HERALD of North-Western State Medical University named after I.I. Mechnikov最新文献

{"title":"Liver injury and novel coronavirus infection: development mechanisms and clinical manifestation","authors":"M. Livzan, O. Gaus, D. A. Gavrilenko","doi":"10.17816/mechnikov105163","DOIUrl":"https://doi.org/10.17816/mechnikov105163","url":null,"abstract":"The novel coronavirus infection (COVID-19) caused by SARS-CoV-2 is characterized by a variety of clinical manifestations. As the infection spreads and the number of observations increases, it is clear that SARS-CoV-2 affects not only the respiratory tract, but also the digestive system. More than half of patients with COVID-19 have changes in the biochemical blood test, indicating liver damage. The reasons for this may be direct cytopathic or mediated immune effect, organ ischemia, the intake of drugs with potential hepatotoxic effects, onset of previously undiagnosed or worsening of the course of an existing liver disease. This article provides a brief overview of the possible etiological factors of liver damage in COVID-19 and presents its own clinical case.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"136 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91448415","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":"Anti-inflammatory therapy for COVID-19: effectiveness and predictors of response","authors":"I. Sukhomlinova, I. Bakulin, M. Kabanov","doi":"10.17816/mechnikov96603","DOIUrl":"https://doi.org/10.17816/mechnikov96603","url":null,"abstract":"BACKGROUND: According to the international guidelines and expert opinions, medicines for the treatment of COVID-19 are prescribed off-label; however, the final decision is made by a physician based on an assessment of the risk/benefit ratio for each patient. Global studies of the efficacy and safety of the use of baricitinib, tocilizumab, olokizumab, dexamethasone in the treatment of COVID-19 are ongoing. There is no information about comparative efficacy of these drugs and on the prognosis of their use in COVID-19. \u0000AIM: To compare the effects of pre-emptive anti-inflammatory therapy (PAT) with tocilizumab, olokizumab, baricitinib, dexamethasone in patients with COVID-19 to identify response predictors and the choice of the most effective treatment. \u0000MATERIALS AND METHODS: A retrospective analysis of 229 cases of severe and moderate course of COVID-19 requiring various types of UPT at the Hospital for War Veterans has been carried out. \u0000RESULTS: In the study of 229 clinical cases of severe COVID-19, it was found that the most significant predictors of the effects of anticytokine therapy include C-reactive protein (CRP), body mass index (BMI), body temperature, saturation level and the need for a certain type of oxygen support at the start of a therapy, platelet count, hematocrit, neutrophil count, and duration of the disease from its onset to development of signs of a cytokine storm. The probability of recovery in the patients with early appointment of UPT increases by 13%; the need for additional oxygen support increases the risk of mortality by 5.3 times as it increases with the transition to each subsequent level; an increase in the level of CRP by 1% increases the unfavorable prognosis; an increase in D-dimer worsens the prognosis by 16%. \u0000CONCLUSION: Based on the statistical data obtained by the method of stepwise regression analysis, was proposed method for predicting the effectiveness of proactive anti-inflammatory therapy in novel coronavirus infections.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"207 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84714478","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":"Influence of risk factors for the development of cardiovascular diseases on the parameters of arterial stiffness in patients with arterial hypertension and atherosclerosis of different degrees of severity","authors":"S. Sayganov, V. Gumerova, V. Gomonova","doi":"10.17816/mechnikov99754","DOIUrl":"https://doi.org/10.17816/mechnikov99754","url":null,"abstract":"BACKGROUND: Arterial hypertension is widespread in the population, leads to the development of arteriosclerosis and increase of arterial stiffness, and is the main non-lipid risk factor of atherosclerosis development. Multiple studies have shown that increase of arterial stiffness is an independent risk factor for the development of cardiovascular events. However, the influence of traditional cardiovascular risk factors on arterial stiffness in arterial hypertension and atherosclerotic process of different degrees of severity has not been sufficiently studied. \u0000AIM: To assess the influence of traditional risk factors on the parameters of arterial stiffness in patients with arterial hypertension (AH) and atherosclerotic process of varying degrees of severity. \u0000MATERIALS AND METHODS: 133 subjects with AH have been divided into 3 groups depending on the severity of the atherosclerotic process. The control group included 33 individuals without known cardiovascular diseases. All the participants have undergone a standard clinical and laboratory examination, 24hr blood pressure monitoring with assessment of arterial stiffness (AS) parameters. The influence of risk factors on AS parameters has been analyzed for all the participants and separately by groups. \u0000RESULTS: In the AH patients, an increase in the arterial stiffness index (ASI) is associated with an older age and an increase in systolic blood pressure (SBP); an increase in the augmentation index (AIx75) is associated with age; SBP in higher in women. Pulse wave velocity in the aorta (PWVao) is most associated with age, smoking, and family history in patients with hypertension and subclinical atherosclerosis. An increase in AIx75 is associated with an older age and is higher in women, while ASI has a positive relationship with age and SBP. In patients with hypertension and coronary artery disease, there is a positive correlation between male body mass index and PWVao. The increase in ASI in this group is associated with female gender, SBP and age. In individuals without hypertension and signs of atherosclerosis with a family history of CVD, PWVao values are higher than in similar individuals without a family history of CVD. \u0000CONCLUSIONS: In the group of all the participants, female gender, smoking, an older age, SBP, and body mass index are associated with increased AS parameters. The association between risk factors and parameters of arterial stiffness has peculiarities in patients with hypertension with varying degrees of severity of the atherosclerotic process.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"128 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76751821","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":"Features of endothelial function and autonomic regulation of heart rhytm in patients with vasospastic angina","authors":"V. M. Guzeva, I. Yarmosh, D. Evdokimov, Sergey V. Serdukov, S. Ermolov, S. Boldueva","doi":"10.17816/mechnikov80403","DOIUrl":"https://doi.org/10.17816/mechnikov80403","url":null,"abstract":"BACKGROUND: The clinical features of vasospastic angina are well known, but pathogenesis remains a subject of discussion. Changes in the autonomic regulation of coronary artery tone and endothelial function that contribute to the development of vasospasm are not well understood. The data on the subject from the published studies are contradictory. \u0000AIM: To evaluate features of endothelial function and autonomic regulation of heart rhythm in patients with vasospastic angina. \u0000MATERIALS AND METHODS: The study included 16 patients with proven vasospastic angina. All the patients have been evaluated for the heart rate variability at rest and vegetative tests (deep breathing, and active standing tests). Endothelial function has been assessed in terms of reactive hyperemia index by peripheral arterial tonometry using an Endo-PAT 2000 device. \u0000RESULTS: The baseline of the total heart rate variability was borderline with the normal parameters SDNN 50 (32.5; 50) ms in the patients with vasospastic angina. There were 14 patients who have demonstrated an imbalance of the autonomic nervous system at rest, mainly due to an increase of parasympathetic influences. The appropriate reaction of the autonomic nervous system, characterized by an increase of vagal influences, has been determined in 13 patients in the deep-breathing test. A paradoxical reaction, characterized by an increase of vagal influences on the heart rhythm, has been registered in 13 patients in the active standing tests. Endothelial dysfunction has been observed in half of the studied patients. Furthermore, a combination of both pathophysiological mechanisms, i.e., endothelial and autonomic dysfunctions have been observed in all the patients with a reduced reactive hyperemia index. \u0000CONCLUSIONS: According to the results of our study, the parasympathetic influences of the autonomic nervous system on the heart rhythm were predominant in the patients with vasospastic angina, which is not typical for coronary heart disease. All the patients had autonomic or endothelial dysfunction. A combination of both pathophysiological mechanisms has been observed in half of the examined patients.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"77 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82840389","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":"N-acetyl-p-benzoquinonimine metabolite as a factor of possible neurotoxicity of paracetamol","authors":"Yuliya A. Vlasova, Ksenia A. Zagorodnikova","doi":"10.17816/mechnikov99620","DOIUrl":"https://doi.org/10.17816/mechnikov99620","url":null,"abstract":"BACKGROUND: Currently, the possible negative effects of paracetamol on the central nervous system are widely discussed in the modern scientific literature. The relationship between the intake of paracetamol during pregnancy by women and the risk of autism spectrum disorders in their children is being studied. However, such conclusions are often met with serious criticism as there are many questions about the methods of assessing behavioral disorders and processing research results. Therefore, experimental data obtained on neuronal cells may be a sufficient ground to confirm or refute assumptions about the neurotoxicity of paracetamol and its metabolites. \u0000AIM: To study the effect of paracetamol and its metabolite N-acetyl-p-benzoquinonimine (NAPQI) on the neurons of the cerebral cortex of fetal rats. \u0000MATERIALS AND METHODS: The study of the effect of paracetamol and its metabolite NAPQI on cell viability has been carried out by a method based on the reduction of 3-(4,5-dimethylthiazole-2-yl)-2,5-tetrazolium bromide (MTT). \u0000RESULTS: It has been shown that during preincubation of neurons in the cerebral cortex of the rats with paracetamol at a concentration of 1 mg/ml for 24 hours and subsequent incubation with 0.3 mM hydrogen peroxide, both hydrogen peroxide and paracetamol itself reduce the viability of neurons. Joint incubation with paracetamol and hydrogen peroxide also reduces the viability of neurons. The same effect of paracetamol and its metabolite is observed with the joint preincubation of paracetamol or NAPQI and hydrogen peroxide. \u0000CONCLUSIONS: Paracetamol as well its metabolite NAPQI reduce the viability of neurons in the fetal cortex of rats.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88446482","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":"Stimulation of bone regeneration using bone morphogenetic proteins: modern concepts","authors":"U. Mukhametov, S. Lyulin, D. Borzunov, I. Gareev","doi":"10.17816/mechnikov82711","DOIUrl":"https://doi.org/10.17816/mechnikov82711","url":null,"abstract":"It is known that the restoration of fractures or bone defects after trauma is one of the urgent problems of modern orthopedics and traumatology. Bone morphogenetic proteins (BMPs) are a group of growth and differentiation factors that are a large subfamily of the transforming growth factor- (TGF-) superfamily. To date, more than 20 types of different BMPs have been identified based on structural similarities, and it has been found that some of them, like BMP-2, -4, -6, -7, and -9, have the most pronounced osteogenic properties. BMPs induce migration, proliferation, and differentiation of undifferentiated mesenchymal stem cells to form osteoblasts and chondroblasts. BMPs have significant inductive effects on various stages of the bone healing process, such as inflammation, angiogenesis, callus formation, and bone remodeling. It is known that recombinant (rh) rhBMP-2 and rhBMP-7 (approved for clinical use in humans by the USA Food and Drug Administration (FDA)), together with the use of bone grafts, they are used to activate reparative osteogenesis in injuries and to replace bone defects in spinal surgery. Therefore, due to its unique properties, the use of BMPs in bone tissue regeneration is one of the most promising and rapidly developing directions in practical medicine. This review discusses the most important concepts regarding the use of BMPs in stimulating bone regeneration, including their mechanisms of action, modes of use, efficacy, and their advantages and disadvantages.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"64 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78669779","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":"Reductive annuloplasty with autopericardium in surgical treatment of mitral insufficiency","authors":"A.V. Sotnikov, M. Melnikov, A. M. Bitieva, Eduard A. Kolmakov","doi":"10.17816/mechnikov83711","DOIUrl":"https://doi.org/10.17816/mechnikov83711","url":null,"abstract":"BACKGROUND: Despite the widespread usage of all-type rings in the surgical treatment of patients with mitral valve insufficiency (MV) and dilatation of its fibrous annulus, the researches on this topic are in progress. \u0000AIM: To study the short- and long-term results of narrowing annuloplasty of the MV utilizing an autopericardium strip of calculated length. \u0000MATERIALS AND METHODS: The study group consisted of 21 patients (average age 60.9 4.3 years, women 23.8 %) with MV insufficiency of non-rheumatic ethiology. The narrowing of the fibrous annulus during valve reconstruction has been performed along with the posterior 2/3 of their circle using interrupted horizontal sutures. With those sutures, an autopericardial strip of the calculated length has been secured to the annulus. The length of the strip has been calculated according to the original method, according to the data obtained during preoperative transesophageal echocardiography. The length of the strip was 2/3 ∙ D (mm), where D the existing length of the anterior leaflet of the MV in the middle portion from the fibrous annulus to the free edge in the zone of the A2 segment. The control group consisted of 38 patients with non-rheumatic MV insufficiency (average age 59.1 3.5 years, women 23.7 %); the strengthening and narrowing of the fibrous annulus have been performed using a strip made from a wicker vascular prosthesis. The length was 55 mm, equal for all the patients. In both groups, in addition to the narrowing of the fibrous annulus, other types of mitral valve-sparing surgery (partial resection of MV leaflets, suture leaflets techniques, their combination) and combined procedures (coronary bypass surgery, left ventricle reconstructions for postinfarction aneurysms) have been also performed. \u0000RESULTS: In the studied groups, the safety and reliability of the performed restrictive MV annuloplasty procedures have been demonstrated. During the follow-up period up to 8 years (average 3.5 0.7 years), there was no recurrence of significant mitral regurgitation, which would require repeated surgery in both groups. Narrowing annuloplasty of the fibrous annulus of MV with a strip from the autopericardium of an individual calculated length allows to perform a more accurate anatomical correction of the valve compared with the control group. The existing methods of mitral annuloplasty, their advantages and disadvantages are discussed. \u0000CONCLUSIONS: The proposed method of restrictive annuloplasty of the MV with an autopericardial strip of the calculated length allows to perform a reliable and safe correction of the dilated fibrous annulus in patients with mitral insufficiency during valve-preserving operations.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84862108","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":"Effect of arterial hypertension on quality of life and anxiety in middle-aged patients with breast cancer","authors":"E. G. Poroshina, I. Vologdina, R. Zhabina, L. Krasilnikova","doi":"10.17816/mechnikov88811","DOIUrl":"https://doi.org/10.17816/mechnikov88811","url":null,"abstract":"BACKGROUND: Arterial hypertension is one of the key risk factors for the development of cardiotoxicity in cancer patients. The importance for patients with left breast cancer is due to the possibility of the heart getting into the radiation area during treatment. The use of a method for assessing the quality of life and symptoms of anxiety can help improve treatment in such patients by increasing the interaction between a physician and a patient. \u0000AIM: The aim of the study is to assess the quality of life and the level of anxiety in patients with breast cancer, depending on the presence of arterial hypertension. \u0000MATERIALS AND METHODS: 67 patients with HER2neu negative cancer of the left breast have been examined. The average age is 42 (47; 63). All the patients after radical mastectomy and a course of chemotherapy with the inclusion of doxorubicin in a cumulative dose of no more than 360 mg/m2 have been hospitalized for 3D conformal radiation therapy. The first group included 32 patients with grade III comorbid hypertension; the second group included 35 patients without hypertension. The examination included an assessment of the status of an oncological patient according to the ECOG scale, echocardiography with an assessment of diastolic function, determination of the level of reactive and personal anxiety according to the Spielberger Khanin scale and quality of life using the SF-36 questionnaire. \u0000RESULTS: In the group of the patients with combined hypertension, left ventricular hypertrophy has been detected in 48 % of cases. In the patients of both groups with preserved ejection fraction, type I diastolic dysfunction has been detected (E/A 1): in the patients of the first group in 59.4 % of cases, in the patients of the second 31.4 % of cases. The difference obtained is due to the effect of hypertension on the left ventricular relaxation disorder. The level of reactive anxiety was significantly higher in the patients of the first group and amounted to 43.8 (41.2; 46.2) versus 38.4 (32.7; 42.6) points in the second group. The level of personal anxiety was high in the patients of both groups, which can be explained by the predominant influence of cancer. In the patients of both groups, there was a decrease in indicators according to the SF-36 questionnaire on all scales. The most significant changes have been obtained on the scales of physical functioning, role-based physical functioning, pain, vitality and general health. Cancer patients with concomitant hypertension rated their health status lower, while they are more likely to note a decrease in daily role activity as a result of their emotional state. \u0000CONCLUSIONS: The data obtained indicate that arterial hypertension has a significant negative effect on the level of reactive anxiety and quality of life indicators of breast cancer patients, which is of great importance in the formation of a patient-oriented approach to the therapeutic support of specific treatment in such patients.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87917351","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":"Drug-induced pleural diseases","authors":"O. Ostroumova, Natalya S. Smetneva, Valeriya A. De","doi":"10.17816/mechnikov97087","DOIUrl":"https://doi.org/10.17816/mechnikov97087","url":null,"abstract":"The problem of differential diagnosis of pleural diseases involves a large number of pathological conditions causing its damage, which physicians are not aware about. Drug-induced (DI) lesion occupies a special place in the structure of pleural diseases, both due to the relatively low prevalence and due to insufficient awareness of doctors about the presence of such adverse reactions in drugs. At the same time, thanks to modern information about the morphology, physiology and pathophysiology of the pleura and pleural cavities, the diagnosis and treatment of pleural diseases are becoming more and more effective. The article presents the data of modern literature and electronic databases of The Drug-Induced Respiratory Disease Website about DI lesions of the pleura. This review provides information about the main types of DI lesions of the pleura and the scope of drugs that cause these reactions. Ultimately, doctors awareness of drug-induced pleural diseases can ensure timely diagnosis of these conditions, correct therapy, and ultimately improve the quality of medical care.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87582501","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 lactacidosis in acute kidney damage and metformin therapy","authors":"O. V. Alekseenko, Evgeniy Yu. Kovalchuk, A. V. Risev, A. M. Sergeeva, Alexey V. Lapickiy","doi":"10.17816/mechnikov81407","DOIUrl":"https://doi.org/10.17816/mechnikov81407","url":null,"abstract":"Тhe article provides a clinical observation of the development of a rare pathological condition of lactic acidosis in a patient with acute kidney injury while taking metformin and confirms the need for timely determination of blood lactate. \u0000Тhe clinical case confirms that the development of lactic acidosis in a patient with diabetes mellitus may have a mixed etiology and be associated not only with the use of metformin, but also with the presence of tissue hypoxia, exposure to an infectious process, and impaired renal function. \u0000The development of lactic acidosis is associated with an increase in secretion and / or a decrease in the rate of excretion of lactate, which is expressed in a state of metabolic acidosis and severe cardiovascular insufficiency. The development of lactic acidosis is most often associated with the presence of renal and / or hepatic insufficiency, diabetes mellitus, lung pathology, macromicrocirculation disorders, and hemoglobin function defects, the treatment with biguanide drugs (metformin). Diagnosis of lactic acidosis is based on the data from a biochemical blood test and electrolyte parameters the concentration of blood plasma lactate, the study of acid-base state of the blood and anion gap.","PeriodicalId":12949,"journal":{"name":"HERALD of North-Western State Medical University named after I.I. Mechnikov","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86944166","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}