Medical alphabet最新文献

{"title":"The phenotype of systemic lupus erythematosus as a factor in rational therapy choosing","authors":"A. Babaeva, E. V. Kalinina, V. P. Goloskova","doi":"10.33667/2078-5631-2024-10-7-12","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-10-7-12","url":null,"abstract":"Systemic lupus erythematosus (SLE) is characterized by a variety of clinical manifestations, which are defined as separate phenotypes of the disease. Despite the universality of immunopathological reactions, which are based on the formation of anti-nuclear antibodies and antibodies to native DNA, the spectrum and severity of immunological disorders in individual phenotypes are different. The role of type I interferons (IFN) in the SLE pathogenesis has now been proven. Hypersecretion of IFN-α and IFN-β leads to the production of antibodies against the components of the cell nucleus through activation of the native and adaptive immunity system. The current treatment strategy provides for achieving remission or low activity with immunosuppressants, including selective ones, such as biological agents. According to the updated international recommendations, anifrolumab, monoclonal antibodies against type I IFN, which has demonstrated high efficacy in the treatment of SLE with skin-mucous and joint lesions., can be used for the treatment of SLE along with rituximab and belimumab. The article presents our own clinical observation on the analysis of the effecacy and safety of anifrolumab in the treatment of a young patient with high-activity SLE and pronounced skin manifestations. It was shown that after the first injections of the drug, there was a rapid dynamics of skin and joint syndrome, the activity of SLE decreased from maximum to minimum according to the SELENA-SLEDAI index. The results obtained confirm the rationale of including anifrolumab in the treatment regimen in cases of insufficient previous therapy.","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141818267","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":"Intense pulsed light is a promising way for telangiectasias / reticular veins treatment: from pathogenesis to pronounced clinical outcomes","authors":"D. V. Demidion, D. A. Koryakin","doi":"10.33667/2078-5631-2024-9-91-94","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-9-91-94","url":null,"abstract":"Varicose veins are the most common pathology of peripheral vessels. A broader concept is the term chronic venous insufficiency (CVI), which, in addition to varicose veins, includes telangiectasias and reticular veins. Sclerotherapy is considered as the basis of treatment for reticular veins. However, the procedure has its drawbacks and side effects, which indicates the importance of implementing safer treatment methods. An alternative treatment for reticular veins is intense pulsed light. To illustrate the effectiveness and safety of IPL treatment for reticular veins, we present a clinical case of a patient aged 73 years with complaints of dark purple and bluish vessels. After clinical evaluation, diagnosis of reticular veins/telangiectasias was made (C 1 according to the CEAP 2020 classification). Due to the patients’ refusal to undergo sclerotherapy, it was decided to perform IPL procedures (M22, Lumenis). The patient’s reticular veins and telangiectasias were almost completely leveled out after the second session of IPL therapy; there was also no progress of CVI. No side effects were noted. The pathogenetic application of intense pulsed light in the treatment of reticular veins can be explained by decreasing the inflammatory process, integrating extracellular matrix, as well as inhibition of mast cell degranulation.","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141818141","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":"COVID-19 in patients with rheumatic diseases: frequency and course","authors":"A. N. Kulikov, N. Muravyeva, B. Belov","doi":"10.33667/2078-5631-2024-10-13-18","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-10-13-18","url":null,"abstract":"Objectives. The aim of the study was to assess frequency and severity of COVID-19 in patients with rheumatic diseases (RD).Patients and methods. The study included information on the presence or absence of COVID-19 in the medical history of 9185 patients with immunoinflammatory RD (IIRD) and 491 patients with osteoarthritis (OA) who were observed at the V. A. Nasonova Research Institute of Rheumatology from September 21, 2021 to December 28, 2023.Results. The incidence of COVID-19 in the analyzed IIRD was significantly higher compared to OA (p<0.02). All IIRD included in the analysis are characterized by an increased risk of COVID-19 incidence when compared with OA by 1.7–3.5 times. Patients with rheumatoid arthritis, ankylosing spondylitis, Sjögren's disease, systemic sclerosis, psoriatic arthritis, systemic lupus erythematosus, microcrystalline arthritis, ANCA- associated vasculitis and poly/dermatomyositis were significantly more likely (p<0.009) to receive COVID-19 therapy compared with the control group. Patients with these diseases are characterized by an increased risk of treatment for COVID-19 by 1.7–6.5 times compared with OA. Also, patients with inflammatory joint diseases (IJD), connective tissue diseases (CTDs) and systemic vasculitis (SV) were hospitalized with COVID-19 more often than patients with OA (p=0.013, p=0.003 and p<0.001, respectively). Patients with IJD, CTDs and SV are characterized by an increased risk of hospitalization with COVID-19 by 3.5–6.8 times compared with OA. In addition, elderly patients with IIRD are characterized by an increasing risk of treatment, hospitalization and use of biologics or targeted synthetic disease-modifying drugs for COVID-19.Conclusion. According to the data obtained, the problem of COVID-19 remains very significant for patients with RD. This dictates the need to continue studying risk factors for adverse outcomes of the disease and vaccine prevention of this infectious pathology.","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141817993","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":"Efficiency and safety of thread implantology in the long term: data from a pathomorphological study","authors":"D. N. Serov, M. S. Kruglova","doi":"10.33667/2078-5631-2024-9-87-90","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-9-87-90","url":null,"abstract":"The evolution of methods used in aesthetic medicine includes a transition to less invasive procedures with high safety and minimal recovery time. That is why numerous non-invasive methods for correcting involutive changes in facial skin (thread lifting, hardware techniques) have been studied for effectiveness and safety over the past decades. Such techniques can improve treatment results and avoid or delay surgical intervention.Material and methods. The work involved a pathomorphological study of material taken by biopsy at the sites of thread implantation and surrounding tissues (1 cm indentation) (Nano spring, Excellence Visage, Excellence Visage HA) within 12 months after thread lifting. Paraffin sections with a thickness of 5–7 microns were made from ready-made paraffin blocks and stained with: hematoxylin – eosin; according to the Weigert-Van Gieson method; Sirius Red paint. Using a microscope with a Sony digital photo attachment with a resolution of 12 megapixels, five photographs were taken from each histological specimen.Research results. As a result of a pathomorphological study of a flap of skin and subcutaneous fat with a synthetic thread in the adipose tissue, it was revealed that along the periphery of the studied material there was moderate chronic inflammation (giant cells of the type of foreign body cells, lymphocytes, fibroblasts) and weak fibrosis, as well as a predominance type I collagen in the skin, and type III collagen predominated in subcutaneous fat tissue.","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141819106","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":"Analysis of experience in the clinical use of dual-energy computed tomography in patients with undifferentiated arthritis","authors":"M. S. Eliseev, Y. I. Kuzmina","doi":"10.33667/2078-5631-2024-10-19-24","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-10-19-24","url":null,"abstract":"Dual-energy computed tomography (DECT) is a radiation diagnostic method that is used in rheumatology to verify microcrystalline arthritis, but in Russia this method is little known and the experience of its use is rather scarce.Objective of the research. To analyze the experience of using DECT in patients with undifferentiated arthritis and lesions of the axial skeleton in clinical practice.Material and Methods. The retrospective study included 20 patients (14 men and 6 women) observed at the V. A. Nasonova Research Institute of Rheumatology, who underwent DECT for diagnostic purposes. 13 patients with undifferentiated arthritis underwent DECT of peripheral joints to diagnose gout; 7 patients with an established diagnosis of gout (based on the 2015 ACR/EULAR classification criteria for gout) – to clarify the genesis of lesions to the axial joints and spine. The study was performed on a Siemens SOMATOM Definition Flash computed tomograph.Results. Using DECT in patients with undifferentiated arthritis, deposits of monosodium urate crystals (MSUc) were detected in 7 out of 13 (54 %), which made it possible to verify the diagnosis of gout. In the second sample, 6 out of 7 patients (85 %) showed signs of MSUc deposition on DECT, which explained the genesis of the existing complaints. Among these 6 patients, in 1 person, DECT revealed the presence of MSUc and calcium pyrophosphate crystals in the shoulder joint, which made it possible to make two diagnoses at once – gout and calcium pyrophosphate deposition disease.Conclusion. DECT in patients with undifferentiated arthritis makes it possible to verify the diagnosis of gout in more than half of the cases (54 %). In 85 % of patients with gout and pain in the back and axial joints of unknown origin, urate deposits are detected according to DECT. This method may be a useful tool for identifying microcrystalline arthritis of the axial joints, but further research is needed to implement the method in routine practice.","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141818770","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":"Laser technologies in the treatment of patients with a combination of rosacea subtypes: comparative data","authors":"A. L. Rodina, Yu. I. Matushevskaya, G. V. Sofinskaya","doi":"10.33667/2078-5631-2024-9-80-82","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-9-80-82","url":null,"abstract":"Phototechnologies occupy a leading position in the treatment of patients with rosacea. The most effective technologies are laser: pulsed dye laser (585nm, 595nm) and neodymium laser (1064nm), however, issues of comparative analysis, including in patients with a combination of rosacea subtypes, require further study.Material and methods. We observed 64 patients with diagnosed rosacea with a combination of subtypes: erythematotelangiectatic and papulopustular. Among them, 48 (75%) were female and 16 (25%) were male. The age of the patients varied widely: from 31 to 57 years, the average age was 39.2±4.6 years. The average duration of the disease was 5.1±2.3 years. Depending on the therapy, patients were divided into 2 groups: group 1 received treatment with a neodymium laser, group 2 – treatment with a pulsed dye laser.Research results. A cumulative assessment taking into account clinical research methods with a sufficient degree of reliability revealed the advantages of a neodymium laser over a pulsed dye laser, regardless of the clinical picture of rosacea, which was confirmed by the dynamics of the IGA/PGA indices: reduction in group 1 was 79.5%/66.7%, in group 2–63.2%/51.3%, respectively. These data were confirmed by the dynamics of the DIQI index – 81.7% and 61.6%, respectively.","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141818035","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":"Aspects of the use of modern injection disease-modifying therapy in real clinical practice in patients with osteoarthritis and (or) back pain","authors":"A. R. Baitimerov, D. R. Gilyazova","doi":"10.33667/2078-5631-2024-10-25-30","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-10-25-30","url":null,"abstract":"The results of a study on the effectiveness of the injectable chondroprotector Ambene® Bio in the treatment of patients with degenerative-dystrophic diseases of the spine and pain in the lower back are presented. The program involved 30 patients diagnosed with osteoarthritis and/ or spondyloarthritis, facet syndrome, osteochondrosis in the acute stage (severe symptoms: pain according to VAS 40–90 mm). All patients were prescribed the chondroprotector Ambene® Bio in the regimen of 2 ml every other day No. 10.Results. During treatment with the injectable chondroprotector Ambene® Bio for 20 days, it was possible to significantly reduce the manifestations of the target nosologies, restore the ability to move and self-care, improve the psycho-emotional state of patients, while reducing the need for NSAIDs.Conclusions. A short course of therapy with Ambene® Bio contributed to the effective treatment of study participants due to the synergism of the unique composition of biologically active substances. The study demonstrated a high safety profile and good tolerability of the therapy.","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141817980","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":"Assessment of the mental status of patients with rosacea","authors":"A. V. Sokolova, G. R. Fimochkina","doi":"10.33667/2078-5631-2024-9-69-72","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-9-69-72","url":null,"abstract":"Rosacea is a common chronic skin disease that significantly impairs patients’ quality of life. Various phenotypic characteristics and the localization on the face can have a negative impact on mental health and socialization, causing anxiety and depression in patients with rosacea. The aim of the study was to determine baseline levels of anxiety and depression in patients with erythematotelangiectatic telangiectatic and papulopustular rosacea and their combination and to compare the effect of combination therapy on patients’ psychoemotional state. We observed 45 patients with a diagnosis of erythematous telangiectatic rosacea and papulo-pustular subtypes of mild and moderate severity and their combination. Patients were divided into three groups according to the choice of combination of treatment methods. In group No. 1: 15 patients received botulinum toxin therapy with topical azelaic acid plus ivermectin. In group No. 2: 15 patients received PDL 595 nm procedure in combination with the topical therapy azelaic acid plus ivermectin. In group No. 3: 15 patients received botulinum toxin therapy with incobotulotoxin in combination with ILC 595 nm and topical azelaic acid therapy in combination with ivermectin. 26.7 % of the patients included in the study showed a deterioration in skin appearance due to emotional strain and stress. All patients showed subclinical manifestations of anxiety and depression according to the Hospital anxiety and depression scale (HADS). In addition, the mental state and anxiety of patients with rosacea can be significantly improved after treatment. Combination therapy with ivermectin, azelaic acid, LC 595 nm and botulinum therapy brings maximum results in normalizing the psychoemotional state. Alleviating the clinical manifestations of rosacea helps to reduce the level of anxiety and depression in patients with rosacea.","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141818230","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":"Trifarotene, a retinoid of the fourth generation, in the treatment of acne: the first experience of use in a real clinical practice","authors":"L. S. Kruglova, S. R. Mayransaeva, N. Gryazeva","doi":"10.33667/2078-5631-2024-9-73-79","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-9-73-79","url":null,"abstract":"The article presents data on the local retinoid of the fourth generation trifarotene. The results of three large trials have been presented, which have proven good efficacy and long-term safety of monotherapy of the drug trifarotene in patients with moderate acne and in patients with severe acne for combination therapy. It has been shown that trifarotene demonstrates high selectivity to retinoic acid receptors RAR-γ, which are predominant in the skin, which provides clinical efficacy in low concentration and good tolerability.","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141818285","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":"Change of epidermal barrier parameters and biomechanical parameters of the skin in children with atopic dermatitis during the use of a lipid-restoring cream containing biotic complex","authors":"D. Zaslavsky, A. V. Taganov, A. V. Molochkov, E. D. Zaslavskaya, Ju. B. Belenkova, K. A. Klimova, D. Kozlova","doi":"10.33667/2078-5631-2024-9-102-108","DOIUrl":"https://doi.org/10.33667/2078-5631-2024-9-102-108","url":null,"abstract":"Emollients are an integral part of the therapy for patients with atopic dermatitis. The most effective will be the new generation of emollients – emollients plus, which normalize the skin microbiome. Their effectiveness can be assessed by determining the parameters of the epidermal barrier (hydratation, sebum level, pH) and skin elasticity.Objectives. To evaluate the effectiveness and safety of a lipid-restoring cream containing a biotic complex LE SANTI in children with atopic dermatitis.Material and methods. From August to December, 25 children (9 girls, 36 % and 16 boys, 64 %) aged from 3 to 17 years (average age 9.2 years) with atopic dermatitis participated in an observational program to evaluate the effectiveness and safety of a lipid-restoring cream LE SANTI. For 21 days, patients applied the cream twice a day, they had 6 visits, during which was collected their medical history, adverse events, physical examination, determined indicators of the epidermal barrier (hydratation, sebum content, pH), biomechanical characteristics (skin elasticity), and also severity of disease (SCORAD) and quality of life (CDLQI). At visit 6, patients were assessed for satisfaction with the use of the cream.Results. All participants of the observation program completed their participation on time. As part of the observational program, there was an increase in skin hydration and sebum level by 3 and 3.5 times, respectively, pH level turned to the acidic values by 18%, an increase in elasticity by 30%, a decrease in SCORAD and CDLQI indices by 1.9 times or more 3 times respectively. The patients did not experience any adverse events; the satisfaction rating from the use of the cream was 4.78/5.Conclusions. Lipid-restoring cream LE SANTI can be recommended for inclusion in the treatment regimen for atopic dermatitis as a basic external agent that meets all the requirements for effectiveness and safety for children with atopic dermatitis, as well as basic care during remission.","PeriodicalId":18337,"journal":{"name":"Medical alphabet","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141819289","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}