Klinicheskaia meditsina最新文献

{"title":"[Extragastric symptoms associated with Helicobacter pylori infection].","authors":"V A Akhmedov,&nbsp;O V Gaus","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This review article highlights the modern views of manifestations associated with Hp infection. The data are presented about the negative impact of the infection on the state of the musculoskeletal system, the development of migraine, progression of diffuse liver disease and the risk of developing liver cancer. The paper also provides information on the possible effects of Helicobacter pylori infection on the formation of halitosis, tympanosclerosis, male reproductive health disorders, colorectal cancer, Alzheimer's and Parkinson's disease, pre-eclampsia during pregnancy, and idiopathic chronic urticaria. In addition, the negative relationship between Hp infection, bronchial asthma, and inflammatory bowel disease is considered.</p>","PeriodicalId":17856,"journal":{"name":"Klinicheskaia meditsina","volume":"95 1","pages":"15-22"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36568651","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":"[PROINFLAMMATORY CYTOKINES AND SIGNALING PATHWAYS IN PERIPHERAL BLOOD MONONUCLEAR CELLS IN PATIENTS WITH CORONARY ARTERY DISEASE].","authors":"A V Logatkina,&nbsp;V S Nikiforov,&nbsp;S S Bondar,&nbsp;I V Terekhov","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>To determine content of mononuclear ells (MNC) in peripheral blood of patients with coronary heart disease (CHD) and factors responsible for their functional state and cytokine production.</p><p><strong>Materials and methods: </strong>Concentration of proteinkinases JNK1/2, ERK1/2, MAPK38, AKT1, JAK2, FAK, AMPK, p70S6K, STAT3, STAT5B and STAT6 was determined in MNC lysate by immune-enzyme assay. Interleukin 1β, 2, 4 and y-interferon levels were measured in blood sera.</p><p><strong>Results: </strong>In patients with angina of effort and unstable angina, the JNK level was 59,8% and 53,1% higher than the normal one respectively (р=0,013) and (р=0,012). The level of the nuclear transcription factor was 26,9% (р=0,015) and 27,9% (р=0,017), JAK2 31,5% (р=0,022) and 48,6% (р=0,018), STAT3 49,6% (р=0,025) and 55,3% (р=0,02), STAT5B 21,5% (р=0,018) and 30,2% (р=0,011) lower. These changes were associated with a 13,1% (р=0,047) and 51,4% (р=0,019) rise in the STAT6 level, 30,1% (р=0,025) and 79,4% (р=0,003) FAK level, 7,6% (р=0,09) and 15,2% (р=0,039) АКТ1 level, 65,3 (р=0,02) and 76,2% (р=0,017) p70S6K level.</p><p><strong>Conclusion: </strong>Results of the study suggest persistent pro-inflammatory activation of whole blood cells in CHD patients due to enhanced levels of IL-1 and IL-2, components of the MAPK/SAPK signal pathway in MNC and decreased STAT3 level determining cell sensitivity to IL-10. The elevated intracellular level of ERK and JNK us responsible for high responsiveness of MNC to pro-inflammatory cytokines.</p>","PeriodicalId":17856,"journal":{"name":"Klinicheskaia meditsina","volume":"95 3","pages":"238-44"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36570419","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":"[SYSTEMIC LUPUS ERYTHEMATOSUS WITH LUPUS NEPHRITIS IN THE ELDERLY (CLINICAL OBSERVATION)].","authors":"M Z Kanevskaya,&nbsp;O M Kuznetsova","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We report a clinical case of SLE in a women affected at the age of 63 years who had recurrent nephrotic syndrome with the development of renal insufficiency at the onset and a good outcome of therapy with a large total dose cyclophosphamide.</p>","PeriodicalId":17856,"journal":{"name":"Klinicheskaia meditsina","volume":"95 2","pages":"168-72"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36579053","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":"[PERSONALIZED MEDICINE IN INTERNAL MEDICINE].","authors":"V G Kukes,&nbsp;V F Marinin,&nbsp;Yu V Olefir,&nbsp;G V Ramenskaya,&nbsp;N B Lazareva,&nbsp;V V Smirnov,&nbsp;M V Zhuravleva,&nbsp;A B Prokofiev,&nbsp;E V Shih,&nbsp;A S Zhestovskaia,&nbsp;N A Rumyantsev,&nbsp;D V Mandich,&nbsp;O A Goroshko","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Personalized medicine - a new direction in medicine, which is based on the study of various biomarkers and the use of new methods of molecular analysis (primarily evaluating the activity of isoenzymes of cytochrome P450), allowing individualized approach to the selection of both the drugs and the selection of the dosing regimen for the purpose of maximize the effectiveness and safety of pharmacotherapy. This personalized medicine is to change the development and use of preventive and curative interventions. Genetic polymorphism isozymes of cytochrome P450 may determine the individual activity of a particular isozyme, and thus, to predict the clinical effectiveness, and in some cases, the risk of adverse reactions. The article is an example of the use of information on the activity of cytochrome P450 in clinical practice in matters of diagnosis, treatment and prevention of diseases. The scheme of the five best-known activity of isoenzymes of cytochrome P450 is shown.</p>","PeriodicalId":17856,"journal":{"name":"Klinicheskaia meditsina","volume":"95 3","pages":"197-200"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36613709","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":"[EVALUATION OF BODY MASS INDICES AND ARTERIAL PRESSURE AS CARDIOVASCULAR RISK FACTORS IN THE ADULT POPULATION OF THE CITY OF VORONEZH].","authors":"A. Kryuchkova, N. M. Seminina, Yu.V. Kondusova, I. Poletaeva, A. Knyazeva","doi":"10.18821/0023-2149-2017-95-2-148-153","DOIUrl":"https://doi.org/10.18821/0023-2149-2017-95-2-148-153","url":null,"abstract":"Aim To determine body mass index (BMI) and blood pressure (BP) of the Voronezh city adult population. Materials and methods 1108 residents of Voronezh city at the age from 20 to 75 years were examined in 2015 including measurement of their height, body mass, arterial pressure, and BMI calculation. Medical histories were analyzed to reveal arterial hypertension in the preceding period in the following age groups: 20-29, 30-39, 40-49, 50-59, 60-75 yr and the entire study group (20-75 yr). Results The mean BMI of the residents of Voronezh was 28.5 (23.8; 33.1) kg/m. The highest values were found between 40 and 59 years. BMI in women under 40 was lower than in men of the same age. The education level affected the prevalence of obesity in that people with secondary vocational education were more likely to be obese than those given higher education. At the age of 40, the incidence of hypertension among women was lower than among men of the same age, it more frequently occurred at the age of 60-75 years. Both age and BMI were related to the level of blood pressure: higher BMI and blood pressure were recorded at an older age. The prevalence of hypertension also increased with age. Conclusion Obesity was detected in 29.7% of the Voronezh population recruited to the study. The prevalence of obesity among young adults (20-29 years) iproved lower than in the middle and old age groups. 30.9% of the residents suffered from AH.","PeriodicalId":17856,"journal":{"name":"Klinicheskaia meditsina","volume":"59 1","pages":"148-53"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77896961","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 PREVALENCE OF RESPIRATORY SYMPTOMS AMONG RESIDENTS OF THE RUSSIAN FAR NORTH].","authors":"S. Andronov, A. Lobanov, A. Popov, A. Emelyanov","doi":"10.18821/0023-2149-2017-95-3-260-263","DOIUrl":"https://doi.org/10.18821/0023-2149-2017-95-3-260-263","url":null,"abstract":"Aim To study the frequency of respiratory symptoms among the reindeer herders of the Yamal region in the Far North of Russia. We conducted a cross-sectional study of the occurrence of respiratory symptoms among 500 subjects of the tundra Nenets population (28.1% of the adult Nenets population in the district), of which 38.3% were men and 61.7% women (average age 40.1 years). All patients were matched for age and occupation. Medical examination was carried out by a pulmonologist with the use of the GARD questionnaire (WHO, 2004) and spirometry. Spirometry was performed with a SpiroUSB device (UK) according to a unified standard and the criteria of ATS/ERS 2005. The frequency of respiratory symptoms among the tundra population was estimated at 71.8%. Cough with expectoration and dyspnea were found in 22.8% of the respondents. 70.0% of the examined subjects worked in the cold, 33% were exposed to the open flame at home, and 34.4% smoked. Respiratory symptoms developed in 16.3% of those working in the cold and in 37% exposed to open fire. The combination of such complaints as cough and sputum production occurred in smokers twice as frequently as in non-smokers (54.1%) (p<0.01).The combination of such complaints as cough and sputum production was twice as likely note in his those who smoked (54.1% vs 20.2%) (p<0.01). The combination of these problems dyspnea was three times more common in the smokers (23,3%vs 7,3%) (p<0.001). At presence at patients of such a factor as work in the cold and the absence of other only 16.3% of them have respiratory symptoms. When using at home the open flame and the absence of other factors leading up 37.0% of the individuals with symptoms of chronic bronchitis. Cough, sputum and dyspnea are formed only among 26.3% of the smokers face when smoking is the only risk factor. If the surveyed residents of all three negative factors respiratory symptoms met at 62.1%. Disorders of respiratory function according to spirometry were not observed in none of the study participants. Respiratory symptoms developed in 62.1% of the subjects exposed to all three risk factors. External respiration indices remain normal in all he examine subjects. It is concluded that residents of the Far North frequently suffer respiratory symptoms without disorders in the external respiratory function. In most cases they associated with three factors (work in the cold, exposure to open fire at home, and smoking). Compensatory stimulation of lung functions may create additional difficulties for diagnostics of bronchial obstruction.","PeriodicalId":17856,"journal":{"name":"Klinicheskaia meditsina","volume":"26 1","pages":"260-3"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77388644","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 HISTORY OF DEPARTMENT OF FACULTY THERAPY, AT THE VORONEZH HIGHER EDUCATION INSTITUTION (ON THE OCCASION OF THE CENTENARY ANNIVERSARY OF N.N. BURDENKO VORONEZH STATE MEDICAL UNIVERSITY)].","authors":"A. Budnevsky, V. Provotorov, Yu I Filatova","doi":"10.18821/0023-2149-2017-95-2-189-192","DOIUrl":"https://doi.org/10.18821/0023-2149-2017-95-2-189-192","url":null,"abstract":"The article is devoted to the history of the Department of Faculty Therapy, N.N. Burdenko Voronezh State Medical University. The history of its creation is inextricably linked to the Derpth (Yurievsky) University that was transferred to Voronezh in 1918. While the Department of Faculty Therapy remained in Voronezh, it several times changed location making use of various city hospitals as its branches. It simultaneously expanded its activities by organizing courses of physical therapy, endocrinology, and other medical disciplines. The article focuses on the events pertaining to the formation and development of the Department of Faculty Therapy, main directions and achievements of its scientific work.","PeriodicalId":17856,"journal":{"name":"Klinicheskaia meditsina","volume":"114 1","pages":"189-92"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77558287","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 ROLE OF LOW-FREQUENCY PIEZOTHROMBOELASTOGRAPHY IN THE COMPREHENSIVE EVALUATION OF HEMOSTASIS IN CORONARY BYPASS SURGERY WITH CARDIOPULMONARY BYPASS].","authors":"E. Fanaskova, O. Gruzdeva, O. Akbasheva, I. Tyutrin, T. Penskaya, E. Uchasova, G. Plotnikov, K. E. Krivoshapova, O. Barbarash","doi":"10.18821/0023-2149-2017-95-3-245-253","DOIUrl":"https://doi.org/10.18821/0023-2149-2017-95-3-245-253","url":null,"abstract":"Aim To monitor the hemostatic system during platelet concentrate transfusions using low-frequency piezothromboelastography in patients with coronary bypass surgery given aspirin therapy. Materials and Methods The study involved 148 patients with coronary bypass surgery, with 76 ones undergoing intraoperative transfusion of platelet concentrate and 72 treated without transfusion. The control group consisted of 20 healthy individuals. In the perioperative period indicators of vascular-platelet, coagulation, anticoagulant and fibrinolytic components of hemostasis were evaluated by low-frequency pezotromboelastography using the ARP-01M \"Mednord\" hardware and software system (Russia). Results It was shown that the antiplatelet effect of aspirin in the preoperative period was manifest as inhibition of the initial stage of blood coagulation accompanied by increased thrombin potential, the total gain of anticoagulant and fibrinolytic activity of the blood. Heart-lung bypass was accompanied by structural and chronometric anticoagulation, reduction of anticoagulation and increase of blood fibrinolytic activity. In the postoperative period, structural and chronometric anticoagulation was more pronounced in patients who did not undergo transfusion of platelet concentrate than in the group of patients with transfusion. Donor platelets further increased the blood hemostatic potential by neutralizing the antiplatelet effect of aspirin. Perioperative thrombohemorrhagic complications were absent in both groups. Conclusion Low-frequency piezothromboelastography provides a tool for real-time monitoring the functional state of hemostasis system. Transfusion of platelet concentrate is not advisable given that the thrombin potential is preserved as confirmed by the results of low-frequency piezothromboelastography.","PeriodicalId":17856,"journal":{"name":"Klinicheskaia meditsina","volume":"16 2","pages":"245-53"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91469326","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 risk of cardiovascular death in type 2 diabetes].","authors":"N V Zeinalova,&nbsp;Y Z Kurbanov,&nbsp;V A Mirzazade,&nbsp;R A Rzayeva,&nbsp;M S Novruzova","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate effects of metabolic disorders on the risk of cardiovascular death in patients with type II diabetes based on Framingham risk score. We analyzed results of examination of 210 men and 210 women with type 2 diabetes who applied for medical care to the VM center of Endocrinology during 1997-2014. A virtual control group was formed matching real patients in terms of the number, sex, age, and height having ideal body mass index, total cholesterol and high-density lipoprotein cholesterol levels. The average risk of cardiovascular death in patients with type 2 diabetes was equal to 4,56±0,254% compared with 0,6±1,028% in the virtual control group. The differences was significant (p <0,001). The minimum risk for the patients of the two groups was estimated at 0,001% and 0,01% respectively. The maximum risk of cardiovascular death is 34,17% in patients with diabetes and 8,24% in controls. It is concluded that type 2 diabetes and related metabolic disorders significantly increase the risk of cardiovascular death.</p>","PeriodicalId":17856,"journal":{"name":"Klinicheskaia meditsina","volume":"95 1","pages":"57-9"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36569072","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":"[Pathogenesis of myocarditis in patients with bronchial asthma and pecilomycosis].","authors":"V M Akhunov,&nbsp;Zh M Sizova,&nbsp;A M Akhunova,&nbsp;T P Lavrent'eva","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We studied the influence of activation ofpecilomycotic infection in blood on the morphofunctional state of myocardium based on the clinical and pathomorphological data. The study included 23 patients with bronchial asthma (BA) concomitant with pecilomycosis after acute viral respiratory infection; protocols of autopsies and pathological sections of the heart muscle of the patients who died from asphixy and acute cardiac insufficiency were analyzed. Histological sections showed up vascular dystonia of the microcirculation bed, arteriole spasms, wall destruction in small and medium-size vessels and the adjacent muscular tissue, stromal oedema, valvular swelling, andperiwall endocarditis. Cardiac cavities and coronary vessels contained erythrocyte-rich thrombi with ferulas of Paecilomyces at different stages of development. Clinical manifestations of destructive changes in the heart muscle developing under effect of Paecilomyces infection had the form of rhythm and conductivity disorders. The local protective inflammatory reaction of productive type had the form of intermediate and vascular-type myocarditis passing to postmyocarditic cardiosclerosis. Periodic bursts of activation ofpecilomycotic infection in blood with the accumulation of fungal phospholipase A2 and lipid metabolites produced membranotoxic effect and can play the key role in the development of atherosclerosis and hypertensive disease in patients with BA and pecilomycosis.</p>","PeriodicalId":17856,"journal":{"name":"Klinicheskaia meditsina","volume":"95 1","pages":"66-71"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36569073","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}