Klinicheskaia meditsina最新文献

{"title":"[DENGUE FEVER IN RUSSIA: PROBLEMS OF DIAGNOSTICS].","authors":"A A Nafeev,&nbsp;L V Il'mukhina","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The authors report clinical and laboratory data concerning a case of hemorrhagic dengue fever introduced to Ul’yanovsk by a tourist who had spent holiday in Vietnam. The clinical picture of the disease is described along with results of clinical and laboratory analyses. The approaches to the evaluation of the patient's health status during the period of primary examination and medical care as well as the problems that arose after the final diagnosis was established are discussed.</p>","PeriodicalId":17856,"journal":{"name":"Klinicheskaia meditsina","volume":"95 2","pages":"154-7"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36579050","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":"[A CASE OF FAMILIAL PULMONARY AND HEPATIC ECHINOCOCCOSIS)].","authors":"O A Tsvetkova,&nbsp;O O Voronkova,&nbsp;D V Ovchinnikova","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Echinococcus granulosus still remains a widespread disease. Moreover, there is a large number of patients in whom it is diagnosed rather late because its clinical presentation can be unspecific and symptoms vary. We report a familial case of the disease. Its specific feature was the onset with the bilateral pulmonary process and late involvement of the liver. This excluded other pulmonary diseases, such as pneumonia, tuberculosis or cancer.</p>","PeriodicalId":17856,"journal":{"name":"Klinicheskaia meditsina","volume":"95 2","pages":"173-6"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36579054","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":"[Criteria for granting permission for disabled persons to participate in the Ready for Labor and Defense training program].","authors":"E. V. Mashkovsky, K. Predatko, A. Magomedova, S. V. Shteĭnerdt, K. Volodina","doi":"10.18821/0023-2149-2017-95-1-23-30","DOIUrl":"https://doi.org/10.18821/0023-2149-2017-95-1-23-30","url":null,"abstract":"Rehabilitation, adaptation, and social integration of the disabled are the priority issues of social welfare policy in the Russian Federation. This includes the enhancement of availability ofphysical education and adapted sports programs. One of the best practices for the improvement ofphysical activity among the population is the \"Ready for labour and defense\" training system (GTO). However, it is not adapted for those with physical challenges and disabilities. To involve this special fraction of the population in physical activity and participation in the GTO system, disability groups eligible for this activity need to be identified. They can include individuals with visual (VI), intellectual (II), hearing (HI), and locomotor problems as well as those with transplanted organs (TO). Also, minimum disability criteria (MDC) for the participants from each group which would make them eligible to practice an adapted GTO system should be defined. The development of MDC for individuals with VI, II, HI, and TO is relatively easy as they are common for most adapted sports. However, it remains a challenge for persons with locomotor problems since they make up a very diverse group bearing in mind that the rules of the International Paralympic Committee envisage different MDC for different adapted sports. There are two possible solutions: (1) to develop specialized MDC for each sport discipline included in the GTO system, (2) to develop universal MDC for all disciplines. The next step in promoting the GTO system among individuals with physical challenges and disabilities will be the development of the para- GTO program that would be unique and adapted for all categories of the disabled individuals.","PeriodicalId":17856,"journal":{"name":"Klinicheskaia meditsina","volume":"9 1","pages":"23-30"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82493125","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 CARDIOVASCULAR RISKS WITH THE USE OF MORPHOGENETIC KLOTHO PROTEIN IN PATIENTS WITH CHRONIC RENAL DISEASE].","authors":"N. Mukhin, L. Milovanova, V. Fomin, L. Kozlovskaya, M. Taranova, T. Androsova, A. Borisov","doi":"10.18821/0023-2149-2017-95-3-272-277","DOIUrl":"https://doi.org/10.18821/0023-2149-2017-95-3-272-277","url":null,"abstract":"The aim of the study was to explore the Klotho protein significance in patients with different stages of chronic kidney disease (CKD) and to assess the influence of antihypertensive therapy on Klotho protein serum levels. Materials and methods 130 patients with stage 5 CKD1 were included in the study. Serum PTH, calcium and phosphorus were measured. ELISA was used to determine serum soluble alpha Klotho. Blood pressure including brachial and central (aortic) pressure was measured in all patients together with pulse wave velocity (using a «Sfigmokor» device); in addition, echocardiography (EchoCG), and X-ray examination of the abdominal aorta by Kauppila method were performed. Results The dynamic study of serum Klotho level showed that it changes with decreasing glomerular filtration rate faster than a rise in phosphate and PTH levels starting from stage 3A of CKD. The two later variables increased at stages 4-5.According to the ROC analysis, the values of serum Klotho below 387 pg /ml suggested enhanced risk of myocardial calcification with 80% sensitivity and 76% specificity. In addition, the highest Klotho serum levels were observed in patients whose target BP values were achieved with angiotensin receptor blockers (ARB) compared to those who used other drugs [р<0,01] or failed to reached target BP levels [p=0,008]. Conclusion The study showed the possibility of practical use of Klotho protein as an early diagnostic marker of cardiovascular risk. Reduced serum Klotho was less pronounced in patients who used ARB for correction of high blood pressure. Normal Klotho protein levels in serum have been associated with a lower frequency of heart and vessels calcification in CKD patients.","PeriodicalId":17856,"journal":{"name":"Klinicheskaia meditsina","volume":"11 1","pages":"272-7"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81885938","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":"[CYTOKINE PROFILE IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION WITH AND WITHOUT COMPLICATIONS].","authors":"A. O. Aimagambetova, L. Karazhanova, A. Kotlyar","doi":"10.18821/0023-2149-2017-95-3-233-237","DOIUrl":"https://doi.org/10.18821/0023-2149-2017-95-3-233-237","url":null,"abstract":"The aim of this study was to evaluate the prognostic role of the cytokine profile in patients with ST segment elevation myocardial infarction (STEMI). Materials and methods In the present paper we studied cytokines IL-6, IL-1β, IL-10, TNFα and CRP in 81 patients with different course of STEMI. Results In patients with complicated course of STEMI a significant increase in the concentration of IL-6, IL-10, FNOα, CRP was recorded on the 1st, 7th and 14th days compared with control group of healthy subjects and a group of patients with uncomplicated STEMI. Concentrations of TNFα>35.49 pg/ml, IL-6>33.37 pg/ml, IL-10>34 pg/ml, CRP>10.84 mg/l on day 1 may suggest cardiovascular complications in STEMI patients within 1 year after the onset of the disease. We have not found reliable prognostic levels of IL-1β, as the concentration of this cytokine remained within the accepted normal range.. Discussion It is concluded that initially elevated levels of CRP l, TNFα, IL-6, IL-10 in the blood make it possible to identify groups of patients with myocardial infarction with ST-segment elevation at high risk of cardiovascular events throughout the year.","PeriodicalId":17856,"journal":{"name":"Klinicheskaia meditsina","volume":"39 1","pages":"233-7"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76641953","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":"[Dynamics of clinical, X-ray and functional data during treatment of patients with sarcoidosis].","authors":"I. Vizel’, A. Vizel’","doi":"10.18821/0023-2149-2017-95-1-60-65","DOIUrl":"https://doi.org/10.18821/0023-2149-2017-95-1-60-65","url":null,"abstract":"Aim To analyze the literature data and the results of original studies on the respiratory function in patients with sarcoidosis. Material and methods The study included 1199 patients with sarcoidosis (67.8% women and 32.2% of males, median age 43 years). The first X-ray stage was documented in 34.8% of patients , stage II in 57.0%, stage III in 6.1%, stage IV in 1.3%, stage 0 in 0.7%. One patient (0.1%) had pleural sarcoidosis. Loefgren syndrome was diagnosed in 20% of the patients. In 658 patients (54.9%) the diagnosis was confirmed by biopsy studies. Results The patients with sarcoidosis exhibited significant correlation between radiographic and spirometric characteristics. In those with Loefgren syndrome, all breathing parameters were much better than in the remaining ones. Changes of spirometry parameters were more pronounced in smokers and in patients with concomitant lung diseases. However, the lung function remained impaired after adjustment for these factors, and 9,7% of the cases positively responded to the administration of a short-acting bronchodilator. Х-ray examination and spirometry are independent methods for the evaluation of the health status of patients with sarcoidosis and their results do not always correlate with each other after different treatment regimens. Changes in Х-ray image and lung vital capacity were consistent in patients treated with prednisone, methotrexate and pentoxifylline, but not in the cases treated with vitamin E and in the absence of treatment. Spirometry with simultaneous X-ray examination is recommended for all patients with intrathoracic sarcoidosis. Conclusion Forced vital capacity of lungs (FVC) is an independent criterion for evaluating the condition of patients with sarcoidosis and the effectiveness of the treatment.","PeriodicalId":17856,"journal":{"name":"Klinicheskaia meditsina","volume":"20 1","pages":"60-5"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75807680","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 CHRONIC DISEASES AS A SYSTEMIC MANIFESTATION OF CHRONIC PULMONARY OBSTRUCTIVE DISEASE].","authors":"A. Budnevsky, É. Voronina, E. Ovsyannikov, L. Tsvetikova, Yu G Zhusina, N. B. Labzhaniya","doi":"10.18821/0023-2149-2017-95-3-201-206","DOIUrl":"https://doi.org/10.18821/0023-2149-2017-95-3-201-206","url":null,"abstract":"Anemia of chronic disease (ACD) is one of the most frequent forms of anemia is often observed in patients with infections, cancer and chronic inflammatory or autoimmune diseases. The underlying mechanisms are complex and include dysregulation of iron homeostasis and erythropoietin production, impaired proliferation of erythroid progenitor cells and reduced life span of red blood cells. Moreover, ACD is often superimposed by malnutrition, bleeding and renal failure. ACD is mediated through inflammatory cytokines and characterized by low serum iron (hypoferremia) and often increased reticuloendothelial stores of iron. ACD is usually normocytic, normochromic anemia, but it can become microcytic and hypochromic as the disease progresses. Hepcidin, the main regulator of iron homeostasis and its synthesis, is inhibited by iron deficiency and stimulated by inflammation. In many patients the disease is associated with several extrapulmonary manifestations regarded as the expression of the systemic inflammatory state of chronic obstructive pulmonary disease (COPD). Recent studies showed that anemia in patients with COPD is more frequent than expected, with its prevalence ranging from 8 to 33%. Systemic inflammation may be an important pathogenic factor, but anemia in COPD can also be the result of a number of factors, such as the treatment with certain drugs (angiotensin-converting enzyme inhibitors or theophylline), endocrine disorders, acute exacerbations and oxygen therapy. Anemia in COPD patients is strongly associated with increased functional dyspnea, decreased exercise capacity and is an independent predictor of mortality. Treatment options to correct anemia used in other chronic diseases, such as congestive heart failure, cancer or chronic kidney disease have not been explored in COPD (i.e. erythropoietic agents, iron supplements or combined therapy). It is not known whether treating the underlying inflammation could improve hematological characteristics. It is important to develop basic diagnostic modalities for this group of patients and formulate methods of anemia correction.","PeriodicalId":17856,"journal":{"name":"Klinicheskaia meditsina","volume":"25 1","pages":"201-6"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73283334","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 SMOKING AND INDICATORS OF SYSTEMIC INFLAMMATION IN PATIENTS WITH CORONARY HEART DISEASE].","authors":"E. Bazdyrev, O. Polikutina, N. A. Kalichenko, Y. Slepynina, E. Uchasova, V. Y. Pavlova, O. Barbarash","doi":"10.18821/0023-2149-2017-95-3-264-271","DOIUrl":"https://doi.org/10.18821/0023-2149-2017-95-3-264-271","url":null,"abstract":"Aim To estimate the severity of systemic inflammation in subjects with coronary artery disease (CAD) without bronchopulmonary system comorbidity depending on smoking factor. Materials and methods The subjects were divided into groups depending on smoking factor. We estimated the following laboratory markers of nonspecific inflammation: interleukine (IL)-12, -1β, tumour necrosis factor-α, matrix metalloproteinase-9, C-reactive protein. The examination of lungs respiratory function included spirometry, body plethysmography and assessment of diffusing lung capacity. Results 29.9% of the subjects with CAD smoked, 40% reported discontinuation of smoking in their histories. Smoking in CAD subjects without the history of bronchopulmonary system comorbidity was associated with a higher level of inflammatory markers (IL-12, IL-1β, TNF-α, ММР-9 and CRP) than in subjects who ceased to smoke and those who have never smoked. No differences in the levels of inflammatory markers were revealed in subjects who had smoked before and never smoked. Conclusion Smoking is widespread among CAD subjects. It is associated with a higher level of markers of nonspecific inflammation as compared to subjects who have never smoked before or ceased smoking.","PeriodicalId":17856,"journal":{"name":"Klinicheskaia meditsina","volume":"210 1","pages":"264-71"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76112894","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":"[\"HELICARB\" - the first Russian breath test kit with 99 % C-urea for Helicobacter pylori: from idea to registration].","authors":"R. Plavnik, S. Rapoport, K. Plavnik, A. R. Elman, V. I. Nevmerzhickij","doi":"10.18821/0023-2149-2017-95-1-78-84","DOIUrl":"https://doi.org/10.18821/0023-2149-2017-95-1-78-84","url":null,"abstract":"The present study was aimed to develop and introduce in medical practice the first Russian kit for the C-urea breath test of Helicobacter pylori. The newly created kit was given the commercial name «HELICARB» and successfully passed technical, toxicological, clinical, and laboratory testing. The optimal dose of 13C-urea was determined and various devices needed to perform the test were compared. The results were approved by the Federal Service for Supervision in the health sector Roszdravnadzor) that issued the Registration certificate № RZN 2016/3773 (order № 1641 of 02.29.2016), which gives the right to manufacture and use the «HELICARB» test kit at the territory of the Russian Federation.","PeriodicalId":17856,"journal":{"name":"Klinicheskaia meditsina","volume":"152 1","pages":"78-84"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77441174","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":"[KYOTO CONSENSUS - THE NEW ETIOLOGICAL CLASSIFICATION OF CHRONIC GASTRITIS AND ITS DISCUSSION].","authors":"Ya S Tsimmerman,&nbsp;Yu A Zakharova","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The main provisions and headings of the new etiological classification of chronic gastritis are discussed in the context of recent data on the true role of Helicobacter pylori infection in the development of this pathology. The methods and results of the authors ’ investigations into gastric microflora are presented along with information about the frequency of detection of its different forms, concentration of microbial forms in gastric mucosa, their pathogenic properties including urease activity, and possible contribution to chronic gastritis etiology. The possibility of alcoholic and chemical chronic gastritis is discussed along with the role of these conditions in the development of stomach cancer. Special emphasis is laid on the disagreement between the adopted consensuses and principles of evidence-based medicine.</p>","PeriodicalId":17856,"journal":{"name":"Klinicheskaia meditsina","volume":"95 2","pages":"181-8"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36567495","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}