Terapevticheskii Arkhiv最新文献

{"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}

{"title":"[Anticoagulant therapy for chronic heart disease atrial failure and fibrillation: a review].","authors":"M V Serova, Y S Sazonova, A S Derevinskaiia, A S Steklov, D A Andreev","doi":"10.26442/00403660.2024.11.203071","DOIUrl":"https://doi.org/10.26442/00403660.2024.11.203071","url":null,"abstract":"<p><p>Atrial fibrillation (AF) and heart failure (HF) often accompany each other, as they share similar risk factors and pathophysiological mechanisms. AF in patients with HF is known to increase hospitalizations and worsen prognosis. A combination of AF and HF translates into high risks of thromboembolic complications, which renders anticoagulants an important aspect of therapy for these patients. Vitamin K antagonists make achieving the target level of anticoagulation challenging due to drug interactions and comorbidities. Direct oral anticoagulants (DOACs) are preferred medications owing to a more favorable risk-benefit ratio in this group of patients. At the same time, patients with HF often require a personalized approach when choosing an anticoagulant due to increased risks of thromboembolic complications and bleeding, as well as multiple comorbidities. The article presents the results of sub-analyses of key studies on the efficacy and safety of DOACs vs vitamin K antagonists in patients with HF and AF. It also explores DOACs use in patients with chronic kidney disease.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"96 11","pages":"1083-1088"},"PeriodicalIF":0.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142897827","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":"[Infant botulism: an underestimated problem. A review].","authors":"V A Malov, V V Maleev, V P Chulanov, D S Sarksyan","doi":"10.26442/00403660.2024.11.202999","DOIUrl":"https://doi.org/10.26442/00403660.2024.11.202999","url":null,"abstract":"<p><p>The article is devoted to a form of botulism that has been little studied in our country and is registered exclusively in infants. The fundamental difference between this form and the most common foodborne botulism is that infants become infected by ingestion of spores, followed by their germination, colonization of the intestines and production of botulinum toxin <i>in situ</i>, which leads to the development of life-threatening flaccid paralysis. Taking into account the peculiarities of pathogenesis, the clinical manifestations of infant botulism have some features, which are discussed by the authors. Particular attention is paid to the epidemiology and risk factors for the development of the disease. The article discusses in detail the issues of diagnosis and laboratory verification of the etiology of the disease. Current data on the treatment of infant botulism are presented.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"96 11","pages":"1069-1075"},"PeriodicalIF":0.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142897899","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 vaccination against pneumococcal infection in patients with severe bronchial asthma].","authors":"G L Ignatova, S N Avdeev, V N Antonov, E V Blinova","doi":"10.26442/00403660.2024.11.203038","DOIUrl":"https://doi.org/10.26442/00403660.2024.11.203038","url":null,"abstract":"<p><strong>Introduction: </strong>The article discusses topical issues of the use of conjugated 13-valent pneumococcal vaccine Prevenar®13 (PCV13) in patients with severe bronchial asthma (SBA), including those receiving targeted therapy with genetically engineered biological drugs (GEBD).</p><p><strong>Aim: </strong>To study the effectiveness of vaccination against pneumococcal infection (PI) in patients with SBA.</p><p><strong>Materials and methods: </strong>The study included 381 patients with SBA. The average age in the study groups was 45.5 (42.0; 52.5) years. All patients underwent clinical and instrumental studies, including spirography with bronchodilation test. After confirming the diagnosis of BA, the patients were divided into 2 observation groups. Group 1 (<i>n</i>=191) consisted of patients undergoing treatment with GEBD. Group 2 included patients with asthma receiving standard therapy, according to the 4th-5th stage according to the criteria of the Global Initiative for Asthma 2022 (Global Initiative for Asthma - GINA). The observation group consisted of 190 patients. In each group, there are subgroups of patients who have been vaccinated against PI and have not been vaccinated for various reasons. The following criteria were used as the main endpoints of observation for 12 months to assess the effectiveness: the number of pneumonia during the observation period, the number of exacerbations of asthma (severe, non-severe), the number of hospitalizations, the duration of exacerbations, the level of control according to the Asthma Control Questionnaire (ACQ5), functional indicators.</p><p><strong>Results: </strong>The coverage of PI vaccination in patients with BA remains quite low, further organizational and methodological work is required to increase their involvement in vaccination. Immunization of PCV13 in patients with SBA at the 4th-5th stage of therapy reduces the risk of community-acquired pneumonia by at least 28.5%. PCV13 vaccination may be an additional effective tool for controlling the symptoms of SBA, including in patients undergoing treatment with GEBD. Vaccination allows to normalize the functional parameters of respiratory function in patients with SBA. PCV13 is well tolerated and does not cause any significant allergic reactions in patients with asthma.</p><p><strong>Conclusion: </strong>PCV13 vaccination is an effective tool for reducing the risk of community-acquired pneumonia in patients with severe bronchial asthma, including those on targeted therapy with genetically engineered biological drugs.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"96 11","pages":"1057-1062"},"PeriodicalIF":0.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142897922","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}