Terapevticheskii Arkhiv最新文献

{"title":"[New pathogenic mutation in LMNA gene: Clinical case of familial cardiomyopathy].","authors":"S Y Kashtanova, E М Rimskaya, A N Meshkov, N А Mironova, I K Dzhumaniiazova, E A Zelenova, V V Daniel', M V Ivanov, D A Kashtanova, V S Yudin, A A Keskinov, S I Mitrofanov, A I Akinshina, Y N Vanyushina, S А Kraevoy, S M Yudin, S P Golitsyn","doi":"10.26442/00403660.2025.01.203030","DOIUrl":"https://doi.org/10.26442/00403660.2025.01.203030","url":null,"abstract":"<p><p>We present a clinical case of familial <i>LMNA</i>-associated cardiomyopathy, confirmed by whole genome sequencing. The typical for lamin-associated cardiomyopathy indicates pathogenic nature of the mutation in the first exon of <i>LMNA</i> gene, previously considered a mutation of unknown clinical significance. The presented clinical case demonstrates a radical change in patient treatment strategies in the context of the widespread introduction of molecular genetic research methods into practice.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 1","pages":"65-70"},"PeriodicalIF":0.3,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032368","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":"[Efficacy of iptacopan monotherapy for suboptimal response to eculizumab in patients with paroxysmal nocturnal hemoglobinuria].","authors":"O U Klimova, I K Golubovskaya, Y N Kuznetsov, M V Marchenko, A D Kulagin","doi":"10.26442/00403660.2025.01.203146","DOIUrl":"https://doi.org/10.26442/00403660.2025.01.203146","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the hematological response within 4 weeks of iptacopan monotherapy in patients with paroxysmal nocturnal hemoglobinuria and suboptimal response to long-term eculizumab therapy.</p><p><strong>Materials and methods: </strong>The analysis included 8 patients, median age 32 years, with persistent anemia on long-term therapy with eculizumab. The hematological response was assessed when switching to oral monotherapy with iptacopan 200 mg twice daily for 4 weeks.</p><p><strong>Results: </strong>After 4 weeks of iptacopan therapy, an increase in hemoglobin levels by more than 20 g/l was achieved in 7/8 (88%), and a complete response in 6/8 (75%) patients. The median increase in hemoglobin levels was 32.5 g/l from the initial 85.5 g/l (74-100) to 121.5 g/l (80-141); <i>p</i>=0.00013. Independence from red blood cell transfusions was achieved in 100% of cases. Achieving a hematological response to iptacopan therapy was accompanied by a decrease in the level of absolute reticulocyte count, bilirubin and lactate dehydrogenase, as well as a negative result of the anti-C3d direct antiglobulin test.</p><p><strong>Conclusion: </strong>The oral complement factor B inhibitor iptacopan is an effective treatment option for paroxysmal nocturnal hemoglobinuria in patients with a suboptimal response to complement inhibitor C5 due to more effective control of extravascular C3-mediated hemolysis.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 1","pages":"46-53"},"PeriodicalIF":0.3,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Experience with the use of undenatured type II collagen in patients with stage III knee osteoarthritis: a multicenter, prospective, double-blind, placebo-controlled, randomized trial].","authors":"L I Alekseeva, N G Kashevarova, E A Taskina, E A Strebkova, T A Korotkova, E P Sharapova, N M Savushkina, A M Lila, N A Shostak, I I Nesterovich, V A Dedkova, V B Vasilyuk, N V Egorova, M A Leontyeva, S P Yakupova, I B Vinogradova, V N Sorotskaya, L I Shirokova, A V Rudakova","doi":"10.26442/00403660.2025.01.203145","DOIUrl":"https://doi.org/10.26442/00403660.2025.01.203145","url":null,"abstract":"<p><strong>Introduction: </strong>Current strategies for treating osteoarthritis (OA) are based on a multimodal approach that includes pharmacological and non-pharmacological methods. Undenatured chicken collagen type II (NK2) is considered safe and effective for maintaining joint health and can be used alone and combined with drugs for OA treatment.</p><p><strong>Aim: </strong>To further evaluate the efficacy of the combination of Artneo containing NK2 in patients with stage III knee OA compared with placebo in a multicenter, prospective, double-blind, placebo-controlled, randomized trial.</p><p><strong>Materials and methods: </strong>The study included 212 patients from 12 centers in the Russian Federation, of whom 50 had radiological stage III knee OA: 41 (82.0%) females and 9 (18.0%) males aged 44 to 75. Using the interactive web response system (IWRS), the study population was randomized into two groups: Group 1 (Artneo group) included 28 patients receiving the drug 1 capsule once a day for 180 days, Group 2 (placebo group) included 22 patients receiving placebo with drug-matched presentation and the same regimen as in Group 1. The effectiveness of therapy was assessed by the change of pain using the Visual Analog Scale, the WOMAC index, KOOS, the EQ-5D quality of life questionnaire, and the need for non-steroidal anti-inflammatory drugs. All patients had a complete blood count, urinalysis, blood chemistry, and ultrasonic examination of the target knee joint.</p><p><strong>Results: </strong>A prospective, double-blind, placebo-controlled, randomized trial demonstrated that Artneo containing NK2 was significantly superior to placebo in all studied parameters, improved all clinical manifestations of OA: reduced pain and stiffness, improved joint function and quality of life, and had a good safety profile.</p><p><strong>Conclusion: </strong>Artneo showed high efficacy and safety in the general population of patients, including those with stage III knee OA.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 1","pages":"54-64"},"PeriodicalIF":0.3,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027279","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":"[Risk factors for new-onset diabetes after transplantation in kidney transplant recipients: own data and meta-analysis].","authors":"M S Novikova, L O Minushkina, O N Kotenko, D A Zateyshchikov, O I Boeva, S S Allazova, E M Shilov, O M Koteshkova, M B Antsiferov","doi":"10.26442/00403660.2025.01.203029","DOIUrl":"https://doi.org/10.26442/00403660.2025.01.203029","url":null,"abstract":"<p><strong>Aim: </strong>To compare risk factors for new-onset diabetes after transplantation (NODAT) among renal transplant recipients (RTRs) from 1989 to 2018 in the City Clinical Hospital №52, with a systematic analysis of published studies on this topic.</p><p><strong>Materials and methods: </strong>In a 30-year (1989-2018) retrospective study, we found statistically significant differences in age, gender, polycystic kidney disease, cadaveric kidney, cyclosporine, i-mTOR, and steroids between two groups of recipients with and without NODAT. Patients with NODAT were older, more male, more likely to have polycystic kidney disease and deceased donor kidneys, and more likely to be treated with cyclosporine, i-mTOR, and steroids (<i>p</i><0.05). We conducted a meta-analysis to evaluate the impact of these indicators on the development of NODAT. MEDLINE, Scopus, and the Cochrane Central Register of Controlled Trials were searched for eligible case-control studies of risk factors for NODAT in RTRs published between 1990 and 2019. Meta-analysis of proportions was performed using the Freeman-Tukey transformation to calculate weighted summary proportions from a fixed and random effects model.</p><p><strong>Results: </strong>A total of 13 case-control studies were included in the meta-analysis. Of the total 849 studies found, 13 were included in the systematic review and meta-analysis, including ours, with a total of <i>n</i>=6797 RTRs, of which <i>n</i>=1305 patients with NODAT and <i>n</i>=5492 without NODAT. A wide range of data was recorded for the analysis of the incidence of NODAT (6.5-50.7%), with an average of 17.9% (fixed model) or 24.3% (random model). The proportion of NODAT recorded in the Russian registry of the City Clinical Hospital №52 was lower (11.5%), however, the data in the analyzed studies were highly heterogeneous: <i>I</i>²=98.14%, 95% CI: from 97.61 to 98.55, <i>p</i><0.0001, Begg's test (<i>p</i>=0.05) and Egger's test (<i>p</i>=0.01) do not exclude the presence of publication bias in this case. Data on NODAT risk factors were less heterogeneous. This meta-analysis showed that age, polycystic kidney disease, i-mTOR and steroid therapy were associated with NODAT, whereas gender, calcineurin inhibitor use, and cadaveric kidney were not. There was no evidence of selection bias in any of the cases.</p><p><strong>Conclusion: </strong>Risk factors for NODAT in kidney transplant recipients include older age, polycystic kidney disease, i-mTOR and steroid therapy, which initiate a state of insulin resistance. To reduce the risk of NODAT, the possibility of modifying immunosuppression regimens and the use of drugs that reduce insulin resistance and have a nephroprotective effect in RTRs should be considered. Therefore, randomized studies are needed to evaluate SGLT2 inhibitor in RTRs.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 1","pages":"35-45"},"PeriodicalIF":0.3,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011743","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":"[History of patient education for chronic diseases (with diabetes mellitus as an example): from an idea to the branch of modern medicine].","authors":"E V Surkova, I V Glinkina, O Y Gurova, D V Mamleeva, G R Galstyan","doi":"10.26442/00403660.2025.01.203139","DOIUrl":"https://doi.org/10.26442/00403660.2025.01.203139","url":null,"abstract":"<p><p>The article describes the history of the formation of therapeutic education as one of the most essential components of the treatment of chronic diseases, in particular diabetes. The varieties and methods of programs for patients existing in the Russian Federation are considered in detail.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 1","pages":"86-93"},"PeriodicalIF":0.3,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Experience in assessing the quality of dispensary observation of adults after myocardial infarction in the Central, Ural, Siberian and Far Eastern Federal Districts of the Russian Federation].","authors":"I V Atyunina, E V Sorokin, Y A Dolgusheva","doi":"10.26442/00403660.2025.01.203027","DOIUrl":"https://doi.org/10.26442/00403660.2025.01.203027","url":null,"abstract":"<p><strong>Aim: </strong>Тo evaluate the quality of dispensary observation (DO) and treatment after myocardial infarction in accordance with the current DO-algoritm and clinical guidelines (CG).</p><p><strong>Materials and methods: </strong>A questionnaire collection of data of the quality of DO and CG compliance was conducted in 28 regions of the Russian Federation (1241 questionnaires). The quality of DO was assessed according to a number of criteria, including the timing of establishing DO and issuing prescriptions for drugs, the specialty of the doctor performing DO, the frequency of DO-visits and adherence to the diagnostic algorithm, compliance with drug prescriptions current CG.</p><p><strong>Results: </strong>Timely DO, cardiologist's follow up of patients discharged from the hospitall did not take place in all regions. The diagnostic algorithms of DO were generally followed, however, the drug therapy did not fully comply to CG, especially in beta-blockers and drugs that affect the renin-angiotensin system.</p><p><strong>Conclusion: </strong>There is a need for further improvement of the DO of patients with myocardial infarction. The introduction, modernization of additional mechanisms that ensure the continuity and efficiency of the diagnostic, treatment process, and the optimization of drug treatment will improve the quality of outpatient cardiac care and DO.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 1","pages":"11-20"},"PeriodicalIF":0.3,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049257","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":"[Emergency measures in the diagnosis and treatment of chronic forms of ischemic heart disease].","authors":"S A Boytsov, S I Provatorov, I I Shestova, N N Nikulina","doi":"10.26442/00403660.2025.01.203125","DOIUrl":"https://doi.org/10.26442/00403660.2025.01.203125","url":null,"abstract":"<p><p>Coronary heart disease (CHD) is one of the most common cardiovascular diseases and the most common cause of death in Russia. Primary diagnostics of CHD involves assessing the pre-test probability of CHD. Thereafter, myocardial ischemia should be verified by visualization technique: stress echocardiography or stress single-photon emission computed tomography of the myocardium. Myocardial revascularization improves the prognosis in patients with stable CHD who have three-vessel coronary disease or significant stenosis of the left main coronary artery. Outpatient monitoring and free provision of medications can significantly reduce mortality among patients with stable high-risk CHD.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 1","pages":"5-10"},"PeriodicalIF":0.3,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018840","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":"[Sudden cardiac death and decompensation of heart failure: how to reduce the risks. A review].","authors":"M V Kuleshova, T M Uskach, O V Sapelnikov","doi":"10.26442/00403660.2025.01.203031","DOIUrl":"https://doi.org/10.26442/00403660.2025.01.203031","url":null,"abstract":"<p><p>The main causes of death in patients with heart failure (HF) are sudden cardiac death and decompensation of HF, especially with a low left ventricular ejection fraction. The prediction and prevention of risk factors for the development of these conditions are important goals both for guideline-directed medical therapy and for electrophysiological treatment methods. The article presents an overview of clinical studies devoted to the study of implantable cardioverter defibrillators in the prevention of sudden cardiac death, highlights the issues of monitoring the course of HF. Special attention is paid to multisensory monitoring in implantable devices equipped with a unique set of sensors for early diagnosis of the development of HF decompensation. It is expected that the practical use of such devices will reduce the number of exacerbations and hospitalizations for HF by detecting signs of threatening decompensation of blood circulation before the appearance of active symptoms, and as a result will reduce mortality in this category of patients.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 1","pages":"80-85"},"PeriodicalIF":0.3,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000296","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 effectiveness of Cytoflavin in the medical rehabilitation of elderly and senile patients].","authors":"E V Bolotova, T Y Zabolotskaya, A V Dudnikova, T I Frolova, E D Tarina","doi":"10.26442/00403660.2024.11.203034","DOIUrl":"10.26442/00403660.2024.11.203034","url":null,"abstract":"<p><strong>Aim: </strong>Study the effectiveness of Cytoflavin in the medical rehabilitation of elderly and senile patients after pneumonia associated with a new coronavirus infection (COVID-19) at the outpatient stage.</p><p><strong>Materials and methods: </strong>A prospective observational randomized study involving 66 patients (45 women and 21 men, average age 66.5±5.1 years) undergoing outpatient medical rehabilitation after pneumonia associated with COVID-19, divided into 2 groups, comparable in age and gender. A standardized comprehensive rehabilitation program was conducted in both groups. Patients of the main group were additionally prescribed Cytoflavin according to the standard regimen. Testing was carried out on scales reflecting the physical condition, degree of asthenization, psycho-emotional and cognitive status (Borg scale, 6-minute walk test, SHAS-scale, Multidimensional Fatigue Inventory, Mini-mental State Examination, Hospital Anxiety and Depression Scale) upon admission to outpatient treatment and upon discharge.</p><p><strong>Results: </strong>Against the background of Cytoflavin therapy, positive dynamics was observed in patients of the main group in the form of a decrease in the values of SHAS-scale (86.5 [7.3] vs 56.3 [7.2]; <i>p</i>=0.00001), Multidimensional Fatigue Inventory (68.6 [14.7] vs 43.6 [12.8]; <i>p</i>=0.025); improvements in TSH (383.3 m [48.2] vs 550 m [32.5]; <i>p</i>=0.0248) and the Borg scale 4.5 [1.32] vs 2.2 [0.52]; <i>p</i>=0.038); the severity of cognitive impairment on the Mini-Mental State Examination decreased (26.05 [1.3] vs 28.47 [0.86]; <i>p</i>=0.0001); the emotional background improved - a decrease in the level of anxiety (10.7 [1.25] vs 5.6 [0.81]; <i>p</i>=0.0001) and depression (11.8 [1.48] vs 7.0 [1.24]; <i>p</i>=0.0001).</p><p><strong>Conclusion: </strong>The standard course of Cytoflavin therapy in the medical rehabilitation of elderly and senile patients after pneumonia associated with COVID-19 significantly reduces the severity of cognitive impairment, fatigue and depressive disorders, improves indicators of the emotional and volitional sphere, increases exercise tolerance.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"96 11","pages":"1063-1068"},"PeriodicalIF":0.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142897906","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":"[Effectiveness of riamilovir in preventing respiratory viral infection among young people from organized collectives].","authors":"K V Kozlov, O V Maltsev, K V Kasyanenko, V S Sukachev, A V Saulevich, S S Karyakin, A D Dubrovin, R N Smirnov","doi":"10.26442/00403660.2024.11.203024","DOIUrl":"https://doi.org/10.26442/00403660.2024.11.203024","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the efficacy of the antiviral drug riamilovir (trade name - «Triazavirin^®») for the prevention of SARS-CoV-2 infection (COVID-19) and other acute respiratory viral infections in young people from organized groups.</p><p><strong>Materials and methods: </strong>The study involved 386 individuals aged 18-22 years: 199 received riamilovir at a daily dose of 250 mg for 15 days, while 187 did not receive prophylactic drugs. For 30 days, disease occurrence was monitored among volunteers. In case of illness, the duration, severity of clinical manifestations, complications, and pathogen elimination dynamics were assessed via PCR from nasopharyngeal and oropharyngeal swabs.</p><p><strong>Results: </strong>During riamilovir administration, a statistically significant reduction in cases of acute respiratory viral infections of non-coronavirus etiology was observed, with no COVID-19 cases reported, confirmed by the absence of SARS-CoV-2 RNA in this group. The shortest duration of acute respiratory viral infections was noted in patients taking the prophylactic drug.</p><p><strong>Conclusion: </strong>Riamilovir (trade name - «Triazavirin^®») showed statistically significant prophylactic efficacy during its administration in an organized group. Its use decreased the frequency of detection of viral pathogens and resulted in milder acute respiratory disease, likely due to reduced viral load in individuals.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"96 11","pages":"1035-1041"},"PeriodicalIF":0.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142897895","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}