Meditsinskiy sovet = Medical Council最新文献

{"title":"Рostural orthostatic tachycardia syndrome","authors":"F. Kh. Orakova, I. K. Tkhabisimova, A. B. Khadzugov, R. A. Ligidova, K. Z. Kodzokova, Z. A. Mizieva, R. M. Alborova, M. R. Khazhkasimov, M. V. Makhmaeva, A. I. Vadaeva","doi":"10.21518/ms2024-153","DOIUrl":"https://doi.org/10.21518/ms2024-153","url":null,"abstract":"Introduction. Postural orthostatic tachycardia syndrome (SPOT) is a heterogeneous clinical syndrome characterized by an excessive increase in heart rate (HR) in the standing position in the absence of orthostatic hypotension.Aim. To study the change in hemodynamic parameters, heart rate variability (HRV) during the tilt test, as well as to evaluate the indicators of Holter monitoring in patients with SPOT and patients without.Materials and methods. From the patients examined for the presence of disorders of the autonomic nervous system (ANS) associated with orthostasis intolerance, fainting in the anamnesis, persons aged 18 to 40 years were selected. According to the results of the tilt test, the following groups were formed: 1 group – patients with episodes of syncopal states and a negative tilt test, 2 group – patients with a pattern of postural tachycardia (PPT), 3 group – control. All patients underwent standard electrocardiography, Holter monitoring, 24-hour blood pressure monitoring and a long-term passive orthostatic test in accordance with the Westminster Protocol.Results. No deviations were found in all groups based on ECG results, daily ECG monitoring data and blood pressure. Sinus normosystole and normative values of the duration of intervals and ECG waves were observed, the subjects demonstrated normal HRV and SAD and DAD indicators throughout the day. In the first group, an increase in heart rate was observed without a decrease in blood pressure. When assessing HRV during the tilt test, a decrease in the tone of the parasympathetic system was observed in the second group. HRV indicators were analyzed during the day to assess the state of the ANS in the groups. When studying the dynamics of RR intervals, an increase in all HRV indicators at night was recorded.Conclusions. The results indicate a violation of the vegetative response to vertical position in patients with PT, which correlates with orthostatic intolerance and indicates violations of heart rate regulation and an imbalance between sympathetic and parasympathetic activity.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"114 41","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141124138","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":"Heart failure phenotypes and clinical and laboratory features of patients with type 2 diabetes in inpatient endocrinology and cardiology practice","authors":"T. Demidova, M. Y. Izmaylova","doi":"10.21518/ms2024-144","DOIUrl":"https://doi.org/10.21518/ms2024-144","url":null,"abstract":"Introduction. Type 2 diabetes is a generally recognized risk factor for the development of not only ASCVD, microvascular complications, but also CHF.Aim. To evaluate the prevalence of CHF phenotypes and clinical and laboratory characteristics of patients with type 2 diabetes who are hospitalized in the endocrinology and cardiology departments.Materials and methods. A total of 107 patients with T2DM was included in the analysis. All patients were examined in accordance with the standards and procedures for providing medical care, followed by evaluation of clinical, laboratory and instrumental indicators.Results. The average age of these patients was 69.7 ± 9.12 years, the age of onset of type 2 diabetes was 58.9 ± 10 years, the duration of diabetes was 6.5 [4; 17] years. When analyzing the main metabolic parameters, the average HbA1c was 8.18 ± 1.72%, BMI 32 [29; 38] kg/m2. The predominant number of patients with type 2 diabetes had a CHF phenotype with preserved ejection fraction, the proportion of which was 68.22%, 19.63% had HF with mildly reduced ejection fraction and 12.15% – heart failure with reduced ejection fraction (HFrEF).Conclusions. The population of patients with type 2 diabetes and CHF, regardless of the specialty of the department, was characterized by a lack of targeted compensation for type 2 diabetes, IR, obesity and a high prevalence of hypertension and dyslipidemia. In the endocrinology department, patients significantly more often had a restrictive phenotype of HF and was characterized by a moderate increase in NTproBNP, with a reduced eGFR, were female, of an older age category, with longer duration of diabetes and higher HbA1c levels. All this dictates the high need for integrating SGLT2 inhibitors into patient management regimens. In the cardiology department, a high frequency of the dilated phenotype of CHF with low EF and ischemic heart disease was observed against the background of significantly increased NTproBNP values, significantly more often in males, middle age, with a short duration of diabetes. According to the standards of medical care, such patients require quadruple therapy, one of the mandatory components of which will be iSGLT 2 type.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"121 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141124105","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":"Current trends in solving the problem of residual cardiovascular risk","authors":"N. Y. Obedkova, A. A. Guslyakova, G. Mal, E. G. Obedkov","doi":"10.21518/ms2024-115","DOIUrl":"https://doi.org/10.21518/ms2024-115","url":null,"abstract":"Cardiovascular mortality is an urgent health problem not only in the Russian Federation, but also throughout the world. Patients of high cardiovascular risk, which suffering from ischemic heart disease and attending dyslipidemia, remain with high residual risk of cardiovascular complications such as unstable angina, myocardial infarction, stroke even in the case of achieved target level of atherogenic lipoproteins, no matter effective multicomponent hypolipidemic therapy. This article reviews the relevant scientific literature, meta-analyses of studies, randomized clinical trials of lipid-lowering drugs, examines the main reasons for the persistence of residual cardiovascular risk, evaluates the role of each clinical diagnostic marker in its progression, among which are the level of lipoprotein (a), triglycerides and other atherogenic lipoproteins, persistent aseptic inflammation of the vascular wall, the markers of which are highly sensitive C-reactive protein, interleukin-6, interleukin-1β. Possible therapeutic strategies for reducing residual risk depending on the etiological factor are discussed including the effectiveness in reducing residual cardiovascular risk with omega-3 polyunsaturated fatty acids, fibrates, options for RNA interference with small interfering RNA and antisense oligonucleotides usage, lipoprotein apheresis, as well as anti-inflammatory therapy using colchicine, low doses of methotrexate and monoclonal antibodies that inhibit the production of proinflammatory interleukins. Assessing a patient’s residual risk in clinical practice allows us to determine the insufficiency or ineffectiveness of secondary prevention measures and choose a different, more modern or comprehensive tactic for cardiovascular risk reducing.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"120 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141124491","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":"Connection between сardiac fibrosis biomarkers and echocardiography parameters in patients with various forms of atrial fibrillation","authors":"A. I. Kochetkov, I. Y. Orlova, O. D. Ostroumova, M. Lopukhina, A. Starodubova, T. N. Korotkova, I. V. Vorozhko, A. V. Landa, A. I. Andrianov","doi":"10.21518/ms2024-167","DOIUrl":"https://doi.org/10.21518/ms2024-167","url":null,"abstract":"Introduction. Myocardial fibrosis is often found in atrial fibrillation (AF), but there are no data on its relationship with structural and functional heart damage in various forms of the latter.Aim. To determine the possible relationship between echocardiographic parameters and blood levels of cardiac fibrosis markers (C-terminal propeptide of procollagen type 1, PICP; N-terminal propeptide of procollagen type 1, P3NP; galectin 3; transforming growth factor beta 1, TGF-β1) in patients with different forms of AF.Materials and methods. The study included 50 patients with paroxysmal AF (median age 73 [65.8;76] years, 34 (68%) women) and 34 patients with persistent/permanent forms of AF (median age 77.5 [67.5;81.3] years, 21 (62%) women). Transthoracic echocardiography was performed in all patients using the speckle tracking technique and serum levels of PICP, P3NP, galectin 3 and TGF-β1 were determined.Results. Serum P3NP correlate with E/e’ media (p=0.048, R2 = 0.117) in patients with persistent/permanent forms of AF. PICP level correlated with the average strain of the left atrium (LA) in patients with persistent/permanent forms of AF (p = 0.01, R2 = 0.189). The blood level of galectin 3 correlated with E/e’ media in the general cohort of patients with AF and in the group of patients with persistent/permanent forms of AF (p = 0.005, R2 = 0.095 and p = 0.027, R2 = 0.144, respectively), and with global longitudinal strain of the left ventricle (LV) – in the group of patients with paroxysmal AF (p = 0.044, R2 = 0.084). The serum TGF-β1 correlated with E/e’ media (p = 0.013, R2 = 0.074) in the general cohort of patients with AF and with values of the global longitudinal LV strain (p = 0.027, R2 = 0.099) in the group of patients with paroxysmal AF.Conclusions. Serum levels of PICP, P3NP, galectin-3 and TGF-β1 correlate with the values of E/e’ media, global longitudinal LV strain and average LA strain. An integrated approach, including standard echocardiography, Speckle Tracking echocardiography, and determination of the level of fibrosis biomarkers in the blood can help to more accurately assess the degree of cardiac fibrosis in a noninvasive way in patients with various forms of AF.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"37 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141123457","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":"Endocrinological aspects of gout","authors":"T. S. Panevin, E. N. Kareva","doi":"10.21518/ms2024-104","DOIUrl":"https://doi.org/10.21518/ms2024-104","url":null,"abstract":"Gout is the most common inflammatory joint disease, and its incidence increases with age and the presence of certain diseases, primarily obesity and chronic kidney disease, as well as while taking certain medications. Treatment of a patient with gout requires the interaction of a rheumatologist, cardiologist and endocrinologist, and even better, a well-trained therapist who is able to independently supervise gout-related diseases without the involvement of specialized specialists. This review was written to highlight current data on the most common endocrinopathies in gout for practitioners. The data presented indicate the existence of a relationship between gout and various endocrine diseases. The most important aspect is the presence of metabolic syndrome in most patients with gout, the treatment of which also requires taking into account the effect of prescribed drugs on purine metabolism. On the other hand, effects on certain endocrinological diseases can lead to improved purine metabolism. It has been shown that weight loss, including through bariatric means, is accompanied by a decrease in uric acid levels and may be accompanied by a decrease in the need for urate-lowering therapy. Most glucose-lowering drugs affect purine metabolism, and the presence of concomitant gout may determine the specific choice of antidiabetic therapy. Menopause is characterized by an increase in uric acid levels and the incidence of gout. At the same time, the use of menopausal hormone therapy may be accompanied by both a decrease in uric acid levels and the risk of developing gout. Despite the fact that an increase in testosterone levels in men is positively correlated with uric acid levels, its deficiency is accompanied not by a decrease, but by an increase in uric acid levels.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"30 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141124007","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 urate-lowering efficacy of isolated and combined use of febuxostat and empagliflozin in patients with gout and type 2 diabetes mellitus (OPORA Clinical Trial)","authors":"V. Salukhov, V. I. Mazurov, I. I. Novikov, A. A. Minakov, D. M. Reut, R. Bashkinov","doi":"10.21518/ms2024-173","DOIUrl":"https://doi.org/10.21518/ms2024-173","url":null,"abstract":"Introduction. Given the increasing frequency of the association of gout and type 2 diabetes, it is necessary to study the impact of modern therapy on their course.Aim. To evaluate the influence of isolated and combined use of febuxostat and empagliflozin on metabolic parameters and inflammatory markers in patients with gout and type 2 diabetes.Materials and methods. The “OPORA” study included 120 men aged 40–65 years with the simultaneous presence of gout and type 2 diabetes. The subjects were randomized into 3 groups (n = 40): group 1 (F), receiving febuxostat 80 mg/day; group 2 (E) – empagliflozin 25 mg/day; group 3 (FE) – combination of drugs febuxostat 80 mg/day + empagliflozin 25 mg/day. The studied parameters were analyzed before the appointment of therapy and after 12 weeks of treatment.Results. The decrease in uric acid levels was most significant in group 1 (F) (Δ = 22.3%, p < 0.01). The most pronounced decrease in glucose levels was achieved in group 2 (E) (Δ = 32.2%, p < 0.01) and group 3 (FE) (Δ = 21.6%, p < 0.01). In group 3 (FE) a more significant decrease in insulin levels was revealed (Δ = 26.2%, p < 0.01) and HOMA-IR (Δ = 23.0%, p < 0.01) after 3 months. The most significant increase in the level of adiponectin and decrease in the level of leptin was noted in group 3 (FE), p < 0.01. The greatest effect in reducing indicators characterizing inflammation was observed in group 3 (PE) in the form of a significant decrease in the levels of ESR, CRP, TNF-a. After 12 weeks, a decrease in body weight of ~3 kg was noted in groups 2 (E) and 3 (FE).Conclusions. The combination of febuxostat and empagliflozin has an additive effect in positively influencing inflammatory markers and adiponectin levels, without mutual attenuation of urateand glucose-lowering effects.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"121 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141124102","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":"Predictors of morphofunctional features of somatotrophic tumors and of the effectiveness of treatment with first-generation somatostatin receptor ligands","authors":"E. Pronin, V. Pronin, M. Antsiferov, A. V. Petryaykin, T. M. Alexeeva, A. Lapshina, L. Urusova, A. Khoruzhaya, S. Tamaeva","doi":"10.21518/ms2024-147","DOIUrl":"https://doi.org/10.21518/ms2024-147","url":null,"abstract":"Introduction. Timely differential diagnosis between densely and sparsely granulated somatotrophic tumors allows predicting the most probable scenario of acromegaly course, receptor phenotype and proliferative potential of tumor cells, risk of continued postoperative growth, as well as the efficacy of planned drug therapy with first-generation somatostatin receptor ligands.Aim. To validate cytological, radiological and therapeutic predictors allowing to evaluate the morphofunctional composition of somatotrophic tumors and to predict sensitivity to first-generation somatostatin receptor ligands.Materials and methods. 525 patients (153 men) aged 60.2 ± 14.0 years receiving drug therapy with first-generation somatostatin receptor ligands for 72.0 ± 51.9 months were examined.Results. Treatment efficacy was evaluated according to the final level of IGF-1 index (≤1) and compared with the data of pathomorphologic (97 patients) and repeated radiologic (53 patients) examination. The influence of cellular composition of densely and sparsely granulated somatotrophic tumors on immunohistochemical and radiologic characteristics with the designation of leading predictors of morphologic identification of somatotrophic tumors was investigated. Additional radio markers for quantitative assessment of relative intensity of tumor signal on T2-, T1and (T2-T1)-weighted MRI for non-invasive differential diagnostics of densely and sparsely granulated somatotrophic tumors and determination of optimal treatment tactics were proposed. The expediency of using pharmacotherapeutic testing with short-term (3–6 months) first-generation somatostatin receptor ligands administration to assess the intactness of receptor and postreceptor mechanisms and to choose optimal drug therapy was substantiated.Conclusion. The precision approach based on comprehensive clinical, radiological, pathomorphological and functional characteristics allows stratification of patients with acromegaly to optimize treatment benefit. Achievement of acromegaly control in drug therapy with first-generation somatostatin receptor ligands depends on tumor volume and its hormonal activity, absolute and relative expression of the 2nd subtype of somatostatin receptors, severity of destructive changes and features of cellular composition. In case of refractoriness to first-generation somatostatin receptor ligands, the use of pegvisomant is expedient.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"23 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141123710","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":"Cardiovascular disease and sleep apnea in patients with type 2 diabetes mellitus","authors":"O. M. Koteshkova, M. Antsiferov, D. Antsiferova, Yu. V. Golubeva, N. A. Demidov","doi":"10.21518/ms2024-179","DOIUrl":"https://doi.org/10.21518/ms2024-179","url":null,"abstract":"The article provides information on concomitant conditions of type 2 diabetes mellitus such as cardiovascular diseases, sleep apnea syndrome. Questions about the types of sleep breathing disorders and factors predisposing to this condition are discussed. Data on the prevalence of sleep apnea in the world are demonstrated. The main approaches to the diagnosis of this condition are shown. Differences in therapy approaches for obstructive sleep apnea and central sleep apnea have been demonstrated. The issues of the relationship between obstructive sleep apnea, type 2 diabetes mellitus and cardiovascular diseases are considered. The data of clinical studies evaluating the relationship of sleep apnea and cardiovascular diseases are presented. Their mutually aggravating influence is shown. Information is provided on the effect of sleep apnea on the main clinical outcomes according to clinical research data. The relationship between sleep apnea and heart failure is discussed. The main issues of the inflammatory profile of sleep apnea are discussed, which are closely related to cardiovascular diseases and type 2 diabetes and include: macrophage recruitment and inflammatory biomarkers such as C-reactive protein, chemokines and cytokines such as interleukin 6, tumor necrosis factor α, nuclear kappa factor B, as well as adhesion molecules such as selectins, intracellular adhesion molecule-1 (ICAM-1) and intracellular vascular adhesion molecule (VCAM-1), imbalance between prooxidant and antioxidant factors. These factors contribute to the development of microvascular and macrovascular complications in type 2 diabetes mellitus. Special attention is paid in the publication to the discussion of the main factors predisposing to the development of sleep apnea in heart failure in patients with type 2 diabetes mellitus. The data on the main diagnostic tests for patients with heart failure and type 2 diabetes are presented. Information is provided on the use of drugs from the group of sodiumglucose cotransporter type 2 inhibitors in patients with type 2 diabetes and sleep apnea syndrome. Reasonable recommendations on the use of these drugs are presented, taking into account the modern strategy for the treatment of type 2 diabetes.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"50 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141123594","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":"Management of a patient at very high cardiovascular risk with myositis during high-intensity statin therapy","authors":"D. Y. Sedykh, V. Kashtalap, O. Barbarash","doi":"10.21518/ms2024-175","DOIUrl":"https://doi.org/10.21518/ms2024-175","url":null,"abstract":"The main purpose of this article is to translate the existing experience of successful optimization of lipid-lowering treatment in a patient with a very high cardiovascular risk and a long history of dyslipidemia, cerebral atherosclerosis and myositis, which developed on a high-intensity statin therapy regimen. Using the example of a 56-year-old patient observed in the lipid center of the city of Kemerovo, it was shown that the combination of pitavastatin in the maximum tolerated dose of 2 mg and the cholesterol absorption inhibitor ezetimibe 10 mg can not only be effective in achieving target values of low-density lipoprotein cholesterol (1.4 mmol/l) after undergoing carotid revascularization, but also safe for registered muscle symptoms that arose during a high-intensity statin therapy regimen. It was demonstrated that, against the background of high adherence to the selected treatment and low-cholesterol diet, and maintenance of regular physical activity, the patient completely disappeared both muscle pain and muscle weakness, and there was no clinical or instrumental progression of cerebral stenosis. The article provides current data on the prevalence of muscle symptoms when taking statins in real practice and in randomized clinical trials, discusses existing predisposing factors and potential mechanisms of occurrence, describes variants of clinical manifestations and tentative diagnostic search criteria. In addition, recommendations on the tactics of managing patients with their development at various cardiovascular risks have been systematized. An expert classification system for statin-associated muscle symptoms is demonstrated. Also presented is the routing of patients with side effects developing during statin therapy, adopted in the city of Kemerovo.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"115 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141124411","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":"Nasal irrigation during seasonal epidemics of influenza and acute respiratory viral infections","authors":"V. Svistushkin, Z. Mokoyan, D. I. Sagova","doi":"10.21518/ms2024-109","DOIUrl":"https://doi.org/10.21518/ms2024-109","url":null,"abstract":"Nasal irrigation is one of the most common recommendations for the treatment of patients with a wide variety of rhinologic diseases. First described in ancient Indian Ayurvedic papers, rinsing the nasal cavity with saline solutions remains relevant today with all the variety of available modern medications for local use. Nasal irrigation is a safe and effective method for the treatment and prevention of acute respiratory viral infections. The preventive use of nasal saline is especially important during the seasonal rise in the incidence of acute respiratory viral infections and influenza. Nasal irrigation reduces the viscosity of mucus and promotes its faster elimination along with pathogens fixed in it. Moreover, the use of isotonic saline solutions increases the effectiveness of the mucociliary clearance and reduces the concentration of local inflammatory mediators and cytokines. Acute upper respiratory tract infections, including common cold and acute rhinosinusitis, are common diseases that cause significant discomfort and are a common cause of temporary disability during periods of increased incidence of acute respiratory viral infections. Despite the fact that treatment of acute upper respiratory tract infections in most cases involves only symptomatic therapy the use of antipyretic drugs, sufficient fluid intake, local elimination and irrigation therapy is often used as adjuvant therapy in this group of patients. At the same time, it is quite difficult to assess the effectiveness of nasal lavage in clinical practice from the standpoint of evidence-based medicine. The purpose of this review is to analyze modern clinical studies and topical reviews assessing the effectiveness of nasal irrigation for various pathologies with a more detailed analysis of the effectiveness of this method for the treatment of patients with acute upper respiratory tract infections and as a preventive measure during the season of epidemic rise in the incidence of acute upper respiratory tract infections.","PeriodicalId":18391,"journal":{"name":"Meditsinskiy sovet = Medical Council","volume":"102 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141124887","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}