Sechenov Medical Journal最新文献

{"title":"Approaches for the prevention and treatment of venous thromboembolism in a patient with anaplastic astrocytoma: a case report","authors":"M. Pavlova, I. I. Amergulov, N. V. Likhodey, I. A. Kurkina, I. Glinkina, O. Zheludkova, M. Gilyarov","doi":"10.47093/2218-7332.2021.12.1.74-82","DOIUrl":"https://doi.org/10.47093/2218-7332.2021.12.1.74-82","url":null,"abstract":"Venous thromboembolism occurs in 48–200 out of 1,000 patients with brain cancer per year, which is significantly more frequent than in general population.Case report. A female patient had surgical treatment of anaplastic astrocytoma following radiotherapy and chemotherapy (temozolomide, irinotecan, bevacizumab) at the age of 17 years old. She also received dexamethasone. At the age of 20 years, she developed cancer recurrence, that required chemotherapy. After chemotherapy had been initiated, the patient developed deep vein thrombosis of the legs. Rivaroxaban 20 mg/d for 2.5 months with the subsequent switch to enoxaparin 60 mg/d showed no recanalization. Enoxaparin dose increasing up to 160 mg/d demonstrated incomplete recanalization, however, superficial venous thrombosis of the legs developed. Combination therapy with enoxaparin plus warfarin resulted in further deep and superficial veins recanalization.Discussion. In cancer-associated venous thromboembolism that is resistant to low molecular weight heparin monotherapy, short-term combination therapy with low molecular weight heparin and vitamin K antagonists can be considered. However, in recurrent cancer standard treatment protocols can be ineffective.","PeriodicalId":129151,"journal":{"name":"Sechenov Medical Journal","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123990426","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":"Local-free recurrence survival after breast-conserving surgery and the breast cancer complex treatment","authors":"A. Zikiryahodjaev, M. Ermoshchenkova, A. Bosieva, J. F. Omarova, N. Volchenko, I. Reshetov","doi":"10.47093/2218-7332.2021.12.1.30-38","DOIUrl":"https://doi.org/10.47093/2218-7332.2021.12.1.30-38","url":null,"abstract":"Aim. To determine the frequency of local recurrence of breast cancer (BC) after performing breast-conserving surgery (BCS) during and after complex treatment, to study the risk factors for local recurrence and survival.Materials and methods. A retrospective cohort study of 675 patients with breast cancer who underwent BCS followed by remote radiotherapy was conducted. The frequency of local relapse and risk factors were studied, 3- and 5-year local-free survival. The odds ratios (OR) and 95% confidence intervals (CI) were calculated, and the Kaplan–Meyer curves were constructed.Results. Radical breast resections (RBR) were performed in 46.7% of patients, and oncoplastic breast resections (OBS) in 53.3% of patients. The most common histological type in both groups was invasive cancer with no signs of specificity: 76.9% and 84.1% – in the OBS and RBR groups, respectively. The incidence of cancer in situ was higher in the OBS group: 14.7% vs. 3.3% in the RBR group (p < 0.001), metastases in regional lymph nodes were more frequent in the RBR group: 34.3% against 20.3% in OBS (p < 0.001). According to the immunohistochemical type and degree of differentiation, the groups did not differ. For 3 years, the relapse-free survival rate was 99.7% in both groups, and for 5 years – 99.2% in the OBS group. and 99.7% in the RBR group, 6 years – 98.3% and 98.7%, respectively; no significant differences were found between the groups. There were no statistically significant differences in the frequency of relapses depending on the width of the resection edges from <1 to ≥10 mm. The risk of relapse was increased with a preserved menstrual status (OR 20.05; 95% CI 2.52–159.33), Her2/neu–positive (OR 5.11; 95% CI 1.04–25.09) and triple-negative types (OR 4.02; 95% CI 1.02–15.95), the degree of differentiation of G3 (OR 5.58; 95% CI 1.59–19.64).Conclusion. BCS is characterized by oncological safety; the rate of local relapse within 6 years is 1.5%. Risk factors for relapse include active menstrual status, highly aggressive immunohistochemical types of breast cancer, and low degree of differentiation.","PeriodicalId":129151,"journal":{"name":"Sechenov Medical Journal","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130280248","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":"Case of step-by-step combined treatment of a patient with a ruptured aneurysm of the ophthalmic segment of the internal carotid artery","authors":"D. V. Litvinenko, E. I. Zyablova, V. V. Tkachev, G. G. Muzlaev","doi":"10.47093/2218-7332.2021.277.02","DOIUrl":"https://doi.org/10.47093/2218-7332.2021.277.02","url":null,"abstract":"Aneurysms of the internal carotid artery are the second most common among cerebral aneurysms. When an aneurysm is located in the ophthalmic segment of the internal carotid artery (ICA), the intravascular treatment method is a priority. At the same time, the treatment of recurrent and non-radially switched-off aneurysms of this localization remains a subject of discussion.Case report. We present a 42-year-old patient with a ruptured ICA aneurysm who was admitted in a serious condition. Initially, the patient underwent partial occlusion of the aneurysm cavity with endovascular coiling. In the control cerebral angiography 3 months after the haemorrhage, the recanalization of the aneurysm was verified, which served as an indication for repeated surgical intervention. We preferred the microsurgical method of treatment. A control angiographic study 1 year after the second operation confirmed the radical shutdown of the aneurysm.Discussion. The presented case illustrates the need for a flexible approach in the treatment of complex paraclinoid aneurysms. The choice of endovascular treatment of such aneurysms in the acute period of haemorrhage is justified as the most sparing, although less radical. Depending on the nature of the embolization performed, the timing of the control angiographic examination should be selected individually and can be reduced to 2 months. If there are indications for repeated surgical intervention, it should be performed by the safest method, providing total shutdown of the aneurysm and reducing the volumetric impact of the aneurysm dome on the optic nerve.","PeriodicalId":129151,"journal":{"name":"Sechenov Medical Journal","volume":"689 12","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133970754","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":"Study of the physical and biological properties of nanocomposite materials obtained with laser radiation","authors":"U. Kurilova, A. Gerasimenko","doi":"10.47093/2218-7332.2021.306.04","DOIUrl":"https://doi.org/10.47093/2218-7332.2021.306.04","url":null,"abstract":"The new method of the formation of nanocomposite materials based on carbon nanotubes for the regeneration of connective tissues has been developed.Aim. Study of the structure, mechanical characteristics and biocompatibility of the obtained materials.Materials and methods. The experimental samples of nanocomposite materials were based on multi-walled and singlewalled carbon nanotubes, the matrix was bovine serum albumin. A layer of liquid dispersion of the components on a silicon substrate or in a container was irradiated with laser radiation to form the solid nanocomposite material. The microstructure of the obtained samples was analyzed with X-ray microtomography, the tensile strength was investigated using a testing machine. Fibroblast cells were incubated with experimental samples for 3, 24, 48, and 72 h and then fixed with glutaraldehyde. Cell growth during incubation with samples was studied using optical and atomic force microscopy.Results. It was found that a slight decrease in tensile strength and increase in the degree of deformation were observed with an increase in the concentration of carbon nanotubes. At the same time, the mechanical parameters of the samples corresponded to the requirements for materials for the restoration of connective tissue defects. Microscopic studies indicate good adhesion of cells to the nanocomposite material, no toxic effect of the samples on the cells was found. After 3 hours of incubation, the cells had their original rounded shape, after 24 hours of incubation cells began to proliferate on the sample’s surface and were spindle-shaped. After 48 and 72 hours, the cells practically formed a monolayer on the surface of the samples.Conclusion. The results of the study show that the structural and mechanical parameters of the developed nanocomposite materials meet the requirements of biomedicine. It was also shown that nanocomposite materials do not suppress cell growth and can serve as a scaffold for the regeneration of damaged tissues.","PeriodicalId":129151,"journal":{"name":"Sechenov Medical Journal","volume":"99 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123630842","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":"VEGF-C — a biomarker of renal injury in the experimental model of intra-abdominal hypertension","authors":"V. Iakovlev, A. Badaeva, E. Ivanova, Lyubov O. Severgina, L. Maltseva, O. Morozova","doi":"10.47093/2218-7332.2020.11.3.47-56","DOIUrl":"https://doi.org/10.47093/2218-7332.2020.11.3.47-56","url":null,"abstract":"Lymphangiogenesis plays an important role in development of renal parenchyma inflammation during kidney injury. Vascular endothelial growth factor type C (VEGF-C), cytokine that regulates lymphangiogenesis, is a potential early biomarker for acute kidney injury. Aim. To study the concentration of VEGF-C in renal homogenate and blood serum of newborn rats with experimental intraabdominal hypertension (IAH) of varying severity and duration, to establish a relationship with morphological changes in the renal tissue. Materials and methods. The experiment was conducted on 50 newborn Wistar rats. Rats were divided into 5 groups of 10 rats each: groups 1 and 2 with mild IAH lasting 5 and 10 days, respectively, and groups 3 and 4 with severe IAH lasting 5 and 10 days, respectively, and the control group. IAH was modelled by injecting sterile vaseline into the abdominal cavity to a predetermined level of IAH under the control of intra-vesical manometry. VEGF-C content was measured by ELISA. Morphological examination of the biopsy material and its photography were carried out using a Leica DM2000 microscope. The Mann—Whitney, Kruskal—Wallis, Wilcoxon tests, as well as one-way ANOVA, were used for statistical analysis. Results. The level of VEGF-C in the renal homogenate was increased in all groups (pc < 0.001); the degree of VEGF-C increase depended on the severity of IAH (p < 0.05) but not on the duration of IAH exposure. The VEGF-C blood serum level was increased only in group 3 (pc = 0.011). Morphological analysis showed hydropic dystrophy: changes in the height of the tubular epithelium, an increase in interstitial edema, expansion of the urinary spaces of glomeruli. The degree of morphological changes depended on the severity and duration of IAH. Conclusion. Changes in VEGF-C level assessed in the renal homogenate correlated with morphological changes in renal tissue of rats with different severity and duration of IAH.","PeriodicalId":129151,"journal":{"name":"Sechenov Medical Journal","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128646147","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":"Frequency of retinal changes in patients with COVID-19: an observational study","authors":"A. Illarionova, O. M. Potapova, O. Kosareva, Yu. R. Kuznetsova","doi":"10.47093/2218-7332.2020.11.2.40-49","DOIUrl":"https://doi.org/10.47093/2218-7332.2020.11.2.40-49","url":null,"abstract":"In order to enter cells, SARS-CoV-2 virus uses the angiotensin-converting enzyme 2 receptor that is also expressed in retina. Aim. Determination of the frequency and nature of retinal changes, evaluation of visual functions in patients who have got over COVID-19. Materials and methods. This observational research includes 31 patients aged from 28 to 79 that got over COVID-19 (with severity according to computed tomography (CT): 1–3) in the period from 15 to 40 days before the research. Standard ophthalmological examination and optical coherence tomography (OCT) were performed; visual acuity measurement and threshold static perimetry were used to assess visual functions.Results. Pathology of the ocular surface wasn’t detected. Ophthalmoscopy revealed retinal changes in only one patient. At OCT, 27 (87%) patients proved to have de novo changes in the retinal neuroepithelium at the level of the internal plexiform layer and the retinal ganglion cell layer in the form of hyper-reflective polymorphic foci with clear borders; 18 (67%) patients had monocular lesions. The maximum corrected visual acuity didn’t differ from the previously defined one; no violations of retinal light sensitivity were detected. No association was found between the severity of CT lung changes and retinal changes. The detected retinal changes weren’t associated with symptoms of anosmia (hyposmia) and ageusia. OCT repeated after 12–15 days showed no dynamics of hyperreflective foci: they remained unchanged in their shape, echogenicity and size. Conclusion. De novo changes in retinal neuroepithelium at the level of the inner plexiform layer and the retinal ganglion cell layer were detected according to OCT data in 87% of patients who had undergone COVID-19. Anatomical changes in the retina weren’t manifested by functional visual disturbances. There is no association of retinal changes with lesions of I and IX cranial nerve pairs.","PeriodicalId":129151,"journal":{"name":"Sechenov Medical Journal","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122874898","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":"Corticosteroids in the treatment of SARS-CoV-2 related lung disease","authors":"V. T. Ivaschkin, O. Zolnikova, A. Svistunov, N. Dzhakhaya, N. Potskhverashvili, N. Kokina, E. R. Buklis, T. V. Roshchina, I. Komkova, M. Nadinskaia","doi":"10.47093/2218-7332.2020.11.2.19-28","DOIUrl":"https://doi.org/10.47093/2218-7332.2020.11.2.19-28","url":null,"abstract":"Aim. To explore the effectiveness of corticosteroids in patients with lung damage caused by SARS-CoV-2.Materials and methods. The retrospective study included patients with confirmed SARS-CoV-2 infection and lung damage diagnosed by computed tomography (CT), who was receiving low molecular weight heparin (LMWH). 56 patients included in Group 1 received dexamethasone 4–12 mg/day for 8–10 days after admission to the hospital. 30 patients included in Group 2 (control group) had no dexamethasone treatment. The laboratory and instrumental data obtained from the patients under admission and for the 8–10th day of the treatment were analyzed. Hospital mortality was evaluated by Kaplan — Meier method. To predict a lethal outcome, we have used the logistic regression method. Results. By the 8–10th day of hospitalization, only in the Group 1, there was a statistically significant decrease in the volume of lung tissue lesions by CT (p = 0.027), fibrinogen concentration (p = 0.001). A statistically significant decrease of the C-reactive protein concentration was noted for the both groups. Oxygen therapy was more often needed in Group 2 (26 patients — 87%) in opposite to Group 1 (36 patients — 64%) (p = 0.028). Hospital mortality was 3.6% in Group 1 and 13.3% in Group 2 (p = 0.177). There was a trend towards an increase in patient survival in Group 1 between 18 and 28 days of hospitalization (Mantel — Cox test, p = 0.095). Age (p = 0.012), percentage of CT lesions at the time of admission (p = 0.020) and assignment to the dexamethasone group (p = 0.080) were included in the logistic regression equation.Conclusion. For the patients with SARS-CoV-2 lung damage, treatment with dexamethasone 4–12 mg, started from the first day of hospitalization additionally to LMWH, contributes to positive CT dynamics on the 8–10th day and decreases hospital mortality.","PeriodicalId":129151,"journal":{"name":"Sechenov Medical Journal","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134391164","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":"The study of cardiotoxicity of hydroxychloroquine and azithromycine combination in hospitalized patients with COVID-19","authors":"Y. Belenkov, I. Menshikova, I. Ilgisonis, Yu. I. Naimann, Y. Pak, I. Kolosova, A. S. Rakovskaya","doi":"10.47093/2218-7332.2020.11.2.29-39","DOIUrl":"https://doi.org/10.47093/2218-7332.2020.11.2.29-39","url":null,"abstract":"Hydroxychloroquine (HCH) is included in guidelines for treatment of novel coronavirus infection (COVID-19). Data on increased risk of cardiovascular complications when using it have been published. Aim. To evaluate the safety and tolerability of HCH and azithromycine (AZM) combination for the treatment of the patients with COVID-19 in recommended by Russian Ministry of Health doses in real practice.Methods. 132 patients (62 men and 70 women of average age 59.2 ± 9.3 years), 59% of whom had cardiovascular comorbidities, were included in prospective сohort study. 112 patients took HCH + AZM (group 1) and 20 patients took other medications without potential cardiotoxicity (group 2). At the admission to the hospital and after 5–7 days of the treatment corrected QT interval was calculated, new rhythm and conduction disorders, other side effects and hospital mortality have been registering. Relative risk (RR) and 95% confidence interval (CI) were calculated. Results. Elongation of corrected QT-interval within the normal range was registered in 22.3% of patients in group 1 and in 15% — in group 2. An increase in the QT length to the upper limit of the norm (480 msec) was observed in 1.8% of patients in group 1. There were no statistically significant differences between the groups in the number of patients with prolonged QT interval (RR = 1.488, 95% CI: 0.496–4.466, р = 0.478). The occurrence of new arrhythmias, conduction disturbances and allergic reactions was not recorded. Tolerability of combination HCH + AZM was satisfactory in the majority of patients. The hospital mortality in group 1 was 1.8%, in group 2 — 5% without statistically significant difference (p = 0.374). Conclusion. A combination of HCL + AZM according to the scheme recommended by the Ministry of Health of the Russian Federation for the treatment of the patients with COVID-19 and cardiovascular comorbidity in inpatient conditions is safe.","PeriodicalId":129151,"journal":{"name":"Sechenov Medical Journal","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131774111","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":"Diagnostic value of lung ultrasound versus chest CT in COVID-19","authors":"Л. В. Шогенова, Сергей Дмитриевич Варфоломеев, В. И. Быков, С. Б. Цыбенова, А. М. Рябоконь, С. В. Журавель, И. И. Уткина, П. В. Гаврилов, С. Петриков, Александр Григорьевич Чучалин, А. А. Панин","doi":"10.47093/2218-7332.2020.11.2.5-18","DOIUrl":"https://doi.org/10.47093/2218-7332.2020.11.2.5-18","url":null,"abstract":"Lung ultrasound demonstrates a high diagnostic value in the assessment of lung diseases.Aim.To determine the diagnostic accuracy of lung ultrasound compared to chest computed tomography (CT) in the diagnosis of lung changes in COVID-19.Materials and methods.The retrospective study included 45 patients (28 men) aged 37 to 90 years who underwent polypositional lung ultrasound with an assessment of 14 zones. The study compared lung echograms with chest CT data in assessing the prevalence of the process and the nature of structural changes. The diagnostic accuracy, sensitivity, and specificity of lung ultrasound in comparison with CT scans were determined, 95% confidence intervals (CI) were calculated.Results.In 44 patients (98%), CT revealed pathological changes with subpleural localization in both lungs. Of these, in 30 cases, the inflammation was limited only to the subpleural parts, and in 14 cases, the changes spread to the basal parts of the lungs, while ultrasound revealed changes at the depth of the lesion no more than 4 cm. The lesion of 10–11 zones according to lung ultrasound corresponds to CT 1–2 degrees, the lesion of 13–14 zones — CT 3–4 degrees. The sensitivity of ultrasound to detect lung changes of various types was ≥ 92%. The highest sensitivity of 97.9% (95% CI: 92.8–99.8%) was determined for small consolidations on the background of interstitial changes (degree 1A+, 1B+), which corresponded to “crazy-paving” pattern on CT. The specificity depended on the nature of the changes and varied from 46.7 to 70.0%. Diagnostic accuracy was ≥ 81%, the maximum values of 90.6% (95% CI: 85.6–94.2%) were obtained for moderate interstitial changes (grade 1A) corresponding to ground-glass opacity (type one) according to CT data.Conclusion.The sensitivity of ultrasound to detect lung changes in COVID-19 is more than 90%. Lung ultrasound has some limitations: inability to determine the prevalence of the process clearly and identify centrally located areas of changes in the lung tissue.","PeriodicalId":129151,"journal":{"name":"Sechenov Medical Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130713686","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":"Endocrine adverse events of immune checkpoint inhibitors: results of a single-center study","authors":"E. Poddubskaya, M. Sekacheva, A. Guryanova","doi":"10.47093/22187332.2019.4.4-11","DOIUrl":"https://doi.org/10.47093/22187332.2019.4.4-11","url":null,"abstract":"Immune checkpoint inhibitors (ICPIs) agents can cause endocrine immune-related adverse events (irAEs).Aim. Determine the incidence, time of onset and risk factors of endocrine irAEs in cancer patients treated with anti-PD1 and anti-CTLA-4 immunotherapy.Materials and methods. This is a retrospective single-center study that included 61 patients aged 28 to 81 years with diagnosed cancer of the lungs, ovaries, esophagus, stomach, bladder, kidney, and pleural mesothelioma. 44 (72%) patients received anti-PDL1/anti-PD1 monotherapy and 17 (28%) received a combination of anti-PD1 + anti-CTLA-4. Calculated: odds ratio (OR) and 95% confidence interval (CI).Results. The incidence of endocrine irAEs was 23% (14 patients): thyroiditis (13%), hypophysitis (8%), adrenal insufficiency and diabetes mellitus (2–3%). IrAEs occurred in 9 (20%) patients with monotherapy and in 5 (35%) patients when using a combination of drugs (p=0.318). The average time of onset of irAEs did not differ depending on the applied regimen and amounted to 6 [4–18] weeks. Symptomatic irAEs developed in 2 (13%) patients. Discontinuation of ICPI therapy due to irAE was not required in any case. Risk factors: age younger than 61 years old – OR 4.4 (95% CI 1.198–16.242), female OR 2.4 (95% CI 0.67–8.591), presence of stage IV disease – OR 2.4 (95% CI 0.689–8.362), combination therapy OR 1.855 (95% CI 0.548–6.277), previous endocrine pathology – OR 0.813 (95% CI 0.152–4.356).Conclusions. The incidence of endocrine irAEs when using ICPI is 23%. Thyroiditis and hypophysitis develop more often. The odds are higher in patients younger than 61 years. In most cases, irAEs are not symptomatic and do not require discontinuation of ICPI therapy.","PeriodicalId":129151,"journal":{"name":"Sechenov Medical Journal","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115007098","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}