pathogenetic therapy
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2022 ◽  
Vol 13 (1) ◽  
pp. 012-018
Author(s):  
Sergiy Prosyanyi ◽  
Andrii Borshuliak ◽  
Yulia Horiuk

The purpose of our research was to test the therapeutic efficacy of the acaricide «Simparica®» in combination with the biostimulator «Catosal» and the hepatoprotector «Tioprotectin» for demodicosis in dogs in the conditions of veterinary clinics in the Kamianets-Podilskyi, Ukraine. The study has been performed on dogs of different genders, ages and breeds that had a generalized form of demodicosis (affected at least 6 areas on the body of animals), to test the effectiveness of this drug in different treatment schemes. Acarological studies of scrapings from the skin of experimental animals for the presence of live or dead mites Demodex canis or their eggs have been carried out by the vital method according to D.O. Pryselkova. As a result of the conducted researches the choice of acaricidal drugs and development of complex therapeutic measures for demodicosis of dogs has been experimentally substantiated. The drug «Simparica®» has proved to be quite effective against demodicosis of dogs, even with a single use. The dependence of the effectiveness of the use of prolonged acaricide «Simparica®» on clinical forms of demodicosis has been shown. The absolute therapeutic effect of acaricide is obtained in the scaly form of demodicosis. However, in pustular and mixed clinical forms of demodicosis, its effectiveness decreased to 71.4 and 57.1%, respectively. In combination with the drug of pathogenetic therapy «Catosal» for pustular and mixed forms of demodicosis, the therapeutic efficacy of the drug «Simparica®» increases to 85.7%. When added to the scheme of hepatoprotector “Thioprotectin”, it is possible to achieve 100% therapeutic effect in pustular forms of demodicosis. However, in severe mixed form of demodicosis, the effectiveness was not absolute and was only 85.7%. In case of generalized demodicosis of dogs, regardless of clinical forms, it is recommended to use the acaricide «Simparica®» in combination with the drug «Catosal» and in the combination of «Catosal» and «Thioprotectin».


2021 ◽  
Vol 11 (4) ◽  
pp. 34-47
Author(s):  
S. N. Bardakov ◽  
D. I. Skulyabin ◽  
A. N. Moshnikova ◽  
S. V. Lapin ◽  
A. A. Sokolov ◽  
...  

Anti‑NMDA encephalitis is a rare autoimmune disease of the central nervous system caused by the synthesis of autoantibodies to the NR1/NR2 subunits of the NMDA receptor, characterized by the development of acute mental, cognitive, motor, autonomic disorders, epileptic syndrome and central hypoventilation.The article presents a three‑year observation of patient 34 years old with anti‑NMDA ncephalitis associated with late‑ stage ovarian teratoma, accompanied by an increase titer of antibodies to NMDA receptors in serum to 1:640.Based on a detailed analysis of clinical, neurological, neuropsychological (MMSE, MoСA, FAB, 10 words test A.R. Luria) and laboratory‑instrumental characteristics of the disease (titer anti‑NMDA, level of IgG, IgM, IgA, lymphocyte subpopulations, EEG, MRI of the brain, pelvis) suggested a combination scheme of first and second line therapy. The sequential use of two cycles of medium‑volume membrane plasmapheresis (25–30 % of the circulating plasma volume, No. 5 + 5) was carried out in combination with pulse therapy with methylprednisolone 1.0 (No. 4 + 3) and cyclophasphamide 1.0 (No. 2 + 1) on background of persistent ovarian teratoma. Symptom regression was achieved by the end of the first cycle, and full recovery to the initial level of cognitive functions occurred after the second cycle, while maintaining the anti‑NMDA antibody titer to 1:160. After removal of ovarian teratoma, the level of anti‑NMDA decreased in a month to 1:40, and after 7 months it reached normal values (<1:10) against the background of basic pill therapy with methotrexate 12.5 mg/week.Thus, a rational combination and sequence of first and second line therapy and therapeutic apheresis, taking into account the pathogenetic features of each phase of the disease, can quickly achieve complete stable remission in patient with anti‑NMDA encephalitis.


2021 ◽  
pp. 64-74
Author(s):  
- -

The menstrual cycle is an important indicator not only of the female reproductive system health but also an integral part of women's health. The issues of therapeutic approaches for menstrual disorders, considering the general trend towards an increase in the proportion of this pathology among the total gynecological disorders in Ukraine, are susceptible and require close attention. The problem of abnormal uterine bleeding (AUB) has a significant impact on women and health care worldwide. Algorithms for the diagnosis and therapy of AUB need to be regularly revised as international recommendations are updated, clinical trials are published, and a new look at pathogenetic mechanisms is made.The prerequisites for holding of this Expert Forum were the updating of the FIGO classification of uterine bleeding in 2018, the NICE guidelines “Heavy menstrual bleeding: assessment and management” in 2018 and 2021, as well as the new conditions of the pandemic era, which has taken its toll on the care of patients with AUB.The Resolution summarized all data unaccounted for in the current clinical protocol for AUB issued in 2016 and updated data from international guidelines and key studies in patients with AUB; highlighted in detail current thinking on the pathogenetic therapy of functional AUB, with an emphasis on chronic AUB associated with ovulatory dysfunction (AUB-O) and endometrial disorders (AUB-E), as the most common; provided modern approaches to the management of chronic AUB associated with non-structural causes (ovulatory dysfunction and endometrial factors), and prevention of acute AUB for implementation in clinical practice and improving the provision of evidence-based medical care and individualized patient care.The Resolution aims to optimize clinical approaches to patient management and ensure therapy personalization, which together will improve the reproductive health and general well-being of Ukrainian women.


Morphologia ◽  
2021 ◽  
Vol 15 (1) ◽  
pp. 48-59
Author(s):  
S.V. Zyablitsev ◽  
P.Yu. Penskyy ◽  
M.L. Litvinets ◽  
A.V. Kovalova ◽  
A.A. Salamaha

Background. Currently, there is a need to create an experimental model for reproducing the main pathogenetic mechanisms of COVID-associated lungs damage. The first stage of such a model may be reproducing acute aspiration bronchopneumonia in rats. Objective. Examine the dynamics of morphological changes in the lungs in the development of experimental acute aspiration bronchopneumonia. Methods. The group of laboratory Wistar rats (n=25) in compliance with bioethical norms under typoental anesthesia was carried out operational intervention with the introduction of a sterile capron thread 2.5 cm long and a thickness of 0.2 mm to a depth of 2.5 cm. In the control group included 5 false-controlled animals. At 7, 14, 21, 28 and 56 days, the animals were derived from the experiment, morphological studies were carried out with the painting serial sections with hematoxylin-eosin. Results. On the 7 day, the morphological picture testified to the development of the acute stage of exudative inflammation with the full-blood of vessels, microtrombosis, dyslectasis, hyperplasia of alveolocytes II type. After 14 days, the proliferative stage was formed with alveolocytes hyperplasia, the epithelium of bronchi, as well as fibroblasts with the formation of sharp peribronchial and alveolar abscesses. After 21 days, the development of the lungs fibrosis with the organization of acute peribronchial and alveolar abscesses was noted, peribronchial and intraalveoli pronounced interstitial edema and the reactive hyperplasia of lymphoid follicles of a mixed nature. After 28 days, bronchopneumonia was organized in the form of fibrosis parenchyma, sections of chronic productive inflammation with the formation of resorbative granuloms; sections of the blood vessels hyalinose. For 56 days, these phenomena were progressed before the development of dense fibrosis (carnification) with sections of chronic abscesses with a formed by a connective tissue capsule, the development of vascular hyalinose. Conclusion. Thus, the model of acute aspiration bronchopneumonia reproduces the dynamics of morphological manifestations of acute lung damage, which is the basis for the development of pathogenetic therapy fields.


Author(s):  
Sergei A. Kurbatov

Background. Spinal muscular atrophy 5q (5q SMA) is the most frequent autosomal recessive hereditary neuromuscular disease. Molecular genetic testing is used for SMA diagnosis, and it can confirm only 5q SMA. The clinical findings and results of paraclinical studies may overlap with hereditary primary-muscular diseases making the diagnosis difficult and delaying the administration of pathogenetic treatment for 5q SMA.Clinical case description. Clinical description of 10 patients with 5q SMA aged from 3 months to 25 years with different severity of proximal tetraparesis, skeletal muscular atrophy and tendon reflexes depression is given. 3 patients under 2 years of age with myogenic pattern at needle electromyography (nEMG) in lateral vastus muscle and 7 patients over 2 years of age with increased levels of creatine phosphokinase (CPK) in blood serum were mistakenly diagnosed for inherited primary-muscular diseases for the period from 1 month to 12 years. After the genetic counselling based on the disease course and clinical findings we suspected and later confirmed 5q SMA.Conclusion. In case of flaccid proximal tetraparesis associated with myogenic pattern at nEMG in young children or with increased CPK levels at late manifestation it is crucial to perform differential diagnosis of 5q SMA since there are options of pathogenetic therapy. 


2021 ◽  
pp. 7-11
Author(s):  
M. G. Sokolova ◽  
M. A. Privalova ◽  
V. A. Shavurov ◽  
O. Yu. Shtakelberg ◽  
E. V. Lopatina ◽  
...  

Clinical and neurological, neurophysiological, and neuropsychological examination of 50 patients aged 50–65 y. o. with an experience of COVID‑19 infection within the last 3 to 6 months, revealed pathological changes in the central nervous system in the form of cerebrastenic and autonomic disorders, motor disorders, vestibulopathy symptoms, which occurred in various combinations, with astheno-vegetative syndrome as obligate. Cognitive impairments were detected in 26% of patients; the mental fatigability index was 1.055 ± 0.124; a high level of situational anxiety was noted in 35% of patients, and a high level of personal anxiety in 50 % of patients with the experience of COVID‑19. The study of brain biopotentials revealed moderate diffuse changes (18%) and irritative disorders on the part of hypothalamic (69 %) and diencephalic structures (20%). All of the above may indicate that, regardless of the form of coronavirus infection occurred in humans, i. e., latent, mild, moderate or severe, one of the targets of the pathological impact of COVID‑19 virus is the median structures of the brain responsible for autonomic and cognitive functions. Nevertheless, in our opinion, these disorders are associated not with a direct pathological effect, but are mediated mainly by circulatory disorders in the microcirculatory bed due to endothelial damage and are rather functional disorders on the part of the central nervous system. This provides the grounds for the selection of pathogenetic therapy aimed at stabilizing the functional state of neurons, and one of the drugs of choice may be citicoline (Noocyl), the action of which is associated with reinforcing the cell membrane of the neuron and normalizing bioelectric processes.


Author(s):  
Irina A. Belyaeva ◽  
Tatiana V. Turti ◽  
Elena P. Bombardirova ◽  
Pavel E. Sadchikov ◽  
Alexander Yu. Nagonov

The review provides the analysis of modern publications on the topic of correlation between development of intestinal microbiota and maturation of neurophysiological activity patterns (on the example of sleep age structure development). The importance of the stage maturation of intestinal microbiota in the concept of the gut-brain axis is presented. Mechanisms and mediators involved in this axis are described, and its ontogenetic significance is justified. The main stages of sleep function development in a child as an important component of the general mental health maturation in relation to environmental factors and family features are presented. Recommendations on sleep periods duration and estimation of sleep onset and sleep structure are also given. Direct and reverse correlations of quantitive and qualitative microbiota parameters with sleep efficiency are shown. Positive correlation was identified between sleep consolidation, number and diversity of Bacteroidetes species in intestinal microbiota, and composition of bacterial metabolites. The presence of such correlations is theoretical justification for further development of methods of pathogenetic therapy of both microbiota and sleep disorders.


Vestnik ◽  
2021 ◽  
pp. 147-150
Author(s):  
С.Н. Ералина ◽  
Е.Л. Исмаилов ◽  
М.Е. Рамазанов ◽  
Б.Ж. Аджибаев ◽  
Д.К. Сейтпанов ◽  
...  

Раннее включение НВВГФ в комплексном лечении сепсиса и септического шока приводит к снижению клинических признаков эндотоксикоза, стабилизации гемодинамики в более ранние сроки, что связано с быстрой элиминацией цитокинов, коррекцией осмотического равновесия, увеличением диуреза, благодаря более раннему протезированию гомеостатической функции почек. Early inclusion of NVHF in the complex treatment of sepsis and septic shock leads to a decrease in clinical signs of endotoxicosis, stabilization of hemodynamics at an earlier time, which is associated with rapid elimination of cytokines, correction of osmotic balance, increased urine output due to earlier prosthetics of homeostatic renal function.


2021 ◽  
pp. 13-17
Author(s):  
А.Е. Турсын

Описан клинический случай пациент с нефротическим синдромом, стероид резистентный вариант, с артериальной гипертензией, осложненный полисерозитом (гидроторакс, асцит, плеврит). Пациент поступил в клинику в состоянии средней степени тяжести, с массивными отеками, полисерозитом, артериальной гипертензией и выраженным нефротическим синдромом. Диагноз: Гломерулярная болезнь. Нефротический синдром, стероид резистентный вариант. Функция почек снижена (СКФ- 84мл/мин по Шварцу). Двухсторонний экссудативный плеврит. Гидроторакс. Полисерозит (в рамках нефротического синдрома) был установлен на основании выраженного нефротического синдрома. Пациенту была проведена патогенетическая терапия. Отмечено улучшение состояния больного, в виде снижения отеков, нормализаций артериального давления, что в свою очередь поспособствовало сохранению и улучшению качества жизни пациента. A clinical case of a patient with nephrotic syndrome, steroidresistant variant, with arterial hypertension complicated by polyserositis (hydrothorax, ascites, pleurisy) is described. The patient was admitted to the clinic in a state of moderate severity, with massive edema, polyserositis, arterial hypertension, and severe nephrotic syndrome. Diagnosis: Glomerular disease. Nephrotic syndrome, steroidresistant variant. The kidney function is reduced (GFR - 84 ml/min according to Schwartz). Bilateral exudative pleurisy. Hydrothorax. Polyserositis (within the framework of nephrotic syndrome) was established based on the severe nephrotic syndrome. The patient underwent pathogenetic therapy. An improvement in the patient's condition was noted, in the form of a decrease in edema, normalization of blood pressure, which in turn contributed to the preservation and improvement of the patient's quality of life.


Author(s):  
A. P. Fisenko ◽  
D. I. Zelinskaya ◽  
R. N. Terleckaya ◽  
I. V. Vinyarskaya

The article provides an overview of special literature, which gives an opportunity to redefine some issues of disability prevention in children with rare (orphan) diseases, which will improve the organizational measures in this area. The prevention of children’s disability is considered as a system of measures to protect the health of the mother and child throughout childhood. The early disability prevention system in children and support for families raising children with disabilities remain among the main priorities of the State social policy of the Russian Federation. The authors describe modern technologies for reducing the genetic burden in the population from the point of view of preventing hereditary and congenital pathologies. They identify the priority areas of disability prevention in children with rare (orphan) diseases, i.e. introduction of prenatal and preimplantation diagnostics; use of the Prenatal Consultation organizational model; conducting a wider screening for congenital and hereditary metabolic diseases with the inclusion of the most common nosological forms of rare (orphan) diseases; finding pathogenetic therapy methods; increasing the knowledge of pediatricians about rare (orphan) diseases.


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