Terapevticheskii Arkhiv最新文献

{"title":"[Metabolic dysfunction-associated steatotic liver disease in patients with prediabetes and type 2 diabetes mellitus].","authors":"A N Sasunova, A A Goncharov, S V Morozov, V I Pilipenko, V A Isakov","doi":"10.26442/00403660.2025.08.203339","DOIUrl":"https://doi.org/10.26442/00403660.2025.08.203339","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study was to identify the prevalence of steatosis degrees and stages of liver fibrosis in metabolic dysfunction-associated steatotic liver disease (MASLD) in connection with the presence of carbohydrate metabolism disorders, such as prediabetes and type 2 diabetes mellitus (DM).</p><p><strong>Materials and methods: </strong>Retrospective database search (4101 records) was performed. Vibration-controlled transient liver elastography with controlled attenuation parameter module was used for the assessment of liver steatosis and fibrosis. Based on the presence of carbohydrate metabolism disorders, subjects with MASLD were allocated to one of the following groups: MASLD without prediabetes or DM (group 1), MASLD with prediabetes (group 2) and MASLD with DM (group 3).</p><p><strong>Results: </strong>Proportion of patients with severe liver steatosis (S3) was lowest in the group 1 (61.9%), while no difference was found between groups 2 and 3 (74.3% vs 76.7%; <i>p</i> = 0.5). Moderate-to-severe liver fibrosis (stages F2-F4) was less widespread in the group 1 (24.1%); significant difference by this parameter was also revealed between groups 2 and 3 (34.0% vs 45.4%; <i>p</i> = 0.004). Proportion of patients with metabolic dysfunction-associated steatohepatitis was similar in groups 2 and 3 (33.9% vs 35.4%; <i>p</i> = 0.7), but was lower in the group 1 (26.7% vs 33.9% and 35.4%; <i>p</i> = 0.02 and <i>p</i> < 0.001, respectively).</p><p><strong>Conclusion: </strong>Carbohydrate metabolism disorders are closely associated with progressive steatosis and liver fibrosis in patients with MASLD. No differences in the severity of liver steatosis was found between groups with prediabetes and T2DM, however, in T2DM, the prevalence of advanced/severe liver fibrosis was highest among all studied groups.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 8","pages":"689-695"},"PeriodicalIF":0.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Serological markers as predictors of the severity of gastric mucosal atrophy in autoimmune and <i>Helicobacter рylori</i>-associated gastritis].","authors":"M V Chebotareva, K A Nikolskaya, D N Andreev, A S Dorofeev, S G Khomeriki, L A Tsapkova, E V Parfenchikova, A M Veliev, A Y Spasenov, I N Voynovan, D S Bordin","doi":"10.26442/00403660.2025.08.203343","DOIUrl":"10.26442/00403660.2025.08.203343","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the possibility of using serum markers of atrophy (pepsinogens - PG I and II) to form high-risk groups for gastric cancer (Operative Link for Gastritis Assessment - OLGA stage III-IV) depending on the etiology of gastritis.</p><p><strong>Materials and methods: </strong>A total of 237 (56 men and 181 women) patients were examined. All patients underwent a ¹³C-urea breath test, a blood test for GastroPanel (PG I, PG II, gastrin-17, antibodies to <i>Helicobacter pylori</i> immunoglobulin G), a blood test for antibodies to gastric parietal cells. All patients underwent esophagogastroduodenoscopy with a biopsy of the gastric mucosa from 5 standard points according to the Sydney system and a histomorphological study according to the OLGA system, as well as a biopsy to detect <i>H. pylori</i> infection using the polymerase chain reaction. The patients were divided into 3 groups depending on the etiology of gastritis: Group 1 included 55 patients with chronic gastritis, autoimmune gastritis and associated with <i>H. pylori</i> gastritis (AIG+HP+); Group 2 - 47 patients with AIG and negative tests for <i>H. pylori</i> infection (AIG+HP-); Group 3 - 135 patients with chronic gastritis associated with <i>H. pylori</i> and negative markers of AIG (AIG-HP+).</p><p><strong>Results: </strong>The analysis showed that in patients with AIG (group 2), the most reliable serological markers of atrophy predicted severe atrophy (OLGA stage III-IV): when the ratio PG I/PG II was ≤ 3, it was detected in 70.21% of cases, and when PG I decreased to ≤ 30 μg/L, it was found in 68.08%. In group 1, stages III-IV according to OLGA were diagnosed in 20% of cases with PG I/PG II indicators ≤ 3; and in 18.18% with a decrease in PG I ≤ 30 μg/L. When analyzing the diagnostic accuracy of GastroPanel biomarkers in identifying severe atrophy (OLGA stages III-IV) in the total sample of patients (all 3 groups), it was possible to achieve cut-off indicators as close as possible to the reference values while maintaining a relatively high sensitivity and specificity - 75.81% and 81.50% for PG I ≤ 30 μg/L and 85.48% and 64.50% for PG I/PG II ≤ 3, respectively. The optimal cut-off in the study population for the PG I indicator was < 22.5 μg/L (sensitivity - 72.58%, specificity - 88.00%), and for the PG I/PG II ratio ≤ 2 (sensitivity - 80.65%, specificity - 78.50%).</p><p><strong>Conclusion: </strong>Serum pepsinogens can be used in the Moscow population as a non-invasive marker of gastric mucosa atrophy for the formation of high-risk patient groups for gastric cancer requiring endoscopic examination.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 8","pages":"651-659"},"PeriodicalIF":0.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Experience in the application of ultrasound indices for assessing the activity of inflammatory bowel diseases].","authors":"D D Mukhametova, I M Minnemullin, O E Akchurina, A K Odintsova, D I Abdulganieva","doi":"10.26442/00403660.2025.08.203303","DOIUrl":"https://doi.org/10.26442/00403660.2025.08.203303","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the diagnostic value of ultrasound (US) parameters and indices for assessing the active inflammatory bowel diseases (IBD).</p><p><strong>Materials and methods: </strong>The study included 115 patients with IBD, 41 (36%) patients were with ulcerative colitis (UC) and 74 (64%) - with Crohn's disease (CD). Transabdominal US examination of the intestine was performed on Sonoscape S2N, with a bowel wall thickness (BWT) of 3 mm considered the norm. To assess activity in UC, the Milan Ultrasound Criteria (MUC) score was used, and in CD - International Bowel Ultrasound Segmental Activity Score (IBUS-SAS).</p><p><strong>Results: </strong>In active UC BWT (5.91 [4.87; 6.95] mm) was greater than in remission (2.9 [2.6; 3.1] mm; <i>p</i> = 0.003). For active UC diagnosis BWT greater than 3 mm had sensitivity (Se) of 90.5% and specificity (Sp) of 70.6%. The MUC in exacerbation (9 [7.88; 11.8]) was higher than in remission (4.2 [3.64; 4.9]; <i>p</i> < 0.001). In 31 (89%) patients in exacerbation, the MUC was higher than 6.2 (Se 88.9%, Sp 87.5%), and in 34 (97%) at a threshold of 5.18 (Se 96.3%, Sp 87.5%). In active CD, BWT (4.9 [3.8; 6.6] mm) was greater than in remission (3.18 [2.6; 3.5]; <i>p</i> = 0.0001), with Se 87.0%, Sp 71.4%. The IBUS-SAS in active CD (46.8 [27; 71.5]) was higher than the remission (12.6 [11.2; 30.2]; <i>p</i> = 0.001). At a threshold of 37.5, the IBUS-SAS had Se 92.6%, Sp 61.5%, and at 45.2, Se 92.6%, Sp 87.2%.</p><p><strong>Conclusion: </strong>US imaging is a useful and effective tool for assessing IBD activity; a threshold value of the MUC score of 5.18 and IBUS-SAS of 45.2 suggests better diagnostic value for differentiating between exacerbation and remission.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 8","pages":"680-688"},"PeriodicalIF":0.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The high-dose dual therapy for eradication of <i>Helicobacter pylori</i>: efficacy and safety].","authors":"N V Bakulina, V A Ponomarenko, A S Kerimova, T Thai Hien, A S Shikhmagomedova, A M Veliev, I V Savilova","doi":"10.26442/00403660.2025.08.203300","DOIUrl":"https://doi.org/10.26442/00403660.2025.08.203300","url":null,"abstract":"<p><strong>Background: </strong>The article presents the results of a prospective open-label comparative interventional study of the efficacy and safety of high-dose dual therapy (HDDT) for eradicating <i>Helicobacter pylori</i> infection.</p><p><strong>Aim: </strong>To evaluate the efficacy and safety of HDDT of the <i>H. pylori</i> eradication regimen, as well as the possible increase in the efficacy of this regimen with the addition of rebamipide.</p><p><strong>Materials and methods: </strong>All patients with verified <i>H. pylori</i> infection were randomized into three groups depending on the treatment regimen. The Era-AmIPP group (<i>n</i> = 24) received HDDT (esomeprazole 120 mg/day and amoxicillin 3000 mg/day) for 14 days. The Era-RebAmIPP group (<i>n</i> = 121) received HDDT with rebamipide 300 mg/day for 14 days. The comparison group (<i>n</i> = 101) received conventional triple eradication therapy enhanced with bismuth tripotassium dicitrate for 14 days. The effectiveness of eradication was evaluated at 4-6 weeks after the end of therapy. Particular attention was paid to assessing the safety of therapy, the incidence of adverse events, and treatment adherence.</p><p><strong>Results: </strong>The study included 246 patients. Low efficacy (87.5% [95% confidence interval [CI] 69.0-95.7]) of HDDT was shown. Adding rebamipide 300 mg/day to HDDT increased the eradication rate to 96.3% (95% CI 90.9-98.6). The efficacy of the Era-RebAmIPP regimen in patients previously treated with conventional eradication regimens was 91.7% (95% CI 64.6-98.5). Adverse events were reported in 37.5% (95% CI 21.2-57.3) patients in the Era-AmIPP group, 19.8% (95% CI 13.7-27.8) in the Era-RebAmIPP group, and 31.3% (95% CI 22.9-41.1) in the comparison group (<i>p</i> = 0.07).</p><p><strong>Conclusion: </strong>The efficacy of the Era-RebAmIPP regimen is comparable to conventional triple therapy with bismuth. To assess the effectiveness of this regimen, larger-scale studies are required in various regions of our country.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 8","pages":"642-650"},"PeriodicalIF":0.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical and morphological features and functional parameters in patients with gastroesophageal reflux disease and Barrett's esophagus].","authors":"A S Trukhmanov, A V Paraskevova, O A Storonova, A B Ponomarev, A A Makushina, V T Ivashkin","doi":"10.26442/00403660.2025.08.203299","DOIUrl":"https://doi.org/10.26442/00403660.2025.08.203299","url":null,"abstract":"<p><strong>Aim: </strong>To develop a treatment strategy based on the analysis of clinical manifestations and the results of morphofunctional diagnostics for patients with gastroesophageal reflux disease (GERD) aimed at preventing the development and progression of intestinal metaplasia (IM) of the esophageal epithelium.</p><p><strong>Materials and methods: </strong>The study included 50 subjects diagnosed with GERD. After esophagogastroduodenoscopy with biopsy and subsequent morphological examination of the esophageal mucosa, two groups were formed: patients with GERD complicated by IM, also known as Barrett's esophagus (<i>n</i> = 19), patients with GERD without IM (<i>n</i> = 31). All participants underwent high-resolution esophageal manometry and 24-hour impedance pH monitoring.</p><p><strong>Results: </strong>The study found that in patients with GERD complicated by IM, complaints of intense heartburn and difficulty swallowing occurred more often than in patients with GERD without IM. According to manometry, the resting pressure of the lower esophageal sphincter in patients with GERD and IM (15.1 [1.3; 36.4] mmHg) was lower than in patients with GERD without IM (20.3 [5.5; 42.1] mmHg). This difference was statistically significant (<i>p</i> = 0.002). In patients with GERD and IM, esophageal motility is less effective; this was translated in a decrease in the distal contractile integral of the esophagus to 276.5 [0.2; 567.7] mmHg × s × cm, while in patients with GERD without IM, it was much higher: 942.5 [47.3; 3759.7] mmHg × s × cm. Difficulties in swallowing were associated with a reduced effectiveness of esophageal motility. In patients with GERD complicated by IM, more acid gastroesophageal refluxes were observed compared to patients without IM (72.5 [53.5; 91.5] vs 54.2 [29.9; 78.3]; <i>p</i> = 0.036). They also have a greater percentage of time with pH < 4.0 in the esophagus (14.5 [9.7; 19.3] vs 10.3 [5.6; 14.9]; <i>p</i> = 0.028) and higher DeMeester index values (35.4 [1.9; 114.5] vs 15.1 [0.2; 47.7]; <i>p</i> = 0.004).</p><p><strong>Conclusion: </strong>GERD is a multifactorial disease with a primary impairment of the motor function of the upper gastrointestinal tract. The acidic reflux may affect the development of the intestinal type of epithelial metaplasia.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 8","pages":"627-634"},"PeriodicalIF":0.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Personalised treatment of patients with immune thrombotic thrombocytopenic purpura].","authors":"G M Galstyan, E E Klebanova, S Y Mamleeva, P V Avdonin, Z T Fidarova, M Y Drokov, E N Parovichnikova","doi":"10.26442/00403660.2025.08.203326","DOIUrl":"https://doi.org/10.26442/00403660.2025.08.203326","url":null,"abstract":"<p><strong>Background: </strong>Treatment of immune thrombotic thrombocytopenic purpura (iTTP) includes plasma exchange (PEX) and immunosuppression (glucocorticoids and rituximab). The addition of caplacizumab to therapy has improved treatment outcomes in iTTP. However, the available therapies focus on the duration of drug administration and clinical response rather than ADAMTS13 activity.</p><p><strong>Aim: </strong>To evaluate the efficacy of therapy for iTTP targeting ADAMTS13 activity.</p><p><strong>Materials and methods: </strong>Treatment of patients with iTTP was started with PEX, prednisolone (1 mg/kg) and caplacizumab (10 mg/day). PEX was discontinued after an increase of platelet count > 150×10⁹/L. Only after PEX cessation treatment with rituximab (375 mg/m² weekly) was started. Caplacizumab was discontinued when partial remission (ADAMTS13 > 20%) was achieved. Rituximab and glucocorticoids were discontinued when complete remission (ADAMTS13 > 40%) was achieved. Platelet count, schistocyte count, haemoglobin, haptoglobin, lactate dehydrogenase activity, ADAMTS13, ADAMTS13 inhibitor titre, number of PEX, plasma volume replaced, time to increase platelet count > 150×10⁹/L, achievement of partial and complete remission were analyzed. Data are presented as median and interquartile range.</p><p><strong>Results: </strong>From 2021 to 2025, the diagnosis of TTP was confirmed in 102 patients. 35 patients were included in the study. Platelet counts > 150×10⁹/L were achieved after 4 (3-5) PEX procedures in 4 (3-4.5) days. In total, 11 395 (7241-16 343) ml of plasma were exchanged. Partial remission was achieved in 100% of patients, the duration of caplacizumab therapy was 23 (12-30) days. Rituximab was administered from 4 to 8 times (median 4), complete remission was achieved in 33 out of 35 patients, 2 patients achieved only partial remission, they were treated with bortezomib and 1 with anti-CD38 monoclonal antibody. The probability of complete remission was 97.1%.</p><p><strong>Conclusion: </strong>The duration of therapy with caplacizumab, rituximab and glucocorticoids in patients with iTTP should be determined by the achievement of target ADAMTS13 activity.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 8","pages":"711-718"},"PeriodicalIF":0.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Impact of atrial functional mitral regurgitation on clinical outcomes in patients with HFpEF and atrial fibrillation during optimal drug therapy].","authors":"A F Safarova, Z D Kobalava, S B Adam, T M Timofeeva","doi":"10.26442/00403660.2025.08.203337","DOIUrl":"https://doi.org/10.26442/00403660.2025.08.203337","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the clinical and prognostic significance of atrial functional mitral regurgitation (AFMR) in patients with heart failure with preserved ejection fraction (HFpEF) and atrial fibrillation (AF) on the background of optimal drug therapy.</p><p><strong>Materials and methods: </strong>The retrospective study included 150 patients (age 75.5 ± 9.9 years, 54% men) with HFpEF with AF and AFMR on the background of optimal drug therapy. Clinical and demographic characteristics (including the scale of assessment of the clinical condition), laboratory and instrumental diagnostic results, and drug therapy were evaluated. MR was assessed as minor, moderate, or severe using a multiparametric approach, including an assessment of the effective area of the regurgitation hole and the MR fraction. The effect of AFMR on rehospitalization for HF, combined endpoint (CE) was studied [cardiovascular death (CVD) and rehospitalization] during the follow-up period of 589 (217-1039) days.</p><p><strong>Results: </strong>Eighty (53.3%) patients had moderate AFMR, and 23 (15.3%) had severe AFMR. These patients had lower SBP and DBP values (<i>p</i> = 0.014), and permanent AF was more common among them (<i>p</i> = 0.025) compared with patients with minor MR. Independent predictors of moderate/severe AFMR were the constant form of AF (OR 3.3 [1.4-8.0]; <i>p</i> = 0.007), end-systolic left ventricular distance (OR 3.0 [1.4-6.5]; <i>p</i> = 0.006), taking antiplatelet agents (OR 0.11 [0.02-0.70]; <i>p</i> = 0.020). The frequency of outcomes in the general group was 46.7% for CE, 34.0% for rehospitalization for HF, and 14.0% for CVD. The predictors of CE were moderate/severe FMR (HR 2.6 [1.4-4.9]; <i>p</i> = 0.002), scores on the scale of assessment of the clinical condition (HR 1.14 [1.04-1.25]; <i>p</i> = 0.003); severe FMR (HR 4.1 [1.7-10.2]; <i>p</i> = 0.002), moderate FMR (HR 2.7 [1.2-5.8]; <i>p</i> = 0.013), creatinine level (HR 0.990 [0.980-1,000]; <i>p</i> = 0.040).</p><p><strong>Conclusion: </strong>Despite the limitations, the importance of AFMR as a factor influencing clinical outcomes in patients with HFpEF and AF has been demonstrated. The present study highlights the need for further investigation of this condition and the development of personalized patient management strategies.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 8","pages":"618-626"},"PeriodicalIF":0.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Structural and functional parameters of erythrocytes as predictors of unfavorable outcome in patients with colorectal cancer].","authors":"M V Kruchinina, M F Osipenko, A A Gromov, A V Starikov","doi":"10.26442/00403660.2025.08.203336","DOIUrl":"https://doi.org/10.26442/00403660.2025.08.203336","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;Identification the characteristics of fatty acids (FAs) in erythrocyte membranes and in blood serum, as well as the electrical and viscoelastic parameters of erythrocytes to assess their ability to be predictors of an unfavorable outcome in patients with colorectal cancer (CRC).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;112 people with an average age of 63.1 ± 9.5 years (62 men, 50 women) with CRC of stages I-IV were examined. The patients were divided into 2 groups depending on the outcome of the disease after 6 years of follow-up: group 1 - with stabilization of the disease (&lt;i&gt;n&lt;/i&gt; = 55), group 2 (&lt;i&gt;n&lt;/i&gt; = 57) - with an unfavorable outcome. The FA composition of erythrocyte membranes and blood serum was studied using gas chromatography/mass spectrometry, a system based on three Agilent 7000B quadrupoles (USA). The electrical and viscoelastic parameters of erythrocytes were studied using the method of dielectrophoresis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;An unfavorable outcome in patients with CRC is associated with elevated levels of docosapentaenoic acid (C22:5n-3) (&lt;i&gt;p&lt;/i&gt; = 0.0003), docosahexaenoic acid (C22:6n-3) (&lt;i&gt;p&lt;/i&gt; = 0.001), docosathetraenoic acid (C22:4n-6) (&lt;i&gt;p&lt;/i&gt; = 0.004), and total omega-3 polyunsaturated fatty acids (PUFA) (&lt;i&gt;p&lt;/i&gt; = 0.0004) in erythrocyte membranes, eicosadienoic acid (C20:2 n-6) in erythrocyte membranes (&lt;i&gt;p&lt;/i&gt; = 0.03) and blood serum (&lt;i&gt;p&lt;/i&gt; = 0.01), and, conversely, reduced levels of ratios saturated fatty acids (SFA)/PUFA (&lt;i&gt;p&lt;/i&gt; = 0.004), SFA / unsaturated fatty acids (USFA) (&lt;i&gt;p&lt;/i&gt; = 0.01) and concentrations of myristic FA (C14:0) (&lt;i&gt;p&lt;/i&gt; = 0.03) in erythrocyte membranes, as well as with a number of changes in electrical, viscoelastic parameters of red blood cells: with increased hemolysis of red blood cells at high frequencies (10&lt;sup&gt;6 &lt;/sup&gt;Hz - &lt;i&gt;p&lt;/i&gt; = 0.0006 and 5 × 10&lt;sup&gt;5 &lt;/sup&gt;Hz - &lt;i&gt;p&lt;/i&gt; = 0.046), increased aggregation indices at low frequencies (10&lt;sup&gt;5 &lt;/sup&gt;Hz - &lt;i&gt;p&lt;/i&gt; = 0.04 and 5 × 10&lt;sup&gt;4 &lt;/sup&gt;Hz - &lt;i&gt;p&lt;/i&gt; = 0.047), as well as a shift in the crossover frequency to the high frequency range (&lt;i&gt;p&lt;/i&gt; = 0.036). In patients with stages 1-2 of CRC, omega-6 PUFAs, eicosadienoic acid C20:2n-6 (&lt;i&gt;p&lt;/i&gt; = 0.006), docosatetraenoic acid C22:4n-6 (&lt;i&gt;p&lt;/i&gt; = 0.012), were of the greatest importance for differentiating disease outcomes, while total content omega-3 PUFAs in erythrocyte membranes (&lt;i&gt;p&lt;/i&gt; = 0.0129), docosahexaenoic acid C22:6 n-3 (&lt;i&gt;p&lt;/i&gt; = 0.0169), total content (C20:5n-3+C22:6n-3) in erythrocyte membranes (&lt;i&gt;p&lt;/i&gt; = 0.0198), docosapentaenoic acid C22:5 n-3 (&lt;i&gt;p&lt;/i&gt; = 0.022) were slightly less important. As in the general group of patients with CRC, the degree of hemolysis at a frequency of 10&lt;sup&gt;6 &lt;/sup&gt;Hz was a predictor of an unfavorable outcome in people with early stages of the oncological process. ROC analysis revealed a high potential of palmitic acid in erythrocyte membranes to predict an unfavorable CRC outcome (AUC 0","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 8","pages":"668-679"},"PeriodicalIF":0.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Fixed-dose combinations of hypoglycemic drugs: potential of alogliptin/pioglitazone in type 2 diabetes mellitus: a review].","authors":"O I Butranova, S K Zyryanov, A R Melnikova, A E Matsepuro","doi":"10.26442/00403660.2025.08.203345","DOIUrl":"https://doi.org/10.26442/00403660.2025.08.203345","url":null,"abstract":"<p><p>Type 2 diabetes mellitus is one of the most common chronic diseases, which is a risk factor for a wide range of complications. The introduction of an approach consisting of early administration of combination hypoglycemic therapy into clinical practice makes it relevant to study available fixed-dose combinations of hypoglycemic drugs. Alogliptin and pioglitazone are of interest in terms of their complex effect on the patient's organism. The purpose of this review is to assess the advantages of the combination of alogliptin and pioglitazone based on an analysis of published data on the pharmacodynamics, pharmacokinetics, efficacy and safety of these drugs.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 8","pages":"735-749"},"PeriodicalIF":0.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The introduction into clinical practice of an algorithm for the diagnosis of liver steatosis in patients with viral pneumonia].","authors":"T A Turankova, A Y Brazhnikov, N G Moroz, A V Mudrova, D L Varganova, C S Pavlov","doi":"10.26442/00403660.2025.08.203365","DOIUrl":"https://doi.org/10.26442/00403660.2025.08.203365","url":null,"abstract":"<p><strong>Aim: </strong>To study the ability and significance of detecting liver steatosis during chest computed tomography (CT) in patients with viral pneumonia.</p><p><strong>Materials and methods: </strong>A prospective cohort study included 100 patients over the age of 18 who were hospitalized with an established diagnosis of viral pneumonia. To CT detection significant liver steatosis (more than 33%), several approaches were used: liver density less than 40 HU; decrease in liver density by at least 10 HU less than the spleen; the ratio of decrease in liver density to the spleen is less than 0.9.</p><p><strong>Results: </strong>According to CT data 2 groups were identified: 25 patients with existing liver steatosis and metabolically associated fatty liver disease, and 74 patients of the control group without signs of significant steatosis, оne patient was excluded due to alcohol abuse. There was a significant difference in the study of liver density (31.68 ± 10.67 and 54.44 ± 5.95; <i>p</i> < 0.001), the ratio of decrease in liver density to spleen density (0.66 ± 0.22 and 1.16 ± 0.13; <i>p</i> < 0.001), as well as a decrease in liver density relative to the spleen (16.30 ± 10.38 and -7.26 ± 6.10; <i>p</i> < 0.001). In the steatosis group, a more severe course of pneumonia was noted (<i>p</i> = 0.041). The incidence of deterioration according to CT was comparable in both groups: 19 (76%) and 45 (60.8%); <i>p</i> = 0.169, although its severity was higher in the group with steatosis (<i>p</i> = 0.012). Patients from the steatosis group were significantly more often prescribed biological (88.0 and 39.19%; <i>p</i> < 0.001) and antibacterial therapy (68.0 and 40.54%; <i>p</i> = 0.017).</p><p><strong>Conclusion: </strong>The use of assessment of liver steatosis according to CT data simultaneously with the study of the underlying disease can become an important diagnostic step determining the prognosis of the course of the disease, as well as a tool for risk stratification in patients with metabolically associated fatty liver disease.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 8","pages":"704-710"},"PeriodicalIF":0.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}