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Vol 30, No 5 (2019)
- Year: 2019
- Articles: 19
- URL: https://journals.eco-vector.com/0236-3054/issue/view/5826
Articles
Optimizing a management strategy for patients with secondary AA amyloidosis
Abstract
Analysis of the data obtained in a large group of patients could present the current structure of the causes and clinical manifestations of AA amyloidosis. By using the results of estimating the levels of SAA and S100A12, the authors consider the fundamental features of amyloidogenesis in the presence of chronic inflammation, discuss the main features of the etiology and course of amyloidosis, and propose approaches to optimizing a management strategy for patients.
Vrach. 2019;30(5):3-10
3-10
Compliance in liver transplant recipients
Abstract
The paper reviews the foreign literature that gives an idea of compliance in liver transplant recipients, its level, and study methods. The data from different transplant centers on compliance in liver transplant recipients are contradictory (from 3 to 99%). Low treatment adherence in liver transplant recipients correlates with a substantial increase in late acute rejection, graft loss, and death. Possible reasons for inconsistency of data on compliance in these patients are considered.
Vrach. 2019;30(5):11-14
11-14
The frequency of MTHFR C677T polymorphism in chronic kidney disease
Abstract
The role of methylenetetrahydrofolate reductase (MTHFR) gene mutation in the progression of chronic glomerulonephritis was investigated. MTHFR C677T polymorphism was evaluated by polymerase chain reaction-restriction analysis of the amplified DNA fragments. The paper shows the prevalence of polymorphic variants in healthy individuals and patients with kidney diseases: 90 with different forms of chronic glomerulonephritis and 30 with chronic renal failure (CRF). MTHFR C677T polymorphism was found in 53% of patients with CRF (odds ratio (OR) = 1.66; p < 0.005) and in 31% of healthy individuals. There is a relationship between the MTHFR C677T polymorphism and the development of CRF.
Vrach. 2019;30(5):15-19
15-19
19-26
Combination antiviral therapy of herpes simplex
Abstract
The article describes the current aspects of epidemiology and treatment of herpes simplex. Results of non intervention scientific research combination therapy herpes simplex amoung adult patients are described. The advantages of antiviral herpes simplex therapy with inclusion of Kagocel are demonstrated
Vrach. 2019;30(5):27-34
27-34
The efficiency and safety of therapy for the main manifestations of dry eye syndrome in perimenopausal and postmenopausal women
Abstract
Peri-and postmenopausal women may develop the clinical and functional signs of dry eye syndrome (DES), which vary in severity. They are most significant in patients with severe menopausal syndrome (MS) and conform to severe DES. The signs of mild DES are accordingly observed in mild MS. In all the patients, DES is manifested chiefly by subjective symptoms according to the severity of MS. The treatment and prevention of DES in peri- and postmenapausal women are considered.
Vrach. 2019;30(5):35-40
35-40
40-46
The pathogenesis of atrophic gastritis: immunological aspects
Abstract
The features of cellular immunity in the blood of patients with atrophic body gastritis were investigated. A comparative study was conducted in 85 patients with moderate atrophic body gastritis, 25 patients with severe atrophic body gastritis, and 90 apparently healthy people at the age of 25 to 65 years who were examined. Atrophic gastritis was diagnosed, by determining serum pepsinogen-1 and pepsinogen-2 levels and morphologically examining the gastric mucosa. Cellular immunity in the blood was estimated by indirect immunofluorescence assay using monoclonal antibodies (CD3, CD4, CD8, and CD16). The serum concentration of immunoglobulins A, M, E, and G was determined by enzyme immunoassay. Patients with severe atrophic body gastritis were found to have lower levels of T lymphocytes, T helper cell subpopulations, blood CD4+/CD8+ ratios and IgA and IgG concentrations than healthy individuals. There were signs of secondary immunodeficiency manifested as a decrease in the T helper cell lymphocytes, a secondary humoral immune response, and local protection in patients with severe atrophic body gastritis as compared to the control group.
Vrach. 2019;30(5):47-50
47-50
Clinical and endoscopic aspects of gastroesophageal reflux disease in patients with rheumatic disease
Abstract
Thirty-six patients with rheumatic diseases were examined. Clinical signs of gastroesophageal reflux disease were detected in 69.4% of cases; the course of the disease was typical and atypical in 52.8 and 16.7% of patients, respectively. Gastroprotective therapy aimed at resolving the symptoms of the disease or preventing the latter was not performed in 61.1%; endoscopic changes in the mucous membrane of the upper digestive tract were detected in 86.1%, and reflux esophagitis was diagnosed in 13.9%.
Vrach. 2019;30(5):50-53
50-53
54-56
57-61
Use of recombinant coagulation factor IX in the surgical treatment of a patient with severe hemophilia B
Abstract
Hemophilia B is one of the inherited coagulopathies associated with coagulation factor IX deficiency. If there is a need for surgical treatment, patients receive replacement therapy with drugs containing IX coagulation factor. In the Russian Federation, there is a state program «Development of the Pharmaceutical and Medical Industry» for 2013-2020, aimed at increasing the production and availability of Russian vital and essential medicines, including those for the treatment of hemophilia A and B. A clinical example of the effective use of recombinant coagulation factor IX (Innonafactor, nonacog alfa, AO «GENERIUM») is described for the first time in the surgical treatment of closed right humeral mid-shaft fracture with displaced fragments in a patient with severe hemophilia B.
Vrach. 2019;30(5):62-65
62-65
The efficiency of self-monitoring the activity of a process in rheumatoid arthritis in outpatient practice
Abstract
The positive experience has been gained with self-monitoring by patients of their status in many chronic noncommunicable diseases: diabetes, hypertensive disease, asthma, etc. Such monitoring can be carried out for a long time without seeking medical advice. A methodology for self-monitoring of disease activity in rheumatoid arthritis (RA) is just coming under study; the results obtained are contradictory. The paper evaluates the efficiency of using a structured procedure for selfdetermination of RA activity by a patient at home. Two groups of patients with RA were formed. These were: 1) those who were trained in self-monitoring techniques (n = 30); 2) those who were untrained (n = 30). The follow-up lasted 6 months. The proposed procedure for self-monitoring allowed patients to monitor RA activity for 6 months after training is not worse than the traditional monthly physician monitoring, which enables it to be recommended for use in outpatient practice.
Vrach. 2019;30(5):65-69
65-69
69-72
73-76
77-78
Immediate and long-term results of Whitehead’s operation
Abstract
The immediate and long-term results of hemorrhoidectomies were assessed using the modified Whitehead procedure. The indication for this surgical treatment were grade IV circular hemorrhoids (patients who had undergone open or closed hemorrhoidectomy with preservation of mucocutaneous bridges) would be associated with leaving hemorrhoidal tissue. Twenty hemorrhoidectomies were performed using a modified Whitehead’s technique (in 12 women and 8 men; the mean age of the patients was 38.7±9.4 years; the mean follow-up period after surgery was 9.5 months). Whitehead’s hemorrhoidectomy (its traditional or modified version) is not the operation of choice for grade III-IV hemorrhoid disease; however, but in some cases it may have clear advantages over traditional procedures, i.e. it is unassociated with an increase in the frequency of postoperative complications (bleeding, suppuration, stricture, incontinence) and with the occurrence of recurrent disease.
Vrach. 2019;30(5):79-83
79-83
The efficiency of methods for the diagnosis of acute appendicitis
Abstract
The diagnostic efficacy of abdominal laparoscopy and ultrasonography was retrospectively in patients who had been hospitalized with a diagnosis of acute appendicitis. Only laparoscopy was used in the period of 2001 to 2003; laparoscopy and ultrasonography were performed in 2015 to 2017. It was shown that the quality of prehospital diagnosis of acute appendicitis became worse; the use of abdominal ultrasonography could reduce the number of laparoscopies from 26.1 to 6.8% (p < 0.05).
Vrach. 2019;30(5):83-84
83-84
Differential diagnosis of salivary gland tumors: a new approach
Abstract
The efficiency of using magnetic resonance imaging in the differential diagnosis of salivary gland tumors was evaluated. Significant differences in the value of the measurable diffusion coefficient was found between malignant tumors and pleomorphic adenoma (p < 0.001), adenolymphoma (p < 0.01), and lymphangioma (p < 0.01).
Vrach. 2019;30(5):85-87
85-87