Terapevticheskii Arkhiv最新文献

{"title":"[Features of disorders of the gut microbiota in patients with urolithiasis, depending on the severity of symptoms of intestinal indigestion and indicators obtained in laboratory and instrumental assessment].","authors":"N V Sturov, S V Popov, Z D Kobalava, Z A Ivanov, V A Zhukov","doi":"10.26442/00403660.2026.04.203575","DOIUrl":"10.26442/00403660.2026.04.203575","url":null,"abstract":"<p><strong>Aim: </strong>The study examined the composition of the gut microbiota (GM) in patients with urolithiasis compared to healthy volunteers, based on laboratory, instrumental, and gastroenterological quality of life questionnaire (Gastrointestinal Symptom Rating Scale - GSRS) results.</p><p><strong>Materials and methods: </strong>The composition of GM was studied using fecal samples obtained from 35 patients with urolithiasis and 31 healthy volunteers using gas chromatography-mass spectrometry. The GSRS questionnaire was used to assess gastrointestinal symptoms. In the group of patients with urolithiasis, the body mass index, serum creatinine concentration (with calculation of glomerular filtration rate), and serum uric acid concentration were analyzed, as well as the density of urinary stones using multispiral computed tomography (MSCT) in Hounsfield units (HU).</p><p><strong>Results: </strong>Statistical analysis of the data revealed violations of the composition of the GM against the background of urolithiasis in comparison with healthy volunteers (control group): patients with urolithiasis had a statistically significant increase in the content of bacteria <i>Corynebacterium</i> spp., <i>Peptostreptococcus anaerobius 18623</i>, a decrease in the number of <i>Clostridium propionicum (Anaerotignum propionicum)</i>, on average, 7 times, compared to the control group. When comparing the composition of the GM depending on the type of urinary stones, in the subgroup of patients with oxalate stones (<i>n</i>=18), an increase in the number of <i>Clostridium perfringens</i> was detected in the fecal samples, and in the subgroup of patients with uric acid stones (<i>n</i>=17), a decrease in the number of <i>Prevotella</i> bacteria was observed. In patients with urolithiasis, there was a negative correlation between the total GSRS score and the severity of dyspepsia syndrome, as well as the number of <i>Propionibacterium</i> spp. in the GM.</p><p><strong>Conclusion: </strong>The composition of the GM in patients with urolithiasis was significantly different from that of the GM in healthy volunteers. Statistically significant differences in the composition of the GM were found in patients with uric acid and oxalate stones.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 4","pages":"217-225"},"PeriodicalIF":0.3,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869638","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 diagnostic significance of extracellular volume in different periods of left ventricular myocardial infarction. A review].","authors":"V E Oleynikov, A V Vdovkin, N A Donetskaya, L I Salyamova, A A Chernova","doi":"10.26442/00403660.2026.04.203577","DOIUrl":"10.26442/00403660.2026.04.203577","url":null,"abstract":"<p><p>This review examines the pathophysiological processes affecting the Extracellular Volume (ECV) in both the acute and chronic phases of myocardial infarction. It discusses how the constellation of acute myocardial injuries leads to ECV expansion, establishing it as a robust and independent predictor of adverse left ventricular remodeling, major adverse cardiovascular events, and arrhythmic risk. The review outlines current methodologies for ECV assessment. It is shown that despite limitations related to its non-specific nature and the need for protocol standardization, ECV mapping surpasses traditional approaches in infarct size quantification and risk stratification, paving the way for personalized monitoring of treatment efficacy. The review encompasses foundational validation studies as well as recent research focused on the pathophysiological rationale of the method, technical aspects of its implementation, and clinical applications of ECV analysis, including its role in evaluating anti-remodeling therapies.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 4","pages":"231-236"},"PeriodicalIF":0.3,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869555","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":"[A clinical case of a mixed variant (cardiomyopathy and polyneuropathy) of hereditary transthyretin amyloidosis].","authors":"D P Golubovskaya, A D Filippova, D N Shaputko, A I German, T B Pecherina, O L Barbarash","doi":"10.26442/00403660.2026.04.203572","DOIUrl":"10.26442/00403660.2026.04.203572","url":null,"abstract":"<p><p>Amyloidosis associated with mutations in the transthyretin gene is the most common form of hereditary systemic amyloidosis. The onset and phenotype of the disease depend on the type of mutation, but the peripheral nervous system and heart are usually affected, and the age of onset of the disease varies from the third to the fifth decade. For the first time in Kuzbass, a case of hereditary transthyretin amyloidosis with a mutation in exon 3 of the <i>TTR</i> gene c.218G>A (Gly73Glu) in a heterozygous state was diagnosed in a 52-year-old man, which is characterized by a long course and late diagnosis (5 years from the first symptoms to confirmed mutation), including pronounced symptoms of autonomic dysfunction (up to severe orthostatic hypotension) and paraclinical signs of heart disease (phenocopy of hypertrophic cardiomyopathy). The work analyzes the spectrum of clinical manifestations of the disease, and also presents changes in the structural and functional parameters of the heart against the background of 2 years of specific therapy with tafamidis.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 4","pages":"251-258"},"PeriodicalIF":0.3,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869562","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":"[A \"risk score scale\" based on computed tomography angiography of the coronary arteries to assess the risk of cardiovascular events in the first year after acute coronary syndrome].","authors":"I N Merkulova, E B Yarovaya, T S Sukhinina, S A Gaman, T N Veselova, M A Shariya, R V Ievlev, S K Ternovoy, D V Pevzner","doi":"10.26442/00403660.2026.04.203573","DOIUrl":"10.26442/00403660.2026.04.203573","url":null,"abstract":"<p><strong>Aim: </strong>Development of a \"Risk Score Scale\" (RSS) to assess the risk of Major Adverse Cardiovascular Events (MACE) based on computed tomographic angiography (CTА) of the coronary arteries in patients with acute coronary syndrome.</p><p><strong>Materials and methods: </strong>The study included 249 pаtients with acute coronary syndrome (77.5% of men, age 58.2±10.7 years). Myocardial infarction occurred in 73.5% of patients, unstable angina - in 26.5%. After percutaneous coronary intervention CTA was performed by 320 - row CT scanner. 30 CTА characteristics were determined.</p><p><strong>Results: </strong>During 39.1 [18.0; 57.4] months of follow-up, 28.5% patients had combined primary endpoint events (PEE) including nonfatal myocardial infarction, unstable angina, cardiac death, unplanned percutaneous coronary intervention, ischemic stroke. RSS was developed by ROC analysis of the significant CT predictors of PEE, which were determined using a univariate Cox model. The uncensored period was 305 days - 26 PEE. Using the Yuden method, cut-off values, AUC values, and other indicators were calculated for predictors. RSS included the following 8 most optimal predictors with their cut-off values and score values: \"number of coronary arteries with plaques\" >1.5 - 1.0 point; \"maximum plaque length\" >14.5 mm - 1.16 points; \"total length of plaques\" >22.5 mm - 1.17; \"maximal coronary stenosis\" >77.5% - 1.23; \"number of plaques with ≥50% stenosis\" >3,5 - 1.1; \"minimum plaque density\" <29.1 HU - 1.33; \"number of plaques with spotty calcifications\" >1.5 - 1.23; \"number of low attenuation plaque <30 HU\" >0.5 - 1.00. For the resulting RSS calculated threshold value was 3 points. A score of >3 points indicates a high risk of MACE: odds ratio 7.2, 95% CI 2.6-19.7 (<i>p</i><0.0001).</p><p><strong>Conclusion: </strong>The use of RSS is a new and practically significant technique that makes it possible to improve the risk stratification of adverse outcomes.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 4","pages":"202-208"},"PeriodicalIF":0.3,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869560","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 combined use of inhaled nitric oxide and molecular hydrogen in patients with post-COVID-19 syndrome].","authors":"D D Pozdnyakova, I A Baranova, V D Selemir, O S Medvedev, A G Chuchalin","doi":"10.26442/00403660.2026.03.203537","DOIUrl":"10.26442/00403660.2026.03.203537","url":null,"abstract":"<p><strong>Background: </strong>Medical gases, inhaled nitric oxide (iNO) and molecular hydrogen (iH2), have been used in the therapy for various medical conditions. When combined, these gases have shown to be more effective and safer for patients, and may become a promising treatment option for various diseases рost-COVID-19 syndrome (PS).</p><p><strong>Aim: </strong>To compare the efficacy and safety of combined therapy iNO/iH₂ with monotherapy iNO and a control group in patients with respiratory disorders during with PS.</p><p><strong>Materials and methods: </strong>A prospective, open-label, controlled trial involving 60 patients with PS was conducted in parallel groups (the mean age of the participants was 58.1 ± 12.9 years, and the sample consisted of 18 men and 42 women). The participants were randomly assigned to 3 groups: 1 (<i>n</i> = 20) - iNO/iH₂ treatment; 2 (<i>n</i> = 20) - only iNO treatment; and 3 (<i>n</i> = 20) - control group. The duration of treatment was 10 days, and the treatment involved inhalation through a nasal cannula for 90 minutes (flow rate of 4 liters per minute, iH₂ concentrations < 4%, iNO - 60 pmm). Clinical outcomes were assessed using self-observation diaries, Modified Medical Research Council Dyspnea Scale questionnaires, the \"Language of Dyspnea\" Scale, Fatigue Assessment Scale, Hospital Anxiety and Depression Scale, and Short Form-36 Health Status Survey questionnaires. Additionally, a 6-Minute Walk Test was performed, and indicators of oxidative status in blood serum and microcirculation in the bulbar conjunctiva were measured.</p><p><strong>Results: </strong>The course of iNO/iН₂ and iNO led to regression of the clinical manifestations of PS (dyspnea, cough, fatigue), improved the physical and psychological component of quality of life, and contributed to improvement in microcirculation (increased venule diameter and velocity) compared to the control group (<i>p</i> < 0.05). In combination therapy, there was an increase in distance traveled by 6-minute walk test and decrease in reactive oxygen species compared to iNO and control groups (<i>p</i> < 0.05). No serious adverse events were noted.</p><p><strong>Conclusion: </strong>The study demonstrates the advantage of the iNO/iH₂ course in comparison with iNO and control in the rehabilitation program of patients with PS. The safety and effectiveness of the iNO/iH₂ course has been proven in the form of regression of clinical manifestations of PS, improvement of quality of life, exercise tolerance, microcirculation parameters, and restoration of the oxidative status of the body.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 3","pages":"147-153"},"PeriodicalIF":0.3,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147487292","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":"[Treatment with inhaled nitric oxide in patients with pulmonary embolism].","authors":"I R Nurkaev, D G Soldatov","doi":"10.26442/00403660.2026.03.203544","DOIUrl":"10.26442/00403660.2026.03.203544","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary embolism (PE) is accompanied by mechanical obstruction of pulmonary vascular bed, as well as pulmonary vasoconstriction, resulting as neurohumoral response to acute increase of pressure in pulmonary circulation system. It has been shown that vasospasm is making a significant contribution to pulmonary artery pressure (PAP) increase. Modern treatment of PE is mainly directed at restoring perfusion, while treatment of pulmonary vasoconstriction is overlooked. Nitrogen monoxide (NO) is endothelial mediator that has vasorelaxing and moderate antiplatelet properties that allow correcting the severity of pulmonary vasoconstriction.</p><p><strong>Aim: </strong>To assess efficacy and safety of inhaled NO therapy in complex treatment of PE.</p><p><strong>Materials and methods: </strong>The study involved patients with moderate-low-risk PE (<i>n</i> = 65) who were randomized into two groups: experimental (<i>n</i> = 30, 27 men, 3 women, mean age 53,1 ± 16,8 years) and control group (<i>n</i> = 35, 21 men, 14 women, mean age 56,8 ± 14,1 years old). Patients in experimental group received inhaled NO therapy with standard anticoagulant therapy, while control group received only anticoagulants.</p><p><strong>Results: </strong>On the 10th day of the study, experimental group showed significantly more pronounced decrease of systolic PAP (sPAP) and right heart sizes compared with control group. There was also statistically significant positive dynamics of vital signs (respiratory rate, heart rate, blood pressure) and dyspnea (mMRC), arterial oxygen partial pressure, nitrosative status (exhaled NO and saliva nitrite), NT-proBNP compared with control group.</p><p><strong>Conclusion: </strong>Inhaled NO therapy in complex therapy of PE demonstrated safety and efficacy in relation to clinical, functional and laboratory parameters.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 3","pages":"170-175"},"PeriodicalIF":0.3,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147487254","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":"[Non-respiratory lung function (problem status)].","authors":"A G Chuchalin","doi":"10.26442/00403660.2026.03.203536","DOIUrl":"10.26442/00403660.2026.03.203536","url":null,"abstract":"<p><p>Non-respiratory lung function (NFL) has been an area of intense scientific research for the past twenty years. Experts from the European Respiratory Society have developed a technical regulation that has made it possible to standardize the study of organic and inorganic volatile compounds both in the portion of exhaled air and in the collection of its condensate. The metabolic function of the pulmonary parenchyma is actively manifested in the regulation of water-electrolyte metabolism, as well as biologically active amines and peptides; unique properties of alveolocytes of the second type and alveolar macrophages in the synthesis and recycling of surfactant. A special role is played by the endotheliocytes of the pulmonary capillaries, which transform angiotensin-1 (deca peptide) into angiotensin-2 (octa peptide) with the help of an angiotensin-converting enzyme. The respiratory system is considered within the NFL as an active immunological organ. Bronchus-associated lymph nodes form mucosal immunity with the participation of secretory immunoglobulin class A, also participating in the formation of innate and acquired immunity. Clinical manifestations of immunopathological reactions of the respiratory system are diverse. Thus, in clinical practice, allergic reactions of both immediate and delayed types can be observed; granulomatous processes of the pulmonary parenchyma occupy a special place. In the mucous membrane of the respiratory tract, neuroepithelium can be identified, which plays an important role in the differentiation of cell structures and in the morphogenesis of lung tissue. However, the participation of the lungs in endocrinological reactions remains, at present, a poorly studied direction. The translation of scientific information on the metabolic, immunological and endocrinological functions of the lungs has made it possible to identify a number of biological markers in diseases such as bronchial asthma, COPD, lung cancer, and pneumonia. Studies of the proteome of exhaled air condensate have brought us closer to the discovery of new biological markers.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 3","pages":"140-146"},"PeriodicalIF":0.3,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147487521","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":"[Renin-angiotensin-aldosterone system blockers in the treatment of patients with cardiovascular diseases combined with bronchial obstruction diseases: a review].","authors":"L G Ambatiello","doi":"10.26442/00403660.2026.03.203546","DOIUrl":"10.26442/00403660.2026.03.203546","url":null,"abstract":"<p><p>The renin-angiotensin-aldosterone system (RAAS) is the main target of pharmacological agents used to achieve blood pressure reduction as well as cardio- and nephroprotection in patients with cardiovascular diseases (CVD). However, the use of drugs from this group, primarily angiotensin-converting enzyme inhibitors (ACE inhibitors), may lead to the development of adverse events (AEs) in patients with obstructive lung diseases (OLD). ACE inhibitors and angiotensin II receptor blockers (ARBs) have comparable efficacy in the treatment of CVD. In the event of AEs, patients receiving ACE inhibitors for arterial hypertension may be switched to ARBs. However, for the treatment of chronic heart failure with reduced ejection fraction, non-<i>ST</i>-segment elevation acute coronary syndrome, and <i>ST</i>-segment elevation myocardial infarction, ACE inhibitors are recommended as first-line therapy; the benefits of ARBs in these conditions have not been proven. Mineralocorticoid receptor antagonists (MRAs) are also frequently prescribed to patients with CVD as part of combination therapy. In addition to their proven efficacy in the treatment of CVD, spironolactone and eplerenone have demonstrated antifibrotic and anti-inflammatory effects in a number of studies, including effects in lung tissue, as well as the ability to influence the progressive course of fibrotic diseases. This class of drugs is being intensively studied. In the United States, Europe, and Japan, new agents from the subclass of nonsteroidal MRAs have been approved. Currently, investigation of the potential of MRAs is highly promising for patients with coexisting CVD and OLD, given the potential of these drugs to affect inflammation and fibrosis in lung tissue. Thus, this review is devoted to the analysis of the efficacy and safety of RAAS-targeting drugs in patients with CVD and OLD, the causes of adverse events, and proposes management strategies for their occurrence and possible correction.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 3","pages":"189-195"},"PeriodicalIF":0.3,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147487275","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":"[Pulmometabolic syndrome: a review].","authors":"T A Bakhareva, A M Belov, S D Gorbunkov, A I Yusupov, I A Baranova","doi":"10.26442/00403660.2026.03.203545","DOIUrl":"10.26442/00403660.2026.03.203545","url":null,"abstract":"<p><p>In this review, we discuss the underexplored issue of the relationship between metabolic syndrome (MS) and respiratory diseases. The review discusses the main pathogenic mechanisms, including chronic low-grade inflammation, oxidative stress, endothelial dysfunction, and mechanical restriction of lung volumes. The concept of pulmonometabolic syndrome is introduced. Data of the results of studies of the functional parameters of the lungs in MS are presented. We describe the clinical and pathobiological characteristics of the mutually aggravating interaction between MS and respiratory disorders, such as chronic obstructive pulmonary disease, bronchial asthma, obstructive sleep apnea, lung cancer, and pulmonary hypertension.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 3","pages":"183-188"},"PeriodicalIF":0.3,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147487221","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":"[In the museum of Dr. F.P. Haass].","authors":"E V Bobkov","doi":"10.26442/00403660.2026.03.203548","DOIUrl":"10.26442/00403660.2026.03.203548","url":null,"abstract":"<p><p>The article provides a description and history of the creation of the room-museum of F.P. Haass in the village of Tishkovo near Moscow.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 3","pages":"196-198"},"PeriodicalIF":0.3,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147487523","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}