Terapevticheskii Arkhiv最新文献

{"title":"[Peculiarities of sarcopenia in occupational chronic obstructive pulmonary disease in conditions of exposure of industrial aerosols containing nanoparticles].","authors":"L A Shpagina, M A Zenkova, A I Saprykin, E B Logashenko, I S Shpagin, O S Kotova, A R Tsygankova, E G Kondyurina, V V Zelenskaia, G V Kuznetsova, E V Anikina, N V Kamneva, V A Sergeev, T N Surovenko","doi":"10.26442/00403660.2026.03.203539","DOIUrl":"10.26442/00403660.2026.03.203539","url":null,"abstract":"<p><strong>Background: </strong>The influence of nanoparticles of industrial aerosols on phenotypes of occupational chronic obstructive pulmonary disease (COPD) is not studied enough. In this connection the system signs and symptoms of the disease including sarcopenia is of a great interest for investigation, because there associations with quality of life and lifespan.</p><p><strong>Aim: </strong>To establish the features of sarcopenia in patients with COPD due to aerosols containing nanoparticles.</p><p><strong>Materials and methods: </strong>A prospective observational study was performed. Previously, chemical and hygienic investigation of nanoparticles in the workplaces air on the machine building enterprise was done. The groups under investigation were occupational COPD patients, who were employed at the workplaces that has been investigated and contacting with aerosols containing metal (<i>n</i> = 48) or silica (<i>n</i> = 55) nanoparticles. Groups were matched by sex, age, COPD duration. Study procedures were Sarcopenia Fast questionnaire, ultrasound measurement of quadriceps femoris, bioelectrical impedance analysis, hand grip strength by dynamometry, sit-to-stand test, short physical performance battery, pulmonary function tests, serum molecular markers measured by enzyme-linked immunosorbent assay or by kinetic method, serum fibrinogen by Klauss method. COPD was diagnosed when postbronchodilator forced expiratory volume in one second divided by forced vital capacity was less than 0.7. Sarcopenia was diagnosed by EWGSOP2 criteria (European Working Group on Sarcopenia in Older People). Statistical analysis included descriptive methods and liner regression.</p><p><strong>Results: </strong>Sarcopenia rate was 26 (47.2%) in COPD due to aerosols containing silica nanoparticles, 17 (35.4%) in COPD due to aerosols containing metal nanoparticles and 15 (30.0%) in control group; <i>p</i> = 0.015. The differences of sarcopenia severity between COPD due to different environmental conditions were seen - <i>Ме</i> (<i>Q</i><sub>2</sub>-<i>Q</i><sub>3</sub>). COPD due to aerosols containing silica nanoparticles was characterized by minimal values of quadriceps cross-sectional area: 4.9 (4.0-5.5) sm<sup>2</sup> compared with 9.4 (8.4-9.9) sm<sup>2</sup> in COPD due to aerosols containing metal nanoparticles patients and with 9,0 (7.8; 9.2) sm<sup>2</sup> in control group respectivel; <i>р</i> = 0.010, quadriceps thickness, appendicular fat-free mass index: 7.1 (5.5-7.4), 7.5 (6.2-8.3) and 8.2 (6.8-9.1) kg/m<sup>2</sup>; <i>р</i> = 0.009, sit-to-stand test 15.8 (13.2-16.7), 12.1 (10.5-13.0) and 11.5 (9.4-13.8) s; <i>р</i> = 0.009, by elevated muscle echogenicity. COPD due to aerosols containing metal nanoparticles patients had the mid values. After 12 months these relationships were preserved. The associations of silica nanoparticles with quadriceps cross-sectional area (В = -0.95; <i>р</i> = 0.009), echogenicity (В = 1.02; <i>р</i> = 0.001), appendicul","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 3","pages":"162-169"},"PeriodicalIF":0.3,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147486318","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":"[Analysis of external respiratory function disturbances in combined pulmonary fibrosis and emphysema].","authors":"N V Markov, N A Khodorik, M M Ilkovich, L N Novikova, I D Rabik, E V Privalova, N T Panina, A N Kulikov","doi":"10.26442/00403660.2026.03.203538","DOIUrl":"10.26442/00403660.2026.03.203538","url":null,"abstract":"<p><strong>Aim: </strong>To analyze the features of indicators of the external respiration function and their dynamics in patients with a combined pulmonary fibrosis and emphysema (CPFE).</p><p><strong>Materials and methods: </strong>The results of studies of 44 patients with a confirmed diagnosis of CPFE are presented. As a control group, the results of a study of respiratory function of 41 patients with idiopathic pulmonary fibrosis (IPF) were analyzed. The study of respiratory function included the measurement of static lung volumes and capacities, speed indicators, airway response to inhalation of a bronchodilator drug, diffusive capacity of the lungs and gas exchange parameters.</p><p><strong>Results: </strong>Spirometry indicators, such as vital capacity (<i>p</i> = 0.003), forced vital capacity - FVC (<i>p</i> = 0.003), forced expiratory volume in the first second - FEV₁ (<i>p</i> = 0.02), were significantly higher in CPFE. The same differences were observed in the group of patients with severe dyspnea (<i>p</i> = 0.029, <i>p</i> = 0.019, <i>p</i> = 0.032, respectively). The FEV₁/FVC ratio in CPFE was significantly lower (<i>p</i> = 0.013). The study of lung volumes and capacities by body plethysmography reveals higher values of total lung capacity (<i>p</i> = 0.002) and functional residual capacity of the lungs (<i>p</i> = 0.01) in CPFE. Alveolar volume was higher in CPFE (<i>p</i> = 0.046) and the DL_CO/VA ratio was higher in IPF (<i>p</i> = 0.013). Diffusion capacity of the lungs was equally low in the group of patients with severe dyspnea and correlated with the severity of dyspnea. There were no statistically significant differences between the rate of decrease in FVC, DL_CO, and other parameters.</p><p><strong>Conclusion: </strong>In CPFE, the results of spirometry and bodyplethysmography do not reflect the degree of functional impairment and may make it difficult to assess the severity of the disease. Measurement of the diffusing capacity of the lungs and its components is an important method for determining the severity of functional disorders in patients with CPFE.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 3","pages":"154-161"},"PeriodicalIF":0.3,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147487532","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":"[Sleep disorders dynamics in patients with chronic thromboembolic pulmonary hypertension after surgical treatment].","authors":"A V Ershov, O O Mikhailova, E M Elfimova, K V Mershin, O V Rodnenkov, N M Danilov, A Y Litvin, I E Chazova","doi":"10.26442/00403660.2026.03.203621","DOIUrl":"10.26442/00403660.2026.03.203621","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the association between various sleep disorders and changes in clinical status in patients with chronic thromboembolic pulmonary hypertension (CTEPH) before and after surgical treatment.</p><p><strong>Materials and methods: </strong>The study included 43 patients with a verified diagnosis of CTEPH hospitalized between December 2023 and February 2025. Assessment included general clinical status, echocardiography, and right heart catheterization data. Patients completed standardized questionnaires (STOP-Bang, Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, Insomnia Severity Index, International Restless Legs Syndrome Study Group Rating Scale) and underwent polyfunctional sleep monitoring before treatment and at least 3 months after completing a series of balloon pulmonary angioplasties or pulmonary thromboendarterectomy.</p><p><strong>Results: </strong>After surgical treatment, patients with CTEPH maintained a high prevalence of sleep apnea/hypopnea (83.8%) and nocturnal hypoxemia (74.4%), despite a significant decrease in mean pulmonary artery pressure - mPAP (<i>p</i> < 0.0001) and pulmonary vascular resistance - PVR (<i>p</i> < 0.0001). The baseline percentage of total sleep time with saturation below 90% (T90) was significantly associated with postoperative mPAP (<i>p</i> = 0.0289), PVR (<i>p</i> = 0.0050), and the six-minute walk test distance - 6MWD (<i>p</i> = 0.0305). A preoperative T90 > 11.0% showed 85.7% sensitivity in predicting the achievement of the target 6MWD (<i>p</i> = 0.0130) after treatment.</p><p><strong>Conclusion: </strong>A high prevalence of sleep-disordered breathing in patients with CTEPH persists despite effective pathogenetic treatment of the underlying disease. Nocturnal hypoxemia may be considered a predictor for prescribing timely respiratory support and pulmonary arterial hypertension-specific therapy.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 3","pages":"176-182"},"PeriodicalIF":0.3,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147487203","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 gut microbiome in obesity: new horizons in personalized medicine].","authors":"A V Starodubova, O A Kislyak, T Y Demidova, I G Nikitin, G E Leonov","doi":"10.26442/00403660.2026.02.203596","DOIUrl":"10.26442/00403660.2026.02.203596","url":null,"abstract":"<p><p>Currently, disturbances in the composition and metabolic activity of the intestinal microbiota are considered a key modifiable factor in obesity and associated metabolic disorders. This review summarizes data on the characteristics and variability of the microbiota composition in individuals with obesity. The main mechanisms linking dysbiosis to metabolic disorders are discussed: changes in the production of short-chain fatty acids and other microbial metabolites, as well as the contribution of lipopolysaccharide-induced chronic inflammation. The influence of the microbiota on the regulation of appetite and eating behavior through the microbiota-gut-brain axis and intestinal hormones is discussed separately. Current approaches to the diagnosis of dysbiosis and potential strategies for correcting microbiome-associated disorders in obesity in the context of personalized medicine are presented.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 2","pages":"92-98"},"PeriodicalIF":0.3,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378578","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":"[Chronic gastroduodenitis, associated and not associated with <i>Helicobacter pylori</i> infection, and its relationship with functional intestinal pathology depending on the content of fecal calprotectin].","authors":"E D Mironova, M A Osadchuk, M T Chernov, M M Osadchuk","doi":"10.26442/00403660.2026.02.203531","DOIUrl":"10.26442/00403660.2026.02.203531","url":null,"abstract":"<p><strong>Background: </strong>In recent years, the role of chronic gastroduodenitis in the occurrence of functional intestinal diseases within the framework of the crossover syndrome, which occurs against the background of minimal inflammation in the stomach and intestines associated with <i>Helicobacter pylori</i> infection, has become increasingly relevant.</p><p><strong>Aim: </strong>To determine the relationship of chronic gastroduodenitis, associated and not associated with <i>H. pylori</i> infection, with the level of fecal calprotectin (FC) and clinical symptoms of functional intestinal disorders.</p><p><strong>Materials and methods: </strong>The study included 158 patients with chronic gastroduodenitis: group 1 (80 patients with gastroduodenitis associated with <i>H. pylori</i> infection in the stomach) and group 2 (76 patients without <i>H. pylori</i> infection). All patients had clinical symptoms of the gastrointestinal tract for at least a year. The patients underwent esophagoduodenoscopy and colonoscopy. Verification of <i>H. pylori</i> was based on data from histiobacterioscopy of impression smears from the mucous membrane of the antrum of the stomach. FC content was determined using an express analyzer.</p><p><strong>Results: </strong>Patients of the first group significantly more often complained of pain, a burning sensation and fullness after eating in the epigastric region, nausea, belching, heartburn, flatulence, pain along the large intestine, a feeling of incomplete evacuation after defecation compared to the group without <i>H. pylori</i> infection. At the same time, in patients with <i>H. pylori</i> infection, FC values were most often determined in the range from 50 to 200 μg/g - in 28.75%, and in patients not infected with <i>H. pylori</i> infection - 13.15% (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>The studies conducted indicate the presence of a statistically significant relationship between chronic gastroduodenitis and functional intestinal disorders, which can be bidirectional in nature, the basis of which is minimal inflammation caused by the presence of <i>H. pylori</i> infection and increased production of FC.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 2","pages":"110-114"},"PeriodicalIF":0.3,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378629","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 new paradigm of the pathogenesis of primary sclerosing cholangitis associated with ulcerative colitis: microbiota and system intestine-liver. A review].","authors":"E S Sbikina, E V Vinnitskaya, A I Parfenov","doi":"10.26442/00403660.2026.02.203529","DOIUrl":"10.26442/00403660.2026.02.203529","url":null,"abstract":"<p><p>The close relationship between primary sclerosing cholangitis and ulcerative colitis has given rise to a number of hypotheses aimed at deciphering their pathogenesis from the standpoint of bidirectional connections involving immune, endocrine and inflammatory mechanisms. The review examines the main directions of the concept of the \"gut-liver axis\" from the point of view of the pathogenetic relationships of primary sclerosing cholangitis associated with ulcerative colitis and intestinal microbiota.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 2","pages":"119-124"},"PeriodicalIF":0.3,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378590","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":"[Gastrointestinal complications of dual antiplatelet therapy in patients with ischemic heart disease: risk stratification, current management tactics. A review].","authors":"E S Deeva, M A Isaikina, O I Trushina, V V Fomin, A V Pogonin, M K Tamkaeva","doi":"10.26442/00403660.2026.02.203532","DOIUrl":"10.26442/00403660.2026.02.203532","url":null,"abstract":"<p><p>Coronary heart disease is one of the leading causes of death worldwide, and antiaggregant therapy is crucial for both its prevention and treatment. The review article presents the data of clinical trials that allow to determine the tactics of management of patients at high risk of gastrointestinal complications on the background of dual antiaggregant therapy. The main risk factors for complications are described, such as: acetylsalicylic acid dose, ulcer or bleeding from the upper GI tract in anamnesis, advanced age, concomitant use of anticoagulants, non-aspirin non-steroidal anti-inflammatory drugs, including COX-2-selective non-steroidal anti-inflammatory drugs, <i>Helicobacter pylori</i> infection. The mechanism of action of antiaggregant drugs and pathogenesis of their damaging effect on the GI mucosa, the use of gastroprotective therapy for the prevention and treatment of existing damage to the GI mucosa are considered.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 2","pages":"125-130"},"PeriodicalIF":0.3,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378636","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":"[Justification for the use of a FODMAP diet in patients with irritable bowel syndrome: focus on small intestinal disaccharidase activity].","authors":"S V Bykova, S R Dbar, E A Sabelnikova, N I Belostotsky, A I Parfenov","doi":"10.26442/00403660.2026.02.203542","DOIUrl":"10.26442/00403660.2026.02.203542","url":null,"abstract":"<p><strong>Background: </strong>The current study hypothesized that gastrointestinal symptoms would improve following a low-FODMAP diet in patients with irritable bowel syndrome (IBS) due to reduced load on enzyme systems and normalization of the activity of disaccharidases involved in the final assimilation of carbohydrates.</p><p><strong>Aim: </strong>To evaluate the effect of a low-FODMAP diet on the dynamics of disaccharidase activity in patients with IBS who have symptoms of food intolerance.</p><p><strong>Materials and methods: </strong>The study included 20 patients with IBS aged 18 to 50 years: median 32.0 years, <i>Q1</i> = 27.0, <i>Q3</i> = 38.0, <i>p</i>-value (Shapiro-Wilk) < 0.05. Complaints were collected from patients, dietary history was analyzed with an emphasis on intolerance to FODMAP products and the occurrence/intensification of clinical symptoms when eating dairy products. All patients underwent esophagogastroduodenoscopy with a biopsy from the subbulb of the duodenum to determine the activity of four intestinal carbohydrates: lactase, sucrase, maltase and glucoamylase according to the Dahlquist method as modified by N.I. Belostotsky. The control group consisted of 30 apparently healthy people, comparable in age and gender to the examined IBS patients. Among them were 10 men and 20 women (average age - 31.2 ± 9.2 years). The activity of intestinal enzymes in this group was within the reference values. Statistical processing of data was carried out using the computer program Statistica 8.0 (StatSoft Inc, USA).</p><p><strong>Results: </strong>The analysis of enzymatic activity showed that initially the level of intestinal carbohydrates in patients with IBS was reduced compared to the control group. 2 months after following the low-FODMAP diet, the activity of all enzymes studied increased, but a statistically significant increase was noted only for lactase and sucrase (<i>p</i> < 0.05). Clinical improvement was observed with adherence to the low-FODMAP diet, decrease in the number of patients with complaints of pain, bloating, rumbling in the abdomen, nausea and diarrhea syndrome, however, a statistical difference was found only for bloating and diarrhea (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>Reducing the substrate load on the enzyme systems of the small intestinal mucosa can help improve clinical symptoms in patients with IBS with symptoms of intolerance to foods containing FODMAPs and have a positive effect on the activity of intestinal enzymes.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 2","pages":"99-104"},"PeriodicalIF":0.3,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378664","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":"[Dynamics of lipid metabolism parameters following the change of targeted therapy for hypercholesterolemia after acute coronary syndrome].","authors":"A A Nekrasov, E S Timoshchenko, S G Erofeeva, E S Kuzyakina, T A Nekrasova","doi":"10.26442/00403660.2026.02.203601","DOIUrl":"10.26442/00403660.2026.02.203601","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate lipid metabolism dynamics by switch from inclisiran to alirocumab in the setting of lipid-lowering therapy (LLT) after acute coronary syndrome (ACS).</p><p><strong>Materials and methods: </strong>26 patients survived ACS with low-density lipoprotein cholesterol (LDL-C) ≥ 4.0 mmol/L during hospitalization were included. All patients were prescribed inclisiran within 6 months after ACS. Each patient received it at least twice. All patients were expected to undergo an unplanned switch from inclisiran to alirocumab due to logistical reasons. All patients gave consent to participate in the study. Eight visits were conducted to assess LDL-C levels: 3 and 1 month before the end of inclisiran therapy, on the day of the first alirocumab injection and 1, 2, 3, 4, and 5 months after the start of alirocumab therapy.</p><p><strong>Results: </strong>LDL-C values (<i>Me</i> [<i>Q1</i>; <i>Q3</i>]) during the inclisiran treatment period (visits 1-3) were 1.34 [0.55; 1.41], 1.44 [0.53; 2.00], 1.67 [1.08; 1.96] mmol/l and during alirocumab treatment (visits 4-8) - 1.10 [0.61; 1.55], 0.95 [0.69; 1.40], 1.01 [0.86; 1.55], 0.88 [0.71; 1.53], 0.87 [0.70; 1.22] mmol/l (<i>p</i> = 0.002). The first administration of alirocumab at visit 3 was associated with the greatest reduction in LDL-C over the month (-34.1%; <i>p</i> = 0.001).</p><p><strong>Conclusion: </strong>The switch from inclisiran to alirocumab in post-ACS patients resulted in a rapid LDL-C reduction without any adverse events.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 2","pages":"105-109"},"PeriodicalIF":0.3,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378612","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":"[Gastrointestinal bleeding after mitral valve implantation. Case report].","authors":"G O Isaev, O I Trushina, B M Tlisov, S V Cherniavskii, J V Boriskina, O A Pallia, V V Fomin","doi":"10.26442/00403660.2026.02.203528","DOIUrl":"10.26442/00403660.2026.02.203528","url":null,"abstract":"<p><p>Performing surgical interventions on the mitral valve is one of the main high-tech treatment methods that requires further anticoagulation therapy. However, patients at high risk of bleeding have traditionally become a group requiring a personalized approach and, in many cases, the guidance of a multidisciplinary team of specialists of various profiles. In this clinical case, it is noteworthy that the 72-year-old patient underwent a full amount of preoperative preparation, and no contraindications to surgical treatment were identified. During esophagogastroduodenoscopy, an endoscopic picture of non-erosive reflux esophagitis, grade M (Minimal), was determined against the background of cardia insufficiency. After surgical treatment, on the background of anticoagulant therapy, vomiting of \"coffee grounds\" and melena were noted. According to the esophagogastroduodenoscopy data, multiple erosive and ulcerative defects of the stomach and duodenum were revealed, and combined endoscopic hemostasis was performed. The patient was prescribed anti-ulcer eradication therapy. The purpose of this clinical case is to emphasize the importance of a personalized approach to the treatment of this group of patients, who often require consultation with a gastroenterologist.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 2","pages":"115-118"},"PeriodicalIF":0.3,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378593","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}