Terapevticheskii Arkhiv最新文献

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[To the problem of extended serological testing for viral hepatitis B in rheumatoid arthritis patients]. [关于类风湿关节炎患者扩大乙型病毒性肝炎血清学检测的问题]。
IF 0.3 4区 医学
Terapevticheskii Arkhiv Pub Date : 2025-06-08 DOI: 10.26442/00403660.2025.05.203214
G I Gridneva, B S Belov, Z G Verizhnikova, E S Aronova, E Y Samarkina, T S Panevin, T A Lisitsyna, G V Lukina
{"title":"[To the problem of extended serological testing for viral hepatitis B in rheumatoid arthritis patients].","authors":"G I Gridneva, B S Belov, Z G Verizhnikova, E S Aronova, E Y Samarkina, T S Panevin, T A Lisitsyna, G V Lukina","doi":"10.26442/00403660.2025.05.203214","DOIUrl":"https://doi.org/10.26442/00403660.2025.05.203214","url":null,"abstract":"<p><strong>Aim: </strong>The objectives of the study: to conduct serologic screening for latent HBV infection in rheumatoid arthritis (RA) patients, to determine the level of protective antibodies to HBsAg in RA patients, and to determine the clinical and laboratory features of RA patients with latent hepatitis B in the course of retrospective analysis.</p><p><strong>Materials and methods: </strong>440 HBsAg-negative RA patients over 18 years old were included in the study. Blood serum was analyzed for the presence of antibodies to HBcAg (anti-HBc) by semi-quantitative method and the content of antibodies to HBsAg by quantitative method. Patients were included in the study consecutively, the inclusion criterion was negative HBsAg test, the exclusion criteria were co-infection with hepatitis C virus or HIV.</p><p><strong>Results: </strong>It was found that 64 (14%) patients were anti-HBs positive, in this group more than half [39 (61%)] had no antibodies to HBsAg (anti-HBs) in protective titer (more than 10 IU/mL), and 26 patients had no anti-HBs at all. Overall, only 130 (30%) patients in the cohort had anti-HBs in protective titer. Retrospective analysis of case histories and outpatient records revealed 33 cases of transaminase elevation, and in 15 patients this adverse event was the cause of antirheumatic drug withdrawal. Clinically significant thrombocytopenia occurred in 10 patients.</p><p><strong>Conclusion: </strong>Extended HBV screening for RA patients showed the absence of anti-HBV protection in 70% of patients. Latent HBV [HBsAg(-)/anti-HBc(+)] was detected in 14% of patients. It is necessary to be alert to cases of combined elevation of ALT and/or AST and thrombocytopenia as symptoms of probable exacerbation of HBV infection.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 5","pages":"443-448"},"PeriodicalIF":0.3,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498062","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}
引用次数: 0
[Features of diet in patients with cardiometabolic diseases with gout and hyperuricemia: A review]. [痛风和高尿酸血症合并心脏代谢疾病患者的饮食特点:综述]。
IF 0.3 4区 医学
Terapevticheskii Arkhiv Pub Date : 2025-06-08 DOI: 10.26442/00403660.2025.05.203227
M A Gromova, V V Tsurko, A V Starodubova, O A Kislyak
{"title":"[Features of diet in patients with cardiometabolic diseases with gout and hyperuricemia: A review].","authors":"M A Gromova, V V Tsurko, A V Starodubova, O A Kislyak","doi":"10.26442/00403660.2025.05.203227","DOIUrl":"https://doi.org/10.26442/00403660.2025.05.203227","url":null,"abstract":"<p><p>Gout, like hyperuricemia, is often associated with serious cardiometabolic and renal comorbidities that lead to persistently elevated rates of premature mortality in the population. Traditional dietary recommendations given to patients to prevent purine load require revision. This article holistically reviews the relevant scientific rationale and available evidence to provide evidence-based dietary recommendations for the prevention and treatment of hyperuricemia and gout and its cardiometabolic comorbidities.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 5","pages":"455-462"},"PeriodicalIF":0.3,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498020","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}
引用次数: 0
[Trends in the prevalence of Helicobacter pylori infection among adults in Moscow: a systematic review and meta-analysis]. [莫斯科成年人幽门螺杆菌感染流行趋势:系统回顾和荟萃分析]。
IF 0.3 4区 医学
Terapevticheskii Arkhiv Pub Date : 2025-06-08 DOI: 10.26442/00403660.2025.05.203250
D N Andreev, A R Khurmatullina, D S Bordin, I V Maev
{"title":"[Trends in the prevalence of <i>Helicobacter pylori</i> infection among adults in Moscow: a systematic review and meta-analysis].","authors":"D N Andreev, A R Khurmatullina, D S Bordin, I V Maev","doi":"10.26442/00403660.2025.05.203250","DOIUrl":"10.26442/00403660.2025.05.203250","url":null,"abstract":"<p><strong>Aim: </strong>To systematize data on the trends of the prevalence of <i>Helicobacter pylori</i> infection among the Moscow adult population.</p><p><strong>Materials and methods: </strong>The MEDLINE/PubMed, EMBASE, Google Scholar, and the Russian Science Citation Index were searched for studies published between January 1, 1985, and February 7, 2025, inclusive. Publications were selected based on an analysis of their titles and abstracts. Included were peer-reviewed publications in Russian and English containing data on the prevalence of <i>H. pylori</i> among the adult population of Moscow, studies using validated methods for the diagnosis of <i>H. pylori</i> based on serological, urease respiratory tests, histological and molecular methods, as well as publications containing detailed statistical processing of data suitable for inclusion in the meta-analysis.</p><p><strong>Results: </strong>The final analysis included seven studies totaling 7,581 subjects (the overall mean age of all subjects was 48.28±13.20 years). The overall prevalence of <i>H. pylori</i> infection in the adult population of Moscow in the analyzed pool of studies for 18 years (2006-2024) was 66.534% (95% confidence interval [CI] 42.097-86.989), including 78.661% (95% CI 59.400-92.910) when using serological diagnostic methods and 48.473% (95% CI 32.331-64.781) when using the <sup>13</sup>C-urease respiratory test. Studies conducted before 2015 showed the prevalence of <i>H. pylori</i> infection of 81.294% (95% CI 67.202-92.109), 68.028% (95% CI 29.383-95.895) in 2015-2020, and 39.860% (95% CI 33.993-45.877) after 2020. The meta-regression analysis revealed a statistically significant decrease in the prevalence of <i>H. pylori</i> depending on the year of the study (regression coefficient for the year -4.22 (95% confidence interval -6.27--2.17; <i>p</i><0,0099).</p><p><strong>Conclusion: </strong>The meta-analysis showed a gradual regression in the prevalence of <i>H. pylori</i> infection in Moscow, the largest metropolis in Russia and Europe. However, infection prevalence in the adult population remains relatively high, supporting the need for continued programs of timely diagnosis of <i>H. pylori</i> and subsequent eradication therapy to reduce the risk of associated diseases.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 5","pages":"463-470"},"PeriodicalIF":0.3,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498064","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}
引用次数: 0
[Advances in pharmacotherapy for immunoinflammatory rheumatic diseases in the 21st century]. [21世纪免疫炎性风湿病的药物治疗进展]。
IF 0.3 4区 医学
Terapevticheskii Arkhiv Pub Date : 2025-06-08 DOI: 10.26442/00403660.2025.05.203213
E L Nasonov
{"title":"[Advances in pharmacotherapy for immunoinflammatory rheumatic diseases in the 21st century].","authors":"E L Nasonov","doi":"10.26442/00403660.2025.05.203213","DOIUrl":"https://doi.org/10.26442/00403660.2025.05.203213","url":null,"abstract":"<p><p>The progress achieved in deciphering the pathogenetic mechanisms of immune-mediated inflammatory rheumatic diseases (IIRDs) served as the basis for the development at the beginning of the 21st century of more than 20 bioligical agents, which are monoclonal antibodies or recombinant proteins that block the activity of proinflammatory cytokines and/or pathological activation of immune system cells, and in recent years, a group of synthetic targeted anti-inflammatory drugs that modulate the signaling of cytokines involved in the development of inflammation, primarily Janus kinase inhibitors. The article will focus primarily on the achievements of pharmacotherapy of inflammatory rheumatic diseases, considered as models for studying the fundamental mechanisms of immunopathology of human diseases and the development of new approaches to anti-inflammatory therapy, with an emphasis on the contribution of Russian rheumatology and pharmacology to the study of this problem.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 5","pages":"401-411"},"PeriodicalIF":0.3,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498017","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}
引用次数: 0
[The role of obesity in the development and progression of osteoarthritis: the influence of medical and surgical therapies for obesity on the course of inflammatory arthritis: A review]. [肥胖在骨关节炎发生和发展中的作用:肥胖症的内科和外科治疗对炎性关节炎病程的影响:综述]。
IF 0.3 4区 医学
Terapevticheskii Arkhiv Pub Date : 2025-06-08 DOI: 10.26442/00403660.2025.05.203230
E A Troshina, T S Panevin, T D Briskman
{"title":"[The role of obesity in the development and progression of osteoarthritis: the influence of medical and surgical therapies for obesity on the course of inflammatory arthritis: A review].","authors":"E A Troshina, T S Panevin, T D Briskman","doi":"10.26442/00403660.2025.05.203230","DOIUrl":"https://doi.org/10.26442/00403660.2025.05.203230","url":null,"abstract":"<p><p>Obesity is considered the most important risk factor for the development of osteoarthritis (ОА) - progressive inflammatory disease of the joints, that is one of the causes of disability and long-term immobilization. Excessively developed adipose tissue not only increases the mechanical load on the joints, but also participates in the maintenance of chronic low-grade inflammation through the production of adipokines, cytokines, hemokines, complement factors and hormones. Adipokines influence cells of synovial tissue, cartilage and bone, which in turn produce some adipokines locally, maintaining an inflammatory microenvironment intraarticularly. Adipokines, including leptin, adiponectin, chemerin, and resistin, regulate inflammatory immune responses in cartilage, also affecting synovial tissue cells and bone. In turn, chondrocytes, osteoblasts and osteoclasts produce some adipokines locally, maintaining an inflammatory microenvironment intra-articularly. Weight loss in OA can improve the patient's quality of life, physical function, lead to reduce pain, and slow or halt the progression of structural degenerative changes. The purpose of this article is to clearly describe the pathogenetic ways between obesity and inflammation, to reveal the mechanisms of the pathological state of adipokines and proinflammatory mediators (IL-6, TNF-á, etc.) on cartilage and bone homeostasis and, as expected, to evaluate their participation in the development of OA. So understanding immune regulation and resolution of inflammation in obesity is critical to developing treatments approaches to OA for these patients. The article also analyzes current researches on the effect of drug therapy (liraglutide, orlistat, sibutramine) and bariatric surgery of obesity on the course of inflammatory joint diseases.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 5","pages":"449-454"},"PeriodicalIF":0.3,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498061","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}
引用次数: 0
[Expert consensus on approaches to risk stratification and choice of therapy in patients with inoperable and residual chronic thromboembolic pulmonary hypertension]. [专家对不能手术和残余慢性血栓栓塞性肺动脉高压患者的风险分层方法和治疗选择的共识]。
IF 0.3 4区 医学
Terapevticheskii Arkhiv Pub Date : 2025-04-15 DOI: 10.26442/00403660.2025.03.203237
I E Chazova, T V Martynyuk, S N Avdeev, Z S Valieva, O Y Vasiltseva, T N Veselova, V V Gramovich, D S Grankin, N M Danilov, A G Edemskiy, A L Komarov, K V Mershin, O M Moiseeva, A M Chernyavskiy, N A Tsareva, S Y Yarovoy
{"title":"[Expert consensus on approaches to risk stratification and choice of therapy in patients with inoperable and residual chronic thromboembolic pulmonary hypertension].","authors":"I E Chazova, T V Martynyuk, S N Avdeev, Z S Valieva, O Y Vasiltseva, T N Veselova, V V Gramovich, D S Grankin, N M Danilov, A G Edemskiy, A L Komarov, K V Mershin, O M Moiseeva, A M Chernyavskiy, N A Tsareva, S Y Yarovoy","doi":"10.26442/00403660.2025.03.203237","DOIUrl":"10.26442/00403660.2025.03.203237","url":null,"abstract":"<p><p>On December 13, 2024, the final working group meeting was held, the purpose of which was to discuss the common position of experts on the problem of chronic thromboembolic pulmonary hypertension of various specialties: cardiologists, cardiac surgeons, pulmonologists, on issues of assessing the operability of patients, risk stratification and choice of therapy in patients with inoperable and residual forms of pathology. The discussion field included a wide range of issues that often arise in real clinical practice, but specific answers to them are not given in national and foreign guidelines. On November 8, 2024, at the preparatory stage, 16 experts under the leadership of Academician of the Russian Academy of Sciences I.E. Chazova (chairman) formulated questions for the preparation of a consensus document (without discussion), consistently discussing the feasibility of including each issue in the document and distributing tasks for the final session. Then, at the intermediate stage, experts searched and systematized scientific information on the formulated questions in the PubMed and eLIBRARY systems to prepare sections of the document in accordance with the established tasks. When finalizing the document, experts answered 28 questions: during anonymous voting an individual score was determined for each block from 1 - completely disagree, to 5 - completely agree. It was considered that a strong consensus was achieved with a mean score of <i>M</i>±<i>m</i> 2.5±2, and with a mean score below 2.5, consensus was not achieved. A strong consensus was reached on all issues.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 3","pages":"279-288"},"PeriodicalIF":0.3,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040026","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}
引用次数: 0
[Historical milestones in the study of pulmonary hypertension]. 【肺动脉高压研究的历史里程碑】。
IF 0.3 4区 医学
Terapevticheskii Arkhiv Pub Date : 2025-04-15 DOI: 10.26442/00403660.2025.03.203137
A K Osokina, O V Rodnenkov, T V Martynyuk
{"title":"[Historical milestones in the study of pulmonary hypertension].","authors":"A K Osokina, O V Rodnenkov, T V Martynyuk","doi":"10.26442/00403660.2025.03.203137","DOIUrl":"https://doi.org/10.26442/00403660.2025.03.203137","url":null,"abstract":"<p><p>The article describes the historical aspects of the discovery of the pulmonary circulation and the study of pulmonary hypertension (PH) as a pathophysiological condition with a key hemodynamic characteristic - an increase in pressure in the pulmonary artery. The complexity of PH treatment is due to the association with various cardiovascular and respiratory diseases, which requires a multifaceted holistic interdisciplinary approach with the active participation of the physician and the patient. Currently, the guide for successful clinical practice are clinical guidelines covering the full range of diagnostic and therapeutic measures for various groups of PH. The development of guidelines is the result of a long way of studying morphology, pathophysiology, creating and researching of pathogenetic medical drugs, clinical observation of patients in the framework of studies and registries.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 3","pages":"289-295"},"PeriodicalIF":0.3,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982776","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}
引用次数: 0
[Efficiency and safety of the integrated use of medical gases thermal heliox, nitric oxide and molecular hydrogen in patients with exacerbation of chronic obstructive pulmonary disease complicated by hypoxemic, hypercapnic respiratory failure and secondary pulmonary arterial hypertension in the post-COVID period]. [热螺旋、一氧化氮和分子氢在慢性阻塞性肺疾病加重合并低氧血症、高碳酸血症性呼吸衰竭和继发性肺动脉高压患者中综合使用的有效性和安全性]。
IF 0.3 4区 医学
Terapevticheskii Arkhiv Pub Date : 2025-04-15 DOI: 10.26442/00403660.2025.03.203131
L V Shogenova
{"title":"[Efficiency and safety of the integrated use of medical gases thermal heliox, nitric oxide and molecular hydrogen in patients with exacerbation of chronic obstructive pulmonary disease complicated by hypoxemic, hypercapnic respiratory failure and secondary pulmonary arterial hypertension in the post-COVID period].","authors":"L V Shogenova","doi":"10.26442/00403660.2025.03.203131","DOIUrl":"https://doi.org/10.26442/00403660.2025.03.203131","url":null,"abstract":"<p><strong>Aim: </strong>To study the efficacy and safety of the combined use of thermal heliox (t-He/O<sub>2</sub>), nitric oxide (NO) and molecular hydrogen (H<sub>2</sub>) in patients with exacerbation of chronic obstructive pulmonary disease (COPD) complicated by hypoxemic, hypercapnic respiratory failure (RF) and secondary pulmonary arterial hypertension (PAH) in the post-COVID period.</p><p><strong>Materials and methods: </strong>The randomized, comparative, controlled, parallel study included patients (<i>n</i>=100, 52 men and 48 women) with exacerbation of COPD levels of evidence C and D (GOLD 2021-2023) with hypoxemic, hypercapnic respiratory failure and secondary PAH, who had pneumonia caused by SARS-CoV-2 before hospitalization. Patients with similar demographic, clinical, and functional parameters, who received non-invasive ventilation (NIV) and oxygen (O<sub>2</sub>) along with standard drug therapy, were divided into 5 groups: Group 1 (main): (<i>n</i>=22: 12 men, 10 women, who received t-He/O<sub>2</sub>, NO, and H<sub>2</sub> sequentially); Group 2 (<i>n</i>=20: 10 men, 10 women, who received t-He/O<sub>2</sub> and NO); Group 3 (n=20: 11 men, 9 women, who received t-He/O<sub>2</sub> and H<sub>2</sub>); Group 4 (<i>n</i>=18: 10 men, 8 women, who received NO and H<sub>2</sub>); Group 5 (control) (<i>n</i>=20: 9 men, 11 women). The dynamics of the clinical condition of patients, gas exchange in the lungs, acid-base balance, left-to-right discharge fraction, hemodynamic parameters, and exercise tolerance were assessed.</p><p><strong>Results: </strong>A positive effect of the complex use of medical gases on the clinical condition of patients, gas exchange parameters in the lungs, metabolism, hemodynamic parameters and exercise tolerance was found in comparison with these parameters in patients who received medical gases separately and with the control group.</p><p><strong>Conclusion: </strong>The combination of t-He/O<sub>2</sub>, NO and H<sub>2</sub> with simultaneous pathogenetic therapy and NIV in patients with exacerbation of COPD complicated by hypoxemic, hypercapnic RF and secondary PAH in the post-COVID period is safe and more effective compared to groups receiving each medical gas separately. Complex therapy improves the clinical condition of patients, reduces signs of hypoxemia and hypercapnia, vascular endothelial dysfunction, metabolic disorders and increases tolerance to physical activity by normalizing gas exchange in the lungs, increasing oxygen delivery to tissues, reducing the shunt fraction, and restoring metabolism.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 3","pages":"242-249"},"PeriodicalIF":0.3,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035729","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}
引用次数: 0
[GERD-associated laryngeal granuloma: a series of clinical observations. Case report]. gerd相关喉部肉芽肿:一系列临床观察。病例报告)。
IF 0.3 4区 医学
Terapevticheskii Arkhiv Pub Date : 2025-04-15 DOI: 10.26442/00403660.2025.03.203133
S V Starostina, O V Tashchyan, M G Mnatsakanyan, K A Nazarov, L S Karapetyan, P A Loskutova, I V Kuprina
{"title":"[GERD-associated laryngeal granuloma: a series of clinical observations. Case report].","authors":"S V Starostina, O V Tashchyan, M G Mnatsakanyan, K A Nazarov, L S Karapetyan, P A Loskutova, I V Kuprina","doi":"10.26442/00403660.2025.03.203133","DOIUrl":"https://doi.org/10.26442/00403660.2025.03.203133","url":null,"abstract":"<p><p>Laryngeal granuloma is a benign neoplasm located on the vocal processes of the arytenoid cartilage. The causes of development may be prolonged or traumatic intubation (23%), gastroesophageal reflux disease leading to chronic cough (30%), excessive vocal load (33%); respectively, post-intubation, contact and idiopathic granulomas are distinguished. In laryngopharyngeal reflux, an extraesophageal manifestation of gastroesophageal reflux disease, morphological changes in the mucous membrane of the larynx and pharynx occur as a result of direct exposure to acidic stomach contents, pepsin, bile and pancreatic enzymes that cause the development of contact laryngeal granuloma. Diagnosis of laryngopharyngeal reflux includes analysis of the patient's life history, registration of complaints using questionnaires, assessment of the clinical and functional state of the larynx using visual analog scales of reflux signs, the use of instrumental methods and laboratory tests. The latter determine the acidity of gastric juice, bile acids, pepsin, as well as the presence of <i>Helicobacter</i><i> </i><i>pylori</i>. Instrumental methods include esophagogastroduodenoscopy, videolaryngostroboscopy, esophageal manometry and 24-hour pH impedancometry - the most accurate method for diagnosing reflux in the esophagus, regardless of the pH of the bolus. During videolaryngostroboscopy in patients with the laryngopharyngeal reflux, laryngeal lesion is often detected in the form of swelling, hyperplasia of the mucous membrane of the intercostal fold and posterior vocal folds. The treatment of patients with laryngeal contact granulomas is based on a combination of antireflux therapy and phonopedia. Surgical intervention is necessary only in the case of large granuloma sizes for morphological verification and restoration of glottis patency. Complex rational therapy of patients with laryngopharyngeal reflux, including the use of proton pump inhibitors, prokinetics and antacids, can increase the effectiveness of surgical treatment of patients with laryngeal granuloma and reduce the risk of recurrence. The own clinical observations presented in the article emphasize the importance of an interdisciplinary approach of laryngologists and gastroenterologists to the diagnosis and treatment of patients with reflux-associated laryngeal granulomas, which makes it possible to minimize and in some cases avoid surgery.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 3","pages":"263-271"},"PeriodicalIF":0.3,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049260","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}
引用次数: 0
[Localized AL amyloidosis]. [局限性AL淀粉样变]。
IF 0.3 4区 医学
Terapevticheskii Arkhiv Pub Date : 2025-04-15 DOI: 10.26442/00403660.2025.03.203136
N A Kashchavtseva, I G Rekhtina, A M Kovrigina, T P Danilina, L P Mendeleeva
{"title":"[Localized AL amyloidosis].","authors":"N A Kashchavtseva, I G Rekhtina, A M Kovrigina, T P Danilina, L P Mendeleeva","doi":"10.26442/00403660.2025.03.203136","DOIUrl":"https://doi.org/10.26442/00403660.2025.03.203136","url":null,"abstract":"<p><p>Localized light chain (AL) amyloidosis (amyloidoma) is a rare disease with unclear pathogenesis and undeveloped approaches to therapy. This article presents 3 clinical observations of localized AL amyloidosis with lesions of the respiratory tract, eyes, and soft tissues of the face. Tumor masses consisted of amyloid masses in which single monotypic plasma cells were \"embedded\". To verify the cell substrate, the method of chromogenic<i> </i><i>in</i><i> </i><i>situ</i> hybridization with probes to immunoglobulin light chains was used. Amyloid typing was performed using FITC-labeled antibodies to kappa and lambda light chains after enzymatic treatment of paraffin sections with pronase. The absence of monoclonal secretion (in two cases) made it difficult to assess the efficacy of the therapy. Taking into account the prevalence and severity of vital organs damage, as well as the recurrent nature of the disease course, systemic combination therapy with targeted drugs was prescribed. Stabilization of the process in all patients was stated during one year of follow-up. Nevertheless, clonreducing therapy in localized AL amyloidosis is not considered as a standard option, its feasibility and efficacy requires further confirmation.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 3","pages":"257-262"},"PeriodicalIF":0.3,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038405","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}
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