Vol 31, No 11 (2020)

The article contains up-to-date data on the history of influenza and its types. Differential diagnostic criteria for influenza and severe acute respiratory syndromes are presented. Evidence-based data on the etiotropic and symptomatic treatment of influenza. Measures of specific and non-specific prevention of the disease are described. Some aspects of flu vaccination are considered.

The data of epidemiological studies suggest that there is an increase in the number of patients with osteoporosis. This disease affects about 14 million people and another 20 million ones have decreased bone mineral density that corresponds to osteopenia. Osteoporosis occupies the fourth place in prevalence (just after cardiovascular diseases, cancer, and diabetes mellitus). Each year in the United States, there are >1.5 million osteoporotic fractures, including 700,000 vertebral body fractures. The social significance of osteoporosis is determined by its consequences (fractures of the vertebral bodies and peripheral skeleton bones), leading to large material treatment costs, disability, and death. The article describes in detail current diagnostic techniques in osteoporosis: spondylography, dual-energy X-ray absorptiometry, X-ray computed tomography, ultrasound densitometry, and magnetic resonance imaging. It details the advantages and disadvantages of each technique, as well as methods for the treatment and prevention of osteoporosis.

In view of the insufficient efficiency of the currently known procedures to treat patients with atopic dermatitis (AD), there is a need to search for new approaches to solving this problem. Objective: to elaborate a therapeutic approach to treating patients with AD on the basis of combination use along with basic agents, as well as a drug from the group of regulatory peptides (such as Selank) and combined phototherapy (CPT). Subjects and methods. A group of 124 patients (mean age, 23.70±6.06 years) underwent a comparative evaluation of the efficiency of basic drug therapy (BDT) for AD, by additionally using the regulatory polypeptide Selank and CPT (narrowband medium-wave and broadband long-wave radiation (UVB-311 nm/ UVA-320-400 nm)), as well as combinations thereof. Results. The combined use of BDT, Selanka, and CPT revealed the potentiation of the clinical effects of the therapeutic procedures used. At 1-year follow-up, the relative risk reduction in disease recurrence was 36% in the Selank + BDT group, 42% in the CPT + BDT group, and 78% in the Selank + CPT + BDT group, as compared to the BDT group. Conclusion. The developed treatment option provides the most effective reduction (78.8%) in the severity of cutaneous manifestations of AD, as shown by the SCORAD index, a 64.7% improvement in quality of life, and a 78% relative risk reduction in disease recurrence, as compared to BDT results.

One of the most frequent complications after reconstructive plastic surgery for breast cancer with the use of a silicone endoprosthesis is the formation of a capsular contracture. Its occurrence is associated with the body's response to a foreign body, which leads to the formation of fibrous tissue around the implant. Subsequently, this complication can lead to discomfort, pain syndrome and an unsatisfactory aesthetic result.

Acute surgical diseases of the abdominal organs are a cause of peritonitis in most cases. The statistical data vary slightly; however, about 4% of peritonitis cases are classified as those due to other causes. We were unable to find data in the available literature on the frequency, with which the cause of peritonitis is a burst of retroperitoneal abscesses, renal ones in particular, into the free abdominal cavity. A female patient with multiple renal abscesses complicated by purulent peritonitis was treated in our clinic.

During the beginning of the pandemic, when a patient with lung damage was admitted to a hospital unit of pulmonology, the algorithm of a physician’s actions included diagnosis of coronavirus infection (COVID-19), determination of the severity of condition, and hospitalization decision. Objective: to study the severity of condition in patients with lung damage and a high probability of the novel coronavirus infection and the timing of referral to the general hospital’s unit of pulmonology during the beginning of the pandemic. Subjects and methods. According to the hospital admission time after disease onset, the investigators formed 2 groups: 1) less than 7 days after disease onset (n = 94); 2) more than 7 days (n = 49). Reverse transcriptase polymerase chain reaction (RT-PCR) and chest computed tomography (CT) were used to diagnose lung damage with a high probability of COVID-19 infection. Results. The majority of patients were admitted within the first week after the onset of symptoms (66%), while 55% of cases had moderate disease. The swabs positive for SARS-CoV-2 were 32%. At the initial stage of the novel coronavirus (COVID-19) infection pandemic, there were no significant differences in lung damage with negative and positive PCR test results for SARS-CoV-2. By taking into account the commonness of manifestations in lung damages, the patients with a negative PCR test for SARS-CoV-2 were diagnosed with the novel coronavirus COVID-19 infection that was highly probable by CT, which allowed a decision to transfer a healthcare facility to the operating mode of a coronavirus hospital.

The aim of present investigation was to study the role of different diagnostic criteria of phenotypes and their correlation with diseases and states associated with alimentary-constitutional obesity in females. Methods. There were examined 273 females with over weight and alimentary-constitutional obesity. Examination included anthropometry, measurement of blood pressure (BP), laboratory tests. All patients were separated on 4 groups depending on age and phenotype:1-st patients with normal sensitivity to insulin and without other characteristics of MS (30%); 2-nd - females with the resistance to insulin and without MS characteristics (15%); 3-d included patients with the insulin resistance and MS characteristics (37,8%); 4-th group - females with MS and normal sensitivity to insulin (17,2%). Results. Cardiovascular risks and phenotype of obesity are mostly determined by sensitivity to insulin and MS characteristics (triglycerides level, Cholesterol of high density and WC). Insuline resistance, already presented at young age, in 50% is accompanied by fat hepatitis, elevation of cholesterol total, Cholesterol of lipoproteines, leptine blood level and is a risk factor of development of MS on oldery. Metabolic syndrome, presented without insulin resistance, should be attributed to non-healthy obesity, because it increases cardio-vascular risk and in these patients fat hepatitis and hormonal and metabolic disbalances are confirmed more often.

Objective. To develop a predictive model to assess the risk of a first noncardioembolic ischemic stroke (IS). Subjects and methods. A case-control study enrolled 412 participants aged 45 to 80 years, including 206 patients who had experienced a first noncardioembolic IS and 206 healthy volunteers who had not and were matched for gender and age to those in the study group. In all the participants of the investigation, their blood was taken from the cubital vein in the morning on an empty stomach after 12-hour fasting, and was estimated using the concentrations of markers, such as glucose, insulin, total cholesterol, low- and high-density lipoprotein cholesterol, triglycerides, apolipoproteins B and A1, homocysteine, C-reactive protein, interleukins 1, 4, 6, 8, and 10, vascular endothelial growth factor A, tumor necrosis factor-а, adiponectin, uric acid, N-terminal propeptide of natriuretic hormone, creatinine, and cystatin C. All the participants underwent genotyping of 25 single nucleotide polymorphisms (SNPs): APOE (rs7412, rs429358, rs5174), APOA5 (rs34282181, rs619054), APOC4 (rs1132899), APON (rs4581), LPL (rs199675233), LPL (rs199675233), LP(a) (rs41267817), APOB (rs1042031, rs676210), APOD (rs7659), ANGPT4 (rs1044250), TNF-α (rs1800620), VEGFA (rs62401172), IL8 (rs1803205), IL6 (rs56383910), MTHFR (rs1801131, rs1801133), ADIPOQ-AS1 (rs17366743, rs185847354), ADIPOR2 (rs12342), GRM1 (rs1047005), GRM3 (rs2228595), and BDNF (rs6265). Analysis of allele recognition by a polymerase chain reaction assay using the ready-made TaqMan probes with Assey ID identification number (Applied Biosystems, USA). Results. The resulting model included the following independent variables: type 2 diabetes mellitus (DM2), adiponectin, ApoA1, IL6, ADIPOQ (rs17366743). The area under the curve (AUC) (95% confidence interval) was 0.947 (0.918; 0.976), the cut-off threshold was 0.565, while the sensitivity of the model was 87.1%, the specificity was 90.3%; the percentage of correct reclassification was 88.7%. Conclusion. The resulting predictive model includes clinical, biochemical, and molecular genetic parameters and is characterized by the high sensitivity, specificity, and accuracy of reclassification.