bluuebunny/crossref_metadata_2025 huggingface dataset:
Review of current and future directions of antiviral therapy of influenza and acute respiratory viral infections in Russia
Authors: Pshenichnaya N Y , Bulgakova V A , Volchkova E V , Kareva E N , Selkova E P , Gorodin V N
Published: June 2020

Aim: to determine the perspectives for the use of drugs with combined antiviral, anti - inflammatory and immunomodulatory activity on the basis of medical studies of existing antiviral drugs for the treatment of influenza and acute respiratory viral infections in Russia. Materials and methods. A brief review of the antiviral drugs used in Russia for the treatment of influenza and acute respiratory viral infections was conducted on the basis of 37 articles published in Scopus, Web of Science (WoS), and RSCI databases in the period from 1997 to 2018. Results. Resistance to neuraminidase inhibitors (oseltamivir, zanamivir), is slowly developing due to the mutations of the neuraminidase gene H275Y and Q136K. Most influenza A viruses remain resistant to adamantane antivirals. Repeated use of immunomodulators with indirect antiviral action leads to a hyporeactivity of the immune system and, subsequently, to a decrease in their effectiveness. Positive clinical and laboratory data in clinical trials were obtained using Enisamium iodide, a drug with combined action - direct antiviral, and immunomodulatory. Conclusion. According to the WHO strategy, the results of the review demonstrate the need for continued research of medications with combined antiviral and pathogenetic effects on the infectious process caused by influenza and acute respiratory viral infections.
Peculiarities of heart risk in patients with non - alcoholic fatial liver disease
Authors: Mosina L M , Stolyarova V V , Esina M V , Titojkina Yu V , Korobkov D M
Published: June 2020

Aim. The purpose of the study is to assess the characteristics of heart risk variability in patients with non - alcoholic fatty liver disease (NAFLD). Materials and methods. The study included 103 patients. All patients were divided into three groups. The first group is 34 healthy patients. The second group - 34 patients with a diagnosis of coronary artery disease; exertional angina II-III FC. The third group - 35 patients diagnosed with NAFLD and type 2 diabetes. An assessment of abdominal circumference, body mass index, ALT, AST, XC, HDL, LDL, TG, glucose and the level of glycated hemoglobin (HbA1c), liver ultrasound and daily ECG monitoring with the determination of HRV were evaluated. Evaluated HRV using statistical analysis: avNN, ms; pNN 50%; SDNNidx, ms; SDNN, ms; SDNNidx, ms; RMSSD, ms. HRV characteristics were evaluated: VLF, LF, HF, LF/HF. Results. Compared with the first group, the increase in cholesterol in patients in the second group was noted by 38.8%, in the third group - by 43.7%, TG - by 34.6 and 41.95%. In patients with NAFLD + DM of the second type, SDNN and SDNNidx decreased in comparison with the healthy patients by 15% (p
Hyperuricemia, gout and high cardiovascular risk - how to manage them in clinical practice
Authors: Fomin V V , Morosova T E , Tsurko V V
Published: June 2020

In recent years, the relationship of hyperuricemia and gout with a high risk of cardiovascular disease has been widely discussed. Therefore, it is important to systematically examine patients in order to diagnose comorbidities, among which cardiovascular disease and its complications occupy a leading place and consider mandatory treatment of patients with hyperuricemia and gout with high cardiovascular risk with lowering drugs, which fully reflects the provisions of the latest European recommendations for the management and treatment of patients with gout.
Peripheral nervous system lesion in systemic vasculitis - issues of diagnosis and treatment
Authors: Golovach I Yu , Yehudina Ye D
Published: June 2020

Vasculitis is a clinically diverse group of diseases with histopathological signs of blood vessel inflammation, which contributes to vascular damage and ischemic damage to the affected tissues. Vasculitic neuropathy is a common complication of the primary systemic vasculitides, such as polyartertis nodosa and antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis, systemic diseases of the connective tissue - systemic lupus erythematosus and Sjogren syndrome, vasculitis associated with infection, most often viral hepatitis C and B and non - systemic vasculitis neuropathy. Vessels of medium and small caliber are involved in the pathological process in these diseases. With all vasculitis, except for those caused by the direct effect of the infectious trigger on the blood vessel walls, the main pathogenetic mechanism is an autoimmune process with the development of vasa nervorum vasculitis - small arteries and vessels that supply peripheral nerves, and the outcome - nerve ischemia. The classic clinical presentation is an acute or subacute painful multifocal neuropathy that has a predilection for the lower extremities, affects two or more named nerves, and progresses in a step wise manner. However, vasculitic neuropathy can manifest in a variety of ways, including asymmetric polyneuropathies and distal symmetric sensory neuropathies, and it also can be slowly progressive, particularly in cases of nonsystemic vasculitic neuropathy (NSVN), a form of vasculitis that clinically remains restricted to peripheral nerves. Nerve biopsy can help establish the diagnosis of a systemic vasculitis, particularly when other organ involvement is not clinically apparent, and is required for diagnosis of NSVN. Neuropathy due to systemic vasculitis should be treated in accordance with the recommendations for the treatment of the underlying disease. In NSVH, the main medicine of choice are glucocrticoids, and in severe/progressive cases, pulse therapy with cyclophosphamide.
Intravascular ultrasound with virtual histology in assessment of atherosclerotic plaque composition in patients with coronary artery disease and type 2 diabetes mellitus
Authors: Zakharov A S , Michurova M S , Terekhin S A , Kalashnikov V Yu , Smirnova O M , Shestakova M V , Dedov I I
Published: June 2020

Type 2 diabetes mellitus (T2DM) is a serious medical and social problem leading to early disability of patients and high mortality from cardiovascular complications. The development of cardiovascular events is associated not only with the degree of coronary artery stenosis, but also with the structure of the atherosclerotic plaque. Aim. This study aimed to characterize structure and composition of coronary artery atherosclerotic plaque in target lesion of T2DM patients and patients without diabetes using intravascular ultrasound (IVUS) and IVUS with virtual histology (IVUS-VH). Materials and methods. We observed 25 patients with coronary artery disease (CAD) with T2DM and without T2DM, which admitted to Endocrinology Research Centre to perform percutaneous coronary intervention (PCI). Patients with CAD and T2DM were included at group 1 and patients with CAD and without T2DM were included at group 2. IVUS and IVUS-VH assessment of target lesion were performed prior to stent implantation. We observed 24 plaques at group 1 and 10 plaques at group 2. Results. In grey - scale IVUS 2D analysis there were no differences in mean cross - sectional area of the vessel (12.5 [10.4; 15.8] mm2 vs. 13.5 [12,7; 16.5] mm2; p=0.223, respectively) and lumen area (3.71 [2.5; 4.5] mm2 vs. 3.2 [2.7; 3.8] mm2; p=0.589, respectively). Plaque burden were higher in patients without T2DM (71.6 [65.5; 75.7] % vs. 77.6 [74.4; 80.4] %; p=0.008, respectively). IVUS-VH analysis showed that percent of necrotic core and dense calcium areas were significantly higher in the T2DM group (31.3 [25.3; 36.5] % vs. 21.65 [14.3; 27.8] %; p=0.01 and 4.7 [2.3; 7.8] % vs. 2.45 [1.2; 4.05] %; p=0.046, respectively). Percent of the fibrotic tissue were higher in non-T2DM group (55.35 [49.7; 63.6] % vs 67.7 [61.8; 76.5] %; p=0.004, respectively). There were no differences in percent of lipidic tissue in both groups. Conclusions. IVUS-VH assessment of coronary artery atherosclerotic plaques showed greater amount of necrotic core and dense calcium in patients with T2DM compared to patients without diabetes.
Features of central hemodynamics in patients with community - acquired pneumonia depending on the course of the disease and cardiovascular comorbidity
Authors: Titova O N , Kuzubova N A , Aleksandrov A L , Perley V E , Volchkova E V , Baryshnikova K A
Published: June 2020

Aim. The study of intracardiac hemodynamics and blood flow in the pulmonary circuit in patients with community - acquired pneumonia, depending on the presence of concomitant pathology of the cardiovascular system and the severity of the pathological process. Materials and methods. In 43 patients with community - acquired pneumonia (22 men, 21 women, mean age 67±17 years), the functional state of pulmonary - cardiac hemodynamics was assessed by echodoplerography. All subjects were divided into 2 groups: 1st group - 25 patients with community - acquired pneumonia (mean age 49±18 years) without concomitant pathology of the cardiovascular system and 2nd group - 18 patients with community - acquired pneumonia (mean age 70.1±11 years) with concomitant cardiovascular disease. Results. The main ultrasound parameters did not differ from the normal values in patients from the 1st group. In patients from the 2nd group there was a significant deterioration of several pulmonary - cardiac hemodynamics parameters, decrease of left ventricular ejection fraction, significant myocardial hypertrophy of the left ventricle and left atrium size increase. Regarding the right heart chambers it was revealed dilatation of the right ventricle, increasing of the estimated systolic pressure in the right ventricle, deterioration of right ventricle myocardial diastolic function, increase of the: RV/LV size ratio, LV eccentricity index, RV myocardium thickness, diameter of the pulmonary artery, velocity of pulmonary regurgitation and the area right atrium size. In addition, the amplitude of systolic displacement of the tricuspid valve ring and the intensity of inspiratory collapse of the inferior vena cava decreased. Correlation analysis of clinical and laboratory parameters, which are markers of endogenous intoxication, oxygen saturation of arterial blood (SpO2), separately for two groups of patients with community - acquired pneumonia, showed a reliable correlation with a number of informative and used in the practice echocardiography parameters of pulmonary cardiac hemodynamics, characterizing systolic (systolic movement amplitude of the tricuspid valve ring - TAPSE), as well as diastolic function (E/A of the right ventricle) of the heart. Conclusion. The relationship between the severity of pulmonary - cardiac hemodynamics disturbances in patients with community - acquired pneumonia, having comorbid pathology, contributing to the deterioration of pulmonary - cardiac hemodynamics and more severe course of the disease with markers of the inflammatory process and oxygen saturation of arterial blood decrease is revealed.
The clinical status and treatment options for osteoarthritis in patients with frailty
Authors: Naumov A V , Khovasova N O , Moroz V I , Tkacheva O N , Shavlovskaya O A
Published: June 2020

Aging is an independent risk factor for the development of many diseases and geriatric syndromes. Osteoarthritis (OA), as the most common joint disease in the elderly, can be attributed to age - associated conditions. And the most significant geriatric syndrome, which dramatically affects the management and prognosis of an elderly, is frailty. The review provides current information on the prevalence of OA and frailty, their clinical and prognostic significance, and also shows the mutually aggravating role of these two conditions. The difference between non - and medication management of patients with OA and frailty is emphasized.
The concept of chronic obstructive pulmonary disease clinical control as a decision - making tool in real clinical practice for optimizing of basic pharmacotherapy
Authors: Avdeev S N , Aisanov Z R , Belevsky A S , Beeh K M , Vizel A A , Zyryanov S K , Ignatova G L , Kostikas K , Leshchenko I V , Ovcharenko S I , Sinopal’nikov A I , Titova O N , Shmelev E I
Published: June 2020

The main goals of COPD therapy are to achieve clinical stability with minimal clinical manifestations and low risk of relapse. The proposed COPD control concept by analogy with asthma has not been quite well characterized yet. COPD control is defined as "the long - term maintenance of a clinical situation with a low impact of symptoms on the patient’s life and absence of exacerbations." The situation of clinical control in COPD is considered desirable and potentially achievable for most patients with COPD. Pharmacotherapeutic options for COPD are constantly expanding. The control concept may be useful when the decision on treatment of COPD is made for dynamic adjustment of the therapy volume.
Etiology of severe community - acquired pneumonia in adults: results of the first Russian multicenter study
Authors: Zakharenkov I A , Rachina S A , Dekhnich N N , Kozlov R S , Sinopalnikov A I , Ivanchik N V , Yatsyshina S B , Elkina M A , Archipenko M V , Gordeeva S A , Lebedeva M S , Portnyagina U S
Published: June 2020

Aim: to study the etiology of severe community - acquired pneumonia (SCAP) in adults in Russian Federation. SCAP is distinguished by high mortality and socio - economic burden. Both etiology and antimicrobial resistance are essential for appropriate antibiotic choice. Materials and methods. A prospective cohort study recruited adults with confirmed diagnosis of SCAP admitted to multi - word hospitals of six Russian cities in 2014-2018. Etiology was confirmed by routine culture of blood, respiratory (sputum, endotracheal aspirate or bronchoalveolar lavage) and when appropriate, autopsy samples, urinary antigen tests (L. pneumophila serogroup 1, S. pneumoniae); real - time PCR for identification of “atypical” bacterial pathogens (M. pneumoniae, C. pneumoniae, L. pneumophila) and respiratory viruses (influenza viruses A and B, parainfluenza, human metapneumovirus, etc.) was applied. Results. Altogether 109 patients (60.6% male; mean age 50.8±18.0 years old) with SCAP were enrolled. Etiological agent was identified in 65.1% of patients, S. pneumoniae, rhinovirus, S. aureus and K. pneumoniae were the most commonly isolated pathogens (found in 43.7, 15.5, 14.1 and 11.3% of patients with positive results of microbiological investigations, respectively). Bacteriemia was seen in 14.6% of patients and most commonly associated with S. pneumoniae. Co - infection with 2 or more causative agents was revealed in 36.6% of cases. Combination of bacterial pathogens (mainly S. pneumoniae with S. aureus or/and Enterobacterales) prevailed - 57.7% of cases; associations of bacteria and viruses were identified in 38.5% of patients, different viruses - in one case. Conclusion. S. pneumoniae was the most common pathogen in adults with SCAP. A high rate of respiratory viruses (mainly rhinovirus and influenza viruses) identification both as mixt infection with bacteria and mono - infection should be taken into account.
The possibilities of using levosimendan in medical preparation to Coronary Artery Bypass Grafting in coronary artery disease patients with low left ventricular ejection fraction
Authors: Gazizova V P , Vlasova E E , Dzybinskaya E V , Gramovich V V , Stukalova O V , Shiryaev A A , Akchurin R S
Published: June 2020

Aim: to work out an approach of preoperative drug preparation for CAD patients with low LVEF and varying degrees of compensation for CHF, to study the possibility of using levosimendan (L) in this preparation. Materials and methods. We studied 82 patients with severe angina pectoris, multivascular coronary disease, extensive postinfarction zone, LVEF ≤35%, chronic heart failure and proven viable myocardium, which performed CABG. All patients received long - term standard CHF therapy before surgery: loop diuretic, ACE/ARA, beta - blocker, aldosterone antagonist. In the first, retrospective part of the study (39 pts), it was determined which factors could be associated with perioperative AHF. In the second, prospective part (43 pts), the course of the operation and the early postoperative period in patients with compensated and uncompensated heart failure were compared; uncompensated pts received L 2 days before surgery in addition to standard therapy. The third, retro - prospective part of the study (37 pts) was the assessment of operation outcome in patients only with uncompensated pre - operative CHF, but with different preoperative drug preparation. Results. Statistically significant direct influence on the perioperative AHF development was provided by the combined clinical sign - venous pulmonary congestion+orthopnea (p
Evaluation of the effectiveness of differentiated therapy of non-alcoholic fatty liver disease
Authors: Vakhrushev Ya. M. , Suchkova E. V. , Lukashevich A. P.
Published: June 2020

Aim.Study of the effectiveness of differentiated therapy of non-alcoholic fatty liver disease taking into account the clinical and pathogenetic features of its course. Materials and methods.168 patients with non-alcoholic fatty liver disease were examined, 108 of them were women and 60 men aged from 30 to 70 years. For treatment, depending on the characteristics of the course of the disease, 3 groups of patients were formed. The first group included patients (n=47) with liver steatosis with a high content of lipids in the blood and an increased atherogenic coefficient; they received therapy with ursodeoxycholic acid with atorvastatin. The second group consisted of patients (n=65) with liver steatosis with an increased level of glycemia, insulin and insulin resistance, they were prescribed therapy with ursodeoxycholic acid and metformin. Patients of the third group (n=56) with steatohepatitis with concomitant bacterial overgrowth received еssentiale forte H therapy with rioflora immuno. Clinical data, blood biochemical parameters, insulin and HOMA-IR levels, intestinal microbiota status, as well as regression of liver steatosis and steatohepatitis were evaluated in the dynamics of treatment. Results.In the dynamics of treatment, there was a decrease in the clinical manifestations of the disease in all observed groups of patients, an improvement in lipid metabolism and indicators of the functional state of the liver, a decrease in excessive bacterial growth. On the basis of ultrasound, elastography and fibrotest, the reverse development of liver steatosis was found in 20% and steatohepatitis in 66.6% of patients. Conclusion.The data obtained indicate the feasibility of differentiated treatment of patients with non-alcoholic fatty liver disease depending on thecharacteristics of its course and stage.
General and particular issues of etiopathogenesis of peptic ulcer and gastric cancer: current status of the problem
Authors: Osadchuk A. M. , Davydkin I. L. , Gricenko T. A. , Osadchuk M. A.
Published: June 2020

The development of peptic ulcer (PU) and gastric cancer (GC) is the result of the interaction of various internal and external factors. Moreover, if the role ofHelicobacter pylori(H. pylori) in the development of diseases of the stomach is fully established, the significance of many other factors continues to be discussed. Serious controversy is caused by the participation of various strains ofH. pyloriin the development of PU and GC. First of all, these are Vac- and Cag-positive strains ofH. pylori. The role of genetic human polymorphism in the development of this pathology is debatable. Especially the interleukin genes and necrotizing tumor factor alpha. The role of environmental factors in the formation of PU and GC is not fully understood. So, the role of alcohol, occupational hazards and drugs in the development of these diseases continues to be discussed. Further study of risk factors for various diseases of the stomach will optimize their prevention and treatment. The review presents a modern view of individual issues in the pathogenesis of PU and GC.
The long-term prospective study of patients with liver cirrhosis after elimination of the hepatitis C virus
Authors: Nabatchikova E. A. , Abdurakhmanov D. T. , Nikulkina E. N. , Rozina T. P. , Tanaschuk E. L. , Nikiforova N. V. , Adonyeva V. S. , Moiseev S. V.
Published: June 2020

Aim.To study liver function and portal hypertension, incidence and risk factors of liver-related complications, including hepatocellular carcinoma (HCC), in patients with HCV-related liver cirrhosis achieved sustained virologic response (SVR) after direct-acting antiviral therapy.
Materials and methods.Patients with HCV-related liver cirrhosis were followed up after achievement SVR with assessment of liver function parameters, portal hypertension, Model for End-stage Liver Disease (MELD) and Сhild Pugh (CP) scores, complications development, including HCC, every 36 months. The median follow-up duration was 24 [18; 30] months after end of treatment.
Results.At last observation, a number of cirrhotic patients with CP class A increased from 72% to 85%, with CP class B reduced from 23.5% to 12.5%, with CP class C from 4.5% to 2.5%. In 89% patients were identified a regress of liver fibrosis (from 23.5 [16.9; 28] to 15.0 [10.2; 21.3] kPa,p0.005), each third patient reduction of fibrosis stage to F2/F3. In 19 (9.5%) patients were occurred liver-related complications, including HCC (in 9 patients). Baseline high total bilirubin level (34 mol/l) (Hazard ratio (HR) 11.5, 95% confidence interval (CI) 2.357.8,р0.005) and ascites (HR=17.6, 95% CI 2.1144.8,p=0.008) were independent risk factors associated with HCC development.
Conclusion.The risk of HCC development remains in patients with HCV-related liver cirrhosis, despite on eradication of hepatitis C virus. Therefore, these patients should continue to undergo more intensive examination (ultrasound examination and determination of alfa-fetoprotein level each 36 months), including contrast-enhanced methods of imaging, the frequency of which should be determined.
Pharmacological and clinical feature of rebamipide: new therapeutic targets
Authors: Zvyaglova M. Yu. , Knyazev O. V. , Parfenov A. I.
Published: June 2020

Rebamipide is a cytoprotector developed in Japan where it has been successfully used for the treatment of stomach diseases for 30 years. Initially discovered effects of the drug included the induction of prostaglandins and the elimination of free oxygen radicals. Recent studies discovered new therapeutic targets of the drug, its new forms that made possible using rebamipid for the treatment of such diseases as NSAID enteropathy, ulcerative colitis, radiation colitis, pouchitis, enteropathy with impaired membrane digestion. It is used in endoscopy, ophthalmology, chemotherapy, rheumatology. The aim of this review is to present current information about the pharmacological and clinical feature of rebamipide and to study its therapeutic potential.
The cough variant asthma
Authors: Uryasjev M. O. , Ponomareva I. V. , Bhar M. F. , Glotov S. I.
Published: June 2020

Cough variant asthma (CVA) was first described by W. Corrao. CVA was described as the isolated chronic cough as the only presenting symptom responsive to bronchodilator therapy.This phenotype of asthma is present with airway hyperresponsiveness, eosinophilic inflammation airways and bronchodilator responsive coughing without typical manifestation of asthma such as wheezing or dyspnea. CVA shares common features with classic asthma such as eosinophilic inflammation and airway remodeling. Because of that, CVA is clinically considered as a variant type of asthma.
Clinical and diagnostical value of 24-hour arterial stiffness monitoring in patients with bronchial asthma
Authors: Karoli N. A. , Zarmanbetova O. T. , Rebrov A. P.
Published: June 2020

Aim. To evaluate 24-hour dynamics of the arterial stiffness main indicators in patients with bronchial asthma of various severity and control.
Materials and methods. The study included 119 patients with bronchial asthma, who formed main groups: the first group 48 patients with mild and moderate asthma, the second 71 patients with severe asthma. All patients underwent the vascular stiffness parameters study using a multifunctional complex for the 24-hour monitoring and office measurements of blood pressure and vessels condition. At the same time vascular stiffness indicators were examined: PWVao pulse wave velocity in the aorta (m/s); Aix augmentation index (%); ASI the arterial stiffness index (mmHg).
Results. When comparing the 24-hour arterial stiffness dynamics indicators, changes were found in patients with severe asthma and non-control. Thus, a statistically significant increase in the pulse wave velocity in the aorta and augmentation index in second group compared to patients of the 1st group and control subjects. In patients with severe asthma Aix at night is significantly higher than daytime, which indicates an increase in arterial stiffness at night.
Conclusions. Patients with severe bronchial asthma have increased arterial stiffness in comparison with controls and mild and moderate asthma. Also, in patients with severe asthma arterial stiffness parameters were higher at night-time in comparison with daytime.
The «obesity paradox» and its degree of proof
Authors: Miklisanskaya S. V. , Mazur N. A. , Solomasova L. V. , Chigineva V. V.
Published: June 2020

The article gives a critical assessment of the so-called obesity paradox. Methodological errors that occur in the organization of studies that studied the obesity paradox and the formation of comparison groups are highlighted. There are also examples of the disappearance of the obesity paradox when taking into account additional risk factors. The organization of prospective studies or more careful consideration of all currently known risk factors for cardiovascular diseases (CVD) will significantly improve the results of the study of the effect of overweight and obesity on mortality in patients with CVD. Thus, despite the biological possibility of the existence of a positive effect of adipose tissue in CVD, the presence of a large number of errors identified in the analysis of the work of researchers obesity paradox require to reconsider the existence of this phenomenon, it should be taken into account the possibility that the obesity paradox may be a consequence of improper design studies to investigate this phenomenon.
Safety and clinical-cost effectiveness of percutaneous coronary interventions with overnight hospitalization
Authors: Basinkevich A. B. , Matchin Yu. G. , Ageev F. T.
Published: June 2020

New methods and treatment plans for patients with chronic coronary artery disease after endovascular interventions are currently introduced into clinical practice. It allows reducing hospital stay down to 24 hour, with discharge the next morning. This approach is called overnight stay. Using a similar strategy increases the availability of various types of endovascular interventions, shorter waiting lists, and cut the cost of treatment due to a reduced hospital stay.
Perspectives of cell therapy for myocardial infarction and heart failure based on cardiosphere cells
Authors: Dergilev K. V. , Vasilets Iu. D. , Tsokolaeva Z. I. , Zubkova E. S. , Parfenova E. V.
Published: June 2020

Cardiovascular diseases are the leading cause of morbidity and mortality worldwide. In recent years, researchers are attracted to the use of cell therapy based on stem cell and progenitor cells, which has been a promising strategy for cardiac repair after injury. However, conducted research using intracoronary or intramyocardial transplantation of various types of stem/progenitor cells as a cell suspension showed modest efficiency. This is due to the low degree of integration and cell survival after transplantation. To overcome these limitations, the concept of the use of multicellular spheroids modeling the natural microenvironment of cells has been proposed, which allows maintaining their viability and therapeutic properties. It is of great interest to use so-called cardial spheroids (cardiospheres) spontaneously forming three-dimensional structures under low-adhesive conditions, consisting of a heterogeneous population of myocardial progenitor cells and extracellular matrix proteins. This review presents data on methods for creating cardiospheres, directed regulation of their properties and reparative potential, as well as the results of preclinical and clinical studies on their use for the treatment of heart diseases.
Idiopathic multicentric Castleman’s disease
Authors: Vasilyev V. I. , Palshina S. G. , Pavlovskaya A. I. , Kokosadze N. V. , Chaltsev B. D. , Shornikova L. A.
Published: June 2020

Idiopathic multicentric Castlemans disease is a rare lymphoproliferative disorder that has many similar laboratory, radiological, clinical and pathological manifestations with various conditions, including IgG4-related disease. Increased activity of cytokines, especially interleukin-6, leads to systemic inflammatory symptoms with the development of lymphadenopathy and rarely extranodal lesions. Histological changes in the lymph nodesin hyaline vascular and plasma cell variants of Castlemans disease are hardly distinguishable from the pattern of reactive, tumor and IgG4-related lymphadenopathy. Idiopathic multicentric Castlemans disease can be diagnosed only when infection with human herpesvirus-8 type and human immunodeficiency virus is excluded. In the article, the authors describe two cases of idiopathic multicentric Castlemans disease, including the first world literature description of extranodal damage of the hip muscle in this disorder. In addition, the authors gave a review of the literature on the main clinical, laboratory and morphological manifestations, which allow confirming the diagnosis of Castlemans disease.
Thrombotic microangiopathy in rheumatology: a link between thrombosis and autoimmunity
Authors: Nasonov Evgeny L. , Reshetnyak Tatyana M. , Alekberova Zemfira S.
Published: June 2020

Uncontrolled hypercoagulation and inflammation (thromboinflammation), which are both independent and closely related and amplifying each other pathological processes, form the basis for pathogenesis of a wide range of diseases and complications, including immuno-inflammatory (autoimmune) rheumatic diseases, with the development of potentially fatal injuries of internal organs. Thrombotic microangiopathy is one of the most prominent prototypes of thromboinflammatory pathological conditions. The close link between environmental factors, hemostasis genetic defects and the complement system, inflammation and autoimmunity as pathogenetic mechanisms of microthrombosis draws particular attention to studying thrombotic microangiopathy in immuno-inflammatory rheumatic diseases, primarily systemic lupus erythematosus, antiphospholipid syndrome and scleroderma renal crisis. In future, these studies may be important for expanding the idea of the role of autoimmune mechanisms in pathogenesis of critical hemostasis disorders in human diseases, and for developing new approaches to therapy. Recently, special attention has been paid to the treatment of systemic lupus erythematosus and antiphospholipid syndrome with eculizumab, which is humanized monoclonal IgG2/4k antibody that blocks the complement component C5a and the membrane attack complex (C5b-9) formation, and which is registered for the treatment of atypical hemolytic uremic syndrome, paroxysmal nocturnal hemoglobinuria, as well as severe forms of myasthenia gravis and neuromyelitis optica. Further studies in this direction will create prerequisites for improving the prognosis not only in patients with orphan disorders, but also for widespread human diseases.
Vitamin D: effects on pregnancy, maternal, fetal and postnatal outcomes
Authors: Eremkina A K , Mokrysheva N G , Pigarova E A , Mirnaya S S
Published: June 2020

A high prevalence of vitamin D deficiency and its negative consequences for health is identified as area of primary concern for scientists and clinicians worldwide. Vitamin D deficiency affects not only bone health but many socially significant acute and chronic diseases. Observational studies support that pregnant and lactating women, children and teenagers represent the high risk groups for developing vitamin D deficiency. Current evidence highlights a crucial role of vitamin D in providing the fetal life-support system and fetus development, including implantation, placental formation, intra - and postpartum periods. Hypovitaminosis D during pregnancy is associated with a higher incidence of placental insufficiency, spontaneous abortions and preterm birth, preeclampsia, gestational diabetes, impaired fetal and childhood growth, increased risk of autoimmune diseases for offsprings. Potential mechanisms for the observed associations contain metabolic, immunomodulatory and antiinflammatory effects of vitamin D. Epigenetic modifications in vitamin D-associated genes and fetal programming are of particular interest. The concept of preventing vitamin D deficiency is actively discussed, including supplementation in different ethnic groups, required doses, time of initiation and therapy duration, influence on gestation and childbirth. An adequate supply of vitamin D during pregnancy improves the maternal and fetal outcomes, short and long term health of the offspring. Still current data on relationship between maternal vitamin D status and pregnancy outcomes remains controversial. The large observational and interventional randomized control trials are required to create evidence-based guidelines for the supplementation of vitamin D in pregnant and lactating women.
The prevalence of components of metabolic syndrome in the patients with diabetes melitus type 2 and mody diabetes in young people of Novosibirsk
Authors: Mustafina S V , Ovsyannikova A K , Voevoda M I , Denisova D V , Sherbakova L V , Rymar O D
Published: June 2020

Aim. To estimate the prevalence of type 2 diabetes mellitus (DM2) and MODY diabetes as well as the prevalence of metabolic syndrome (MS) components for these types of diabetes in the young population of the city of Novosibirsk. Materials and methods. In 2013-2017 years a population survey was conducted of a random representative sample of the population of 25-45 years of both sexes, residents of one of the typical districts of Novosibirsk. WHO criteria (1999-2013) were used for the diagnosis of diabetes: fasting blood glucose ≥7.0 mmol / l after an 8-hour fasting. Also group with DM2 included persons with a fasting blood glucose level
Nephrolithiasis against type 2 diabetes mellitus: on the effect of hypoglycemic therapy on lithogenesis
Authors: Yarovoy S K , Kareva E N , Djalilov O V
Published: June 2020

Aim. To study the effects of oral hypoglycemic agents that can affect the probability of recurrence of nephrolithiasis. Materials and methods. The article is based on the results of examination and treatment of 315 patients suffering from recurrent nephrolithiasis and medically compensated type 2 diabetes mellitus treated at the N.A. Lopatkin Institute of Urology and Interventional Radiology - the branch of the SMRC of Radiology, Ministry of Health of Russia and D.D. Pletnev City Hospital Moscow Healthcare Department in 2012-2017. The patients were divided into three groups according to the applied tool antidiabetic: metformin, glibenclamide, canagliflozin. The control group consisted of patients receiving insulin therapy. Results and discussion. The propensity of Metformin to reduce the pH of urine, which has a negative impact in the conditions of urate nephrolithiasis, which is most common in the population of patients with type 2 diabetes mellitus. Glibenclamide, on the contrary, somewhat latches urine. But changes in the reaction of urine under the influence of the drug do not go beyond normal values and are not clinically significant. Canagliflozin increases diuresis due to medication induced glycosuria and stimulates renal excretion of uric acid and its salts. However canagliflozin does not cause significant shifts in the pH of urine that may somewhat negates the increased risk of recurrence of urate stone formation in the background of the uricosuric effect of the drug. Conclusion. Drug therapy of type 2 diabetes mellitus significantly affects the properties of urine from patients with nephrolithiasis.
The effects of menopausal hormone therapy on proinflammatory cytokines and immunoglobulins in perimenopausal patients with type 2 diabetes mellitus and chronic obstructive pulmonary disease (COPD)
Authors: Panevina A S , Smetneva N S , Vasilenko A M , Shestakova M V
Published: June 2020

Aim. To determine the effects of menopausal hormone therapy dosage on levels of proinflammatory cytokines and immunoglobulins in bodily fluids of patients with type 2 diabetes mellitus (DM) and chronic obstructive pulmonary disease (COPD) during perimenopause. Materials and methods. The study included 119 perimenopausal females with moderate type 2 DM and stable COPD with signs of menopausal syndrome. Cytokine levels in bronchoalveolar lavage fluid and blood serum were measured with flow cytofluorometry (Вeckman Coulter FC500, USA) using a multiplex kit for human cytokines (BMS810FF) in adherence to the manufacturer’s instructions. The lower limit of quantification was 2.5-52.7 pg/mL. The following cytokines were studied: IL-1β, IL-6, IL-8, TNF-α and IF-γ. The data was analyzed with Flow CytomixProver 3.0 manufacturer-licensed software package. IgМ, IgG and IgА in the blood serum (Vektor-Best, Russia) were detected using an immunoenzymatic assay (Stat Fax 3200Analyzer, Awareness Technology, USA). Menopausal hormone therapy (MHT) with 17 beta-estradiol/dydrogesterone (standard - 2 mg, low - 1 mg, ultralow - 0.5 mg): 0.5/2.5 (estradiol 0.5 mg/dydrogesterone 2.5 mg) - ultralow-dose MHT, 1/10 (estradiol 1 mg/dydrogesterone 10 mg) - low-dose MHT; 2/10 (estradiol 2 mg/dydrogesterone 10 mg) - standard-dose MHT. Саrbohydrate metabolism was assessed in three groups. Results and discussion. While 2/10 MHT yielded the most prominent decrease in IL-1β, IL-6, IL-8, TNF-α and IF-γ levels in bronchoalveolar lavage fluid and blood serum, the effect was statistically insignificant compared to 0.5/2.5 and 1/10 MHT. Initially decreased IgM, IgG and IgA levels were elevated in all the three dosage groups with no significant differences between them. As to carbohydrate metabolism target values of glycemia were achieved in all three groups taking MHT. Conclusion. Standard-, low - and ultralow-dose MHT has positive effects on levels of proinflammatory cytokines and immunoglobulins characteristic of the association between type 2 DM, COPD and menopausal syndrome. The differences between the three dosage groups were statistically insignificant. Different dosage of MHT with dydrogesterone provide for improving impaired carbohydrate metabolism.
Reproductive disorders, osteoporosis and secondary hyperparathyroidism with celiac disease
Authors: Krums L M , Bykova S V , Sabelnikova E A , Aminova Ts V , Poleva N I , Gudkov R B , Turaeva M B , Parfenov A I
Published: June 2020

A clinical observation of a patient with celiac disease, aged 23, with severe form of osteoporosis, accompanied by atraumatic fractures bones, lameness, late onset of menstruation and pathology of pregnancy is described. It is emphasized that only a timely diagnosis celiac disease and timely prescribed treatment make it possible to avoid severe complications.
The role of systemic inflammation in the pathogenesis of insulin resistance and metabolic syndrome in patients with chronic hepatitis C
Authors: Tkachenko L I , Maleev V V
Published: June 2020

The systemic inflammatory response plays a key role in the development of atherosclerosis, insulin resistance (IR) and diabetes mellitus 2-type (diabetes mellitus). IR in patients with chronic hepatitis C (CHC) is considered as a possible factor in the progression of fibrosis, a predictor of the development of DM T2 and a component of the metabolic syndrome. The use of biomarkers of non-specific inflammation can be a valuable tool for assessing the risks of IR and cardiovascular diseases in patients with chronic hepatitis C. Aim of the study. To determine the role of nonspecific inflammation in the formation of IR and metabolic syndrome in patients with chronic hepatitis C. Materials and methods. The study included 205 patients with CHC aged 18 to 69 years. Patients with CHC are randomized into two groups depending on the presence of IR: group 1 - patients with a HOMA index ≥2.77, which corresponded to IR (n=110); group 2 (n=95). The levels of serum iron, C-reactive protein (CRP), serum ferritin and adipose tissue hormones [leptin, resistin, adiponectin and tumor necrosis factor-α (TNF-α)] were additionally investigated. Results. At all stages of development of IR, nonspecific inflammation was detected (according to ferritin, CRP and serum iron), increasing with increasing HOMA index [Homeostasis Model of Assessment - Insulin Resistance (HOMA-IR)] (Matthews D., 1985), metabolic syndrome and its components. In the analysis of indicators in patients with chronic hepatitis C with a body mass index
Clostridium difficile in inflammatory bowel disease
Authors: Knyazev O V , Kagramanova A V , Chernova M E , Korneeva I A , Parfenov A I
Published: June 2020

Aim. To study epidemiology and risk factors for Clostridium infection (CDI) associated with Clostridium difficile in patients with inflammatory bowel disease (IBD). Materials and methods. 1179 medical records were analyzed in a retrospective study of patients with IBD, of which 764 patients met the inclusion criteria. Patients were divided into 2 groups based on the presence of a preliminary diagnosis of CDI. Statistical analysis was carried out using Pearson Chi-square and two-sample t-test. Results. The incidence of CDI in patients with IBD was 17.3%, with the same prevalence in patients with Crohn's disease (CD) (n=53/40.1%) and ulcerative colitis (UC) (n=79/59.9%). The mean age of occurrence of CDI in patients with IBD was 37.8±12.9, 84.8% of infections were community-acquired and only 4.5% occurred in medical institutions. Only 21.2% of all patients with CDI had a history of antibiotic use, and 24.2% had previously used steroids. Long-term immunosuppressive therapy in patients with IBD has an impact on the development of CDI: among patients with CDI 45.5% long-term received azathioprine/6-mercaptopurine, in patients without IBD - 17.7% (p
Bilateral thalamic stroke in patient with patent foramen ovale and hereditary thrombophilia
Authors: Brovko M Yu , Akulkina L A , Sholomova V I , Yanakayeva A Sh , Strizhakov L A , Lebedeva M V , Zakharov V V , Volkov A V , Lazareva A V , Kinkul’kina M A , Ivanets N N , Fomin V V
Published: June 2020

Patent foramen ovale and hereditary thrombophilia are both known risk factors for ischemic stroke. Artery of Percheron is a rare anatomical variant in which vast areas of the midbrain and thalamus have a single source of blood supply. This case report presents a 45-years old female patient with bilateral thalamic stroke due to Percheron artery occlusion, with a combination of hereditary thrombophilia and patent foramen ovale as the risk factors. Modern approaches to the diagnosis and secondary prevention of this pathology are also discussed herein.
Hepatic decompensation associated with an interferon-free antiviral therapy in patients with HCV-cirrhosis
Authors: Batskikh S N , Vinnitskaya E V , Sandler Yu G , Khaimenova T Yu
Published: June 2020

Today, there is no complete clarity about the pathogenetic mechanisms of the hepatic decompensation in patients with HCV-cirrhosis during the course of direct-acting antiviral (DAAs) therapy. The current article describes several clinical observations of decompensation (with the development of liver failure and portal hypertension) in cirrhotic patients during the course of DAAs-therapy of hepatitis C. The authors present contemporary views and their own assumptions about the possible mechanisms of the hepatic decompensation associated with DAAs-therapy in patients with liver cirrhosis.
Bacterial combating potential of biogenic nano silver particles
Authors: Dinesh Babu J
Published: June 2020

The nanotechnology had been gaining importance in all the fields like technology, medicine even in robotics. The scientists are focusing on that type of synthesis wherein the advantages overcomes the disadvantages of the production and the plants have been probed as better alternatives in this field. The emerging technology of using plants as precursors or aiding in the production of nanotechnology is viewed as , low toxicity and better in approaching the preparation of . That is why of silver had been in usage considering its antibacterial potency to kill any kind of bacteria. Silver particles had been the best choices for physicians to treat wounds. Hibiscus Rosa plant leaves are found to have abundant so they can be used to reduce the silver ions into . The formed were less toxic as they were synthesized in a natural process. These when tested for antibacterial activity against three species of bacteria, the results were as expected. The produced silver particles showed a significant ZOI compared to the standard drug.
Evaluation of antipyretic activity of Capsicum annuum by Brewer’s yeast method
Authors: Dinesh Babu J
Published: June 2020

Plants are being used in medicine and treatment of diseases from years in the evolution. During the development of science, investigations to establish eh scientific proof and validation for the activities and mechanism of herbs to treat diseases. Capsicum annuum has anti-cancer properties, analgesic properties, anti lithogenic and thermogenic properties. It is used to alter the gastrointestinal function and boost metabolism. Many formulations are enriched with capsaicin which is a crucial ingredient in Capsicum to exhibit its weight loss properties. Based on the anti-inflammatory and analgesic properties of the plant and taking into consideration, the current research will focus on the investigation and comparison of the antipyretic activity of Capsicum in fruits and leaves. Results show that the leaves have similar chemical constituents that had antipyretic potential compared to the fruits. Overall, the Capsicum showed a comparatively same activity with the standard drug, paracetamol.
The Majestic Equality of Disenfranchisement: Assessing the Right to Freedom from Discrimination in Light of the Ngaranoa Litigation
Authors: Cox Charlie
Published: June 2020

The right to freedom from discrimination in New Zealand is underpinned by equality, one of the most influential, yet amorphous principles in political theory. This article argues that the failure of New Zealand courts to articulate the norms behind the anti-discrimination guarantee enables arbitrary and inconsistent reasoning. The decisions of the High Court in Taylor v Attorney-General and the Court of Appeal in Ngaronoa v Attorney-General thus reflect a wrong turn in New Zealand discrimination law, taken in the case of Ministry of Health v Atkinson. Because discrimination law necessitates moral judgment, this article argues that the courts have been wrong to treat discrimination law as a largely amoral enterprise. Seen in this context, it should be unsurprising that the decisions of Taylor v Attorney-General and Ngaronoa v Attorney-General appear to mask moral judgments behind a façade of empiricism and common sense, and reveal different conceptions of equality.