Terapevticheskii Arkhiv最新文献

{"title":"[Uric acid and skeletal muscle status in females with rheumatoid arthritis].","authors":"O V Dobrovolskaya, M V Kozyreva, N V Demin, N V Toroptsova","doi":"10.26442/00403660.2025.05.203215","DOIUrl":"https://doi.org/10.26442/00403660.2025.05.203215","url":null,"abstract":"<p><strong>Aim: </strong>To study the association of uric acid (UA) levels with skeletal muscle mass, strength and physical performance in women with rheumatoid arthritis (RA).</p><p><strong>Materials and methods: </strong>One hundred thirty women (median age 61 [53; 66] years) with confirmed RA who signed informed consent were examined. A clinical and laboratory examination was performed, including an assessment of muscle strength, physical performance. Dual-energy X-ray absorptiometry according to the \"whole body\" program was done.</p><p><strong>Results: </strong>The median UA level was 262.8 [197.4; 310.5] μmol/l, the incidence of hyperuricemia was 9.2%. Positive correlations of UA with the total lean mass index <i>(r=</i>0.32; <i>p<</i>0.001), appendicular lean mass index <i>(r=</i>0.24; <i>p=</i>0.006) were established. These associations were confirmed in multiple linear regression analysis (b*=0.38; <i>p<</i>0.001 and b*=0.29; <i>p<</i>0.001, respectively). There was no association between the level of UA and RA parameters (duration of the disease, glucocorticoid intake, RF and ACCP seropositivity, ESR, CRP and DAS-28 index), as well as with muscle strength. A negative correlation between the level of UA and parameters of physical performance was found.</p><p><strong>Conclusion: </strong>The frequency of hyperuricemia was 9.2% in women with RA. Multiple regression analysis confirmed an independent association between lean mass and UA level.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 5","pages":"427-433"},"PeriodicalIF":0.3,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498065","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":"[Frequency and clinical and laboratory features of ankylosing spondylitis with secondary AA-amyloidosis].","authors":"K V Sakharova, S O Krasnenko, A E Dimitreva, S F Erdes","doi":"10.26442/00403660.2025.05.203229","DOIUrl":"https://doi.org/10.26442/00403660.2025.05.203229","url":null,"abstract":"<p><strong>Background: </strong>Pathogenesis of ankylosing spondylitis (AS) is based on long-term chronic inflammation, which can lead to the development of secondary amyloidosis.</p><p><strong>Aim: </strong>To analyze the frequency of secondary amyloidosis in a hospital cohort of patients with AS and describe their clinical and laboratory features.</p><p><strong>Materials and methods: </strong>Four hundred and fifty eight patients with AS were examined. Patients' disease activity and functional status were assessed according to the Russian expert recommendations. Additionally, in all patients, SAA in blood serum was determined using nephelometric method. Patients having high laboratory activity during several years underwent fibrogastroduodenoscopy and biopsy of the duodenum submucosal layer, in the absence of contraindications.</p><p><strong>Results: </strong>Among 458 patients with AS, the diagnosis of AA amyloidosis was confirmed in 21 (4.5%) cases; the frequency among men was 5.6%, among women - 2.6%. In 15 (3.3%) cases, AA amyloidosis was diagnosed for the first time, and only in 6 (1.3%) patients it was diagnosed before. Patients with AA-amyloidosis had higher disease activity measured by ASDAS-CRP and higher ESR values. Patients with amyloidosis had higher frequency of syndesmophytes and they underwent joint arthroplasty more often compared to the control group. Among the patients with amyloidosis, a significant negative association was revealed between the patients' age of enrollment in the study and the presence of arthritis, the values of BASDAI and ASDAS indices. The following associations were not observed in the control group. We did not find the expected association between SAA and activity scores, these values did not differ between groups.</p><p><strong>Conclusion: </strong>In a specialized rheumatology department, the frequency of AA-amyloidosis in patients with AS reaches 4.5%. Amyloidosis significantly more often develops in males, in patients with juvenile onset, in the late stage of the disease, in patients with high disease activity. Without a targeted search for secondary amyloidosis in patients with AS, its detection rate in real clinical practice is about 30%.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 5","pages":"412-418"},"PeriodicalIF":0.3,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498021","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":"[Relationship between vitamin D and osteoarthritis].","authors":"N G Kashevarova, L I Alekseeva, E A Taskina, E A Strebkova, E P Sharapova, N M Savushkina, K M Mikhaylov, S I Glukhova, O G Alekseeva, D M Kudinsky, N V Demin, E Y Samarkina, A M Lila","doi":"10.26442/00403660.2025.05.203228","DOIUrl":"https://doi.org/10.26442/00403660.2025.05.203228","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Osteoarthritis (OA) is a common joint disease and one of the leading causes of disability worldwide. The role of vitamin D in the etiology and development of OA is still unclear, but it may be important for both diagnosis and timely therapy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To evaluate the relationship of vitamin D levels with clinical and instrumental parameters in OA in a cross-sectional study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;The study included 171 patients aged 40-75 with confirmed knee OA according to the American College of Rheumatology (ACR) classification, stage I-III (according to Kellgren and Lawrence). All patients signed informed consent. The mean age was 53.5±9.94 years, body mass index (BMI) was 29.8±6.4 kg/m&lt;sup&gt;2&lt;/sup&gt;, and disease duration was 3 [1; 7] years. For each patient, a case record form was filled out, including anthropometric indicators, medical history, clinical examination data, an assessment of knee joint pain according to the Visual Analog Scale (VAS), WOMAC, and the patient's general health condition (PGHC). All patients underwent standard radiography, knee ultrasound examination and magnetic resonance imaging (MRI) (WORMS), densitometry of the lumbar spine and femoral neck, and laboratory tests. Statistical processing of the data was performed using the Statistica 10 software.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Normal vitamin D values (≥30 ng/mL) were found in 62 (36.3%) patients, low levels (&lt;30 ng/mL) in 109 (63.7%) patients, insufficiency (&lt;30 ng/mL and &gt;20 ng/mL) in 66 (38.6%) patients, and deficiency (&lt;20 ng/mL) in 43 (25.1%). Patients were divided into three groups according to the presence or absence of vitamin D insufficiency/deficiency: Group 1 included patients with normal vitamin D levels, Group 2 included patients with insufficiency, and Group 3 included patients with vitamin D deficiency. Patients of the three groups were comparable in age and disease duration but differed significantly in body weight, BMI, and waist measurement (higher in groups with reduced vitamin D values; &lt;i&gt;p&lt;/i&gt;&lt;0.05). Also, these patients had significantly higher VAS pain scores, total WOMAC and its components (pain, stiffness, and dysfunction), PGHC, and worse KOOS. More patients in Groups 2 and 3 had OA of the hip and hand joints, clinically detected synovitis, flat feet, and quadriceps muscle hypotrophy. Ultrasound examination significantly more often revealed a reduction of cartilage tissue on both the anteromedial and anterolateral surfaces of the knee joint; MRI showed more often osteitis in the medial condyles of the femur and tibia (&lt;i&gt;p&lt;/i&gt;&lt;0.05 for all values).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Our study demonstrated that low blood vitamin D levels (insufficiency/deficiency) were associated with a more severe knee OA. These patients had a large body weight, BMI, higher VAS pain values, WOMAC index (overall and its components), worse KOOS, PGHC, and smaller cartilage sizes in the ","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 5","pages":"434-442"},"PeriodicalIF":0.3,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498060","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":"[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}

{"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 ¹³C-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}

{"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}

{"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}

{"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}

{"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":"https://doi.org/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}

{"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}