Saint Petersburg, Russia
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Vladimirova S.G.,Federal Biomedical Agency of Russia | Tarasova L.N.,Federal Biomedical Agency of Russia | Skolskaya O.Y.U.,Federal Biomedical Agency of Russia | Cherepanova V.V.,City Hospital Thirty Three
Terapevticheskii Arkhiv | Year: 2013

Aim. To determine C-reactive protein (CRP) levels as diagnostic markers of infection in acute myeloid leukemia (AML) patients with neutropenia. Subjects and methods. Sixty-three AML'patients (28 men and 35 women) aged 20 to 77 years (median 50 years) were examined. According to the French-American-British (FAB) classification, the types of AML were as follows: MO (n=3), M1 (n=9), M2 (n=35), M4 (n=10), and M5 (n=6). All the patients had chemotherapy-associated neutropenia (granulocytes, less than 0.5-109/l). In different treatment steps, all the patients developed infectious complications (the study analyzed the data of 86 cases). Results. In patients with localized infections (such as mucositis, abscess, pneumonia, etc.) or fever of unknown origin (FUO), the levels of CRP were not statistically significant different, but were significantly-higher than in those without infectious complications. The concentrations of CRP did not differ in patients with systemic inflammatory response syndrome (SIRS) and in those with sepsis. At the same time, the level of CRP in systemic infection (SIRS, sepsis) was significantly higher than that in localized infection (p<0.001 ). In patients with neutropenia, the median CRP levels were as follows: 7 mg/l (range 037; 95% reference interval (RI) 0 to 32) for those without infection 56 mg/l (range 13-104; 95% RI 17 to 104) for those with localized infection or FUO; and 168 mg/l (range 103399; 95% RI 105 to 362) for those with systemic infection. Conclusion. CRP is a marker of the severity of an infectious process in AML patients with neutropenia. The increase of its level more than 32 mg/l serves a valid criterion for the presence of infection and more than 105 mg/l does for that of a systemic inflammatory response in these patients.


Ostapenko Y.N.,Federal Biomedical Agency of Russia | Elkis I.S.,Moscow University of Medicine and Dentistry
Terapevticheskii Arkhiv | Year: 2010

The paper considers the pathogenesis, clinical picture, and diagnosis of acute intoxications with alcohol and substitutes, and its prehospital medical care. It details an emergency team's tactics in patients with the above conditions.


Avdeyev S.N.,Federal Biomedical Agency of Russia
Terapevticheskii Arkhiv | Year: 2012

Hypoxemia can cause damage to any tissue in the human body. Tissue hypoxia is a condition in which oxygen (O2) delivery to the tissues does not meet their metabolic needs. The major goal in the treatment of patients with hypoxemic acute respiratory failure (ARF) is to ensure normal oxygenation of the body. The leading therapy option for ARF is the use of O2. The paper gives the basic principles of emergency O2 therapy: indications, treatment goals, monitoring guidelines, methods for delivery of O2, and measures to prevent its toxic effects.


Tsareva N.A.,Federal Biomedical Agency of Russia
Terapevticheskii Arkhiv | Year: 2013

The paper reviews current views of the problem of pulmonary hypertension. It shows the classification of pulmonary hypertension and considers the general issues of its pathogenesis, morphological changes, clinical picture, and main approaches to treating patients with pathology. Particular emphasis is placed on the review of clinical trials of the class of endothelin receptor antagonists.


Vladimirova S.G.,Federal Biomedical Agency of Russia | Tarasova L.N.,Federal Biomedical Agency of Russia
Terapevticheskii Arkhiv | Year: 2016

It is considered that hypercholesterolemia is life-threatening and low cholesterol levels are a positive factor. however, taking into consideration the fact that cholesterol plays a key role in cell proliferation, it should be remembered that its low blood level may be linked to high cholesterol demands from neoplastic cells. The literature review analyzes the results of recent investigations of lipid metabolism in patients with hematologic cancers and their other types. All given investigations show a significant reduction in the serum levels of total cholesterol and high-density lipoproteins in patients with hematological disease at its onset. The data for other indicators of the lipid transport system are ambiguous. Such changes have been elucidated to be associated with the accumulation of cholesterol in the leukemia cells due to enhanced synthesis de novo, a more active absorption from circulation and blocked release of its surplus. If the disease runs a favorable course, lipid metabolic parameters become normalized and, in case of remission, correspond to those seen in healthy individuals. They continue to decline in patients with disease progression. This allows the consideration of cholesterol, its fractions, and apolipoproteins as biochemical prognostic markers in hematological cancer patients and as indicators for assessment of treatment results. In addition, there is evidence for the effect of chemotherapeutic agents on lipid metabolism. Recent attempts to elaborate new treatment strategies, by using the current knowledge on the role of lipid metabolism in cancers, are considered.


Schaefer T.V.,Federal Biomedical Agency of Russia
Bulletin of experimental biology and medicine | Year: 2012

The effect of artificial acidification of the intestinal content on neurological manifestations of acute severe cyclophosphamide intoxication was studied in rats. The animals were gavaged with 20 ml/kg sulfuric (0.05 M), hydrochloric, boric, or lactic acids (0.1 M) 3 h before intraperitoneal injections of the cytostatic in doses of 0, 200, 600, or 1000 mg/kg. The decrease in pH (by.0) and ammonia-producing activity of the cecal chyme developed within 3 h after administration of acids. Cyclophosphamide caused hyperammonemia; glutamine/ammonia and urea/ammonia ratios in the blood decreased. These changes augmented after administration of acids (boric acid produced maximum and lactic acid minimum effects). Acid treatment resulted in greatest elevation of ammonia level in the portal venous blood and a lesser elevation in the vena cava posterior blood. Acid treatment promoted manifestation of cyclophosphamide neurotoxic effect and animal death. Hence, acidification of the chyme inhibited the formation of ammonia in it, while ammonia release from the gastrointestinal tract into the blood increased; the treatment augmented hyperammonemia and aggravated the neurological manifestations of cyclophosphamide intoxication.


Chuchalin A.G.,Federal Biomedical Agency of Russia
Terapevticheskii Arkhiv | Year: 2013

In current clinical practice, there are increasing numbers of patients in whom chronic obstructive disease is concurrent with three diseases: diabetes mellitus, coronary heart disease, and arterial hypertension. The concomitance of these socially significant diseases reflects a new stage of diseases of this century.


Marchenkov Ya.V.,Federal Biomedical Agency of Russia
Terapevticheskii Arkhiv | Year: 2013

Tracheal diverticula (TD) are a rare congenital or acquired condition. The diagnosis of TD is based on the data of multislice spiral computed tomography and fibrotracheal bronchoscopy. DTs are most frequently located in the right, may be solitary or multiple, uni- or multilocular. Uncomplicated DTs generally have no characteristic clinical features. Their symptoms can arise from the compression of adjacent organs or the addition of secondary bacterial infection and most commonly appear as cough. Differential diagnosis is mainly made with pharyngeal and laryngeal cysts and pharyngoesophageal diverticula. Asymptomatic TDs usually require no treatment. Surgical TD excision is possible in case of compression of adjacent organs and infection.


Avdeev S.N.,Federal Biomedical Agency of Russia
Terapevticheskii Arkhiv | Year: 2015

Pulmonary hypertension (PH) is a specific clinical group of severe and rare diseases with similar morphological, hemodynamic, and therapeutic characteristics. Despite the fact that there have been international conciliative documents and advances in drug therapy for PH, the long-Term prognosis of the disease in these patients remains rather poor. Clinical trials have demonstrated that bosentan therapy in patients with PH improves pulmonary hemodynamics and exercise endurance and delays the development of the disease. According to the data of long-Term studies, as compared to the historical control, bosentan used as a first-line drug can improve survival in PH patients.


Naumov V.A.,Federal Biomedical Agency of Russia
Bulletin of experimental biology and medicine | Year: 2012

Association study of 6 candidate single-nucleotide polymorphisms (rs7921, rs7956547, rs3761243, rs11737764, rs6599400, rs1690916) was carried out in a group of patients with bone tumors of different histological structure (n=68) and control group of normal subjects (n=96). Significant associations of rs6599400 and rs1690916 polymorphisms with disease risk were detected (odds ratio 2.15 [1.06-4.24] and 0.39 [0.19-0.78], respectively). These polymorphisms were located in untranslated genome regions: polymorphism rs6599400 in the 5' region of fibroblast growth factor-3 receptor gene (FGFR3), rs1690916 in the 3' region of mouse MDM2 p53-binding protein homolog (MDM2). These data indicated a possible role of hereditary genetic factors in the formation of predisposition to bone sarcomas and confirmed previous findings according to which these genes should be regarded among the most probable factors involved in tumor development, including tumors of the bone and cartilage tissues.

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