Peer-review scientific medical journal


  • professor Anatoliy I. Martynov, MD, doctor of medical sciences, Academician of the Russian academy of sciences; professor of the Department of Hospital Therapy № 1, Medical Faculty of A.I. Yevdokimov Moscow State Medical and Dental University; president of Russian scientific medical society of internal medicine (RSMSIM).


  • LLC “Bionika Media”


  • Autonomous non-profit organization of additional vocational training "Training Center of Russian Scientific Medical Society of Internal Medicine"

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Aims and Scope

THERAPY – peer-reviewed scientific and practical medical journal; since 2015, it is the official publication of the Russian scientific medical society of internal medicine (RSMSIM).

The Therapy journal sets sights on contribution to the most comprehensive and complete development of national health care, medical research and education, professional development of health professionals in the research, teaching and practical work in the field of therapy and related disciplines. Each issue of journal is thematic and dedicated to a particular medical specialty (cardiology, neurology, gastroenterology, rheumatology, endocrinology, etc.). Targeted audience: therapists of outpatient and inpatient facilities, general practitioners, highly specialized doctors.

The Therapy journal publishes clinical guidelines/consensuses, original articles, reviews, clinical cases, lectures & reports, reviews of new releases in specialized literature, as well as materials about RSMSIM activities.

Current Issue

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Vol 8, No 10 (2022)


Study of macrophage infiltration of various organs’ tissues in case of COVID-19 coronavirus infection
Vishnyakov D.S., Kabirov I.R., Enikeeva K.I., Kalimullina L.I., Sadretdinova L.D., Tyurin A.V., Pavlov V.N., Kzhyskowska J.G.
Studies of the presence of macrophages in various organs and tissues in COVID-19 are fragmented and mainly limited to the study of the lungs. The aim of the study was to determine the presence of macrophage infiltration in various organs and tissues in patients with COVID-19. Material and methods. A complex pathoanatomical study of sectional material obtained after autopsies of 23 deceased patients with the main diagnosis of COVID-19 was carried out. Results. Multiple aberrant aggregations of obese CD68 positive macrophages were found, with lesions predominantly observed in the parenchyma of the lungs and kidneys. Conclusion. CD68-positive macrophages were detected in all organs studied in COVID-19 patients, with different intensity and localization of infiltration, which may indicate a single mechanism of pathogenesis in lesions of various organs in patients with this disease.
Therapy. 2022;8(10):7-12
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Course of COVID-19-associated pneumonia in patients vaccinated against COVID-19
Lysenko M.A., Poteshkina N.G., Ibragimova A.M., Krylova N.S., Kovalevskaya E.A., Karasev A.A., Svanadze A.M.
In the context of the COVID-19 pandemic, vaccination has shown high efficiency in reducing the rate of hospitalization and mortality rate of patients. The aim of the study was a complex estimation of the course of COVID-19-associated pneumonia in patients vaccinated against COVID-19. Material and methods. 220 patients with COVID-19-associated pneumonia were examined. The main group (I) consisted of patients vaccinated against COVID-19 (n=110, including 57 male persons, mean age 64,6±12,0 years), the comparison group (II) consisted of not vaccinated against COVlD-19 patients (n=110, including 56 male persons, mean age 64,8±12,8 years). Estimation of clinical, laboratory and instrumental data of patients in both groups was carried out twice: on the 10±3rd day (groups I10, II10) and on the 17±3rd day from the onset of symptoms (groups I17, II17). Results. On the 10±3rd day from the onset of symptoms, vaccinated patients were characterized by a milder clinical status, as was proved by significant differences in the scores of the SHOX-COVID scale (4 [4; 6] in group I10 vs 5 [4; 7] in II10, p=0,042) and SpO2 (95±3% in I10 vs 94±3% in II10, p=0.037). When assessing laboratory data in the group of vaccinated patients, the level of lymphocytes was higher (1,2±0,8 х 109/l versus 0,9±0,4 х 109/l, p=0,004), the level of LDH was lower (284,5±103,9 U/L vs 321,6±121,1 U/L, p=0,016) and AST (30,9 [24,2-41,1] U/L vs 38,2 [29,2-50,9] U/L, p=0,002). When comparing the volume of pulmonary parenchyma damage, there were no significant differences between the groups: 1 [1; 2] in I10 vs 2 [1; 2] in II10, p=0,317. On the 17±3rd day from the onset of symptoms, there was a difference between the groups in SpO2 level: 97 [96; 98] % vs 96 [95; 98] %, p=0,003. When comparing the dynamics of laboratory parameters, in group I, a higher level of lymphocytes remained (1,3 [0,8; 1,9] х 109/l in I17 vs 1,0 [0,7; 1,5] х 109/l in II17, p=0,009). The stage of pneumonia according to MSCT of thoracic region was significantly lower in group I, in contrast to group II: 1 [1; 2] versus 2 [1; 2], p=0,024, Conclusion. In fully vaccinated against COVID-19 patients, the course of COVID-19-associated pneumonia was characterized by less severe clinical manifestations, the absence of lymphopenia and, in dynamics, a smaller amount of pulmonary parenchyma damage.
Therapy. 2022;8(10):14-20
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Clinical and laboratory features of hospitalized patients with COVID-19 infection and coronary heart disease
Markelova O.A., Vezikova N.N., Egorova I.S., Koryakova N.V.
Results of various studies demonstrate the importance of CAD as a risk factor for poor outcomes in patients with COVID-19. The aim: to compare the clinical picture, data of laboratory and instrumental studies in COVID-19 patients with CAD and without it. Material and methods. The study included 147 inpatients from a multidisciplinary hospital with identified COVID19. They were divided into main and control groups depending on the presence or absence of coronary artery disease. Results. The average age of examined patients was 60,1 ± 15,2 years, the average duration of hospitalization was 11,0±6,7 days. The average age of patients with CAD (main group) was 67.9±9.6 years, without CAD (control group) 57,7±15,9 years. In CAD group, the incidence of obesity (BMI≥30 kg/m2) was significantly lower (17,8 vs 40,2%), and incidence of DM 2, acute myocardial infarction, atrial fibrillation and CHF was significantly higher than in the group without CAD. Also, in the main group, sinus rhythm was significantly more common (82,4 vs 95,2%) and Q wave pathology (11,8 vs 1,0%), the QT interval was longer (0,38±0,04 vs 0,34±0,08 s.), while the ejection fraction was significantly lower (47,86±12,62 vs 60,78±6,89%). The proportion of patients with COVID-19 admitted to the hospital in a severe condition was 2 times higher in the CAD group, they were more likely to experience catarrhal symptoms (28.6 vs. 19.6%) and leg swelling (11,4 vs 3,6%). In the main group, comparatively with the control group, a lower average heart rate was revealed (79,3±14,5 vs 84,6±14,9 beats/min.). The degree of lung damage according to CT of thoracic organs in the groups was approximately the same. Finally, patients with SpO2 <90% (17,1 vs 8,0%) were more than 2 times more likely to occur in CAD group, lower average blood leukocyte level (5,85±3,40 vs 7,65±4,82 x 109 g/l), higher mean sodium levels (140,56±3,83 vs 138,68±4,34 mmol/l) and PTT (44,28±27,71 vs 35,72±6,45 s.), as well as higher mortality rates (5,7 vs 1,8%) were also fixed there. Conclusion. Patients with COVID-19 in combination with CAD comparatively with patients without CAD were significantly older, more often suffered from hypertension, DM 2, acute myocardial infarction, atrial fibrillation, CHF, more often had pathological Q and QT prolongation on ECG, low ejection fraction, SpO2 <90%, leukopenia, elevated sodium levels, PTT, and urea.
Therapy. 2022;8(10):21-30
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Chronic brain ischemia in youthful age persons with undifferentiated connective tissue dysplasia
Maltseva I.V., Sheremetyeva I.I., Kotovschikova E.F., Stroganov A.E., Lukinov V.L.
Factors unfavorable for the development of chronic cerebral ischemia (CCI), such as arterial hypotension and cardiac arrhythmias due to vegetative dysregulation, blood flow disturbances in brachiocephalic vessels, anemic syndrome are often found in people with undifferentiated connective tissue dysplasia (UCTD). Clinically, the early stages of CCI occur in the form of cognitive and psychovegetative disorders, which are also UCTD characteristics. Such a biomarker as antibodies to the NR-2 peptide (NR2-At) determines the past cerebral ischemia. The aim: to study the correlation of UCTD with cerebral ischemia development in youthful age people. Material and methods. The study involved 80 persons aged 18-22 studying at the ASMU. According to the content of NR2-At, 2 groups were separated: with normal (control group, n=23) and increased (comparison group, n=57) titer of this marker. A general clinical and neuropsychological examination was carried out, markers of anemia, inflammation, neurotrophism, neurodegeneration were studied, duplex scanning of brachiocephalic vessels, electroencephalography were performed. Results. The marker of cerebral ischemia was elevated in 71% of students. Autonomic dysfunction, asthenia, anxiety, depression, headache index were higher in the comparison group. A significant increase in NR2-At was found in the group with severe UCTD. Presence of UCTD, headaches, a decrease in red blood indexes, and female sex were the predictors associated with an increase in the chances of cerebral ischemia developing. Conclusion. A correlation between the development of cerebral ischemia and severe UCTD in youthful age people has been established, so the dysplastic process correction can become an important part in prevention and treatment of CCI and non-psychotic mental disorders. Obtained results allow us to consider pronounced UCTD as an independent risk factor for the development of CCI.
Therapy. 2022;8(10):31-40
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Peculiarities of the association of bronchial asthma with obesity depending on the time of asthma debut and the possibilities of cardiovascular risk prediction in this group of patients
Anikin D.A., Solovieva I.A., Demko I.V., Sobko E.A., Gordeeva N.V., Kraposhina A.Y.
Bronchial asthma (BA) is a global medical and social problem. The incidence of asthma and obesity worldwide is steadily increasing. The aim of the study was to evaluate the clinical, pathophysiological and molecular features of various obesity phenotypes in patients with BA in order to optimize anti-asthma therapy and early diagnosis of cardiovascular complications. Material and methods. 150 asthma patients were examined. They were divided into 3 groups depending on the ratio of the onset time of asthma to obesity: «Obesity + BA» (Group 1), «BA + obesity» (Group 2), «BA without obesity» (BMI 18.5-25 kg/m2, Group 3). The comparison group consisted of 30 relatively healthy volunteers. Following parameters were studied: the degree of obesity and asthma, respiratory function parameters, lipid profile, indicators of insulin metabolism, insulin resistance and levels of adipokines in peripheral blood, level of NO in exhaled air (FeNO), cellular composition of induced sputum, values of left ventricular hypertrophy (LVH), thickness of the intima-media complex of the common carotid artery (CCA TIM). Results and conclusion. In the «Obesity + BA» group, a severe course of the disease was recorded more often (33%), which correlated with a low level of control, impaired bronchial patency, and pulmonary hyperinflation formation. In the «Obesity + BA» group, dyslipidemia, insulin resistance, and adipokines imbalance were more evident. FeNO was comparatively lower in the «Obesity + BA» group. When assessing the cellular composition of induced sputum in the Obesity + BA group, neutrophilic biotype was recorded in 39% of patients, and a small granulocytic BA biotype was recorded in 43%. In the group of patients «Obesity + BA», the highest values of LVH and CCA TIM were recorded. Identification of different phenotypes of BA associated with obesity is necessary due to the need to verify patients with high cardiovascular risks.
Therapy. 2022;8(10):41-52
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Levels of middle and low molecular weight substances in patients with Q-wave and without Q-wave myocardial infarction associated with chronic obstructive pulmonary disease
Prokofieva T.V., Polunina O.S., Sevostianova I.V., Polunina E.A., Belyakova I.S., Perova N.Y.
In recent decades, enough data has accumulated that in cases of both cardiovascular and bronchopulmonary systems, endogenous intoxication syndrome is developing. The aim: to study and analyze the level of substances of medium and low molecular weight (SMLMW) and oligopeptides (OP) in patients with myocardial infarction (MI) associated with COPD, depending on the Q-wave presence. Material and methods. 225 patients with MI were examined, including 195 persons with MI in combination with COPD. In the main group (MI + COPD), 49 persons had MI without Q-wave (non-Q-MI), and 146 had MI with Q-wave (Q-MI). In the comparison group (MI without COPD), the division was as following: 29 persons with non-Q-MI, 101 with Q-MI. The control group was represented by 110 somatically healthy individuals. The level of SMLMW and OP was determined by the method of M.Ya. Malakhova (1995) by means of direct spectrometry. Results. Among patients with myocardial infarction as a mononosology with Q-MI, higher SMLMW and OD were fixed both in plasma and in erythrocytes comparatively with non-Q-MI patients. In patients with myocardial infarction associated with COPD, the levels of SMLMW and OP were significantly higher and did not depend on the size of the necrosis focus. Index of endogenous intoxication and coefficient of intoxication showed the same laws. The levels of SMLMW and OP in the urine, both in patients with MI without COPD and in patients with MI associated with COPD, did not show dependence on the presence of the Q-wave. Among patients with MI as a mononosology in the presence of a Q-wave, more expressed phases of endogenous intoxication were recorded; among patients with MI associated with COPD, this law was not observed. Conclusion. The results of our study demonstrated that the volume of the necrosis zone affects the level of endotoxemia in the development of MI as a mononosology. In patients with combined cardiorespiratory comorbidity, COPD is the dominant cause of chronic endotoxemia, and the development of acute coronary pathology against this background only exacerbates the existing endogenous intoxication. Dysfunction of the excretory organs, which occurred in the group of patients with MI associated with COPD, is not connected with the depth of myocardial damage.
Therapy. 2022;8(10):53-62
pages 53-62 views
Risk factors for the development of various subtypes of gestational diabetes mellitus
Volkova N.I., Davidenko I.Y., Sorokina Y.A., Degtyareva Y.S.
According to modern concepts, the processes of gestational diabetes mellitus (GDM) associated with pancreatic β-cell dysfunction, insulin resistance (IR) or a combination of these factors may prevail in the basis of the formation of GSD, forming various subtypes of GDM. Identification of risk factors for the development of various subtypes of GDM in pregnant women may be important for timely verification and selection of therapy. Objective: to establish risk factors for the development of various subtypes of GDM. Materials and methods. 130 pregnant women were examined without a history of carbohydrate metabolism disorders. According to the Matsuda index, the subjects were divided into: group I 45 pregnant women with GSD and β-cell dysfunction, group II 43 pregnant women with GSD and IR, group III 42 pregnant women without GSD (control). The study examined risk factors whose contribution to the development of GSD is already well known, as well as factors that, in our opinion, can influence the development of GSD. Carbohydrate metabolism was evaluated. The data were considered statistically significant at p <0,05. Results. Pregnant women with GDM and IR are characterized by an older age at the onset of pregnancy (p=0,009), signs of acanthosis nigricans (p=0,03), the weight of the first child at birth (p=0,047), a large body weight, rarer intake of folic acid and low physical activity before pregnancy (p <0,001). Patients with GDM and β-cell dysfunction are characterized by a younger age, lack of regular MC before pregnancy (p=0,02), lower body weight and BMI (p <0,001) and more frequent use of folic acid (p=0,048). Both groups of patients were characterized by the absence of pre-gravidar preparation (p=0,03). Conclusion. We have found that in addition to the influence of the patient's age and body weight before pregnancy, low physical activity and lack of pregravidar preparation have an important contribution to the development of various subtypes of GDM.
Therapy. 2022;8(10):63-71
pages 63-71 views
Influence of secondary diabetic respiratory muscle myopathy at external respiratory function in type 2 diabetes mellitus patients
Ivanov K.M., Kunarbaeva A.K., Miroshnichenko I.V., Miroshnichenko A.I.
Diabetes mellitus (DM) has an adverse effect on the skeletal muscle system. The aim of the study is to assess changes in external respiration function in patients with type 2 diabetes having secondary diabetic myopathy. Material and methods. We examined 47 patients with type 2 diabetes (29 patients with a disease duration of less than 5 years and 18 patients with a disease duration of more than 5 years), in whom the parameters of lung ventilation and the strength of the respiratory muscles were assessed in terms of maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP). In accordance with the revealed values of changes in the strength of the respiratory muscles, patients with DM were divided into 2 subgroups: 1st 25 patients with established weakness of the inspiratory muscles; 2nd 22 patients with preserved inspiratory muscle strength. Results. In patients with DM, MIP median was 28,6% lower than in patients without carbohydrate metabolism disorders. MIP median in patients with more than 5 years of DM was 6,3% lower than the expected value, which indicated weakness of the inspiratory muscles coming with such a duration of the disease. Patients with DM had lower indicators of lung ventilation than in the comparison group. Also, lower spirometry values were observed in study participants with a duration of diabetes over 5 years relatively to patients with a shorter history of the disease and in patients with diagnosed inspiratory muscle weakness comparatively with individuals who had preserved the strength of these muscles. Performed correlation analysis revealed statistically significant positive correlations between spirometry data and MIP and MEP in the group of diabetic patients. Conclusion. Long lasting course of type 2 diabetes (more than 5 years) leads to the development of secondary diabetic myopathy, characterized by the development of inspiratory muscle weakness. With the duration of type 2 diabetes over 5 years and the occurrence of secondary diabetic myopathy, a decrease of pulmonary ventilation parameters takes place.
Therapy. 2022;8(10):72-78
pages 72-78 views
The contribution of the polymorphism of MMR 12 (rs652483) and PPARG (rs1801282) genes to the formation of NAFLD in obese patients
Shulkina S.G., Erbes P.E., Smirnov E.N.
The increase in the incidence of non-alcoholic fatty liver disease (NAFLD) among people of working age is due to the large influence of environmental factors, while the role of the genetic aspect in the formation and progression of this disease is debatable. The purpose. To study the frequency of occurrence of allele pairs by polymorphic loci of matrix metalloproteinase MMP12 (rs652483) genes and gamma receptor activated by peroxisome proliferator PPARG (rs1801282) and to determine the role of genes in the formation of NAFLD in obese women and compare with practically healthy women in Perm. Material and methods. The study included 100 obese patients who were divided into groups: group 1 (n=50) patients without NAFLD (average age 43,3±5,6 years); group 2 (n=50) patients with established NAFLD (average age 45,3±3,2 years). The control group consisted of 100 healthy women from Perm. Single nucleotide polymorphic variants of genes were determined by the method of allele-specific polymerase chain reaction using sets of genes MMP12 (rs 652483), PPARG (rs1801282). Results. Carrying the Pro12Pro genotype of the PPARG gene increases the risk of obesity by 2 times (x2=5,31, p=0,02, OR 2,05), carrying the Pro12Ala genotype reduced the risk of obesity and NAFLD by 1,7 times (x2=5,89, p=0,04, OR 0,58). Carrying the pPArG genotype Pro12Pro increases the risk of developing NAFLD in obese patients by 2,5 times. Carrying the polymorphism of the Ala12Ala genotype reduced the risk of obesity by 9 times (x2=4,23; p=0,04; OR 0,11). Carriers of the Ala12Ala genotype were associated with an increase in IGF-1 levels (p=0,024), carriers of the Pro12Pro genotype with an increase in TG levels (p=0,018). The associations of the carrier of the polymorphic position of the MMR12 gene with an increase in the waist/hip ratio (p=0,02), cystatin C (p=0,01) and MCP-1 (p=0,004) were obtained. Conclusions. In the female population carrying the PPARG gene polymorphism (rs1801282) of the Ala12Al genotype reduces the risk of obesity and metabolic disorders, carrying the Pro12 Pro genotype increases the risk of obesity and NAFLD. The carrier of the polymorphism of the MMR 12 gene (rs 652438) in women is associated with the development of abdominal obesity and systemic inflammatory response.
Therapy. 2022;8(10):79-88
pages 79-88 views
Persistent viral shedding of SARS-CoV-2 in pathogenesis of Long-COVID-19
Bolieva L.Z., Malyavin A.G., Vyalkova A.B.
The term «Long-COVID-19» refers to a condition when patients with COVID-19 suffer from long-term symptoms lasting more than 28 days from the onset of the disease. A number of mechanisms influencing the development of Long-COVID-19 are discussing, among which the most controversial is the possibility of long-term persistence of the SARS-CoV-2 virus in the body. The data currently available are insufficient to draw definitive conclusions about the persistence of SARS-CoV-2 in the body and its role in the development of Long-COVID-19, relapses and reinfection. At the same time, it is impossible to deny the importance of this factor as a reason of prolonged relapsing course of infection in some patients, primarily immunocompromised ones. The article presents currently available data on the long-term persistence of SARS-CoV-2 after the end of the acute period of COVID-19, potential risk factors for virus persistence and prolonged recurrent course of the disease
Therapy. 2022;8(10):90-97
pages 90-97 views
Cellular and molecular mechanisms of COVID-19 pathogenesis, systemic dysregulation and therapy targets
Gomazkov O.A.
Accumulated clinical experience shows that the pathogenesis of respiratory distress syndrome in patients with COVID-19 has a huge range of manifestations. The key component of this pathogenesis is endothelial dysfunction and dysregulation of multiple molecular and cellular control systems for blood coagulation, microhemodynamics, diffusion, hyperinflammation, and immunothrombosis, which is referred to in this review as «storm-2». From the viewpoint of pathophysiology, COVID-19 is a dissonance of a large number of cellular and molecular components, functional details that make up homeostasis, which, under conditions of viral aggression, work as a sequential destruction system. The processes of biochemical and cellular disorganization caused by the SARS-CoV-2 coronavirus reflect the key links in the pathogenesis of a new coronavirus infection. Identification of these links determines the search for effective approaches to the treatment of COVID-19 using both traditional and innovative curative facilities.
Therapy. 2022;8(10):98-105
pages 98-105 views
Inspection of the skin and its additives: relevance in the diagnostics of endocrine diseases
Gazdanova A.A., Lenkova N.I., Ryazantseva O.V., Solovieva S.A., Sivkov A.S., Knyazeva S.A., Plieva A.S.
The review describes in detail the skin changes and changes in the skin appendages in endocrine diseases diabetes mellitus (acanthosis nigricans, xeroderma, scleredema, diabetic rubeosis, diabetic dermopathy, lupoid necrobiosis, etc.), thyroid hyperfunction (melasma, pretibial and preradial myxedema), hypothyroidism (xerosis, myxedema), chronic adrenal insufficiency (bronze color of the skin and pigmentation of the oral cavity), Itsenko-Cushing's disease, obesity, polycystic ovary syndrome etc. Correct and timely interpretation of changes in the skin in this pathology can increase the efficiency of the treatment and diagnostic process. One of the physical methods, the inspection method, is of particular relevance in this regard.
Therapy. 2022;8(10):106-116
pages 106-116 views
Pulmonary thromboembolism in a young female patient due to the novel coronavirus infection
Larina V.N., Karpenko D.G., Serova E.N., Ryzhikh A.A., Tyazhelnikov A.A.
Article presents a case of sudden PATE after COVID-19 in a 36-year-old female patient. The patient was admitted to the cardiology department with complaints of mixed dyspnea. She had suffered from COVID-19 about a month earlier and had syncope condition the same month. After admission to the hospital, the patient was diagnosed with bilateral polysegmental interstitial pneumonia, and three days later she was discharged for outpatient treatment. Having suffered episodes of loss of consciousness three times a few days after discharge, she went to the city hospital on her own. On examination, the condition is satisfactory, body temperature is 36,8 °C, SpO2 is 91%, blood pressure is 130/70 mm Hg, pulse is 80/min. Ultrasound of the veins of the lower extremities - no signs of thrombosis. According to MSCT angipulmonography data, two days after the appeal, the patient was diagnosed with thromboembolism of the pulmonary artery and its branches. This observation allows us to conclude that the high incidence of thromboembolism in COVID-19 requires clinical vigilance regarding this complication even among young people and consideration of the appointment of anticoagulants, regardless of the treatment conditions.
Therapy. 2022;8(10):117-123
pages 117-123 views
Clinical case of mitral and tricuspid insufficiency in a patient with chronic rheumatic heart disease and arrhythmia by type of atrial fibrillation
Kobzeva N.D., Kadyan E.G., Nerusin I.I., Saybel M.D., Oleinikova V.D., Appakov G.I.
The article presents a clinical observation of a multimorbid patient who underwent mitral and tricuspid valve surgery, left atrium auricle implication and atrial septal defect suturing in conditions of artificial blood circulation. The features of approaches to the treatment of a patient with a multimorbid pathology, the features of rhythm disturbances in acquired heart defects and the frequency of occurrence of combinations of such pathologies are discussed.
Therapy. 2022;8(10):124-129
pages 124-129 views
Polycystic liver and kidney disease
Mukhametova D.D., Odintsova A.K., Kirshin A.A., Kirshina A.R., Khasanshina A.Y., Garaeva A.R., Mardanov I.A., Abdulganieva D.I.
Article presents two clinical observations of patients with associated polycystic liver and kidney disease. Their peculiarity is the presence of clinical manifestations of the disease, which, according to the literature data, is rare. Both cases had a family history of polycystic liver and kidney disease. Onset of illness in example No. 1 occurred at 76 years of age, in example No. 2 at 44 years of age. At the same time, a different outcome of the disease was fixed with the development of portal hypertension in the first case and the need for bisegmentotomy in the second. Both patients were included in the waiting list for liver transplantation.
Therapy. 2022;8(10):130-135
pages 130-135 views
Arterial hypertension and longevity
Reznik E.V., Golubev Y.Y., Zhuravlev A.K., Yurtaeva N.V., Ischenko G.Y.
Longevity is the phenomenon of increasing human life expectancy. A large number of works are devoted to the study of the processes of aging of the body and the accumulation of pathology in it. It is customary to distinguish several factors of longevity: certain stages of natural aging, factors of the external and internal environment of the body, genetic predisposition. An important factor in the reduction of life is the incidence and mortality from cardiovascular events. Prevention and treatment of cardiovascular diseases, including arterial hypertension, is a priority direction in longevity achievement.
Therapy. 2022;8(10):136-143
pages 136-143 views
Consensus of the experts of the round table «ARVI therapy in adults: traditional concepts and prospects»
Malyavin A.G., Gorelov A.V., Esaulenko E.V., Kalyuzhin O.V., Shikh E.V., Babak S.L., Pchelintsev M.V.
With the support of: Russian Scientific Medical Society of Internal Medicine (RSMSIM), Russian Association of Allergologists and Clinical Immunologists (RAACI), Society of Clinical Pharmacologists of Russia.
Therapy. 2022;8(10):144-151
pages 144-151 views
Structure of polymorbidities of the digestive diseases in patients receiving direct oral anticoagulants: results of a multicenter cross-sectional pharmacoepidemiological study
Ostroumova O.D., Orlova I.Y., Kochetkov A.I., Polyakova O.A., Listratov A.I., Shatalova N.A., Batyukina S.V.
To develop optimal strategies for protecting the gastrointestinal tract in patients using anticoagulants, and to personalize the selection of gastroprotective drugs, which can significantly differ in their mechanism of action, it is necessary to understand the structure of polymorbidities of the digestive diseases in this category of patients. Purpose: to evaluate the frequency and structure of polymorbidities of the digestive diseases in patients receiving direct oral anticoagulants (DOACs). Material and methods. A multicenter cross-sectional (one-stage) pharmacoepidemiological study was conducted (June 2021 March 2022) with the participation of 13 hospitals and 13 outpatient centers in 15 cities of Russia. The selection of patients was carried out retrospectively in accordance with the analysis of medical records and data from electronic records. Results. The study included 662 patients using DOACs. During the analysis of polymorbidities in patients, 1099 diseases of the digestive system were described, 408 (61,6%) people had one or another pathology of the gastrointestinal tract. The most common pathologies were diseases of the stomach (54,8%), esophagus (33,8%), intestines (32,2%), gallbladder and biliary tract (21,6%). Liver diseases were observed in 10,7% of patients, pancreatic pathology in 8,0%. Chronic gastritis of unspecified etiology (26,7%), atrophic gastritis (16,8%) and gastric ulcer (12,9%) prevailed among stomach diseases, while GERD and esophagitis (both 41,9%) were the most common esophageal diseases. On the part of the intestine, there was a rather high incidence of hypoand atonic constipation (22,1%) and duodenal ulcer (21,6%). 1,2% of the study participants had a history of gastrointestinal bleeding (GIB), and 38,4% had a high risk of developing GIB. Conclusion. A high incidence of polymorbidities of the digestive diseases in patients taking DOACs has been established. In this regard, it is necessary to further develop optimal strategies for protecting the gastrointestinal tract in this category of patients and to take measures to improve the awareness of doctors about the need for an appropriate approach to managing patients.
Therapy. 2022;8(10):152-161
pages 152-161 views
pages 162-165 views
From the results-2022 to the plans-2023
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Therapy. 2022;8(10):166-167
pages 166-167 views

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