Terapevticheskii Arkhiv最新文献

{"title":"[The role of the ubiquitin-proteasome system in the development of acute myocardial injury. Case report].","authors":"D A Kudlay, V V Tarasov, E A Smolyarchuk, V S Shchekin, K A Zavadich, V I Korunas, I D Krylova, A V Samorodov","doi":"10.26442/00403660.2025.12.203541","DOIUrl":"10.26442/00403660.2025.12.203541","url":null,"abstract":"<p><strong>Background: </strong>Acute myocardial injury (AMI) is a universal pathological process that complicates both cardiac and non-cardiac pathologies. However, understanding of the molecular mechanisms underlying the various types of AMI remains insufficient. One of the current concepts for the development of AMI is the regulation of the ubiquitin-proteasome system (UPS), which mediates apoptosis and the adaptive response to injury. However, the patterns of its activation in the myocardium in various clinical situations remain poorly understood.</p><p><strong>Aim: </strong>To evaluate and compare the expression of ubiquitin and the deubiquitinating enzymes USP28/USP40 in patients who have suffered acute myocardial injury of various etiologies.</p><p><strong>Materials and methods: </strong>As part of a single-center prospective cohort study (RNF-NSFC \"Assessment of the Role of Deubiquitinating Enzymes in Myocardial Ischemia-Reperfusion Injury and Development of Cardioprotective Agents\", 2024-2026), three clinical cases were analyzed at the Clinic of the Federal State Budgetary Educational Institution of Higher Education Bashkir State Medical University of the Ministry of Health of the Russian Federation (Ufa) during the period 2024-2025. The analysis assessed and compared the dynamics of UPS activity depending on the mechanism of myocardial injury.</p><p><strong>Results: </strong>Different causes of acute myocardial infarction demonstrate differential involvement of UPS components in the pathogenesis of coronary and non-coronary myocardial injury. IHC staining of ubiquitin in clinical cases demonstrates overexpression in the perifocal necrotic zone compared to areas more distant from necrosis, and moderate cytoplasmic and nuclear expression in myocardium without acute ischemic injury.</p><p><strong>Conclusion: </strong>The prospects for further study of ubiquitin and deubiquitinating enzymes (USP28, USP40) in the search for potential targets for differential diagnosis and targeted therapy of AMI of various etiologies have been determined.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 12","pages":"1031-1036"},"PeriodicalIF":0.3,"publicationDate":"2026-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221247","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":"[Viral pericarditis today: Challenges in diagnosis and therapy illustrated by a \"typical\" clinical case].","authors":"Z N Sukmarova, R G Gulyan, A V Torgashina, T S Sukhinina, E S Aronova, O A Fomicheva, O V Stukalova, D V Pevzner, A S Starkova","doi":"10.26442/00403660.2025.12.203467","DOIUrl":"10.26442/00403660.2025.12.203467","url":null,"abstract":"<p><p>According to modern concepts, pericarditis is a more complex condition than was previously thought. A clinical case is presented in which, as often happens, the symptoms of pericarditis were mistaken for radicular syndrome and an acute respiratory viral infection; therefore, adequate treatment was not initially administered. It led to hyperactivation of autoinflammation, which colchicine and nonsteroidal anti-inflammatory drugs failed to control, and required high doses of glucocorticosteroids. However, at this stage, probably due to the destruction of cardiomyocytes, the activation of the autoimmune processes has already occurred, which resulted in the relapsing disease. Further management was associated with challenges in differential diagnosis, decision-making regarding the use of reserve drugs - interleukin-1 inhibitors and immunoglobulin - and the treatment of complications. It took about 1.5 years to achieve stable remission, made possible by the coordinated work of the cardiology and rheumatology centers.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 12","pages":"1023-1030"},"PeriodicalIF":0.3,"publicationDate":"2026-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221238","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":"[Effect of sodium-glucose cotransporter type 2 inhibitors on the course of heart failure in patients with amyloid cardiomyopathy: Results of a pilot single-center randomized trial].","authors":"A A Shoshina, S N Nasonova, I V Zhirov, S N Tereshchenko","doi":"10.26442/00403660.2025.12.203510","DOIUrl":"10.26442/00403660.2025.12.203510","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the efficacy and safety of the use of sodium-glucose cotransporter type 2 (SGLT-2) inhibitors in patients with chronic heart failure (CHF) due to amyloid cardiomyopathy (ACM).</p><p><strong>Materials and methods: </strong>50 patients with CHF due to different types of ACM were included and randomized in two groups at a ratio of 1:1. In the 1st group (<i>n</i>=25), SGLT-2 inhibitors were added to basic therapy. In the 2nd group (<i>n</i>=25) patients received only basic therapy. The observation period was 6 months. Clinical function status, laboratory marker dynamics, echocardiography parameters, frequency of hospitalizations and presence of cardiovascular events were evaluated.</p><p><strong>Results: </strong>SGLT-2 inhibitors therapy was well tolerated, safe. The frequency of hospitalizations due to decompensated heart failure was higher in the 2nd group (<i>p</i>=0.048), cases of hospitalization in the 2nd group occurred statistically significantly earlier (<i>p</i>=0.017). Mortality in the 1st group was 4% (1 case), in the 2nd group - 16% (4 cases), due to progressive CHF. In the 1st group, the distance of a 6-minute walk test increased (<i>p</i><0.001), the quality of life assessed by the Minnesota Living with Heart Failure Questionnaire improved (<i>p</i><0.001), the expression of shortness decreased (<i>p</i><0.001), there was an improvement in clinical status according to the clinical assessment scale (<i>p</i><0.001), while in the 2nd group there was a statistically significant deterioration of clinical functional status. The dynamics of the N-terminal pro-Brain Natriuretic Peptide and troponine levels were positive in the 1st group and negative in the 2nd group (<i>p</i>=0.001 and <0.001 respectively). Significant changes in the glomerular filtration rate in the 1st group were not detected (<i>p</i>=0.475), in the 2nd group there was a decrease of this parameter (<i>p</i><0.001). According to the results of echocardiography in the 2nd group a significant reduction of the left ventricular (LV) ejection fraction (<i>p</i>=0.001) was observed, and in the 1st group was a tendency to decrease of the LV ejection fraction (<i>p</i>=0.238). Regardless of the SGLT-2 inhibitors intake, there was a decrease in the end-diastolic dimension of LV (<i>p</i>=0.046 for 1st group and <0.001 - for 2nd group), as well as a progressive thickening of heart walls (<i>p</i>=0.011 and <0.001 for interventricular septum thickness, <i>p</i>=0.004 and <0.001 - for posterior wall thickness of LV).</p><p><strong>Conclusion: </strong>The administration of SGLT-2 inhibitors to patients with CHF due to ACM leads to an improvement in quality of life, a decrease in the frequency of hospitalizations due to decompensated heart failure of CHF, but does not affect mortality. Further study of therapeutic efficacy in more patients is needed.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 12","pages":"994-1002"},"PeriodicalIF":0.3,"publicationDate":"2026-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221178","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 adverse events in patients with multidrug-resistant tuberculosis, HIV-infection and viral hepatitis C].","authors":"A V Kukurika","doi":"10.26442/00403660.2025.11.203451","DOIUrl":"10.26442/00403660.2025.11.203451","url":null,"abstract":"<p><strong>Aim: </strong>To identify risk factors for adverse drug reactions (ADRs) in patients co-infected with multidrug-resistant tuberculosis (MDR-TB), HIV and viral hepatitis C (HCV).</p><p><strong>Materials and methods: </strong>The incidence, spectrum, association with medications, and outcomes of ADRs were studied in 132 patients with MDR-TB/HIV/HCV receiving antituberculosis and antiretroviral therapy. Statistical methods of data processing were used to identify predictors of ADRs development.</p><p><strong>Results: </strong>The overall incidence of undesirable ADRs amounted to 67%, severe ADRs of 3-4 degrees - 12%. Hepatotoxic (31%), nephrotoxic (18%) and dyspeptic (16%) reactions took the leading place in the spectrum of undesirable ADRs. Among the outcomes of all undesirable ADRs, the vast majority of TB drugs were canceled (61%), and undesirable ADRs were managed only in 6% of cases. Pyrazinamide, para-aminosalicylic acid, injectable aminoglycosides had the most unfavorable safety profile in the studied cohort, which led to their final exclusion from chemotherapy regimens.</p><p><strong>Conclusion: </strong>Independent predictors of any undesirable ADRs were kanamycin, pyrazinamide and para-aminosalicylic acid administration, severe reactions were hepatobiliary disorders, and drug withdrawal due to the development of undesirable ADRs were pyrazinamide and para-aminosalicylic acid administration. Bedaquiline, delamanid, moxifloxacin and ethambutol had the most favorable safety profile in the study cohort. The obtained data allow to form risk groups for the development of ADRs in patients with triple infection, to identify indications for enhanced monitoring and prescription of drug prophylaxis at the start of treatment.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 11","pages":"920-926"},"PeriodicalIF":0.3,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952959","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":"[Contemporary approaches to the treatment of acute respiratory viral infections and influenza. A review].","authors":"O I Trushina","doi":"10.26442/00403660.2025.11.203505","DOIUrl":"10.26442/00403660.2025.11.203505","url":null,"abstract":"<p><p>The article's scope is to review the modern approaches to the treatment of acute respiratory viral infections and influenza in adults, including those go higher risk. Both the main mechanisms of action of the drugs and the evidence base of their use in various clinical situations, including the prevention of complications, are discussed. The main prospects for the development of this area are outlined, taking into account the characteristics of pathogens.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 11","pages":"950-954"},"PeriodicalIF":0.3,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952966","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 family imported case of dengue fever. Case report].","authors":"A L Bondarenko, E L Kontyakova","doi":"10.26442/00403660.2025.11.203450","DOIUrl":"10.26442/00403660.2025.11.203450","url":null,"abstract":"<p><p>Dengue fever is the most common zoonotic infection with a transmissible mechanism of virus transmission in tropical and subtropical countries. In the first two decades of the 21st century, a significant increase in dengue fever cases was registered in more than 120 countries worldwide. The article presents a family imported case of dengue fever in a 34-year-old man and a 35-year-old woman who fell ill within 3 days after returning from Thailand (Phuket Island). In both cases, there was an acute onset of the disease with an increase in body temperature to (39-40°С), severe weakness, severe muscle and joint pain, severe headache, and loose stools once or twice. They were treated independently for acute respiratory infections. They sought medical help on the 4th and 5th days of their illness and were admitted to an infectious diseases hospital. The disease was accompanied by the development of posterior cervical and submandibular lymphadenitis, hepatomegaly, an uncommon spotty-papular rash on the skin of the trunk and arms, single point hemorrhages, severe thrombocytopenia and leukopenia. The woman was diagnosed with posterior cervical and submandibular lymphadenitis, and hepatosplenomegaly. On the 6th day of the disease, the woman was radiographically diagnosed with peribronchial edema of the interstitium. On the 7th day of the disease, the man developed a hydrocele on the right. Type 2 dengue virus was detected in blood, urine, and saliva by polymerase chain reaction in both patients. The man was discharged on the 20th day of his illness with asthenovegetative and dyspeptic symptoms that persisted for several weeks. The woman was discharged on the 17th day of her illness with residual asthenovegetative manifestations and secondary thrombocytopenia lasting several years.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 11","pages":"940-944"},"PeriodicalIF":0.3,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953109","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":"[Evaluation of the efficacy and safety of levilimab in the treatment of patients with rheumatoid arthritis in real practice].","authors":"E R Myasoutova, A R Iuskaeva, L S Kostakova, E V Sukhorukova, R Z Abdrakipov, D I Abdulganieva, N M Taratorkin","doi":"10.26442/00403660.2025.11.203445","DOIUrl":"10.26442/00403660.2025.11.203445","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the efficacy and safety of levilimab (LVL) in patients with rheumatoid arthritis (RA) in real clinical practice.</p><p><strong>Materials and methods: </strong>A retrospective observational study of 144 patients with RA and the need to adjust previously prescribed therapy against the background of an exacerbation of the disease, which took place at the Republican Clinical Hospital in Kazan. All patients included in the study were prescribed LVL (Ilsira). The activity of RA was assessed using Disease Activity Score 28 - DAS28-ESR/CRP indices. The assessment was performed before initiation of LVL therapy and at the end of follow-up.</p><p><strong>Results: </strong>The analysis included 144 patients with RA (112 - women, 32 - men, average age - 55.1±12.3 years). The patients were divided into 3 groups, depending on the duration of follow-up. The first group (up to 4 weeks) - 33 (22.9%) patients, the second group (4-8 weeks) - 75 (52.1%), the third group (more than 8 weeks) - 36 (25%). The duration of follow-up described in the study did not exceed 12 weeks. The assessment was performed before initiation of LVL therapy and at the end of follow-up. In each of the groups, at the time of completion of the observation, there was a decrease in RA activity according to the DAS28-ESR/CRP indices by 6.1% (<i>p</i>=0.000162), 11.1% (<i>p</i>=0.00001) and 27% (<i>p</i>=0.0001) respectively, according to acute phase indicators - ESR by 39.6% (<i>p</i>=0.0001), 55.4% (<i>p</i>=0.0001) and 44.6% (<i>p</i>=0.000028) respectively, CRP decreased by 65.2% (<i>p</i>=0.000196), 71.5% (<i>p</i>=0.0001) and 58.6% (<i>p</i>=0.000707) respectively. At the end of the follow-up, the number of patients with high RA activity decreased by 65.8% (<i>p</i>=0.000022). Against the background of LVL therapy, the proportion of patients taking CS≥7.5 mg/day decreased by 31.4% (<i>p</i>=0.006). LVL's safety profile was assessed as favorable. The registered AE related to deviations in the reference values of laboratory parameters and corresponded to 1 or 2 degrees of severity according to CTCAE version 5.0. No serious AE were reported.</p><p><strong>Conclusion: </strong>Levilimab has demonstrated high efficacy and a favorable safety profile for RA therapy.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 11","pages":"927-932"},"PeriodicalIF":0.3,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952936","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":"[Cryoglobulinemia and HCV-infection: stages of study].","authors":"S Y Milovanova, L V Lysenko, L Y Milovanova, D T Abdurakhmanov, A V Volkov, S V Moiseev","doi":"10.26442/00403660.2025.11.203464","DOIUrl":"10.26442/00403660.2025.11.203464","url":null,"abstract":"<p><p>The article presents the main stages of studying cryoglobulinemia and the associated clinical symptom complex as a manifestation of cryoglobulinemic vasculitis. Achievements in the study of hepatitis C virus are shown: the etiological role of the hepatitis C virus, pathogenesis, diagnosis. Variants of the course are considered, modern criteria for differential diagnosis, prognosis, choice of tactics and treatment methods are given.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 11","pages":"955-959"},"PeriodicalIF":0.3,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952988","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 rare variant of glomerulonephritis associated with generalised salmonellosis infection mimicking systemic lupus erythematosus: difficulties in differential diagnosis and treatment. Case report].","authors":"T Е Rudenko, N I Khalilova, G К Chuchin, O А Li, O К Popugaeva, M Y Shvetsov, L V Lysenko","doi":"10.26442/00403660.2025.11.203465","DOIUrl":"10.26442/00403660.2025.11.203465","url":null,"abstract":"<p><p>The presented case demonstrates the development of glomerulonephritis associated with generalized salmonellosis. At the onset of the disease, a symptom complex mimicking systemic lupus erythematosus was noted. A kidney biopsy made it possible to make the correct diagnosis and choose the optimal treatment.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 11","pages":"945-949"},"PeriodicalIF":0.3,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952210","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":"[Changes in the metabolomic profile of blood plasma in patients with lymphoma during polychemotherapy].","authors":"V G Varzieva, A A Boldin, K M Shestakova, S N Baskhanova, V M Samoylov, I S Ilgisonis, Y Y Kirichenko, R R Karimov, E A Smolyarchuk, D A Kudlay, V V Tarasov, Y N Belenkov, S A Appolonova","doi":"10.26442/00403660.2025.11.203491","DOIUrl":"10.26442/00403660.2025.11.203491","url":null,"abstract":"<p><strong>Background: </strong>Metabolomics studies in oncology provide a deeper understanding of the biochemical processes associated with tumor growth and the body's response to treatment. In patients with lymphoma, systemic metabolic changes remain poorly understood despite their high clinical significance.</p><p><strong>Aim: </strong>To evaluate changes in the metabolomic profile of blood plasma in patients with lymphoma at various stages of polychemotherapy (PCT) and compare them to those of healthy volunteers.</p><p><strong>Materials and methods: </strong>The study included 18 patients with lymphoma from whom blood was collected before treatment and after the first and third courses of PCT. The control group included 30 healthy volunteers. The analysis was performed by high-performance liquid chromatography with tandem mass spectrometry (HPLC-MS/MS) and included measurements of amino acids, tryptophan and arginine derivatives, and acylcarnitines. Statistical processing was performed using analysis of variance and principal component analysis.</p><p><strong>Results: </strong>Prior to therapy, patients showed characteristic metabolic disorders: activation of the kynurenine pathway of tryptophan metabolism, a decrease in arginine, and an increase in its methylated derivatives, as well as shifts in the amino acid and acylcarnitine profiles. During PCT, partial normalization of these indicators was observed, especially for the serotonin-melatonin cascade and kynurenine metabolites.</p><p><strong>Conclusion: </strong>Metabolomics analysis revealed characteristic biochemical changes in patients with lymphoma and their changes over time during treatment. The data obtained emphasize the potential of metabolomics as a tool for monitoring treatment effectiveness and patient condition in oncology.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 11","pages":"908-919"},"PeriodicalIF":0.3,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952938","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}