Terapevticheskii Arkhiv最新文献

{"title":"[Uric acid and mitochondrial dysfunction: a review].","authors":"G V Grigorenko, V V Tsurko","doi":"10.26442/00403660.2026.05.203610","DOIUrl":"10.26442/00403660.2026.05.203610","url":null,"abstract":"<p><p>The relationship between hyperuricemia and mitochondrial dysfunction remains poorly described in literature, despite its important clinical significance. The aim of this review is to identify the causes and mechanisms of uric acid's influence on the development of mitochondrial dysfunction. This review presents a comprehensive analysis of the pathogenetic relationship between uric acid (UA) and mitochondrial dysfunction as an evolutionarily formed process aimed at maintaining cellular energy homeostasis in conditions of energy deficiency, but modified into a pathological process in modern conditions of over-nutrition. The important role of the metabolism of fructose and its metabolite, UA, in the regulation of the energy balance of the cell is analyzed. The mechanisms of increased oxidative stress caused by UA and their effect on mitochondrial function have been determined. The important role of AMP-activated protein kinase (AMPK), a key regulator of cellular homeostasis, is analyzed, the inhibition of which by UA leads to mitochondrial dysfunction.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 5","pages":"320-324"},"PeriodicalIF":0.3,"publicationDate":"2026-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362565","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":"[Rheumatoid nodule in the myocardium as part of the chain in a clinical detective. Case report].","authors":"Z N Sukmarova, L M Blank, A P Skopintseva, A S Starkova","doi":"10.26442/00403660.2026.05.203609","DOIUrl":"10.26442/00403660.2026.05.203609","url":null,"abstract":"<p><p>The article describes a clinical case of a patient, at first glance healthy from the cardiovascular side, whose only complaint was ventricular extrasystole during exacerbations of arthritis. A typical scenario of such patients management is the suppression of the rheumatoid arthritis activity with the expectation that the involvement of target organs will subside accordingly. A rheumatoid nodule - specific manifestation of rheumatoid arthritis in the heart, that is usually detected in postmortem examinations and rare - according to echocardiography. Despite its small size (1.5×2 mm), the granuloma was the first clue to the patient's hidden heart condition. Further investigations revealed potential \"killers\" such as postinflammatory myocardial fibrosis, malignant ventricular arrhythmias, and coronary heart disease, prompting preventive measures. The case serves as an example of how, by pulling on the thread of a \"clinically insignificant\" finding, it is possible to identify a slowly progressing life-threatening pathology. The discussion of the case demonstrates an algorithm for making decisions about the management of cardiac arrhythmias in patients with rheumatic pathology, based on modern research methods and understanding of the complex mechanism of arrhythmias in inflammatory cardiomyopathy.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 5","pages":"314-319"},"PeriodicalIF":0.3,"publicationDate":"2026-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362567","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":"[Immunoglobulin G4-related retroperitoneal fibrosis: clinical, laboratory, imaging, and histopathological features in a Russian single-center cohort].","authors":"A S Veretennikov, A V Torgashina, B D Chaltsev, A M Kovrigina, J I Khvan, D A Dibrov","doi":"10.26442/00403660.2026.05.203608","DOIUrl":"10.26442/00403660.2026.05.203608","url":null,"abstract":"<p><strong>Aim: </strong>To describe a Russian cohort of patients with IgG4-related retroperitoneal fibrosis (RPF).</p><p><strong>Materials and methods: </strong>This retrospective single-center study included 36 patients diagnosed with IgG4-related RPF according to the revised 2020 diagnostic criteria. Clinical, laboratory, instrumental, and pathomorphological data were analyzed.</p><p><strong>Results: </strong>The cohort of 36 patients with IgG4-related RPF predominantly comprised males (4:1 ratio), with a median onset age of 52 years and median time to diagnosis of 8 months. The disease most presented with low back or lower abdominal pain (75%), renal dysfunction (44%), elevated serum IgG4>1.35 g/L (82%), and increased ESR/CRP. Urinary tract infection was detected in 44% due to frequent ureteral catheterization. Isolated retroperitoneal involvement occurred in 72% of cases, with typical infrarenal periaortitis in 58%; atypical sites included perirenal, periureteral, and presacral localizations. Biopsy (<i>n</i>=23) revealed lymphoplasmacytic infiltrate (100%), fibrosis (87%), IgG4+/CD138+>40% (71%), with obliterative phlebitis (26%) and tissue eosinophilia (26%) less common.</p><p><strong>Conclusion: </strong>Compared to international data, our findings reveal a higher prevalence of atypical localizations and concomitant urinary tract infections, necessitating their consideration in diagnostic algorithms and treatment planning for RPF patients.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 5","pages":"306-313"},"PeriodicalIF":0.3,"publicationDate":"2026-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362569","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":"[Initial disorders of pulmonary hemodynamics in patients with systemic sclerosis: the relevance of the new hemodynamic definition of pulmonary arterial hypertension].","authors":"A V Volkov, N N Yudkina, E V Nikolaeva, E L Nasonov","doi":"10.26442/00403660.2026.05.203604","DOIUrl":"10.26442/00403660.2026.05.203604","url":null,"abstract":"<p><strong>Aim: </strong>To investigated the impact of the new hemodynamic definition of pulmonary arterial hypertension (PAH) as proposed by the 6th PH World Symposium on the phenotypes, outcome and survival in patients with systemic sclerosis (SSc).</p><p><strong>Materials and methods: </strong>We retrospectively analyzed consecutive SSc patients included in our Center for a first right-heart catheterization between 2011 and 2019. The association between hemodynamics' phenotype and outcome and survival was studied.</p><p><strong>Results: </strong>We included 33 SSc patients, who had a high risk of PAH development with mPAP< 25 mmHg and 7 with early PAH I-II FC. Among them, 6 had a baseline mPAP value between 21 and 24 mmHg and PVR≥2 mmHg without interstitial lung disease and left heart disease, and were reclassified as PAH; only 1 of which raised their mPAP≥25 mmHg during 123 months follow-up. In 18 patients with mPAP< 20 mmHg; 1 of which raised their mPAP≥25 mmHg during 157 months follow-up. In 8 patients with unclassified PH mPAP didn't raise during 123 months of follow-up. The 5-year survival rate was 83% in the group with unconfirmed PH, 100% in the group with unclassified PH, and 88% in those with early PAH. With classical PAH-SSс I-II FC, according to the old hemodynamic criteria, the 5-year survival rate was 100%. No significant differences were found. There were also no differences in survival during the entire follow-up period. We did not observed relation between mPAP, PVR and outcome and mortality.</p><p><strong>Conclusion: </strong>Among patients with the PAH phenotype of SSc who do not have interstitial lung disease or left heart disease, those with early PAH can be found, although the frequency and rate of progression to classical PAH at these stages are very slow.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 5","pages":"275-281"},"PeriodicalIF":0.3,"publicationDate":"2026-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362521","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":"[Cutaneous manifestations of systemic lupus erythematosus and coexisting dermatologic conditions].","authors":"A A Shumilova, E I Travkina, P A Sholkina, T M Reshetnyak","doi":"10.26442/00403660.2026.05.203607","DOIUrl":"10.26442/00403660.2026.05.203607","url":null,"abstract":"<p><strong>Aim: </strong>To analyze the clinical heterogeneity of cutaneous manifestations in systemic lupus erythematosus (SLE) and the features of coexisting dermatologic conditions in these patients.</p><p><strong>Materials and methods: </strong>The single-center cross-sectional study included 210 patients with SLE followed at Nasonova Research Institute of Rheumatology. Clinical, laboratory, and instrumental parameters were assessed, including disease activity (SLEDAI-2K [Systemic Lupus Erythematosus Disease Activity Index 2000], SLE-DAS [Systemic Lupus Erythematosus Disease Activity Score]), organ damage (Damage Index of SLICC/ACR [Systemic Lupus International Collaborating Clinics / American College of Rheumatology]), and cutaneous manifestations using the CLASI (Cutaneous Lupus Disease Area and Severity Index), R-CLASI (Revised Cutaneous Lupus Erythematosus Disease Areas and Severity Index), and the mucocutaneous domain of Easy-BILAG (Easy British Isles Lupus Assessment Group). Coexisting dermatologic conditions and skin changes not directly related to SLE activity were additionally analyzed.</p><p><strong>Results: </strong>Cutaneous and mucosal involvement was observed in 85% of patients during the disease course and represented one of the most frequent manifestations at SLE onset. At study inclusion, active mucocutaneous manifestations were present in 50% of patients. Cutaneous involvement was characterized by marked clinical heterogeneity and a high prevalence of overlapping phenotypes, including acute and chronic cutaneous lupus, mucosal lesions, and non-scarring alopecia. Active cutaneous involvement was associated with serositis and hemolytic anemia. Coexisting dermatologic conditions, including treatment-related skin complications, were identified in 70% of patients.</p><p><strong>Conclusion: </strong>Cutaneous and mucosal manifestations in SLE constitute a complex, multicomponent disease phenotype reflecting both systemic inflammatory activity and processes of chronicity and damage accumulation. The high prevalence of overlapping cutaneous phenotypes and coexisting dermatologic conditions underscores the need for comprehensive skin assessment and a multidisciplinary approach to the management of patients with SLE.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 5","pages":"299-305"},"PeriodicalIF":0.3,"publicationDate":"2026-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362595","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 role and place of rivaroxaban in modern anticoagulant therapy of patients with atrial fibrillation. A review].","authors":"S K Zyryanov, E A Baybulatova, B B Ogurlieva","doi":"10.26442/00403660.2026.04.203513","DOIUrl":"10.26442/00403660.2026.04.203513","url":null,"abstract":"<p><p>Atrial fibrillation is the most common type of arrhythmia, the \"epidemic of the 21st century\" and the leading cause of cardioembolic ischemic stroke. Clinical guidelines recommend direct oral anticoagulants as first-line therapy for the prevention of ischemic stroke in patients with atrial fibrillation. Rivaroxaban is a selective, direct factor Xa inhibitor widely used for the prevention of thromboembolic complications. However, optimal patient adherence to anticoagulant therapy is crucial for achieving treatment benefit. Key factors influencing compliance include the frequency of dosing and cost. Poor compliance increases the risk of stroke or transient ischaemic attack by 2-6 times. A meta-analysis of 39 studies (976 494 patients) confirmed higher adherence and persistence with the once-daily regimen compared to the twice-daily regimen (<i>p</i><0.05). In December 2024, following the expiration of the patent for the original rivaroxaban, generic versions became available in Russia, including Rivaroxia^® (KRKA, d.d., Novo Mesto). This high-quality generic, with proven bioequivalence and identical anticoagulant effect, offers an affordable alternative, reducing healthcare costs with a wide range of dosages.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 4","pages":"237-242"},"PeriodicalIF":0.3,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869547","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":"[Interleukin-1 activity regulators in acute decompensated heart failure: dependence on obesity degree].","authors":"A A Korotaeva, E V Samoilova, O S Medvedev, D A Drugova, S N Nasonova, I V Zhirov, S N Tereshchenko","doi":"10.26442/00403660.2026.04.203576","DOIUrl":"10.26442/00403660.2026.04.203576","url":null,"abstract":"<p><strong>Aim: </strong>To assess the circulating levels of IL-1 and its activity regulators, IL-1Ra and IL-1R2, in patients with acute decompensated heart failure (ADHF) depending on body mass index (BMI).</p><p><strong>Materials and methods: </strong>The study included 159 patients hospitalized for ADHF. Depending on the BMI, the patients were assigned to 5 groups. The first group included 30 patients with healthy weight (BMI<25 kg/m²), the second - 50 overweight patients (25≤BMI<30 kg/m²), the third - 38 patients with class I obesity (30≤BMI<35 kg/m²), the fourth - 28 patients with class II obesity (35≤BMI<40 kg/m²), the fifth group - 13 patients with class III obesity (BMI≥40 kg/m²).</p><p><strong>Results: </strong>With increasing BMI, IL-1 levels increased, while IL-1R2 levels, on the contrary, decreased, but no statistically significant differences were found. IL-1Ra concentrations changed ambiguously and had U-shaped dependence. IL-1Ra levels were lower in overweight patients than in normal weight and obese groups. At the same time, the increase in obesity was accompanied by higher IL-1Ra levels. The highest IL-1Ra value was observed at a BMI≥40 kg/m².</p><p><strong>Conclusion: </strong>In ADHF an increase in obesity is accompanied by an increase in the inhibition of IL-1 activity, which may be one of the mechanisms by which adipose tissue exerts a protective effect.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 4","pages":"226-230"},"PeriodicalIF":0.3,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869598","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":"[Cardiorenal syndrome in an 85-year-old patient with neurofibromatosis. Case report].","authors":"E V Reznik, T A Gaydina, E A Koltsova, D V Gornostaev, S V Shigeev, Y Y Golubev, N V Yurtaeva, G Y Ishchenko, S E Arakelov","doi":"10.26442/00403660.2026.04.203586","DOIUrl":"10.26442/00403660.2026.04.203586","url":null,"abstract":"<p><p>Neurofibromatosis (NF) is a hereditary disease characterized by the formation and growth of benign tumors of neuroectodermal origin. There are three main nosological forms: NF1, NF2, NF3. It is believed that the disease debuts in childhood and significantly reduces the life expectancy of patients. The main cause of death in middle age are cardiovascular diseases and malignant neoplasms. There are isolated publications on NF in patients over 60 years old. The relationship between NF and cardiorenal syndrome has not been sufficiently studied. The development of vasculitis with vasculopathy is described, which leads to narrowing and occlusion of the coronary, renal, cerebral and other arteries. The article presents a description of an 85-year-old patient with NF and the development of cardiorenal syndrome.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 4","pages":"243-250"},"PeriodicalIF":0.3,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869564","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":"[Department of Hospital Surgery No. 2 - 60 years of surgical development].","authors":"Z G Berikkhanov, E A Tarabrin, A Y Kotaev, I A Tarasova, A L Shestakov, S Y Muraviev, A M Nikolaev, V V Kimutsadze, A V Balutskaya","doi":"10.26442/00403660.2026.04.203578","DOIUrl":"10.26442/00403660.2026.04.203578","url":null,"abstract":"<p><p>The work is dedicated to the 60th anniversary of the founding of the Department of Hospital Surgery No. 2 and aims to preserve the historical memory of the establishment and development of the Department, which was created on the basis of the N.V. Sklifosovsky Research Institute of Emergency Care in 1964. The paper tells about the prerequisites of the founding of the Department of Hospital Surgery of the Evening Medical Faculty of the 1st Moscow Order of Lenin I.M. Sechenov Medical Institute, contribution to the development of medical sciences, in particular surgery and transplantology, about all the heads of the Department (B.A. Petrov, A.P. Sytnik, V.I. Petrov, G.M. Solovev, A.F. Chernousov, A.I. Chernookov), their scientific and practical activities. The article presents for the first time historical photographs of the staff of the department at different times, archival documents.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 4","pages":"259-265"},"PeriodicalIF":0.3,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869593","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":"[Forced oscillation technique in the diagnosis of fibrotic phenotype interstitial lung diseases].","authors":"G V Nekludova, N V Trushenko, I A Levina, B B Lavginova, F T Kurkieva, R A Yandieva, S N Avdeev","doi":"10.26442/00403660.2026.04.203574","DOIUrl":"10.26442/00403660.2026.04.203574","url":null,"abstract":"<p><strong>Aim: </strong>To identify functional features in patients with interstitial lung diseases (ILD), depending on disease phenotypes, using the forced oscillation technique.</p><p><strong>Materials and methods: </strong>A single-center cross-sectional observational study was conducted on 68 patients with ILD (mean age 64 years, 70.6% women). The diagnoses were distributed as follows: idiopathic pulmonary fibrosis 17.7%, chronic hypersensitivity pneumonitis 44.1%, non-specific interstitial pneumonia 14.7%, unclassified ILD 23.5%. According to Tomographia Computata data, fibrotic changes were detected in 74.1% of patients. All patients underwent comprehensive pulmonary function testing, including spirometry, body plethysmography, measurement of diffusing capacity of the lungs, and oscillometry (forced oscillation technique).</p><p><strong>Results: </strong>The ΔX5 parameter was statistically significantly higher in patients with a fibrotic phenotype than in those without fibrosis [0.92 (0.06- 1.63) hPa×s/L vs 0.19 (-0.05-0.43) hPa×s/L; <i>p</i>=0.016]. Patients with fibrosis also had significantly lower for diffusing capacity of the lungs (45.5% vs 52% predicted; <i>p</i>=0.027) and CO diffusion capacity - Kco (73% vs 81.5% predicted; <i>p</i>=0.037) values. Independent predictors of the fibrotic phenotype were ΔX5 (odds ratio 6.386, 95% confidence interval 1.479-27.564; <i>p</i>=0.013) and Kco (odds ratio 0.929, 95% confidence interval 0.867-0.997; <i>p</i>=0.040). ROC analysis showed that the combination of ΔX5 and Kco parameters has high diagnostic value for detecting fibrosis (AUC 0.817; <i>p</i><0.001).</p><p><strong>Conclusion: </strong>The oscillometry parameter ΔX5 and the Kco index from diffusing capacity measurement are independent predictors of a fibrotic phenotype in patients with ILD. The combination of these functional parameters improves diagnostic capabilities for detecting fibrotic changes. The FOT method provides clinically important information in patients with ILD and restrictive impairment.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 4","pages":"209-216"},"PeriodicalIF":0.3,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869631","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}