Klinicheskaia Meditsina[JOURNAL]
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200 papers
[PEMPHIGUS ACANTHOLYTICUS PARANEOPLASTIC: LITERATURE REVIEW AND CASE REPORT].
Ufimtseva MA, Bochkarev JM, Gurkovskaya EP … +2 more , Nikolaeva KI, Lesnaya OD
Klin Med (Mosk) · 2017 · PMID 30303651
The article describes the clinical observation of a rare severe dermatosis, paraneoplastic acantholyticus pemphigus, associated with colon cancer with reference to pathogenesis, clinical variations and difficulties of di...
The article describes the clinical observation of a rare severe dermatosis, paraneoplastic acantholyticus pemphigus, associated with colon cancer with reference to pathogenesis, clinical variations and difficulties of diagnostics of this condition.
[EVALUATION OF CARDIOVASCULAR RISKS WITH THE USE OF MORPHOGENETIC KLOTHO PROTEIN IN PATIENTS WITH CHRONIC RENAL DISEASE].
Mukhin NA, Milovanova LY, Fomin VV … +4 more , Kozlovskaya LV, Taranova MV, Androsova TV, Borisov AA
Klin Med (Mosk) · 2017 · PMID 30303650
THE AIM: of the study was to explore the Klotho protein significance in patients with different stages of chronic kidney disease (CKD) and to assess the influence of antihypertensive therapy on Klotho protein serum level...
THE AIM: of the study was to explore the Klotho protein significance in patients with different stages of chronic kidney disease (CKD) and to assess the influence of antihypertensive therapy on Klotho protein serum levels. MATERIALS AND METHODS: 130 patients with stage 5 CKD1 were included in the study. Serum PTH, calcium and phosphorus were measured. ELISA was used to determine serum soluble alpha Klotho. Blood pressure including brachial and central (aortic) pressure was measured in all patients together with pulse wave velocity (using a «Sfigmokor» device); in addition, echocardiography (EchoCG), and X-ray examination of the abdominal aorta by Kauppila method were performed. RESULTS: The dynamic study of serum Klotho level showed that it changes with decreasing glomerular filtration rate faster than a rise in phosphate and PTH levels starting from stage 3A of CKD. The two later variables increased at stages 4-5.According to the ROC analysis, the values of serum Klotho below 387 pg /ml suggested enhanced risk of myocardial calcification with 80% sensitivity and 76% specificity. In addition, the highest Klotho serum levels were observed in patients whose target BP values were achieved with angiotensin receptor blockers (ARB) compared to those who used other drugs [р<0,01] or failed to reached target BP levels [p=0,008]. CONCLUSION: The study showed the possibility of practical use of Klotho protein as an early diagnostic marker of cardiovascular risk. Reduced serum Klotho was less pronounced in patients who used ARB for correction of high blood pressure. Normal Klotho protein levels in serum have been associated with a lower frequency of heart and vessels calcification in CKD patients.
[RELATIONSHIP BETWEEN SMOKING AND INDICATORS OF SYSTEMIC INFLAMMATION IN PATIENTS WITH CORONARY HEART DISEASE].
Bazdyrev ED, Polikutina OM, Kalichenko NA … +4 more , Slepynina YS, Uchasova EG, Pavlova VY, Barbarash OL
Klin Med (Mosk) · 2017 · PMID 30303364
AIM: To estimate the severity of systemic inflammation in subjects with coronary artery disease (CAD) without bronchopulmonary system comorbidity depending on smoking factor. MATERIALS AND METHODS: The subjects were divi...
AIM: To estimate the severity of systemic inflammation in subjects with coronary artery disease (CAD) without bronchopulmonary system comorbidity depending on smoking factor. MATERIALS AND METHODS: The subjects were divided into groups depending on smoking factor. We estimated the following laboratory markers of nonspecific inflammation: interleukine (IL)-12, -1β, tumour necrosis factor-α, matrix metalloproteinase-9, C-reactive protein. The examination of lungs respiratory function included spirometry, body plethysmography and assessment of diffusing lung capacity. RESULTS: 29.9% of the subjects with CAD smoked, 40% reported discontinuation of smoking in their histories. Smoking in CAD subjects without the history of bronchopulmonary system comorbidity was associated with a higher level of inflammatory markers (IL-12, IL-1β, TNF-α, ММР-9 and CRP) than in subjects who ceased to smoke and those who have never smoked. No differences in the levels of inflammatory markers were revealed in subjects who had smoked before and never smoked. CONCLUSION: Smoking is widespread among CAD subjects. It is associated with a higher level of markers of nonspecific inflammation as compared to subjects who have never smoked before or ceased smoking.
[THE PREVALENCE OF RESPIRATORY SYMPTOMS AMONG RESIDENTS OF THE RUSSIAN FAR NORTH].
Andronov SV, Lobanov AA, Popov AI … +1 more , Emelyanov AV
Klin Med (Mosk) · 2017 · PMID 30303360
To study the frequency of respiratory symptoms among the reindeer herders of the Yamal region in the Far North of Russia. We conducted a cross-sectional study of the occurrence of respiratory symptoms among 500 subjects...
To study the frequency of respiratory symptoms among the reindeer herders of the Yamal region in the Far North of Russia. We conducted a cross-sectional study of the occurrence of respiratory symptoms among 500 subjects of the tundra Nenets population (28.1% of the adult Nenets population in the district), of which 38.3% were men and 61.7% women (average age 40.1 years). All patients were matched for age and occupation. Medical examination was carried out by a pulmonologist with the use of the GARD questionnaire (WHO, 2004) and spirometry. Spirometry was performed with a SpiroUSB device (UK) according to a unified standard and the criteria of ATS/ERS 2005. The frequency of respiratory symptoms among the tundra population was estimated at 71.8%. Cough with expectoration and dyspnea were found in 22.8% of the respondents. 70.0% of the examined subjects worked in the cold, 33% were exposed to the open flame at home, and 34.4% smoked. Respiratory symptoms developed in 16.3% of those working in the cold and in 37% exposed to open fire. The combination of such complaints as cough and sputum production occurred in smokers twice as frequently as in non-smokers (54.1%) (p<0.01).The combination of such complaints as cough and sputum production was twice as likely note in his those who smoked (54.1% vs 20.2%) (p<0.01). The combination of these problems dyspnea was three times more common in the smokers (23,3%vs 7,3%) (p<0.001). At presence at patients of such a factor as work in the cold and the absence of other only 16.3% of them have respiratory symptoms. When using at home the open flame and the absence of other factors leading up 37.0% of the individuals with symptoms of chronic bronchitis. Cough, sputum and dyspnea are formed only among 26.3% of the smokers face when smoking is the only risk factor. If the surveyed residents of all three negative factors respiratory symptoms met at 62.1%. Disorders of respiratory function according to spirometry were not observed in none of the study participants. Respiratory symptoms developed in 62.1% of the subjects exposed to all three risk factors. External respiration indices remain normal in all he examine subjects. It is concluded that residents of the Far North frequently suffer respiratory symptoms without disorders in the external respiratory function. In most cases they associated with three factors (work in the cold, exposure to open fire at home, and smoking). Compensatory stimulation of lung functions may create additional difficulties for diagnostics of bronchial obstruction.
[RESEARCH ON THE LEVEL, COMPONENTS AND THE TYPE OF COOPERATIVITY IN THE PATIENTS WITH ASTHMA].
Bogovin LV
Klin Med (Mosk) · 2017 · PMID 30303358
The patient’s cooperativity is the major factor which determines the patient’s adherence to doctor’s prescriptions and, consequently, the achievement of disease control. We proposed the “Evaluation of the cooperativity i...
The patient’s cooperativity is the major factor which determines the patient’s adherence to doctor’s prescriptions and, consequently, the achievement of disease control. We proposed the “Evaluation of the cooperativity in asthma” questionnaire to evaluate the level, components and types of cooperativity in 141 patients with the mixed or atopic form of asthma (94.3 and 5.7%, respectively) at admission to hospital who were aware about their disease. The analysis of investigated parameters depending on the level of patients’ awareness of their condition (according to the “Awareness of patients about asthma” test), severity and duration of the disease, presence of alexithymia and social and economic index was done. It was found out that patients with asthma exaggerate the degree of their compliance. The general indices of cooperativity (GIC=58.1±7.3%) and understanding of danger (35.8±3.3%) in the patients who were aware about their disease were low. Qualitative characteristics of individual cooperativity components in examined patients are presented. Nearly 76% of the patients showed negative cooperativity inversely correlating with the severity of asthma and the duration of the disease. Positive cooperativity appeared to be directly related with the higher educational level, occupation and higher income level of the patients. Generally speaking, low average GIC ratings and low patients’ adherence to asthma treatment suggest their low cooperativity.
[THE ROLE OF LOW-FREQUENCY PIEZOTHROMBOELASTOGRAPHY IN THE COMPREHENSIVE EVALUATION OF HEMOSTASIS IN CORONARY BYPASS SURGERY WITH CARDIOPULMONARY BYPASS].
Fanaskova EV, Gruzdeva OV, Akbasheva OE … +6 more , Tyutrin II, Penskaya TY, Uchasova EG, Plotnikov GP, Krivoshapova KE, Barbarash OL
Klin Med (Mosk) · 2017 · PMID 30303352
AIM: To monitor the hemostatic system during platelet concentrate transfusions using low-frequency piezothromboelastography in patients with coronary bypass surgery given aspirin therapy. MATERIALS AND METHODS: The study...
AIM: To monitor the hemostatic system during platelet concentrate transfusions using low-frequency piezothromboelastography in patients with coronary bypass surgery given aspirin therapy. MATERIALS AND METHODS: The study involved 148 patients with coronary bypass surgery, with 76 ones undergoing intraoperative transfusion of platelet concentrate and 72 treated without transfusion. The control group consisted of 20 healthy individuals. In the perioperative period indicators of vascular-platelet, coagulation, anticoagulant and fibrinolytic components of hemostasis were evaluated by low-frequency pezotromboelastography using the ARP-01M "Mednord" hardware and software system (Russia). RESULTS: It was shown that the antiplatelet effect of aspirin in the preoperative period was manifest as inhibition of the initial stage of blood coagulation accompanied by increased thrombin potential, the total gain of anticoagulant and fibrinolytic activity of the blood. Heart-lung bypass was accompanied by structural and chronometric anticoagulation, reduction of anticoagulation and increase of blood fibrinolytic activity. In the postoperative period, structural and chronometric anticoagulation was more pronounced in patients who did not undergo transfusion of platelet concentrate than in the group of patients with transfusion. Donor platelets further increased the blood hemostatic potential by neutralizing the antiplatelet effect of aspirin. Perioperative thrombohemorrhagic complications were absent in both groups. CONCLUSION: Low-frequency piezothromboelastography provides a tool for real-time monitoring the functional state of hemostasis system. Transfusion of platelet concentrate is not advisable given that the thrombin potential is preserved as confirmed by the results of low-frequency piezothromboelastography.
[PROINFLAMMATORY CYTOKINES AND SIGNALING PATHWAYS IN PERIPHERAL BLOOD MONONUCLEAR CELLS IN PATIENTS WITH CORONARY ARTERY DISEASE].
Logatkina AV, Nikiforov VS, Bondar SS … +1 more , Terekhov IV
Klin Med (Mosk) · 2017 · PMID 30303349
AIM: To determine content of mononuclear ells (MNC) in peripheral blood of patients with coronary heart disease (CHD) and factors responsible for their functional state and cytokine production. MATERIALS AND METHODS: Con...
AIM: To determine content of mononuclear ells (MNC) in peripheral blood of patients with coronary heart disease (CHD) and factors responsible for their functional state and cytokine production. MATERIALS AND METHODS: Concentration of proteinkinases JNK1/2, ERK1/2, MAPK38, AKT1, JAK2, FAK, AMPK, p70S6K, STAT3, STAT5B and STAT6 was determined in MNC lysate by immune-enzyme assay. Interleukin 1β, 2, 4 and y-interferon levels were measured in blood sera. RESULTS: In patients with angina of effort and unstable angina, the JNK level was 59,8% and 53,1% higher than the normal one respectively (р=0,013) and (р=0,012). The level of the nuclear transcription factor was 26,9% (р=0,015) and 27,9% (р=0,017), JAK2 31,5% (р=0,022) and 48,6% (р=0,018), STAT3 49,6% (р=0,025) and 55,3% (р=0,02), STAT5B 21,5% (р=0,018) and 30,2% (р=0,011) lower. These changes were associated with a 13,1% (р=0,047) and 51,4% (р=0,019) rise in the STAT6 level, 30,1% (р=0,025) and 79,4% (р=0,003) FAK level, 7,6% (р=0,09) and 15,2% (р=0,039) АКТ1 level, 65,3 (р=0,02) and 76,2% (р=0,017) p70S6K level. CONCLUSION: Results of the study suggest persistent pro-inflammatory activation of whole blood cells in CHD patients due to enhanced levels of IL-1 and IL-2, components of the MAPK/SAPK signal pathway in MNC and decreased STAT3 level determining cell sensitivity to IL-10. The elevated intracellular level of ERK and JNK us responsible for high responsiveness of MNC to pro-inflammatory cytokines.
[CYTOKINE PROFILE IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION WITH AND WITHOUT COMPLICATIONS].
Aimagambetova AO, Karazhanova LK, Kotlyar A
Klin Med (Mosk) · 2017 · PMID 30303344
UNLABELLED: The aim of this study was to evaluate the prognostic role of the cytokine profile in patients with ST segment elevation myocardial infarction (STEMI). MATERIALS AND METHODS: In the present paper we studied cy...
UNLABELLED: The aim of this study was to evaluate the prognostic role of the cytokine profile in patients with ST segment elevation myocardial infarction (STEMI). MATERIALS AND METHODS: In the present paper we studied cytokines IL-6, IL-1β, IL-10, TNFα and CRP in 81 patients with different course of STEMI. RESULTS: In patients with complicated course of STEMI a significant increase in the concentration of IL-6, IL-10, FNOα, CRP was recorded on the 1st, 7th and 14th days compared with control group of healthy subjects and a group of patients with uncomplicated STEMI. Concentrations of TNFα>35.49 pg/ml, IL-6>33.37 pg/ml, IL-10>34 pg/ml, CRP>10.84 mg/l on day 1 may suggest cardiovascular complications in STEMI patients within 1 year after the onset of the disease. We have not found reliable prognostic levels of IL-1β, as the concentration of this cytokine remained within the accepted normal range.. DISCUSSION: It is concluded that initially elevated levels of CRP l, TNFα, IL-6, IL-10 in the blood make it possible to identify groups of patients with myocardial infarction with ST-segment elevation at high risk of cardiovascular events throughout the year.
[CHARACTERISTICS OF BONE MINERAL DENSITY IN ELDERLY PATIENTS WITH DIABETES MELLITUS].
Sergeeva VV, Dymnova SE, Bobylev VA
Klin Med (Mosk) · 2017 · PMID 30303342
Diabetes mellitus is a most important medical and social problem in Russia. Osteoarthropathy, osteopenia and osteoporosis are chronic complications of diabetes. There is no consensus on the pathogenetic mechanisms of dev...
Diabetes mellitus is a most important medical and social problem in Russia. Osteoarthropathy, osteopenia and osteoporosis are chronic complications of diabetes. There is no consensus on the pathogenetic mechanisms of development of changes of the bone tissue in this pathology. The present literature review outlines the problem.
[TRENDS IN DEVELOPMENT OF GI-SAFE ANTI-INFLAMMATORY DRUGS].
Sulaieva ON, Wallace JL
Klin Med (Mosk) · 2017 · PMID 30303341
Despite the introduction of anti-inflammatory drugs that selectively inhibit cyclo-oxygenase-2 (COX-2), and potent inhibitors of gastric acid secretion, the gastrointestinal adverse effects of non-steroidal anti-inflamma...
Despite the introduction of anti-inflammatory drugs that selectively inhibit cyclo-oxygenase-2 (COX-2), and potent inhibitors of gastric acid secretion, the gastrointestinal adverse effects of non-steroidal anti-inflammatory drugs (NSAIDs) remain a significant clinical problem. Combined use of antisecretory drugs and COX-2 inhibitors is helpful to limit the damage in the proximal gastrointestinal tract (stomach and duodenum), but it increases the risk of injury of small intestine and colon. It was proven that proton pump inhibitors and H2 receptor antagonists significantly worsen NSAID-induced small intestinal damage and microbiota balance. Nowadays, there is no proven effective preventative or curative treatment for NSAID-induced enteropathy. The new strategy of gastrointestinal protection is based on the discovery of endogenous cytoprotective molecules such as hydrogen sulfide (H₂S). H2S is a gaseous mediator that produces strong cytoprotective and antioxidant effect on the gastrointestinal tract. The role of H₂S in promoting mucosal integrity, healing of tissue injury and resolution of inflammation has been well documented. In addition, H₂S stimulates productions of other cytoprotective molecules including prostaglandins, carbon monoxide and nitric oxide. Nowadays, the new generation of H₂S-releasing non-steroidal anti-inflammatory drugs is developed and tested in clinical trials. H₂S-NSAIDs possess enhanced anti-inflammatory activity and high gastrointestinal safety.
[DESIALATED LOW DENSITY LIPOPROTEINS IN HUMAN BLOOD].
Ryzhkova AI, Karagodin VP, Sukhorukov VN … +2 more , Sazonova MA, Orekhov AN
Klin Med (Mosk) · 2017 · PMID 30303339
The present article is a review of literature on circulating low-density lipoproteins (LDLP) which can induce accumulation of lipids (mainly, cholesterol), in a SMA(+) cell culture of normal human aortic intima. An attem...
The present article is a review of literature on circulating low-density lipoproteins (LDLP) which can induce accumulation of lipids (mainly, cholesterol), in a SMA(+) cell culture of normal human aortic intima. An attempt was undertaken to resolve the paradox of the absence of both native LDLP influence on intracellular lipid accumulation and modifications of in vitro obtained LDLP in the blood-vascular system. It was showed that atherogenic LDLPs are characterized by a number of changes in carbon, protein and lipid components which can be regarded as multiple modifications of LDLP taking place in human blood plasma. Multiply modified circulating LDLP possess of capacity to interact with various cell membrane receptors differing from B and E receptor, and with proteoglycans. Marked absorption of desiliated LDLPs by the cells simultaneous with a decrease in the degradation of apolipoproteins and cholesterol esters as well as induction of peresterification of free cholesterol leads to intracellular accumulation of esterified cholesterol. Formation of large LDLP-containing complexes especially circulating low-density lipoproteins can stimulate accumulation of lipids by smooth muscle cells of intima. Desiliated LDLPs stimulated cell proliferation and connective tissue matrix synthesis despite cholesterol ester accumulation. In conclusion, the authors of this article found and characterized natural multiply modified LDLPs that can be responsible for the symptoms of atherosclerosis at the cellular level.
[DIAGNOSTIC SIGNIFICANCE OF PLASMA TROPONIN AND CARDIOMYOCYTE FATTY ACID-BINDING PROTEIN LEVELS IN ACUTE CORONARY SYNDROME].
Titov VN
Klin Med (Mosk) · 2017 · PMID 30303338
Blood serum content of fatty acid-binding (FABP) protein increases within 2-3 h after the onset of acute coronary syndrome and myocardial infarction (MI) and reaches the maximum 8.5 h after the initiation of cardiomyocyt...
Blood serum content of fatty acid-binding (FABP) protein increases within 2-3 h after the onset of acute coronary syndrome and myocardial infarction (MI) and reaches the maximum 8.5 h after the initiation of cardiomyocyte death. FABP content considerably decreases by the end of at 24-h period due to excretion with urine, remaining elevated for subsequent 24 h. High clinical sensitivity and relatively high organ specificity are typical of FABP for 12 h after ACS. Within the early period of MI clinical specificity of FABP prevails over troponin in terms of concentration. Troponins display higher clinical sensitivity and diagnostic specificity during a 12-h period after ACS, prevailing for several days after MI. Simultaneous measuring of FABP and troponins (Tr) within the first 12 h increases the sensitivity of biochemical diagnostics by 30%. At later periods, simultaneous determination of FABP and Tr becomes unnecessary: FABP is excreted with urine and Tr level acquires predominant diagnostic significance. No relationship has been revealed between blood content of FABP and reperfusion according to electrocardiography data, probably due to rare measurements of this highly dynamic parameter. FABP test cannot be used in patients with circulatory disorders since its results are not adequate. The best option for differential diagnostics of ACS within the first 24 h would be a combined express immunochromatographic test which allows to measure blood FABP and Tr levels pending objective evaluation.
[ANEMIA OF CHRONIC DISEASES AS A SYSTEMIC MANIFESTATION OF CHRONIC PULMONARY OBSTRUCTIVE DISEASE].
Budnevsky AV, Voronina EV, Ovsyannikov ES … +3 more , Tsvetikova LN, Zhusina YG, Labzhaniya NB
Klin Med (Mosk) · 2017 · PMID 30303337
Anemia of chronic disease (ACD) is one of the most frequent forms of anemia is often observed in patients with infections, cancer and chronic inflammatory or autoimmune diseases. The underlying mechanisms are complex and...
Anemia of chronic disease (ACD) is one of the most frequent forms of anemia is often observed in patients with infections, cancer and chronic inflammatory or autoimmune diseases. The underlying mechanisms are complex and include dysregulation of iron homeostasis and erythropoietin production, impaired proliferation of erythroid progenitor cells and reduced life span of red blood cells. Moreover, ACD is often superimposed by malnutrition, bleeding and renal failure. ACD is mediated through inflammatory cytokines and characterized by low serum iron (hypoferremia) and often increased reticuloendothelial stores of iron. ACD is usually normocytic, normochromic anemia, but it can become microcytic and hypochromic as the disease progresses. Hepcidin, the main regulator of iron homeostasis and its synthesis, is inhibited by iron deficiency and stimulated by inflammation. In many patients the disease is associated with several extrapulmonary manifestations regarded as the expression of the systemic inflammatory state of chronic obstructive pulmonary disease (COPD). Recent studies showed that anemia in patients with COPD is more frequent than expected, with its prevalence ranging from 8 to 33%. Systemic inflammation may be an important pathogenic factor, but anemia in COPD can also be the result of a number of factors, such as the treatment with certain drugs (angiotensin-converting enzyme inhibitors or theophylline), endocrine disorders, acute exacerbations and oxygen therapy. Anemia in COPD patients is strongly associated with increased functional dyspnea, decreased exercise capacity and is an independent predictor of mortality. Treatment options to correct anemia used in other chronic diseases, such as congestive heart failure, cancer or chronic kidney disease have not been explored in COPD (i.e. erythropoietic agents, iron supplements or combined therapy). It is not known whether treating the underlying inflammation could improve hematological characteristics. It is important to develop basic diagnostic modalities for this group of patients and formulate methods of anemia correction.
[PERSONALIZED MEDICINE IN INTERNAL MEDICINE].
Kukes VG, Marinin VF, Olefir YV … +10 more , Ramenskaya GV, Lazareva NB, Smirnov VV, Zhuravleva MV, Prokofiev AB, Shih EV, Zhestovskaia AS, Rumyantsev NA, Mandich DV, Goroshko OA
Klin Med (Mosk) · 2017 · PMID 30303336
Personalized medicine - a new direction in medicine, which is based on the study of various biomarkers and the use of new methods of molecular analysis (primarily evaluating the activity of isoenzymes of cytochrome P450)...
Personalized medicine - a new direction in medicine, which is based on the study of various biomarkers and the use of new methods of molecular analysis (primarily evaluating the activity of isoenzymes of cytochrome P450), allowing individualized approach to the selection of both the drugs and the selection of the dosing regimen for the purpose of maximize the effectiveness and safety of pharmacotherapy. This personalized medicine is to change the development and use of preventive and curative interventions. Genetic polymorphism isozymes of cytochrome P450 may determine the individual activity of a particular isozyme, and thus, to predict the clinical effectiveness, and in some cases, the risk of adverse reactions. The article is an example of the use of information on the activity of cytochrome P450 in clinical practice in matters of diagnosis, treatment and prevention of diseases. The scheme of the five best-known activity of isoenzymes of cytochrome P450 is shown.
[Landmark events in the history of medicine to be commemorated in 2017].
Klin Med (Mosk) · 2017 · PMID 30299631
Abstract loading — click title to view on PubMed.
[A critical incident during marathon competition as a result of metabolic decompensation].
Orlov YP, Govorova NV, Glushchenko AV … +2 more , Efremov EN, Vasilenko YB
Klin Med (Mosk) · 2017 · PMID 30299072
A case of polyorganic insufficiency syndrome associated with coma, convulsive disorder, acute hepato-renal and respiratory dysfunction, hypovolemic shock, and hyperthermal syndrome in a 46 year-old participant ofa marath...
A case of polyorganic insufficiency syndrome associated with coma, convulsive disorder, acute hepato-renal and respiratory dysfunction, hypovolemic shock, and hyperthermal syndrome in a 46 year-old participant ofa marathon competition is reported. The clinical picture was dominated by acute hepatic insufficiency treated with remaxol to activate substrate phosphorylation under effect of exogenous succinate for slowing down the development of energy deficit in mitochondria under condition of oxygen deficit. This case can be regarded as a variant of correction of mitochondrial dysfunction with the use of a mitochondria-targeted medication such as succinate-containing remaxol. This medication reduced AST and ALT activities and utilization of endogenous enzymes for succinate synthesis from alanine and aspartate under hypoxic conditions. Prescription of remaxol as a form of direct substitution therapy was dictated by pathogenetic considerations.
["HELICARB" - the first Russian breath test kit with 99 % C-urea for Helicobacter pylori: from idea to registration].
Plavnik RG, Rapoport SI, Plavnik KR … +2 more , Elman AR, Nevmerzhickij VI
Klin Med (Mosk) · 2017 · PMID 30299071
The present study was aimed to develop and introduce in medical practice the first Russian kit for the C-urea breath test of Helicobacter pylori. The newly created kit was given the commercial name «HELICARB» and success...
The present study was aimed to develop and introduce in medical practice the first Russian kit for the C-urea breath test of Helicobacter pylori. The newly created kit was given the commercial name «HELICARB» and successfully passed technical, toxicological, clinical, and laboratory testing. The optimal dose of 13C-urea was determined and various devices needed to perform the test were compared. The results were approved by the Federal Service for Supervision in the health sector Roszdravnadzor) that issued the Registration certificate № RZN 2016/3773 (order № 1641 of 02.29.2016), which gives the right to manufacture and use the «HELICARB» test kit at the territory of the Russian Federation.
[Medical scores in clinical practice. Part III. Heart Failure].
Belyalov FI
Klin Med (Mosk) · 2017 · PMID 30299070
Scores for heartfailure prognosis are discussed in the review. The prognostic scores may help in patients’ selection for advanced device-based treatment.
Scores for heartfailure prognosis are discussed in the review. The prognostic scores may help in patients’ selection for advanced device-based treatment.
[Pathogenesis of myocarditis in patients with bronchial asthma and pecilomycosis].
Akhunov VM, Sizova ZM, Akhunova AM … +1 more , Lavrent'eva TP
Klin Med (Mosk) · 2017 · PMID 30299069
We studied the influence of activation ofpecilomycotic infection in blood on the morphofunctional state of myocardium based on the clinical and pathomorphological data. The study included 23 patients with bronchial asthm...
We studied the influence of activation ofpecilomycotic infection in blood on the morphofunctional state of myocardium based on the clinical and pathomorphological data. The study included 23 patients with bronchial asthma (BA) concomitant with pecilomycosis after acute viral respiratory infection; protocols of autopsies and pathological sections of the heart muscle of the patients who died from asphixy and acute cardiac insufficiency were analyzed. Histological sections showed up vascular dystonia of the microcirculation bed, arteriole spasms, wall destruction in small and medium-size vessels and the adjacent muscular tissue, stromal oedema, valvular swelling, andperiwall endocarditis. Cardiac cavities and coronary vessels contained erythrocyte-rich thrombi with ferulas of Paecilomyces at different stages of development. Clinical manifestations of destructive changes in the heart muscle developing under effect of Paecilomyces infection had the form of rhythm and conductivity disorders. The local protective inflammatory reaction of productive type had the form of intermediate and vascular-type myocarditis passing to postmyocarditic cardiosclerosis. Periodic bursts of activation ofpecilomycotic infection in blood with the accumulation of fungal phospholipase A2 and lipid metabolites produced membranotoxic effect and can play the key role in the development of atherosclerosis and hypertensive disease in patients with BA and pecilomycosis.
[Dynamics of clinical, X-ray and functional data during treatment of patients with sarcoidosis].
Vizel IY, Vizel AA
Klin Med (Mosk) · 2017 · PMID 30299068
AIM: To analyze the literature data and the results of original studies on the respiratory function in patients with sarcoidosis. MATERIAL AND METHODS: The study included 1199 patients with sarcoidosis (67.8% women and 3...
AIM: To analyze the literature data and the results of original studies on the respiratory function in patients with sarcoidosis. MATERIAL AND METHODS: The study included 1199 patients with sarcoidosis (67.8% women and 32.2% of males, median age 43 years). The first X-ray stage was documented in 34.8% of patients , stage II in 57.0%, stage III in 6.1%, stage IV in 1.3%, stage 0 in 0.7%. One patient (0.1%) had pleural sarcoidosis. Loefgren syndrome was diagnosed in 20% of the patients. In 658 patients (54.9%) the diagnosis was confirmed by biopsy studies. RESULTS: The patients with sarcoidosis exhibited significant correlation between radiographic and spirometric characteristics. In those with Loefgren syndrome, all breathing parameters were much better than in the remaining ones. Changes of spirometry parameters were more pronounced in smokers and in patients with concomitant lung diseases. However, the lung function remained impaired after adjustment for these factors, and 9,7% of the cases positively responded to the administration of a short-acting bronchodilator. Х-ray examination and spirometry are independent methods for the evaluation of the health status of patients with sarcoidosis and their results do not always correlate with each other after different treatment regimens. Changes in Х-ray image and lung vital capacity were consistent in patients treated with prednisone, methotrexate and pentoxifylline, but not in the cases treated with vitamin E and in the absence of treatment. Spirometry with simultaneous X-ray examination is recommended for all patients with intrathoracic sarcoidosis. CONCLUSION: Forced vital capacity of lungs (FVC) is an independent criterion for evaluating the condition of patients with sarcoidosis and the effectiveness of the treatment.
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