Terapevticheskii Arkhiv最新文献

{"title":"[From the history of pancreatology and pancreatitis classification].","authors":"E A Dubtsova, L V Vinokurova","doi":"10.26442/00403660.2026.02.203527","DOIUrl":"10.26442/00403660.2026.02.203527","url":null,"abstract":"<p><p>The retrogastric location, small size and soft consistency of the pancreas were the reason for the late discovery of the physiology of this organ. The first information about the anatomy and physiology of the pancreas appeared only in the 16th-17th centuries. The role of the pancreas in digestion was studied in the 18th-19th centuries, its participation in carbohydrate metabolism - in the 19th century, and insulin was discovered in the first half of the 20th century. Clinical signs of pancreatitis were first described in the early 19th century, but diagnosis of this disease still presents certain difficulties. The same can be said about the classification of pancreatitis. Due to the variety of etiological factors and clinical manifestations of acute and, especially, chronic pancreatitis, a single universal classification of pancreatitis has not yet been created, despite repeated attempts and existing classifications.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 2","pages":"131-136"},"PeriodicalIF":0.3,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378632","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":"[Characteristics and 5-year outcomes in patients with chronic lymphocytic leukemia receiving ibrutinib (a real-world study)].","authors":"U P Ergasheva, E P Panchenko, C G Chernyshenko, E A Dmitrieva, M I Kislova, Y A Fedotkina, E B Yarovaya, E V Rimashevskaya, V V Ptushkin, E A Nikitin","doi":"10.26442/00403660.2026.01.203492","DOIUrl":"10.26442/00403660.2026.01.203492","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate major cardiovascular complications in chronic lymphocytic leukaemia (CLL) patients receiving ibrutinib, and to characterise those with new-onset atrial fibrillation (AF) during ibrutinib therapy, examining their outcomes in a real-world clinical setting.</p><p><strong>Materials and methods: </strong>A retrospective analysis of the medical records of 641 patients diagnosed with CLL who were treated with ibrutinib at the haematology centre of the Botkin Moscow Multidisciplinary Scientific and Clinical Center from 2013 to 2024 was conducted. The primary endpoint of the study was the occurrence of atrial fibrillation during ibrutinib therapy. The secondary endpoint of the study was thrombotic and haemorrhagic complications. To assess the impact of AF on patient outcomes, a comparison was made between patients with AF and those without AF based on sex and age. A composite endpoint was used to evaluate outcomes, which included cardiovascular death and fatal bleeding.</p><p><strong>Results: </strong>The incidence of new-onset AF in patients receiving ibrutinib therapy during the five-year was 15%. Patients with AF occurring during ibrutinib therapy were found to be older and characterised by the presence of standard risk factors for AF. No significant differences were observed in the characteristics of CLL and its treatment. The occurrence of AF during ibrutinib therapy was associated with a fourfold increased risk of thrombotic complications (OR 4.071, 95% CI 1.837-9.024; <i>p</i> < 0.001), including an increased incidence of fatal pulmonary embolism (<i>p</i> = 0.035) with a comparable incidence of fatal bleeding.</p><p><strong>Conclusion: </strong>The incidence of AF in patients with CLL receiving ibrutinib is significantly higher than the incidence of AF in elderly patients without CLL. The occurrence of new-onset AF during ibrutinib therapy has been observed to be associated with an increased incidence of thrombotic complications, including fatal thrombotic complications. The incidence of fatal haemorrhagic complications has been noted to be comparable.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 1","pages":"56-65"},"PeriodicalIF":0.3,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228805","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 study of clinical blood test parameters as potential predictors of atrial fibrillation].","authors":"A G Plisyuk, P P Poletskov, E A Zhdanova, I A Orlova","doi":"10.26442/00403660.2026.01.203498","DOIUrl":"10.26442/00403660.2026.01.203498","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the relationship of inflammatory parameters and calculated inflammatory indices obtained from clinical blood test with the presence of atrial fibrillation (AF) in patients.</p><p><strong>Materials and methods: </strong>A retrospective analysis of the data of 5,041 patients aged 18 to 99 years was conducted. A group of 470 patients without AF, comparable in age, gender, and presence of cardiovascular diseases to a group of 470 patients with AF, was selected using propensity score matching. The groups were compared by key parameters of clinical blood test and calculated inflammatory indices. For the parameters that showed significant differences when comparing groups, optimal thresholds were determined using ROC analysis. To assess the predictive ability of inflammatory parameters, a logistic regression analysis with the calculation of the odds ratio of the presence of AF was applied.</p><p><strong>Results: </strong>When comparing the groups, the following parameters showed significant differences: the number of neutrophils, monocytes, immature granulocytes, and most inflammatory indices were significantly higher, while the number of lymphocytes and the LMR index were significantly lower in the AF group. The most significant predictors were SIRI values of more than 1.3 and LMR values of more than 4.84 (the odds of AF according to multivariate logistic analysis increased by 2.13 times and decreased by 2.27 times, respectively).</p><p><strong>Conclusion: </strong>Biomarkers of chronic systemic inflammation were associated with the presence of AF regardless of gender, age, and concomitant diseases. Thus, markers of systemic inflammation detected in routine blood tests have the potential to be used as predictors of the presence of AF.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 1","pages":"66-72"},"PeriodicalIF":0.3,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228741","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":"[Prevalence and predictors of suboptimal peak inspiratory flow values with metered-dose dry powder inhalers in patients with asthma and chronic obstructive pulmonary disease].","authors":"B B Lavginova, N V Trushenko, G V Nekludova, O S Belkina, S N Avdeev","doi":"10.26442/00403660.2026.01.203558","DOIUrl":"10.26442/00403660.2026.01.203558","url":null,"abstract":"<p><strong>Background: </strong>A key requirement for effective dry powder inhaler (DPI) use is adequate patient inspiratory effort, measurable through peak inspiratory flow (PIF).</p><p><strong>Aim: </strong>To assess the prevalence of suboptimal PIF values, and identify factors significantly affecting PIF in pulmonary disease (COPD) and asthma outpatients.</p><p><strong>Materials and methods: </strong>The study enrolled asthma and COPD patients using DPIs for maintenance therapy. PIF was measured using In-Check DIAL G16^® at resistance levels matching each patient's DPI, both before and after proper inhalation technique training. Clinical and functional parameters were evaluated to identify predictors of suboptimal PIF.</p><p><strong>Results: </strong>The study included 61 asthma and 30 COPD patients. Baseline suboptimal PIF rates were 34% (asthma) and 63% (COPD). After training, these decreased significantly to 10% (asthma) and 23% (COPD); <i>p</i> < 0.0001. Key limiting factors for achieving optimal PIF were age ≥ 60 years, FVC ≤ 70% predicted, and FEV1 ≤ 45% predicted.</p><p><strong>Conclusion: </strong>Many patients had insufficient inspiratory flow for effective DPI use due to technique errors or age/functional limitations. Pre-prescription PIF measurement objectively evaluates DPI suitability and enhances treatment efficacy.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 1","pages":"35-42"},"PeriodicalIF":0.3,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228736","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 poor annual prognosis in patients after acute decompensation of heart failure].","authors":"O A Lozhkina, E A Shmidt, A G Neeshpapa, V N Karetnikova, D P Golubovskaya, O L Barbarash","doi":"10.26442/00403660.2026.01.203520","DOIUrl":"10.26442/00403660.2026.01.203520","url":null,"abstract":"<p><strong>Background: </strong>Patients with acute decompensation of heart failure (ADHF) have a poor prognosis. According to various sources, hospital mortality is 6-8%, and up to 25% of patients require re-hospitalization within the first 3 months after discharge. Prognosis assessment and identification of high-risk groups have been the focus of HF specialists worldwide in recent years.</p><p><strong>Aim: </strong>To assess the role of clinical, history, laboratory, and instrumental risk factors for the development of adverse events within a year after ADHF.</p><p><strong>Materials and methods: </strong>A retrospective study evaluating medical records (medical charts) included 374 patients aged 18 years or older hospitalized with ADHF. All patients had clinical severity scores greater than 8.5 (NYHA IV) at admission. A comparative analysis of clinical and history data and in-hospital instrumental and laboratory parameters was conducted; outcomes were assessed 1 year after the ADHF episode, namely, repeated hospitalizations for ADHF after discharge and/or death from all causes.</p><p><strong>Results: </strong>During 12 months of follow-up, 81 (27.6%) patients had at least 1 adverse event. Using Cox regression, the four most significant factors for an unfavorable 1-year outcome were determined: anemia (risk ratio - RR 1.57 [95% confidence interval - CI 1.01-2.46]), age over 65 years (RR 1.85 [95% CI 1.18-2.91]), sodium level less than 135 mmol/L at the first measurement (RR 1.86 [95% CI 1.07-3.23]), and male gender (RR 2.0 [95% CI 1.11-3.67]). The C-index of the obtained regression was 0.636 (95% CI 0.575-0.697), and the area under the ROC-curve was 0.658 (95% CI 0.607-0.706).</p><p><strong>Conclusion: </strong>According to the study results, age over 65 years, male sex, hyponatremia, and anemia on admission can be regarded as factors of unfavorable 1-year prognosis in patients after an ADHF episode.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 1","pages":"28-34"},"PeriodicalIF":0.3,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228913","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":"[Prognostically significant right ventricular echocardiographic parameters for one-year outcomes of inferior wall myocardial infarction].","authors":"E G Akramova, Z N Akramova","doi":"10.26442/00403660.2026.01.203519","DOIUrl":"10.26442/00403660.2026.01.203519","url":null,"abstract":"<p><strong>Aim: </strong>To establish prognostically significant for one-year outcomes of left ventricular inferior wall myocardial infarction echocardiographic indicators of right ventricular involvement.</p><p><strong>Materials and methods: </strong>Multivariate mathematical analysis of 184 parameters, including 131 echocardiographic ones, of 144 patients with myocardial infarction of the inferior wall of the left ventricle was performed.</p><p><strong>Results: </strong>Before percutaneous coronary intervention, signs of right ventricular infarction on ECG (<i>ST</i> elevation in V_3R-V_4R leads) were present in 45.8% of patients. On the 5th-7th day of myocardial infarction the values of echocardiographic parameters between the groups with and without right ventricular infarction did not differ significantly. Among patients with biventricular infarction in 40.9% of cases hypokinesis of the basal inferior segment of the right ventricle was visualized, in 9.1% - dilatation of the right ventricle, a large zone of local contractility impairment and global systolic dysfunction of both ventricles. The prognostic significance for unfavorable posthospital outcomes of inferior wall myocardial infarction was stenting of more than one coronary artery, decreased global circular deformation and visualization of more than four segments with impaired local contractility of the left ventricle (AUC 81.4%, sensitivity 69%, specificity 83%). Such unfavorable outcomes as recurrent myocardial infarction and necessity of aortocoronary bypass surgery are predicted by: hypokinesis of LV on echocardiography, ECG signs of right ventricular infarction, end-systolic volume index and left ventricular ejection fraction (AUC 71.9%, sensitivity 62%, specificity 70%).</p><p><strong>Conclusion: </strong>Among echocardiographic signs of right ventricular involvement, hypokinesis of the basal inferior segment of the right ventricle was determined to be prognostically significant for one-year outcomes of inferior wall myocardial infarction of the left ventricle. Hypokinesis of the basal inferior segment of the right ventricle was visualized in 40.9% of patients with biventricular (according to ECG) inferior wall infarction, including 9.5% with extensive right ventricular infarction and right ventricular dilatation.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 1","pages":"51-55"},"PeriodicalIF":0.3,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228778","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 impact of comorbid cardiovascular pathology and triple inhalation therapy on outcomes in patients with chronic obstructive pulmonary disease: a review of current evidence].","authors":"N V Trushenko, B B Lavginova, E O Markeeva, S N Avdeev","doi":"10.26442/00403660.2026.01.203556","DOIUrl":"10.26442/00403660.2026.01.203556","url":null,"abstract":"<p><p>The article describes the pathophysiological ground of the relationship between chronic obstructive pulmonary disease (COPD) and cardiovascular diseases (CVDs), the prevalence and prognostic significance of this comorbidity, as well as the optimal treatment of concomitant CVD and COPD. A review of the current literature is provided, including the results of large cohort, observational studies and meta-analyses on the epidemiology, pathophysiological mechanisms, clinical outcomes, and specific features of the treatment of concomitant CVD and COPD. It is shown that the prevalence of CVD in patients with COPD is 25-70%, which is 2-5 times higher than in the general population. It was found that the pathophysiological relationship between COPD and CVD is due to smoking, age, sex, and other common risk factors, as well as systemic inflammation, oxidative stress, endothelial dysfunction, hypoxemia, activation of the sympathetic nervous system, and pulmonary hyperinflation. Modern triple inhalation therapy (long-acting anticholinergics/long-acting â₂-agonists/inhaled glucocorticosteroids) has demonstrated advantages over dual therapy (long-acting â₂-agonists/long-acting anticholinergics) in reducing overall mortality (hazard ratio 0.66-0.76) as well as the risk of acute cardiovascular events and cardiovascular mortality (hazard ratio 0.52-0.455). It is concluded that the optimization of inhalation therapy, in particular the administration of triple therapy to patients at high risk of COPD exacerbations, contributes not only to improving COPD control, but also to reducing cardiovascular risks and mortality.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 1","pages":"73-80"},"PeriodicalIF":0.3,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228841","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 outpatient care in the management of patients with chronic non-communicable diseases].","authors":"S A Boytsov","doi":"10.26442/00403660.2026.01.203585","DOIUrl":"10.26442/00403660.2026.01.203585","url":null,"abstract":"<p><p>The increasing burden of chronic non-communicable diseases, rising comorbidity, and population ageing are enhancing the role of outpatient care within healthcare systems. This article outlines the key clinical and organizational priorities of ambulatory medical care and highlights the importance of interdisciplinary and personalized approaches to the management of patients with chronic diseases.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 1","pages":"4-5"},"PeriodicalIF":0.3,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228914","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":"[Menopausal hormone therapy in patients with cardiovascular and metabolic diseases: an interdisciplinary Delphi consensus among Russian gynecologists, cardiologists, endocrinologists, gerontologists and geriatricians, phlebologists, and clinical pharmacologists].","authors":"G T Sukhikh, V N Serov, E V Shlyakhto, I I Dedov, G P Arutyunov, O N Tkacheva, A A Smetnik, I A Suchkov, I I Baranov, M V Shestakova, G A Mel'nichenko, O V Vasyukova, E V Sheremetyeva, E N Andreeva, E A Shestakova, Y A Orlova, S V Villevalde, O B Irtyuga, I V Sergienko, I S Yavelov, N A Koziolova, E I Ermakova, E N Dudinskaya","doi":"10.26442/00403660.2026.01.203470","DOIUrl":"10.26442/00403660.2026.01.203470","url":null,"abstract":"<p><p>More than one million women in Russia enter menopause each year. The severe estrogen deficiency associated with this transition causes symptoms that significantly impair quality of life and contribute to an increased risk of cardiovascular and metabolic diseases. Menopausal hormone therapy (MHT) is the established standard of care for menopausal symptoms. On the initiative of several professional societies (the Russian Society of Obstetricians and Gynecologists, the Russian Society of Cardiology, the Russian Association of Endocrinologists, the Eurasian Association of Therapists, the Russian Society of Gynecological Endocrinology and Menopause, the Russian Association of Gerontologists and Geriatricians, the Association of Phlebologists of Russia), a Delphi panel was convened to develop a multidisciplinary expert consensus on MHT for patients with cardiovascular and metabolic diseases. The goal was to enhance research and clinical approaches to managing menopausal women. A consensus was reached at the end of the first Delphi round. The experts agreed that initiating MHT requires a thorough assessment of individual risks, including cardiovascular health and comorbidities. MHT can offset metabolic and cardiovascular risk factors in peri- and postmenopausal women by normalizing the lipid profile, improving carbohydrate metabolism, and reducing insulin resistance. An interdisciplinary approach allows for personalized MHT, minimizes potential complications, improves the quality of life for peri- and postmenopausal women, and promotes active longevity.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 1","pages":"6-27"},"PeriodicalIF":0.3,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228800","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 prognostic significance of domain approach in patients with chronic heart failure and senile asthenia].","authors":"Z D Kobalava, A Y Moiseeva, A Al-Autairi, E O Kotova","doi":"10.26442/00403660.2026.01.203518","DOIUrl":"10.26442/00403660.2026.01.203518","url":null,"abstract":"<p><strong>Aim: </strong>To characterize the features of the course of decompensated heart failure in hospitalized elderly patients depending on the domains (clinical, psychocognitive, functional and social), as well as to study the effect of the number of domains on the prognosis.</p><p><strong>Materials and methods: </strong>A prospective study included 150 patients over 75 years old [median age (IQR) 83.0 [77.8-87.0] years, 38% (<i>n</i> = 57) were men] admitted to a multidisciplinary hospital for chronic heart failure (CHF) decompensation, who were assessed for the prevalence of HFA-ESC domains (2019) - clinical, psychocognitive, functional and social. All patients underwent traditional laboratory and instrumental examination, NT-proBNP testing, echocardiographic examination, as well as body composition was assessed using bioimpedance analysis on the 5th day of hospitalization. The combined endpoint was a combination of death from all causes and repeated hospitalizations for CHF within 180 days.</p><p><strong>Results: </strong>96.7% (<i>n</i> = 145) of senile patients with CHF had at least one domain of senile asthenia, the presence of all four domains was observed in more than a third of patients. Disorders in the psychocognitive and social spheres were the most common - 88.7% (<i>n</i> = 133) and 74.0% (<i>n</i> = 111), respectively, and clinical and functional domains were less common in 64.0% (n = 96) and 56.7% (<i>n</i> = 85) of patients, respectively. Patients with a large number of domains were characterized by an older age, a greater degree of physical activity restriction and the severity of CHF symptoms, were more often unmarried (including widowers, single and divorced), and most patients lived in a nursing home. A greater number of domains of senile asthenia was associated with a higher incidence of events for the combined endpoint - all-cause death and/or repeated hospitalization for CHF (Log Rank 10.76; <i>p</i> < 0.03). In a comprehensive analysis, the presence of all four domains of fragility syndrome increases the risk of combined events from the primary endpoint by 2.5 times (odds ratio 2.5; 95% confidence interval 1.1-5.7, <i>p</i> < 0.05), hospital mortality by 14.7 times (odds ratio 14.7, 95% confidence interval 3.3-66.4; <i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>A domain-based approach to determining the severity and prognosis of CHF in \"fragile\" senile patients seems to be a necessary and convenient tool for identifying a special group of patients at high risk of unfortunate outcome that requires a multidisciplinary approach together with a geriatric team.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"98 1","pages":"43-50"},"PeriodicalIF":0.3,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228768","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}