scholarly journals Clinical variants of esophageal stenosis caused by infectious esophagitis in children

2021 ◽  
Vol 20 (4) ◽  
pp. 108-115
Author(s):  
S. G. Podlipaeva ◽  
I. V. Zakharov ◽  
Yu. A. Dmitrieva ◽  
T. S. Shubina ◽  
I. V. Serkova ◽  
...  
Keyword(s):  
Drug Therapy ◽  
Patient Management ◽  
Esophageal Stenosis ◽  
Ethics Committee ◽  
Immunocompromised Patients ◽  
Oncological Diseases ◽  
Clinical Variants ◽  
Endoscopic Picture ◽  
Endoscopic Methods ◽  
Methods Of Treatment

Infectious esophagitis (IE) is commonly seen in immunocompromised patients. IE may be the first symptom of immunodeficiency state, also can be complication of immunosuppressive therapy in patients with hematological and oncological diseases. Severe complication of IE is esophageal stenosis. Patient management tactics continue to be discussed. A purpose of our publication is to demonstrate our experience in the management of patients with infectious esophageal stenosis. The etiology, features of the clinical and endoscopic picture, as well as the effectiveness of drug therapy and endoscopic methods of treatment have been analyzed. The study was approved by the Independent Ethics Committee and the Scientific Council of the D. Rogachev NMRCPHOI. In each case, parents gave their consent to the use of their child’s data, including photographs, for research purposes and in publications. 

POLYPHARMACY IN ELDERLY OUT PATIENTS

2019 ◽  
pp. 16-22
Author(s):  
E.A. Panova ◽  
V.A. Serov ◽  
A.M. Shutov ◽  
N.N. Bakumtseva ◽  
M.Yu. Kuzovenkova
Keyword(s):  
Drug Therapy ◽  
Elderly Patients ◽  
Drug Prescription ◽  
Daily Practice ◽  
Drug Prescriptions ◽  
Ulcer Disease ◽  
Start Criteria ◽  
Therapeutic Value ◽  
Elderly Outpatients ◽  
Oncological Diseases

The aim of the work is to study the daily practice of prescribing drugs at the outpatient stage of medical care and to analyze the data obtained based Beers 2012 criteria and STOPP / START version 1. Materials and Methods. The authors analyzed drug prescriptions for 150 outpatients, who were over 65 years old. Results. Cardiovascular diseases, diseases of the osteo-articular system and type 2 diabetes mellitus prevailed in the morbidity structure of patients. Oncological diseases, thyroid diseases, bronchial asthma, cataracts, pancreatitis, anemia, peptic ulcer disease were diagnosed in some patients. All drug prescriptions during the year were taken into account. Simultaneous prescription of more than 4 drugs was considered polypharmacy. All the patients were monitored for a year since drug prescriptions had been made. Death was taken as the end point. The authors considered drug therapy to be irrational according to Beers and STOPP / START criteria. The therapeutic value of drug prescription audit based on restrictive lists was evaluated. Conclusions. Polypharmacy is observed in more than half of elderly outpatients. According to Beers 2012 criteria, irrational drug therapy was detected in 20 % of elderly patients, according to STOPP and START lists – in 43.3 % and 66.6 %, respectively. The lack of drug prescriptions in accordance with START criteria is associated with increased mortality of elderly patients. Keywords: polypharmacy, pharmacotherapy, drug therapy, geriatrics, restrictive lists, Beers criteria, STOPP / START criteria. Цель работы – изучение ежедневной практики назначения лекарственных препаратов на амбулаторном этапе медицинской помощи и анализ полученных данных на основе критериев ограничительных перечней Бирса 2012 г. и STOPP/START версии 1. Материалы и методы. Проанализированы лекарственные назначения 150 пациентам старше 65 лет, находившимся на амбулаторном лечении. Результаты. В структуре заболеваемости пациентов преобладали сердечно-сосудистые заболевания, а также болезни костно-суставной системы и сахарный диабет 2-го типа. Онкологические заболевания, заболевания щитовидной железы, бронхиальная астма, катаракта, панкреатит, анемия, язвенная болезнь диагностированы у единичных больных. Учитывались все лекарственные назначения в течение года. За полипрагмазию принималось одновременное назначение более 4 препаратов. В течение последующего года отслеживалось состояние пациентов, за конечную точку принята смерть. Выявлена нерациональная лекарственная терапия на основе критериев Бирса и STOPP/START. Оценена терапевтическая значимость аудита лекарственных назначений по ограничительным перечням. Выводы. Полипрагмазия наблюдается более чем у половины амбулаторных пациентов пожилого возраста. На основе критериев ограничительных перечней Бирса 2012 г. нерациональная лекарственная терапия выявлена у 20 % пациентов пожилого возраста, на основе критериев STOPP и START – у 43,3 и 66,6 % соответственно. Отсутствие назначений лекарств в соответствии с критериями START ассоциировано с увеличением смертности пациентов пожилого возраста. Ключевые слова: полипрагмазия, фармакотерапия, лекарственная терапия, гериатрия, ограничительные перечни, критерии Бирса, критерии STOPP/START.

The value of endoscopic examination methods in infertile marriage

2021 ◽  
Vol 50 (3) ◽  
pp. 52-56
Author(s):  
I. E. Korneeva
Keyword(s):  
Medical Care ◽  
Retrospective Analysis ◽  
Reproductive Function ◽  
Endoscopic Examination ◽  
Female Infertility ◽  
Infertile Women ◽  
Important Stage ◽  
Examination Methods ◽  
Endoscopic Methods ◽  
Methods Of Treatment

To optimize the management of infertile women the estimation of efficacy of endoscopic methods of treatment (laparoscopy and hysteroscopy) in this category of patients was undertaken. With the method of retrospective analysis clinico- laboratory and endoscopic examination of2785 sterile pairs was carried out. The results of the study showed that endoscopic methods are not only the most important stage of diagnostics but also the first pathogenetically substantiated stage in treating female infertility. It became clear that half of the patients demonstrated from 2 till 5 factors in pathogenesis of reproductive function abnormalities that brings on the necessity of elaboratingthe algorithm of treatingparticular patients considering the disturbances revealed.So, to increase the effectiveness of treating the patients in question, distinct standards of medical care should be put into practice.

Dilation of malignant esophageal stenosis to allow EUS guided fine-needle aspiration: safety and effect on patient management

2000 ◽  
Vol 51 (3) ◽  
pp. 309-313 ◽  
Author(s):  
Michael B. Wallace ◽  
Robert H. Hawes ◽  
Anand V. Sahai ◽  
Annette Van Velse ◽  
Brenda J. Hoffman
Keyword(s):  
Fine Needle Aspiration ◽  
Patient Management ◽  
Needle Aspiration ◽  
Esophageal Stenosis ◽  
Fine Needle

Clinical variants of esophageal injuries, diagnostics and treatment methods

2020 ◽  
Author(s):  
Vladimir Belokonev ◽  
Sergey Pushkin ◽  
Zinaida Kovaleva ◽  
Elena Aksenova ◽  
Nikolay Abashkin ◽  
...  
Keyword(s):  
Higher Education ◽  
Postoperative Period ◽  
Treatment Options ◽  
Surgical Anatomy ◽  
Diagnostic Methods ◽  
Federal State ◽  
Educational Standards ◽  
Clinical Variants ◽  
State Educational ◽  
Methods Of Treatment

The textbook is devoted to the diagnosis of esophageal injuries and treatment of patients. The article describes the surgical anatomy of the organ, causes of esophageal injuries, classification, diagnostic methods, tactics, describes possible treatment options for patients depending on the clinical picture, technique and volume of operations depending on the developing complications. The paper presents original methods of treatment of the esophagus, methods of management of patients in the postoperative period, treatment of possible complications and their prevention. Meets the requirements of the Federal state educational standards of higher education of the latest generation. For doctors-surgeons, clinical residents, postgraduates, undergraduates and teachers of medical universities.

scholarly journals Management of a patient with terminal chronic heart failure.

2018 ◽  
Vol 96 (3) ◽  
pp. 273-276
Author(s):  
N. A. Kosheleva ◽  
Elena Yu. Ponomareva ◽  
D. S. Sedov
Keyword(s):  
Heart Failure ◽  
Drug Therapy ◽  
Chronic Heart Failure ◽  
Heart Transplantation ◽  
Dilated Cardiomyopathy ◽  
Patient Management ◽  
Clinical Case ◽  
Clinical Manifestations

The presented clinical case describes the development of diffuse myocarditis in a 31-year-old man with the outcome of dilated cardiomyopathy and terminal chronic heart failure, resistant to drug therapy that required heart transplantation. Discussed aspects of diagnosis, clinical manifestations, tactics of patient management and indications for heart transplantation.

scholarly journals IMPACT OF ACNE VULGARIS ON A PERSON’S QUALITY OF LIFE AND IT’S CORRELATION WITH THE CLINICAL SEVERITY PRE AND POST-DRUG THERAPY

2022 ◽  
pp. 13-16
Author(s):  
SWOPNA PHUKAN ◽  
SAHELI DAS
Keyword(s):  
Quality Of Life ◽  
Drug Therapy ◽  
Observational Study ◽  
Acne Vulgaris ◽  
Ethics Committee ◽  
Clinical Severity ◽  
Grading System ◽  
Institutional Ethics

Objective: The aim of the study is to assess the therapeutic efficacy of drugs used in acne vulgaris by measuring the severity of acne using the Global Acne Grading System score (GAGS) and Cardiff Acne Disability Index (CADI) questionnaire score pre and post-drug therapy. Methods: The present study was conducted in the Department of Dermatology after getting approval from the Institutional Ethics Committee (No MC/190/2007/Pt1/MAR-2019/PG/123) dated 10/04/2019. It was an observational study for a period of 1 y. 172 patients were enrolled in the study. Patients were divided into 4 grades depending on their clinical manifestation. The severity of acne vulgaris and the quality of life were measured using the GAGS scale and the CADI questionnaire, respectively at the first visit and at the follow-up visit in all the grades of acne vulgaris. A correlation was done between the GAGS and the CADI score at the follow-up visit in all grades of acne. Results: It was observed that the GAGS score and the CADI score was significantly improved at the F/U visit (p<0.05) as compared to baseline in all the 4 grades of acne. A correlation between GAGS score and QoL using CADI scale was done using Pearson Parametric Correlation Test. In none of the groups, the correlation was significant (p>0.05). Conclusion: We can conclude from our study that following treatment with drugs, the clinical severity of acne decreased and there was also a significant improvement in the quality of life of patients.

scholarly journals COMPARATIVE ANALYSIS OF COST OF DRUG THERAPY OF THE MOST HIGH-COST ONCOLOGICAL DISEASES IN MOSCOW

2018 ◽  
Vol 8 (2) ◽  
pp. 12-20
Author(s):  
К. I. Poliakova ◽  
M. E. Holownia-Voloskova ◽  
M. Yu. Byakhov ◽  
T. N. Ermolaeva ◽  
A. G. Fisun ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prostate Cancer ◽  
Drug Therapy ◽  
Health Department ◽  
Point Of View ◽  
Cancer Register ◽  
Number Of Patients ◽  
Oncological Diseases ◽  
Moscow City ◽  
Therapy Costs

Objectives.According to literature and experts, prostate cancer (PC), breast cancer (BC), colon cancer (CC), melanoma (MEL) and renal cell carcinoma (RCC) are the most high-cost oncological diseases. The aim of our study was to calculate the charges for each of these nosologies from the point of view of Moscow’s budget and compare them with each other.Methods.To assess the annual costs of drug therapy in Moscow in patients with PC, BC, CC, MEL and RCC there has been developed an analytical model in MS Excel software, considering the data of Cancer Register, as well as literature sources.Results.There has been estimated that if the costs of drug therapy for all five of assessed types of cancer are taken as 100 %, then the most costly is BC (41 % of costs), then MEL (20 %), RCC (15 %), CC (13 %) and PC (12 %). There has been also calculated, that if the number of patients with all five types of assessed cancer undergoing drug therapy, we would consider as 100 %, the highest percentage of them is in BC (50 % of all patients), then PC (36 %), CC (9 %), MEL (3 %) and RCC (1 %).Conclusions. The structure of drug therapy costs in patients with PC, BC, MEL, CC and RCC in Moscow shows that the most expensive is the treatment of patients with melanoma (for 3 % of patients Moscow City Health Department spends 20 % of charges) and RCC (1 % of patients spends 15 % of charges).

scholarly journals REVIEW OF APPROACHES TO IMMUNOTHERAPY IN ONCOLOGY

2017 ◽  
Vol 4 (3) ◽  
pp. 51-65
Author(s):  
I. L. Tsarev ◽  
A. V. Melerzanov
Keyword(s):  
Cell Therapy ◽  
Tumor Cells ◽  
Checkpoint Inhibitors ◽  
Immune Therapy ◽  
Regulatory Mechanisms ◽  
Inhibitory Influence ◽  
Oncological Diseases ◽  
Immunological Reactions ◽  
New Biomarkers ◽  
Methods Of Treatment

The article discusses modern ideas about the immune therapy of cancer — methods of treatment of oncological diseases based on immunological reactions of the organism to the appearance of malignant cells in it. This area is actively studied in clinical practice in the last decade, and some therapy has already been approved for use by regulators after promising results of clinical trials 3 phase.Immune therapy is based on antitumor immune cycle — the cascade of processes responsible for the immune system’s response to tumor cells. Involved regulatory mechanisms are targets for various therapies, the overall goal is to restore proper functioning of the cycle and to achieve the elimination of cancer cells.Currently, the most studied two types of immune therapy — checkpoint inhibitors and adaptive cell therapy. Checkpoint inhibitors increase the activity of body immune cells, reducing the inhibitory influence of the tumor microenvironment and the tumor cells themselves, which allowed them to get out from under the pressure of the immune system during the development of the disease. Adaptive cell therapy, in turn, allows to compensate the lack of active immune against tumor cells.Mechanisms of action determine the effectiveness of various therapies for different diseases, and for patients inside of one diagnosis. To determine the effectiveness of other treatment prior to a particular patient it is necessary to use the latest achievements in precision medicine, based on the search for new biomarkers and analyzing each patient separately. This approach will significantly reduce costs and save precious time for the patient. 

scholarly journals Drug therapy in the treatment of endometriosis

2016 ◽  
pp. 86-91
Author(s):  
A. A. Popov ◽  
B. A. Slobodyanyuk ◽  
T. N. Manannikova ◽  
A. A. Fedorov ◽  
T. Z. Chanturia ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Drug Therapy ◽  
Surgical Procedures ◽  
Reproductive Medicine ◽  
Management Plan ◽  
Surgical Methods ◽  
American Society ◽  
Practice Committee ◽  
Xix Century ◽  
Methods Of Treatment

Clinical studies of medicine-based and surgical methods for the treatment of endometriosis are described. Although endometriosis was described as early as in the XIX century, the causes for its emergence and spread have not been fully investigated. Also, many questions regarding methods of treatment remain far from being solved. Due to the chronic and often relapsing nature of the disease, Practice Committee of the American Society for Reproductive Medicine (ASRM) has concluded the following: "endometriosis should be viewed as a chronic disease that requires a lifelong management plan with the goal of maximizing the use of medical treatment and avoiding repeated surgical procedures." Thus, treatment of endometriosis should not only be comprehensive but also adapted to the specifics of each woman's organism.

scholarly journals EFFICIENCY AND SAFETY OF RADIOFREQUENCY CATHETER ABLATION OF ATRIAL FIBRILLATION IN ELDERLY PATIENTS

2017 ◽  
Vol 8 (2) ◽  
pp. 34-41
Author(s):  
M H Fedorova ◽  
A V Chapurnykh ◽  
V B Nizhnichenko ◽  
S V Lakomkin ◽  
V L Doshicin
Keyword(s):  
Atrial Fibrillation ◽  
Drug Therapy ◽  
Radiofrequency Ablation ◽  
Catheter Ablation ◽  
Elderly Patients ◽  
Radiofrequency Catheter Ablation ◽  
Risk Of Death ◽  
Group A ◽  
People Group ◽  
Methods Of Treatment

Atrial fibrillation is one of the most frequent and significant rhythm disturbances. The effectiveness and expediency of using one of the most effective methods of treatment of this arrhythmia (radiofrequency ablation in elderly patients) remains a controversial and insufficiently studied issue. The article compares the results of the treatment of 63 patients of mature age (up to 75 years) and senile age (from 75 years). Patients underwent 78 operations of radiofrequency catheter ablation of atrial fibrillation and atypical atrial flutter, which was resistant to drug therapy. In the groups of patients of mature and senile age, there were no statistically significant differences in the effectiveness of treatment. In elderly people group, a higher incidence of complications was found mainly due to hydrothorax, but these complications did not increase the risk of death and were stopped during treatment. This allows to conclude that the senile age of patients should not be the reason for refusing to conduct radiofrequency catheter ablation.

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