute period of this disease. Apoptosis is one of the universal mechanisms for maintaining the body homeostasis. Annexin A5 (ANXA5) is a calcium-containing protein indicative of early apoptosis. Aim: To determine the relationship between the annexin A5 levels and the regression of pulmonary complications in patients with SARS-CoV-2-associated pneumonia 6 months after being treated regarding COVID-19. Materials and Methods. We examined 90 residents of the Astrakhan region, diagnosed with the coronavirus infection COVID-19 (virus identified), aged 47 [39; 57] years. Pulmonary complications were detected in 46 patients using сomputed tomography at discharge: 30 (33.3 %) with diffuse pulmonary fibrosis, 3 (3.3 %) with exudative pleuritis, and 13 (11.1 %) with the combination of the two. After 6 months of outpatient follow-up, pulmonary complications were detected in 16 (17.8 %) patients: Diffuse pulmonary fibrosis in 7 (7.8 %), pleural adhesions in 5 (5.6%), and both complications 4 (4.5 %) patients. ANXA5 level (ng/ml) in blood serum was determined by enzyme immunoassay method using immune-enzyme reaction analyzer Uniplan AIFR-01 manufactured by Picon, Russia. The distribution of numerical scores was nonparametric. To determine the statistical significance of differences in quantitative characteristics, we used the Mann-Whitney test in two independent samples and the Wilcoxon test in dependent samples. Differences in qualitative characteristics in two independent groups were analyzed using contingency tables with subsequent calculation of Pearson’s χ2 criterion, odds ratio, and 95% confidence interval. Results and Discussion. Even after 6 months of follow-up the differences remained statistically significantly higher than in the control group. Number of patients with pulmonary complications on сomputed tomography 6 months after hospitalization decreased threefold, i. e., from 51.1% down to 17.8 %. ANXA5 level after 6 months of follow-up in patients with pulmonary complications on сomputed tomography was statistically significantly higher compared to the patients of this group without pulmonary complications (p<0.001). Conclusions. Probability of pulmonary complications on сomputed tomography after 6 months of follow-up was 10 times higher in patients with the insufficient dynamics of ANXA5 levels, as compared to those with the positive dynamics of this index level (OR 10.0, 95% CI 2.7-33.3).","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"589 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140468373","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":"PREMATURE RUPTURE OF MEMBRANES IN FULL-TERM PREGNANCIES AS A RISK FACTOR OF UTERINE CERVIX RUPTURES IN CHILDBIRTH","authors":"N. F. Khvorostukhina, V.O. Bakhmach, O. V. Trushina, E. A. Kolesnikova, O. S. Odnokozova, R.V. Chupakhin","doi":"10.20969/vskm.2024.17(1).63-70","DOIUrl":"https://doi.org/10.20969/vskm.2024.17(1).63-70","url":null,"abstract":"Abstract. Introduction. Premature rupture of membranes continues to be one of the urgent problems in modern obstetrics, since it is exactly the pathology a high frequency of unfavorable pregnancy outcomes is associated with. At the same time, an equally important task in obstetrics and gynecology remains the problem of maternal birth injuries, including cervical ruptures, the frequency of which ranges 6 to 15 %. Aim. To study how premature ruptures of membranes in full-term pregnancies affect the frequency of cervical ruptures in childbirth and to identify the risk factors of cervical injuries in at-term labor complicated by premature rupture of membranes. Materials and Methods. A retrospective analysis of birth histories for the years 2019-2020 was carried out according to the data of the perinatal center at Saratov City Clinical Hospital No. 8. The study group included 894 histories of single at-term vaginal deliveries complicated by premature rupture of membranes, while the control group included 6,735 birth histories of women whose vaginal deliveries were performed with timely ruptures of membranes. Later, we identified subgroups within the study group: Subgroup 1 (n=101) included patients with premature rupture of membranes at full-term gestation, whose at-term labors were complicated by uterine cervix ruptures, while Subgroup 2 (n=336) included women with premature ruptures of membranes during at-term labors without any maternal birth traumas. When analyzing medical records, special attention was paid to the anamnesis details and to the special aspects of birth courses and outcomes. Statistical data processing was performed using the MS Excel and Statistica 7.0 software programs. Differences in indications were considered statistically significant at p<0.05. Results and Discussion. Probability of premature ruptures of membranes during full-term pregnancy increases in patients expecting their first childbirth by 1.6 times (χ2 = 173.49; p <0.001), those with a burdened obstetric/gynecological history, such as abortions, miscarriages, and genital pathology, and those with concomitant extragenital diseases (85.9%). In the study group, we identified an increase in the incidence of labor anomalies (by 3 times) and acute fetal distress (by 1.9 times), which increased the proportion of using surgical aids in childbirth (by 2.7 times) and the risk of obstetric injuries to the mother (by up to 63.4%), including uterine cervix ruptures by up to 11.3%. Conclusions. Premature rupture of membranes at full-term gestation increases the risk of uterine cervix ruptures in childbirth by 10.3 times. In this obstetric context, the uterine cervix rupture risk factors should include the first birth (57.4%; p= 0.003) in the absence of biological readiness of the birth canal (“unripe” or “insufficiently ripe” uterine cervix, 76.2%), development of ineffective uterine contractions (12.9%), and the use of surgical aids in delivery (vacuum-assisted deliveries and episiotomies, ","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"219 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140470246","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":"DECOMPENSATED CHRONIC HEART FAILURE MANAGEMENT MODIFICATIONS FOR PATIENTS WITH FRAILTY","authors":"Ivan V. Podobed, Liliya S. Lokinskaya, Anna V. Alehina, Kirill V. Osipov, Sergey G. Lenkin, Alexey S. Ponomarev, NATAL’YA V. Fomchenkova","doi":"10.20969/vskm.2024.17(1).44-52","DOIUrl":"https://doi.org/10.20969/vskm.2024.17(1).44-52","url":null,"abstract":"Abstract. Introduction. Frailty affects the prognosis of patients suffering from chronic heart failure. This syndrome increases the frequency of hospitalizations, complicates treatment, and increases the patients’ lethality. Managing patients with chronic heart failure requires some strategic modifications, namely, such management should be supplemented with the procedures aimed at correcting geriatric syndromes. Aim. Optimization of management tactics patients with chronic heart failure and frailty syndrome. Materials and Methods. The study included 52 patients with decompensated chronic heart failure and severe or terminal frailty. Patients were divided into 2 groups: 27 people in group 1, where patients were managed in a standard manner for 7 days, and 25 people in group 2 where integrated management was used. Results and Discussion. Patients of the two groups were comparable in lethality (p=0.17). By the 7th day of observation, the groups were comparable in terms of the number of persons with malnutrition syndrome (p=0.73). The patients were comparable in terms of the pressure ulcer stages and of the presence of infectious complications (p = 1.0). The frequency of thromboembolic complications in the study sample was 5.7%. Conclusions. Integrated management may be considered to improve long-term prognosis for the decompensated chronic heart failure patients with frailty, despite the lack of improvement in short-term outcomes.","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"64 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140465947","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 THE SINGLE-NUCLEOTIDE POLYMORPHISM OF GENES IL1β, EDN1, AND NOS3 GENES ON THE INDIVIDUAL GENETIC PROFILE OF PATIENTS WITH CORONARY HEART DISEASE IN THE REPUBLIC OF CRIMEA","authors":"E. A. Zakharyan, O. Y. Gritskevich","doi":"10.20969/vskm.2023.16(6).31-36","DOIUrl":"https://doi.org/10.20969/vskm.2023.16(6).31-36","url":null,"abstract":"Abstracts. Introduction. Coronary heart disease prevalence rate grows, which determines the importance of researchers’ inquiries aiming to improve the prevention, diagnosis, and treatment of this pathology. Aim. This study was aimed at identifying the associations of polymorphisms of genes interleukin 1-beta, endothelin-1, and endothelial nitric oxide synthase in patients with coronary heart disease. Materials and Methods. We studied polymorphic markers of endothelin-1 (rs5370), endothelial nitric oxide synthase (rs2070244), and interleukin 1-beta genes (rs1143634 and rs16944) in patients with ischemic heart disease (n=229) and in controls (n=56) by multiplex allele-specific polymerase chain reaction with electrophoretic detection. Odds ratio (OR) was used to state the association of genotypes with the disease; 95% confidence interval limits were calculated to assess the significance of OR. Results and Discussion. Analysis of the T-511C polymorphism in the interleukin 1-beta gene demonstrated a trend towards an increased risk of coronary heart disease associated with the TT genotype in the study group (Odds ratio=2.2, 95%. Confidence interval: 1.3-3.6). At the same time, the CC genotype can be associated with a protective effect (Odds Ratio=0.3, 95%. Confidence Interval: 0.2-0.6). When analyzing the C3953T polymorphism in the interleukin 1-beta gene, the TT genotype showed a significantly increased disease development risk within the pathology under study (Odds Ratio=6.4, 95%. Confidence Interval: 1.7-23.4). Analysis of the polymorphic marker C786T in the NOS3 gene showed a correlation between the TT genotype and susceptibility to coronary heart disease (Odds ratio=2.07, 95%. Confidence interval: 1.3-3.2), while the CC genotype showed a protective effect (Odds ratio=0.3, 95%. Confidence interval: 0.2-0.5). A similar result was obtained in an experiment with the Lys198Asn polymorphism in the endothelin-1 gene. TT genotype showed an association with the increased risk of coronary heart disease (Odds ratio=6.5, 95%. Confidence Interval: 3.4-12.4). Odds ratio analysis of the effect of heterozygotes showed no risk of coronary heart disease (Odds ratio=0.3, 95%. Confidence Interval: 0.1-0.5). Conclusions. This study allowed us to find an association between the polymorphic markers of genes endothelin-1 (rs5370), eNOS (rs2070244), and interleukin-1β (rs114634 and rs16944) and the coronary heart disease risk in the population, which may be useful for both stratification and selection of further therapeutic strategies.","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"208 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139300739","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":"ANEMIA OF VARYING SEVIRITY DEGREES IN PATIENTS WITH STEMI","authors":"Ilida F. Khamadullina, Alia A. Khusainova, E. N. Ivantsov, Niyaz R. Khasanov","doi":"10.20969/vskm.2023.16(6).78-81","DOIUrl":"https://doi.org/10.20969/vskm.2023.16(6).78-81","url":null,"abstract":"Abstract. Introduction. Anemia associated with cardiovascular diseases, particularly with myocardial infarction, is a significant risk factor for adverse outcomes. At the same time, it is poorly known about the issue of acute blood circulatory disturbances during myocardial infarction in the setting of anemia of varying severity degrees. Our aim was to study the at-admission hemoglobin levels in patients with ST-elevation myocardial infarction with favorable and fatal outcomes of hospitalization. Material and Methods. We selected 177 records of patients with fatal outcomes of and 380 records of patients discharged with favorable outcomes of ST-elevation myocardial infarction from the emergency departments for patients with acute coronary syndrome of State Clinical Hospital 7, Kazan. The study included 349 men and 208 women aged 32 to 96 years, median age being 67 (58–76) years. Results and Discussion. Incidence of anemia (hemoglobin lower than 130 g/l in men and 110 g/l in women) in the group of patients under study with favorable and fatal hospitalization outcomes was significantly different and amounted to 8.7% and 18.1%, respectively (p = 0.001). Probability of unfavorable outcomes in the group of patients with anemia was 2.32 times higher than that in the group of patients without anemia, the differences in odds were statistically significant (95% CI: 1.38 - 3.92; p = 0.001). Moderate and severe anemia (Hb <90 g/l) was more common in patients with unfavorable outcomes than in patients with favorable outcomes of hospitalization, i.e., in 43.8% and 15.2% of cases, respectively. Odds of an unfavorable outcome were 4.35 times higher in patients with moderate to severe anemia than in patients with mild anemia, the difference in odds was statistically significant (95% CI: 1.34 - 14.08, p = 0.015). Conclusions. Anemia in an ST-elevation myocardial infarction patient is associated with a 2.32 greater chance of an unfavorable outcome. A decrease in hemoglobin level below 90 g/L in a patient with ST-elevation myocardial infarction is associated with a 4.35 times greater chance of an unfavorable outcome.","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"47 23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139301900","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 ELECTRONIC CIGARETTES ON ACID-FORMING AND MOTOR FUNCTIONS OF THE STOMACH","authors":"Yulia I. Galikhanova, Alexey E. Shklyaev, A. S. Pantyukhina, Valery M. Dudarev, D. Kazarin","doi":"10.20969/vskm.2023.16(6).14-18","DOIUrl":"https://doi.org/10.20969/vskm.2023.16(6).14-18","url":null,"abstract":"Abstract. Introduction. Currently, the use of electronic cigarettes is becoming the most popular with and widespread among young people. In Russia, one third of electronic cigarettes consumers are people aged 18 to 29 years. The impact of vaping on various body organs and systems is still understudied now. The aim of our study is to investigate the acid-forming and motor functions of the stomach in people consuming electronic cigarettes. Materials and methods. The study involved 54 people, of which 27 were consumers of electronic cigarettes, all without any diagnosed organic diseases in their digestive systems. The severity of gastroenterological symptoms was assessed using the Gastrointestinal Symptom Rating Scale (GSRS) questionnaire, while motor and acid-forming functions of the stomach were assessed according to pH-impedance measurements. The findings were processed statistically using nonparametric tests with the Microsoft Office Excel 2013 and Statistica 10.0 computer programs. Results and discussions. Vaping participants had significantly more gastrointestinal symptoms according to the Gastrointestinal Symptom Rating Scale as compared to their non-smoking peers. In the group of subjects consuming electronic cigarettes, there was a greater number of pathological gastroesophageal refluxes and increased acidity in the lower esophagus and stomach as compared to the control group. Conclusions. Our findings indicate the adverse effects provided by electronic cigarettes on the functional activity of the upper gastrointestinal tract.","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"95 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139304104","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":"CHANGES IN LEFT VENTRICULAR SYSTOLIC FUNCTION IN PATIENTS WITH IRON DEFICIENCY WITHIN 6 MONTHS AFTER MYOCARDIAL INFARCTION","authors":"D. Khastieva, N. A. Tarasova, M. I. Malkova, E. B. Zakirova, N. R. Khasanov","doi":"10.20969/vskm.2023.16(6).82-87","DOIUrl":"https://doi.org/10.20969/vskm.2023.16(6).82-87","url":null,"abstract":"Abstract. Introduction. According to the scarce data available, iron deficiency is a risk factor of worse prognosis for coronary artery disease, in particular, myocardial infarction. Aim. To study left ventricular systolic function by assessing the left ventricular ejection fraction and total wall motion score index in patients with iron deficiency being corrected and with normal iron status within 6 months after myocardial infarction. Materials and Methods. We included in the study 86 patients hospitalized with myocardial infarction. The patients were divided into 2 groups: Group 1 comprised 40 (46%) patients with iron deficiency, and group 2 consisted of 46 (54%) patients without iron deficiency. In case of iron deficiency, patients underwent correctional therapy. Echocardiography was performed within 24 hours and 6 months after myocardial infarction. Statistical analysis was performed using parametric and nonparametric criteria. Results and Discussion. According to echocardiographic findings, we found a statistically significant increase in the median of left ventricular ejection fraction after 6 months as compared to the baseline in group 1 patients. Left ventricular ejec- tion fraction median was 54% (46 – 58) after 6 months, as compared to the baseline of 50% (45-54), (p<0.001). In group 2, left ventricular ejection fraction did not change. In group 1, wall motion score index was 1.19 (1.00-1.55) after 6 months, which was significantly lower than the baseline: 1.25 (1.13-1.63) (p<0.001), respectively. Patients in group 2 had no change in the wall motion score index after 6 months. We observed a reduction in wall motion score index value in 19 patients in group 1 (47%) within 6 months after myocardial infarction. In group 2, only 11 patients (24%) manifested a decrease in wall motion score index (RR 3.06, 95% CI: 1.06 - 8.87) (p=0.007). Conclusion. Correction of iron deficiency is associated with increased left ventricular systolic function within 6 months after myocardial infarction.","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"228 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139295095","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}