Klinicist最新文献

{"title":"Возможности фармакологической коррекции структурно-функциональных изменений микроциркуляции в условиях эндотелиальной дисфункции у коморбидных больных, перенесших инсульт","authors":"И. А. Золотовская, И. Л. Давыдкин","doi":"10.17650/1818-8338-2016-10-2-32-42","DOIUrl":"https://doi.org/10.17650/1818-8338-2016-10-2-32-42","url":null,"abstract":"Aim of the study – reveal clinical efficacy of naftidrofuryl in the aspect of correcting structural and functional changes of microcirculation (MC) in relation to the influence of the endothelial dysfunction (ED) parameters in comorbid patients suffered stroke event. Materials and methods. The study included 95 patients suffered ischemic type of stroke in the carotid bassin. An average age of patients was 69.0 ± 5.3 years, stroke duration was 73.5 ± 8.4 days. Patients were randomized in 2 groups by using blind method of envelopes. The mentioned groups matched on the main clinical and demographic characteristics. Patients from the 1st group (primary group, n = 47) were treated with naftidrofuryl (Duzofarm) at the daily dose of 300 mg, 2 patients (comparison group, n = 48) received basic therapy only. 50 people without an acute cerebrovascular accident in history were allocated as a control group (group 3). The following blood biochemical parameters were assessed: glucose, creatinine, total cholesterol, high density lipoprotein; triglycerides; markers of endothelial dysfunction: von Willebrand factor (VWF), tissue plasminogen activator inhibitor-1 (PAI 1), antithrombin III (AT III) and plasminogen. MC was studied by the method of laser doppler flowmetry. The duration of the observation period was 6 months, and 4 visits were performed during this period. Results. Initial task of group formation within the study protocol has been solved by us in a full range. Patients from Group 1 that received naftidrofuryl noted statistically significant differences after 3 and 6 months of follow-up observation. These differences reflected improvement in perfusion index, coefficient of variation, as well as endothelial, neurogenic and myogenic regulation of microvasculature, increase in perfusion oxygen saturation index in the microcirculation. We have found that an index of relative perfusion oxygen saturation in microvascular blood (Sm) being the main indicator that reflects oxygen saturation of microcirculation has significantly correlated with ejection fraction, PAI1, AT III, and plasminogen levels in group 1 patients in 3 and 6 months. We have also found significant correlation with ED when comparing parameters that express endothelial, neurogenic and myogenic regulation of microvessels. These data clearly demonstrated an association between improving of MC parameters and ED parameters in Group 1 patients. Conclusion. Possibility of correction of MC alterations leading to the worsening of ischemia and ED progression is one of the most promising directions in the treatment of stroke patients. Aim of the drug therapy is to prevent ED progression, reduced vascular tone and restore an adequate level of tissue hemoperfusion.","PeriodicalId":30685,"journal":{"name":"Klinicist","volume":"10 1","pages":"32-42"},"PeriodicalIF":0.0,"publicationDate":"2016-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67769819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ОПТИМАЛЬНОЕ ПРИМЕНЕНИЕ БЕТА- АДРЕНОБЛОКАТОРОВ ПРИ ХРОНИЧЕСКОЙ СЕРДЕЧНОЙ НЕДОСТАТОЧНОСТИ","authors":"Надежда Александровна Шостак, Н. А. Демидова","doi":"10.17650/1818-8338-2016-10-2-60-66","DOIUrl":"https://doi.org/10.17650/1818-8338-2016-10-2-60-66","url":null,"abstract":"Objective – review current data on the use of beta-blockers (BB) in chronic heart failure (CHF). Materials and methods. This article discusses beneficial effects of BB administration in CHF patients. It has been demonstrated that decrease in heart rate underlies clinical efficacy of BB therapy in patients with chronic heart failure. We reviewed the question of the necessity to achieve target doses of BB in the treatment of CHF patients. It has been shown that administration of BB in patients with chronic heart failure and reduced left ventricular ejection fraction increase pumping function of heart, and thus reduce the number of hospitalizations for decompensated heart failure, reducing the risk of total and sudden mortality. We demonstrated substantial advantages of β1-selective BB over nonselective ones with respect to their impact on hemodynamics, metabolic processes, rheological parameters of blood and bronchi. We also considered therapeutic tactics in case of BB administration in CHF patients. Results. Based on the data of the current studies we proved high efficiency and safety of β1-selective BBs in CHF patients. Conclusion. Correct choice of BB in patients with CHF and decrease in heart rate during the treatment can significantly increase an effectiveness of the treatment.","PeriodicalId":30685,"journal":{"name":"Klinicist","volume":"10 1","pages":"60-66"},"PeriodicalIF":0.0,"publicationDate":"2016-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67770055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"АНАЛИЗ ОТДАЛЕННЫХ РЕЗУЛЬТАТОВ МЕДИКАМЕНТОЗНОГО И ХИРУРГИЧЕСКИХ МЕТОДОВ ЛЕЧЕНИЯ ПАЦИЕНТОВ С ТЯЖЕЛОЙ ХРОНИЧЕСКОЙ СЕРДЕЧНОЙ НЕДОСТАТОЧНОСТЬЮ","authors":"О. Т. Коцоева, Ольга Леонидовна Бокерия","doi":"10.17650/1818-8338-2016-10-2-25-31","DOIUrl":"https://doi.org/10.17650/1818-8338-2016-10-2-25-31","url":null,"abstract":"Objective: study was analysis of long-term results of medical and surgical treatment of patients with severe chronic heart failure (CHF). Materials and methods. We studied 90 patients with CHF III–IV functional class (FC) of NYHA, treated in A.N. Bakulev Scientific Center for Cardiovascular Surgery in 2007. All patients were divided into 3 groups: 30 patients who underwent conventional medical therapy (MT); 30 patients who underwent cardiac resynchronization therapy (CRT); 30 patients extremely severe category, which was performed orthotopic heart transplantation. Patients were followed up for 5 years to assess long-term results of treatment of CHF. Results. In patients with severe CHF, CRT (with respect to MT) significantly reduces the 5-year risk of total mortality, death from progressive heart failure, rehospitalization for heart failure, cardiac arrhythmias, need for heart transplantation, as well as helping to reduce FC of CHF, and an increase in ejection fraction the left ventricle. Conclusion. Surgical treatment of patients with severe CHF demonstrated a significant advantage over conventional MT in terms of improving the 5-year forecast.","PeriodicalId":30685,"journal":{"name":"Klinicist","volume":"10 1","pages":"25-31"},"PeriodicalIF":0.0,"publicationDate":"2016-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67769632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ВЛИЯНИЕ ПИЩИ НА КЛИНИЧЕСКИЕ СИМПТОМЫ И ВНУТРИЖЕЛУДОЧНУЮ КИСЛОТНОСТЬ ПРИ ЯЗВЕННОЙ БОЛЕЗНИ ДВЕНАДЦАТИПЕРСТНОЙ КИШКИ","authors":"А И Ковешников, И. Ю. Колесникова","doi":"10.17650/1818-8338-2016-10-4-50-54","DOIUrl":"https://doi.org/10.17650/1818-8338-2016-10-4-50-54","url":null,"abstract":"Objective: to evaluate the effect of food on the clinical symptoms of duodenal ulcer (DU) and postprandial changes in intragastric acidity. Materials and methods. 52 patients with uncomplicated and 56 – with a complicated course of DU in the acute stage were examined. The control group consisted of 50 apparently healthy individuals. All of the subjects completed a questionnaire including questions about food preferences and the effect of food on the clinical symptoms of the disease. Also, all patients conducted 24-hour pH-metry. We calculated basic parameters and postprandial gastric acidity in the stomach. Results . Patients with DU are characterized by night snacks, ignore breakfast, a rare use of the first course, rare use of soup, roughage and fresh fruit, which provoke pain or dyspepsia in patients with DU. The decrease postprandial pH and reducing the time consumtion found in patients with DU, especially pronounced in complicated course of the disease, compared with healthy volunteers. Conclusions. Frequent meals, night snacks, food avoidance “dry rations” and fresh vegetables, fruits typical for patients with DU. Also characteristic of complicated PUD decrease actions alkalizing food, short and low postprandial rise pH.","PeriodicalId":30685,"journal":{"name":"Klinicist","volume":"11 1","pages":"50-54"},"PeriodicalIF":0.0,"publicationDate":"2016-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67770354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ОПЫТ УСПЕШНОЙ ТЕРАПИИ АКНЕФОРМНЫХ ВЫСЫПАНИЙ У ПАЦИЕНТА С ДИАГНОЗОМ МНОЖЕСТВЕННОЙ МЕЛАНОМЫ","authors":"Ольга Минкина, А. С. Дворников, П. А. Скрипкина, Т. А. Гайдина, Е. В. Трушина","doi":"10.17650/1818-8338-2016-10-1-52-56","DOIUrl":"https://doi.org/10.17650/1818-8338-2016-10-1-52-56","url":null,"abstract":"Objective: to describe the results of the joint monitoring and diversified treatment of oncologists and dermatologists those patient with multiple recurrent melanoma who received over a long period a targeted anti-cancer therapy, which was complicated by side-effect as widespread acneform rush, resistant to traditional treatment. Patient A., born in 1988, was followed up and got a treatment more than 2 years in oncology out-patient clinic diagnosed with “Melanoma of the front surface of the left leg T2bN0M0 IIA”. Subsequently, the patient was verified metastasis in the inginal lymph nodes, in the soft tissues of the hips, to liver. Acute adverse reaction has developed in a short time after getting the anti-tumor target therapy as generalized acneform rush and itching of the skin. Skin symptoms accompanied by pronounced psychological and emotional stress, therefore, dermatologists have been invited to provide additional medical assistance to this patient. Due to the fact that subsequent traditional anti-acne algorithms of topical and oral treatment was not such effective, there was made a decision to use an alternative supporting external therapy, which did not have similar examples of usage previously. Results. External application of tacrolimus ointment in combination with other drugs and then as a mono-therapy, allows us in a rather short period achieve a stable and pronounced regression of skin pathological lesions, to return to the previously cancelled initial drug dose of the anti-tumor target therapy, to change significantly components of the patient’s quality of life. Conclusion. The search for additional and alternative treatment approaches for similar patients, as in our case, remains relevant for specialists and patients themselves. This case is an example of alternative approach to the tacrolimus topical application in patient with drug-mediated acneform rush.","PeriodicalId":30685,"journal":{"name":"Klinicist","volume":"10 1","pages":"52-56"},"PeriodicalIF":0.0,"publicationDate":"2016-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67769321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Особенности хронического болевого синдрома при ревматоидном артрите и лечебно-диагностическая тактика","authors":"М. А. Громова, С. Е. Мясоедова","doi":"10.17650/1818-8338-2016-10-1-12-16","DOIUrl":"https://doi.org/10.17650/1818-8338-2016-10-1-12-16","url":null,"abstract":"Objective: to establish features of a chronic pain syndrome disorders in patients with rheumatoid arthritis, to reveal correlation with psychoemotional disorders and to develop the differential approach to maintaining patients. Materials and methods. 101 patients at the age of 60.6 ± 11.8 years, 92 % of women, with reliable rheumatoid arthritis (American College of Rheumatology – ACR, 1987), were examined. The visual analog scale was used for an assessment of pain strength at the moment; the Van Korff’s questionnaire – for determination of pain strength at the moment and retrospectively for the last half a year with an assessment of disadaptation level and disability, ranging of a chronic pain syndrome on classes; the McGill Pain Questionnaire – for the characteristic of touchsensitive and emotional components of pain. Neuropathic pain was revealed by DN4 questionnaire. Anxiety and depression were determined by the Hospital Anxiety and Depression Scale (HADS). Fibromyalgia diagnosed by criteria of ACR, (1990). Results. Pain estimated by various scales and questionnaires varied from moderated to intensive. According to Van Korff’s questionnaire it was characterized by average level of disadaptation and easy disability that corresponded to the second class of chronic pain. The Rank pain index of the McGill Pain Questionnaire touch scale testified that pain was described by a smaller number of definitions on a touch scale than on emotional. This indicates a moderate impact of pain syndrome on a state of mind. Neuropathic pain is diagnosed for 37.3 % of patients with tunnel syndrome, mononeuritis and touch polyneuropathy. The secondary fibromyalgia is revealed for 2 % of patients with early rheumatoid arthritis of high activity. According to HADS anxiety and depression was revealed for 58 and 59 % of patients correspondingly. This demanded psychotherapeutic consultation and additional correction. We proposed the algorithm of diagnostic and medical tactics for rheumatoid arthritis patients with a chronic pain syndrome in therapeutic practice based on pain strength gradation, assessment of chronic pain syndrome variations, definition of anxiety and depression signs. All this allows to validate consultation of medical specialists and to differentiate treatment. Conclusions. The integrated approach to diagnostics of a chronic pain syndrome for rheumatoid arthritis allows to estimate pain strengths in dynamics of disease development, to reveal existence of pain variations, anxiety and depression. It enables usage of patient maintenance tactics and increases efficiency of treatment in therapeutic practice.","PeriodicalId":30685,"journal":{"name":"Klinicist","volume":"10 1","pages":"12-16"},"PeriodicalIF":0.0,"publicationDate":"2016-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67768688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ИЗУЧЕНИЕ ДИНАМИКИ ЧАСТОТЫ ПРИЕМА ОСНОВНЫХ КЛАССОВ ЛЕКАРСТВЕННЫХ ПРЕПАРАТОВ, ПОКАЗАННЫХ ПРИ ЛЕЧЕНИИ ПАЦИЕНТОВ С ХРОНИЧЕСКОЙ ИШЕМИЧЕСКОЙ БОЛЕЗНЬЮ СЕРДЦА, С 2004 ПО 2014 Г. ДАННЫЕ РЕГИСТРА ПРОГНОЗ ИБС","authors":"С. Н. Толпыгина, С. Ю. Марцевич","doi":"10.17650/1818-8338-2016-10-1-29-35","DOIUrl":"https://doi.org/10.17650/1818-8338-2016-10-1-29-35","url":null,"abstract":"Objective: to estimate a trend in the frequency of using drugs with their proven effect on disease outcome in patients with chronic coronary heart disease (CHD) in 2004–2014 within the CHD PROGNOSIS registry. Materials and methods. The investigation included data from the CHD PROGNOSIS registry on 303 patients with verified CHD during the 2004–2007 reference hospitalization at the National Research Center for Preventive Medicine, who made a control visit 4 years later, and those on 125 patients who had come following 7 years. Results. There was a low frequency of prescribing the drugs that were able to improve prognosis in patients with stable CHD prior to the 2004–2007 reference hospitalization with an increase at discharge and with a further reduction during outpatient treatment. 7.6 and 86.5% of the patients took statins; 68 and 96 % received disaggregants; 24.8 and 94 % used β-adrenoblockers (β-AB), and 19 and 83 % had angiotensin-converting enzyme (ACE) inhibitors before hospitalization and at discharge, respectively (p < 0.001). Four and seven years after discharge, there were reductions in the frequency of using statins to 67 and 70 %, disaggregants to 80 and 90 %, β-AB to 80 and 75 %, and ACE inhibitors to 66 and 65 %, respectively (p < 0.01). At the same time, the above-mentioned drugs were taken by 15 and 69 % of patients on admission and at discharge, respectively (p < 0.001), by 41 and 35 % after 4 and 7 years (p < 0.01). In 2004 to 2014, most drugs were used at low and moderate doses with a gradual increase in the share of generics. Conclusion. The therapy in patients with stable CHD was characterized by a low frequency of using the drugs with their proven effect on prognosis prior to the 2004–2007 reference hospitalization with an increase and a decrease in the frequency of their use on discharge and after 4 and 7 years. During 10 years, β-AB, ACE inhibitors/angiotensin II receptor antagonists, and statins were used mainly at low and moderate doses. Moreover, there was a gradual rise in the share of generics, in the use of statins in particular.","PeriodicalId":30685,"journal":{"name":"Klinicist","volume":"10 1","pages":"29-35"},"PeriodicalIF":0.0,"publicationDate":"2016-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67769313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Внесуставной болевой синдром после первичного протезирования тазобедренного сустава","authors":"И. В. Кирпичев, М. Н. Кирпикова","doi":"10.17650/1818-8338-2016-10-1-17-21","DOIUrl":"https://doi.org/10.17650/1818-8338-2016-10-1-17-21","url":null,"abstract":"Objective: to determine the dynamics of the extra-articular pain after primary hip replacement. Materials and methods. A total of 1286 patients undergoing primary total hip arthroplasty. Among the patients were women, mean age was 56.6 ± 13.9 years. In a clinical study of patients using differential diagnostic table extra-articular pain, visual analogue scale of pain, with instrumental examination – X-ray data, and sonographic densitometry study. Results. The incidence of the disease state is 42.7 %. Risk factors for decompensation classified muscles that stabilize the hip joint (r = 0.78), shortening of the operated limb more than 3 cm (r = 0.72). The most intense pain is fixed from the 3 rd to the 6 th month after the surgery. The least pronounced dynamics of reduction in pain severity observed in patients with dysplastic coxarthrosis and diseases arising on a background of systemic pathology. Conclusion. Extra-articular pain occurs more than a third of patients after primary prosthesis. According to the etiology is often vertebrogenic and adaptive pain. From the 3 rd to the 6 th month, in connection with the formation of a new dynamic stereotype of gait is highest probability of occurrence and/or enhance the intensity of the pain, which are reduced to 12 th month after surgery.","PeriodicalId":30685,"journal":{"name":"Klinicist","volume":"20 1","pages":"17-21"},"PeriodicalIF":0.0,"publicationDate":"2016-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67768794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"СЛУЧАЙ ЭФФЕКТИВНОЙ АНТИКОАГУЛЯНТНОЙ ТЕРАПИИ У БОЛЬНОГО С ИШЕМИЧЕСКОЙ БОЛЕЗНЬЮ СЕРДЦА, ХРОНИЧЕСКОЙ СЕРДЕЧНОЙ НЕДОСТАТОЧНОСТЬЮ, ФИБРИЛЛЯЦИЕЙ ПРЕДСЕРДИЙ И ТРОМБОЗОМ ЛЕВОГО ЖЕЛУДОЧКА","authors":"С.В. Шекоян, З. Т. Джндоян, А. С. Сисакян","doi":"10.17650/1818-8338-2016-10-1-48-51","DOIUrl":"https://doi.org/10.17650/1818-8338-2016-10-1-48-51","url":null,"abstract":"Objective: to describe effective treatment in a patient with stent thromboses and a left ventricular (LV) thrombus resistant to therapy with the novel anticoagulants clopidogrel and prasugrel. Materials and methods. Patient P.V., aged 53 years, was admitted to the Department of Cardiology with complaints of dyspnea, lower limb edema, general weakness, palpitation, reduced urine output, and elevated body temperature. His medical history showed myocardial infarction experienced three times, coronary stenting using 3 drug-eluting stents, and stent thromboses. Echocardiography (EchoCG) revealed a mobile thrombus with a total area of 11 cm 2 in the area of chronic LV aneurysm. Results. According to the data of EchoCG conducted over time, there was a decrease in thrombus sizes to 3.06 cm 2 during rivaroxaban therapy, their subsequent increase up to 9.25 cm 2 after anticoagulant therapy that was discontinued without permission, and final lysis of a LV thrombus following the intake of rivaroxaban 20 mg/day during one month. Conclusion. LV thrombus lysis in the rivaroxaban-treated patient with post-infarction cardiosclerosis and stent thromboses resistant to therapy with clopidogrel and prasugrel was described in this case.","PeriodicalId":30685,"journal":{"name":"Klinicist","volume":"10 1","pages":"48-51"},"PeriodicalIF":0.0,"publicationDate":"2016-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67769742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"УЗЛОВАТАЯ ЭРИТЕМА ПРИ СИНДРОМЕ ЛЕФГРЕНА","authors":"Array А. Карпова, Array С. Белов, Array Н. Егорова, Array М. Савушкина, Array И. Глухова, Array Г. Раденска-Лоповок","doi":"10.17650/1818-8338-2016-10-1-22-28","DOIUrl":"https://doi.org/10.17650/1818-8338-2016-10-1-22-28","url":null,"abstract":"Objective: to study the clinical, laboratory, and radiographic characteristics of early-stage sarcoidosis in a cohort of patients referred to a rheumatology center. Materials and methods. The investigation enrolled 125 patients (104 women and 21 men; mean age 42 ± 12 years) with the clinical and X-ray signs of Lofgren’s syndrome. All the patients were referred to a rheumatology center with diagnosed erythema nodosum (EN). The median disease duration was 1 (0.5–2.0) month. All the patients underwent comprehensive clinical examination and laboratory and instrumental studies of biochemical and immunological parameters, chest X-ray or computed tomography (CT), as well as postmortem examinations of skin and subcutaneous fat biopsy specimens were done in 15 cases. Results. EN was located on the lower leg mostly on its anterior surface (97 %), hip (35 %), upper limbs (25 %), and trunk (3 %). There was a symmetric pattern of eruptions in 50 % of the patients. Nodules fused into a conglomerate in 48 %. More than 50 % injury of the shin surface (68 %) was directly related to the number of nodules (p < 0.001; r = 0.60) and the level of C-reactive protein (p = 0.006; r = 0.38). There was a direct relationship of the number of nodules to the duration of EN (p = 0.04; r = 0.20) and their trend of fusion (p < 0.001; r = 0.39). The signs of joint injury were found in 106 (85 %) patients. The predictors of the CT frosted glass phenomenon were male sex (odds ratio (OR) 6.5; confidence interval (CI) 1.2–35.0; p = 0.026) and the presence of nodular conglomerates (OR 4.8; CI 1.4–16.1; p = 0.01). EN did not recur and articular syndrome virtually completely regressed in 90% of the patients during one-year follow-up. Conclusion. Patients with acute sarcoidosis require that physicians of different specialties, including rheumatologists, should coordinate their actions to determine the volume of further examination and to use adequate treatment.","PeriodicalId":30685,"journal":{"name":"Klinicist","volume":"10 1","pages":"22-28"},"PeriodicalIF":0.0,"publicationDate":"2016-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67768681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}