scholarly journals The Possible Role of Herpesviruses in the Pathogenesis of Coronary Atherosclerosis

2021 ◽  
Vol 11 (4) ◽  
pp. 391-396
Author(s):  
Julia Kotova
Keyword(s):  
Cause Of Death ◽  
Coronary Atherosclerosis ◽  
Viral Infections ◽  
Clinical Manifestations ◽  
Vascular Lesions ◽  
Rapid Progression ◽  
Coronary Syndrome ◽  
Lipid Metabolism Disorders ◽  
Hereditary Disorders ◽  
Atherosclerotic Process

Cardiovascular diseases are still the dominant cause of death worldwide. Coronary artery disease (CAD) is the most common type of heart disease and the leading cause of death for both men and women. Coronary atherosclerosis underlies multiple clinical manifestations ranging from asymptomatic to stable angina, acute coronary syndrome, MI, heart failure, and sudden cardiac death. The prerequisites for a closer study of the pathogenesis of the atherosclerotic process were the development of atherosclerotic vascular lesions at a younger age and the rapid progression of the process. Currently, it is generally accepted that CAD is a multifactorial disease. Attention is drawn to hereditary disorders of the receptor apparatus, endothelial dysfunction, and lipid metabolism disorders. In addition, latent viral infections are one of the etiopathogenetic factors in the development of atherosclerosis. A number of scientific studies have confirmed the relationship between infectious agents and the development of atherosclerotic vascular lesions. The viral etiology of the development and progression of atherosclerosis is the subject of debate among scientists around the world.

scholarly journals 345. Dermatological Manifestations in Patients with COVID-19 Pneumonia in Veracruz, Mexico

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S276-S277
Author(s):  
Luis Del Carpio-Orantes ◽  
Sergio García-Méndez ◽  
Jesús Salvador Sánchez-Díaz ◽  
Andrés aguilar-silva ◽  
Elisa Estefania Aparicio-Sánchez ◽  
...  
Keyword(s):  
Viral Infections ◽  
Clinical Manifestations ◽  
Adaptive Immune System ◽  
Severe Pneumonia ◽  
Acute Stage ◽  
Androgenetic Alopecia ◽  
Vascular Lesions ◽  
Cutaneous Manifestations ◽  
Low Incidence ◽  
The One

Abstract Background A large number of viral infections are characterized by the presence of cutaneous manifestations. Multiple dermatological manifestations have been observed in patients with COVID-19. Dermatological lesions in patients infected by SARS-CoV-2 such as livedo reticularis, rash and vascular lesions may represent manifestations of secondary phenomena such as paraviral rashes or by participation of the innate or adaptive immune system that cause vasodilation, vascular leakage or procoagulant effects Methods Descriptive and observational study, adult patients with COVID-19 pneumonia were selected, confirmed by RT-PCR and chest CT. General symptoms, hematic cytometry results, pneumonia severity, prognosis as well as dermatological manifestations are characterized. Results 100 patients were entered into the study, with an average age of 49.4 years, 54% male. The general symptoms with the highest incidence were: fever, cough and dyspnea characteristic of SARS-CoV-2 infection, followed by chest pain, headache, anosmia and dysgeusia. The main alteration of the hemogram was lymphopenia, no leukopenia or plaquetopenia was demonstrated. 54% of those affected had mild pneumonia, the rest severe pneumonia. 75% progressed towards improvement and 25% died. Among the dermatological manifestations identified, all occurred in cases with severe pneumonia, the one with the highest incidence was the morbilliform viral exanthema in 18%, the presence of diffuse partial alopecia in 7% as well as manifestations of lividity and maceration in 1%. Regarding alopecia, in 6% it was reversible androgenetic alopecia, having manifested during the acute stage of pneumonia (all men), in 1% it presented alopecia areata (male) that has been persistent beyond the acute phase and in frank recovery Demographic and clinical variables Clinical manifestations Conclusion The incidence of dermatological manifestations is low in this study population, the most frequent being the morbilliform viral exanthema expected in a virus, however they present manifestations of low incidence such as reversible androgenetic alopecia associated with severity of the disease, a finding that has been documented recently as a manifestation associated with COVID-19 Disclosures All Authors: No reported disclosures

Acute respiratory viral infections in COVID-19 pandemic in practice of polyclinic doctor

2021 ◽  
Vol 1 (11) ◽  
pp. 29-33
Author(s):  
V. V. Nikiforov ◽  
N. V. Orlova ◽  
V. V. Lomaychikov
Keyword(s):  
Differential Diagnosis ◽  
Viral Infections ◽  
Clinical Course ◽  
Respiratory Infections ◽  
Clinical Manifestations ◽  
Acute Respiratory Infections ◽  
Interferon Inducer ◽  
Coronary Syndrome ◽  
Respiratory Viral Infections ◽  
High Level

Acute respiratory viral infections (ARVI), including influenza, remain the most common infectious diseases. In the context of COVID‑19 pandemic, there is a need for differential diagnosis of respiratory syndrome. The clinic of ARVI, depending on the pathogen, may have its own characteristics. Influenza and COVID‑19 have common pathways of transmission of the pathogen and similar symptoms, so the optimal differential diagnosis is the use of test systems for both viruses. Against the background of influenza and other acute respiratory infections, complications from various organs and systems can develop. The article discusses in detail the issues of the clinical course of ARVI, differential diagnosis, modern approaches to therapyand prophylactic. Complications of influenza from the cardiovascular system are considered in detail. The data of our own observations on the risk of developing acute coronary syndrome in persons who have undergone COVID‑19 are presented. Prevention of the development of complications of influenza and other acute respiratory infections is the early appointment of antiviral therapy. Numerous studies confirm the effectiveness of interferon inducers in the treatment of influenza and other ARVI. The article presents the results of clinical studies confirming the effectiveness of therapy with the interferon inducer Kagocel. Against the background of its use, a decrease in the severity of clinical manifestations, a reduction in the duration of the disease, and the prevention of complications were noted. In studies, the drug has shown a high level of safety. The article discusses studies on the effectiveness of chemoprophylaxis of influenza and other acute respiratory infections.

Polymyalgia Rheumatica - a Disease of the Elderly

2018 ◽  
Vol 69 (1) ◽  
pp. 152-154
Author(s):  
Vasilica Cristescu ◽  
Aurelia Romila ◽  
Luana Andreea Macovei
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Polymyalgia Rheumatica ◽  
Temporal Arteritis ◽  
Viral Infections ◽  
Clinical Manifestations ◽  
The Elderly ◽  
Clinical Aspects ◽  
Immune Disorder ◽  
Markers Of Inflammation

Polymyalgia rheumatica is a disease that occurs mostly in the elderly and is rarely seen in patients less than 50 years of age. Polymyalgia rheumatica is a vasculitis, which manifests itself as an inflammatory disease of the vascular wall that can affect any type of blood vessel, regardless of its size. It has been considered a form of giant cell arteritis, involving primarily large and medium arteries and to a lesser extent the arterioles. Clinical manifestations are caused by the generic pathogenic process and depend on the characteristics of the damaged organ. PMR is a senescence-related immune disorder. It has been defined as a stand-alone condition and a syndrome referred to as rheumatic polyarteritis with manifestations of giant cell arteritis (especially in cases of Horton�s disease and temporal arteritis) which are commonly associated with polymyalgia. The clinical presentation is clearly dominated by the painful girdle syndrome, with a feeling of general discomfort. Polymyalgia and temporal arteritis may coexist or be consecutive to each other in the same patient, as in most of our patients. The present study describes 3 cases of polymyalgia rheumatica, admitted to the Clinic of Rheumatology of Sf. Apostol Andrei Hospital, Galati. The cases were compared with the literature. Two clinical aspects (polymyalgia rheumatica and/or Horton�s disease) and the relationship between them were also considered. Polymyalgia rheumatica is currently thought to have a multifactorial etiology, in which the following factors play a role: genetic factors or hereditary predisposition (some individuals are more prone to this disease), immune factors and viral infections (triggers of the disease). Other risk factors of polymyalgia rheumatica include age over 50 years and the association with giant cell arteritis. The characteristic feature of the disease is girdle pain, with intense stiffness of at least one hour�s duration. Markers of inflammation, erythrocyte sedimentation rate and C-reactive protein are almost always increased at the onset of the disease. Diseases that can mimic the clinical picture of polymyalgia rheumatica are neoplasia, infections, metabolic disorders of the bone and endocrine diseases.

scholarly journals Myocardial amyloidosis following multiple myeloma in a 38-year-old female patient: A case report

Open Medicine ◽  
2020 ◽  
Vol 15 (1) ◽  
pp. 396-402
Author(s):  
Qisi Zhang ◽  
Yingli Qiao ◽  
Dongmei Yan ◽  
Yuhui Deng ◽  
Mengyang Zhang ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Plasma Cells ◽  
Laboratory Data ◽  
Young Patients ◽  
Clinical Manifestations ◽  
The Elderly ◽  
First Episode ◽  
Rapid Progression ◽  
Congo Red Staining ◽  
Impaired Cardiac Function

AbstractMultiple myeloma (MM) is an immunoglobulin-producing tumor of plasma cells, which occurs commonly in the elderly. The incidence of myocardial amyloidosis with MM is extremely low and early clinical manifestations are nonspecific. The diversity of clinical manifestations and first episode symptoms often cause misdiagnosis in young patients with myocardial amyloidosis following MM. In this study, we analyzed the clinical data of a young woman with MM and impaired cardiac function combined with echocardiography, electrocardiography (ECG), laboratory data, cell Congo Red staining, and other manifestations to diagnose amyloidosis. Considering the rapid progression, short survival, and poor prognosis in most patients, a clear, definitive, and timely diagnosis is essential for the treatment of patients with MM complicated with myocardial amyloidosis.

scholarly journals POS0083 USEFUL EXPERIENCE OF RHEUMATOLOGISTS FOR UNDERSTANDING OF THE DISEASE ORIGIN AND APPROACHES TO THERAPY IN FIBRODYSPLASIA OSSIFICANS PROGRESSIVA

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 249.2-250
Author(s):  
I. Nikishina ◽  
S. Arsenyeva ◽  
V. Matkava ◽  
A. Arefieva ◽  
M. Kaleda ◽  
...  
Keyword(s):  
Heterotopic Ossification ◽  
Kinase Inhibitor ◽  
Inflammatory Diseases ◽  
Clinical Manifestations ◽  
Fibrodysplasia Ossificans Progressiva ◽  
Rapid Progression ◽  
Time Duration ◽  
Long Term Follow Up ◽  
Vertebral Bodies ◽  
The One

Background:Many monogenic genetic conditions, such as auto-inflammatory diseases (AIDs), have similar clinical manifestations and immunopathogenesis to “classic” rheumatic diseases (RD). Such cases may include Fibrodysplasia ossificans progressiva (FOP), an extremely rare genetic disease, which, according to our previous study and data from other authors1, may represent an example of AID with catastrophic heterotopic ossification due to a mutation in the ACVR1 gene. it seems that the experience of rheumatologists, especially children’s ones, will be useful in the treatment of FOP.Objectives:To analyzed the dynamics of clinical manifestations and to therapy approaches including target anti-inflammatory drug Tofacitinib (TOFA) in the one of the world’s largest groups of patients (pts) with FOP.Methods:The study was based on the analysis retrospective and prospective observation of the 35 pts (17 males and 18 females) with a verified diagnosis of FOP for the period from 1998 to 2020. In 9 pts with severe course of FOP TOFA administration were evaluated.Results:In all 35 pts the diagnosis was verified by “classic” FOP phenotype: malformed great toes in 33 pts (94,3%); short malformed thumbs-8 (22.8%); peripheral osteochondromas-20 (57.1%); abnormalities of the cervical spine-32 (91.4%), multiple heterotopic ossifications-32 (91,4%). Genetic tests were done in 26, it confirmed mutation in the ACVR1 gene in 100%. Long term follow-up detected a lot of spondyloarthritis-like signs similar to the manifestation of RD: ankylosis of the facet joints and vertebral bodies (by the type of syndesmophytes) in most pts, sacroiliitis, confirmed by radiological methods (X-ray, CT, MRI), gradual ankylosis in the peripheral joints in 18 (56.4%), synovitis in large joints in 8 (25%) pts (knee and hip mostly). In 9 pts with the most difficult course with rapid progression of ossification due to continuous flares despite the NSAIDs and steroids intake, we tried to use TOFA after the approval of the local Ethic Committee. We use the similar dose to randomized trial for JIA (up to 5 mg twice a day). The first patient was 16 y.o. at the time of TOFA administration in December 2019, the age of the other pts was from 2 to 12 y.o. By present time duration of TOFA therapy is from 6 to 15 mo. For the previous 6 months before TOFA initiation the number of flares was in average 8 per patient. After 6 months of TOFA treatment the number of new flares decreased to 0-1, except youngest patient of 2 y.o. in whom the number of flares decreased from 10 to 4 per the same period. In all 9 pts we minimize the dose or completely stop the steroids. New nodes formation stopped immediately in most pts and also the significant motion improvement of large (shoulder) joints were established. Drug tolerance was good in all pts, no AE were registered. But despite the good clinical effect without new heterotopic ossification in our first patient, we found continuous intraskeletal ossification between vertebral bodies, facet and sacroiliac joints in MRI.Conclusion:We are confident that the processes of heterotopic ossification in FOP are very similar to new born formation phenomenon in spondyloarthritis and reliable suppression of inflammation can interrupt the progression of the disease. We used similar justifications to our colleagues for the use of anti-cytokine drugs, but used a JAK-kinase inhibitor, it was extremely important the oral rout of drug administration and possibility to escape any injections in FOP. TOFA demonstrated positive effect and safety in children with severe course of FOP. It showed their advantages over the use of steroids and possibility to inhibit the rate of progression.References:[1]R.Haviv et al. Is fibrodysplasia ossificans progressiva aninterleukin-1 driven auto-inflammatory syndrome? Pediatric Rheumatology (2019) 17:84 //doi.org/10.1186/s12969-019-0386-6Disclosure of Interests:None declared.

scholarly journals Impact of Morning Onset on the Incidence of Recurrent Acute Coronary Syndrome and Progression of Coronary Atherosclerosis in Acute Myocardial Infarction

2017 ◽  
Vol 81 (3) ◽  
pp. 361-367 ◽  
Author(s):  
Hiroshi Nakashima ◽  
Yuka Mashimo ◽  
Masaya Kurobe ◽  
Shigenori Muto ◽  
Shinnosuke Furudono ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Coronary Atherosclerosis ◽  
Coronary Syndrome

Effectiveness of protected aminopenicillins in treatment of non-social pneumonia in children

2021 ◽  
Author(s):  
Е.Е. Краснова ◽  
В.В. Чемоданов ◽  
Е.Г. Кузнецова
Keyword(s):  
Viral Infections ◽  
Respiratory Infections ◽  
Acquired Resistance ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Severe Pneumonia ◽  
Physical Symptoms ◽  
Community Acquired Pneumonia ◽  
Natural Activity ◽  
Respiratory Viral Infections

Пневмония – острое инфекционно-воспалительное заболевание легких преимущественно бактериальной этиологии, характеризующееся выраженной в разной степени дыхательной недостаточностью, токсическими и респираторными нарушениями, локальными физикальными симптомами, а также инфильтративными изменениями на рентгенограмме. Заболеваемость внебольничными пневмониями повышается в октябре-декабре, достигая максимума в январе-апреле, коррелируя с сезонным повышением уровня острых респираторных вирусных инфекций. Схожесть симптомов дебюта пневмонии с проявлениями острых респираторных вирусных инфекций может привести к несвоевременной ее диагностике и, как следствие, к отсроченному началу лечения. Поэтому в период сезонной заболеваемости респираторными инфекциями должна повышаться настороженность врачей-педиатров в отношении внебольничной пневмонии. Антибактериальная терапия оказывает решающее влияние на прогноз пневмонии, поэтому при достоверном диагнозе или у больного в тяжелом состоянии с вероятным диагнозом ее следует начать незамедлительно. Выбор антибиотика в каждом случае внебольничной пневмонии проводят индивидуально с учетом природной активности препаратов в отношении предполагаемого возбудителя и их возможной приобретенной резистентности, тяжести и течения заболевания, наличия у пациента противопоказаний к использованию тех или иных антибиотиков. В статье приводятся сведения о диагностических критериях внебольничных пневмоний. Рассмотрены вопросы антибактериального лечения типичной нетяжелой пневмонии у детей разных возрастных групп амоксициллином с клавулановой кислотой и показана его эффективность. Результаты проведенного исследования позволяют заключить, что пероральное использование одного курса защищенного аминопенициллина эффективно при лечении типичной внебольничной нетяжелой пневмонии у детей разного возраста, о чем свидетельствует ликвидация основных клинических проявлений болезни в короткие сроки. Pneumonia is an acute infectious and inflammatory lung disease of predominantly bacterial etiology, characterized by respiratory failure, toxic and respiratory disorders, local physical symptoms, and infiltrative changes on the roentgenogram. The incidence of community-acquired pneumonia increases in October-December, reaching a maximum in January-April, correlating with the seasonal increase in the level of acute respiratory viral infections. The similarity of the symptoms of the onset of pneumonia with the manifestations of acute respiratory viral infections can lead to its untimely diagnosis and, as a consequence, to a delayed start of treatment. Therefore, during the period of seasonal morbidity with respiratory infections, the alertness of pediatricians in relation to community-acquired pneumonia should increase. Antibiotic therapy has a decisive influence on the prognosis of pneumonia, therefore, with a reliable diagnosis or in a patient in serious condition with a probable diagnosis, it should be started immediately. The choice of antibiotic in each case of community-acquired pneumonia is carried out individually, taking into account the natural activity of the drugs in relation to the alleged pathogen and their possible acquired resistance, the severity and course of the disease, the patient's contraindications to the use of certain antibiotics. The article provides information on the diagnostic criteria for community-acquired pneumonia. The issues of antibacterial treatment of typical non-severe pneumonia in children of different age groups with amoxicillin with clavulanic acid are considered and its effectiveness is shown. The results of the study allow us to conclude that the oral use of one course of protected aminopenicillin is effective in the treatment of typical community-acquired non-severe pneumonia in children of different ages, as evidenced by the elimination of the main clinical manifestations of the disease in a short time.

Drinking mineral water in the correction of metabolic syndrome in patients with cicatricial skin changes

2021 ◽  
pp. 56-61 ◽  
Author(s):  
V. K. Frolkov ◽  
S. N Nagornev ◽  
K. V. Kazantseva
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Water Intake ◽  
Mineral Water ◽  
Clinical Manifestations ◽  
Practical Interest ◽  
Resistance Index ◽  
Mineral Waters ◽  
Skin Changes ◽  
Lipid Metabolism Disorders

The article analyzes the efficiency of complex physiotherapy in combination with internal intake of medium-mineralized water “Essentuki № 17” in patients with cicatricial skin changes in the presence or absence of metabolic syndrome. It was found that internal mineral water intake supplementing physiotherapy effectively corrected carbohydrate and lipid metabolism disorders by reducing the insulin resistance index, which contributed to a greater regression of clinical manifestations of cicatricial skin changes in patients with metabolic syndrome. Meanwhile, in the absence of metabolic syndrome, the course intake of mineral water did not signifi cantly affect complex physiotherapy, although the index of insulin resistance and body weight of patients significantly decreased. It is suggested that, given the presence of nonspecifi c preventive potential of the course of drinking mineral waters intake, there is some theoretical and possibly practical interest in research on pre-course mineral water intake before performing cosmetic operations to accelerate the process of skin regeneration and the formation of scarring in a less pronounced form.

Abstract P193: Increased High Density Lipoprotein Cholesterol:ApolipoproteinA1 Ratio is Associated with Less Progression of Coronary Atherosclerosis in Statin-Treated Patients

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Preethi Mani ◽  
Kiyoko Uno ◽  
Julie Thornton ◽  
Stephen Nicholls
Keyword(s):  
Coronary Atherosclerosis ◽  
Coronary Plaque ◽  
Cholesterol Content ◽  
Favorable Effect ◽  
Plaque Burden ◽  
P Value ◽  
Plaque Progression ◽  
Coronary Syndrome ◽  
Hdl Function ◽  
Atheroma Volume

Background HDL cholesterol (HDL-C) and apolipoprotein AI (apoAI) levels are inversely related to adverse cardiovascular outcome. Associations between these HDL related measures and their ratio with coronary plaque progression have not been studied. It has been proposed that increasing HDL particle cholesterol content impairs HDL function, but impact on disease progression is unknown. We hypothesize that all HDL related measures are inversely associated with coronary plaque progression. Methods Retrospective analysis was performed of 1528 statin treated patients with angiographic CAD who had serial evaluation of atheroma burden with intravascular ultrasound. Relationships between achieved levels of HDL related measures with clinical characteristics and changes in plaque burden were determined. Results Strong correlation between HDL-C and apoAI (r=0.73, p<0.0001) was noted. Patients with highest levels of HDL-C:apoAI were more likely to be female, black, and have lower BMI and less likely to be smokers or have previous revascularization (all p<0.001) or acute coronary syndrome (p=0.013). HDL-C, apoAI, and HDL-C:apoAI demonstrated negative correlation with change in total atheroma volume (p<0.01). For HDL-C:apoAI and HDL-C, increasing tertiles of achieved levels were associated with a linear benefit in slowing progression. For apoAI, a nonlinear association was seen, with similar benefit on progression in the middle and upper tertiles ( Table ). There was no statistical interaction for heterogeneity between HDL-C:apoAI and atheroma burden based on achieved levels of HDL-C (p=0.581). Change in IVUS Measures By Tertiles of Achieved HDL-related Parameters Percent Atheroma Volume Parameter T1 T2 T3 P Value HDL-C 0.58±0.27 0.26±0.27 0.11±0.27 0.012 ApoAI 0.28±0.26 −0.04±0.26 −0.08±0.26 0.10 HDL-C:ApoAI 0.22±0.27 0.13±0.27 −0.27±0.27 0.021 Total Atheroma Volume Parameter T1 T2 T3 P Value HDL-C −2.46±2.21 −4.18±2.20 −5.31±2.20 0.035 ApoAI −4.94±2.13 −6.30±2.13 −7.40±2.13 0.135 HDL-C:ApoAI −4.59±2.25 −6.38±2.24 −8.07±2.26 0.022 Conclusions Increase in all HDL related measures was associated with less progression of coronary atherosclerosis. Association of higher HDL-C:ApoAI with favorable effect on plaque progression at all levels of HDL-C suggests intact HDL functionality of larger cholesterol rich particles. Interventions that increase HDL particle cholesterol content, such as CETP inhibitors, may thus have beneficial effect at the artery wall.

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