Vol 25, No 2 (2024): Опубликован 28.06.2024

In the POLARIX (A Study Comparing the Efficacy and Safety of Polatuzumab Vedotin with Rituximab, Cyclophosphamide, Doxorubicin, and Prednisone vs. Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone in Participants with Diffuse Large B-cell Lymphoma) study of patients with DLBCL, there was a 6,5% 2-year progression-free survival (PFS), with no difference in overall survival (OS) or safety with polatuzumab vedotin, rituximab, cyclophosphamide, doxorubicin and prednisone (Rola-R-CHP) compared to standard line of therapy with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP).

We evaluated the cost-effectiveness of pola-R-CHP for the treatment of DLBCL by modelling a hypothetical cohort of treatment-naive adults (mean age 65 years) with DLBCL, developing a Markov (life horizon) model to predict the cost-effectiveness of pola-R-CHP and R-CHOP using two plausible long-term outcomes. The rate of progression and life duration were estimated using POLARIX data. Assuming the same rate of progression between 2 and 5 years with the two strategies, we showed that Pola R-CHP could be cost-effective, as the incremental efficacy was 1.21 life-years, 0.5 years longer with R-CHOP. In a best-case scenario, where it is likely that pola-R-CHP has a lower rate of disease progression between 2 and 5 years compared with R-CHOP, pola-R-CHP would be an even more cost-effective therapy regimen. Incremental efficacy in this hypothesis was 1.51 years with Pola-R-CHP therapy, resulting in a difference of about 0.9 years, compared with R-CHOP. At the same time, the cost-effectiveness ratio for Pola-R-CHP therapy is 714,101 rubles versus 565,463 rubles for R-CHOP therapy, with a difference of only 148,638 rubles. The findings illustrate the long-term benefits of Rola-R-CHP compared to R-CHOP in patients with DLBCL. This analysis may help to support the use of Rola-R-CHP by haematologists and identify patient groups for whom it may be most cost-effective.

The presence in patients of foci of chronic odontogenic and non-odontogenic infections in the oral cavity, on the skin of the face and neck leads to the spread and generalization of the infectious process in the maxillofacial region. The purpose of our work was to identify the most effective drugs used in the treatment of phlegmon and abscesses of the face and neck. A search was performed for scientific articles in PUBMED and eLIBRARY.RU An analysis of the information on this topic has been carried out. A questionnaire was developed for practicing dental surgeons and maxillofacial surgeons, and the results of the survey were analyzed. According to the results of the survey, the most effective and frequently prescribed antibacterial agents were drugs of the cephalosporin series (cefazolin, cefotaxine, ceftriaxone, sulcef). Antimicrobial drugs (metronidazole, tinidazole). Antihistamines are chlorpyramine and diphenhydramine. Detoxification agents - hemodesis, glucose, sodium chloride, Ringer's solution and aminoplasmal. Drugs for immunoprophylaxis - thymogen and thymoline. Analgesics are "Analgin", "Ketorol" and "Ketorolac". Enzymes - lidase and langidase, antiseptics - chlorhexidine, "Miramistin" and "Chlorfilipt". Thus, it can be concluded that the medical treatment of abscesses and phlegmon of the face and neck should be comprehensive. It is mandatory to use antibacterial drugs, antihistamines, analgesics, multivitamins, and detoxification therapy.

Spinal muscular atrophy is a group of hereditary diseases that selectively affect the alpha motor neuron. Among autosomal recessive pathologies, this condition is the leading cause of hereditary infant mortality. The incidence of spinal muscular atrophy in the world ranges from 4 to 10 cases per 100,000 newborns. This article presents a clinical case of a child with Kugelberg-Velander disease, with a debut at school age.

The described literature sources established the role of serum HSP 70 in the development of atherosclerosis. This is due to stress exposure, which determines the release of DAMPs and the connection with Toll-like receptors. Their activation entails the development of a signaling cascade and the production of proinflammatory cytokines, which contributes to the development of inflammation. It was proven that high concentrations of HSP significantly increased in patients with a high value of the intima-media thickness of the carotid arteries. Other studies noted a decrease in the titer of antibodies to circulating HSP 70 in myocardial infarction, which leaves the study of this biomarker in the development of atherosclerotic lesions relevant. An increase in the level of HSP 70 can be a predictor of the development of major diseases of the cardiovascular system, which requires further study of their role in the pathogenesis of atherosclerosis.

The leading cause of coronary heart disease (CHD) is atherosclerosis. Disorders in immunological regulation in the development of this pathology play an important role. The proinflammatory and dysregulated condition that forms in atherosclerosis can play a crucial role in increasing the human body's susceptibility to the development of a cytokine storm and worsening COVID-19 manifestations. The Sars-CoV-2 virus can affect the cardiovascular system, as its cells highly express the angiotensin converting enzyme receptor 2. The aim of the study was to study the dynamics of the immune status in patients with a new coronavirus infection with concomitant pathology of coronary heart disease. The influence of coronary heart disease on the course of the immunological scenario of the average form of this infection was revealed.

Biochemical prerequisites of coronary heart disease (CHD)They have been intensively studied in the last few decades. But many aspects of this issue remain to be fully explored. Uric acid is considered one of the potential risk factors underlying the development of cardiovascular diseases. Thus, the scientific and practical problem of hyperuricemia in patients with chronic forms of coronary heart disease is relevant. The study involved 120 patients with chronic forms of coronary heart disease, 55 of them women and 65 men (average age 65.7±11.9 years) of the cardiology department of the BUZ VOKB No. 1. The control group consisted of 30 healthy individuals (18 men and 12 women), average age 66.3±10.3 years). At the first stage of the study, the prevalence of patients with hyperuricemia among patients with coronary heart disease was studied. At the second stage, the degree of lipid profile impairment was investigated, depending on hyperuricemia in patients

This article is devoted to a new scientific direction in hyperbaric medicine - hyperoxic sanology. Its main goal is to form a unified methodological approach for practitioners to understand the mechanisms of the therapeutic effect of hyperoxia, which are aimed at increasing the sanogenic potential of a healthy and diseased organism. The object of study is a healthy and diseased organism. The subject of study is the therapeutic regimens of normobaric and hyperbaric hyperoxygenation used in the clinic. Research area: experimental and clinical. The adaptive-metabolic theory of hyperbaric medicine by A.N. Leonov is proposed as the gnoselogical basis for understanding the mechanisms of the therapeutic effect of hyperoxia.

The analysis of satisfaction with the quality of the educational process of students of the medical faculty of the medical University in educational, social areas, building the professional development of students is carried out. The results of the survey showed that most criteria of the educational environment of the university have a high level of satisfaction. The development of individual educational trajectories for students is one of the important directions for improving the quality of training of future medical specialists.

The purpose of the study was to determine the effect of osteoarthritis (OA) on physical activity and the control level in patients with asthma using predictive analysis methods.

Materials and methods. The study involved 137 patients with moderate asthma (26.2% men, 73.3% women, median age 54 [47; 60] years). Two groups were formed: 1st group of patients with asthma without OA (n=46), 2nd group of patients with asthma and OA (n=91). All patients underwent X-ray examination of the knee and hip joints, spirometry, determination of the Lequesne algofunctional index, the amount of physical activity using the physical activity questionnaire ODA23+, and the level of asthma control using the Asthma Control Questionnaire-5 (ACQ-5). Quality of life was assessed using the Asthma Quality of Life Questionnaire (AQLQ-S). The concentration of leptin in the blood serum was also determined.

Results and conclusion. Patients with asthma and OA had lower levels of physical activity (p=0.0000), quality of life (p=0.0000) and asthma control (p=0.0000), as well as higher BMI values (p=0. 0000) and algofunctional index (p=0.0000). The results of paired and multiple regression analyzes made it possible to establish the negative impact of OA on the level of asthma control, FEV1 and physical activity of patients with asthma. The positive effects of increased physical activity on asthma control and respiratory function have also been demonstrated.

The presented prognostic model allows one to mathematically calculate the expected severity of bronchial obstruction in patients with asthma and OA.

Viral hepatitis E (HEV) is a significant problem of world and domestic public health, is one of the main causes of morbidity and mortality from liver diseases. Goal. To identify possible regional features of the clinic of acute viral hepatitis E based on medical records of patients with hepatitis E over the past 11 years. To analyze the features of the epidemiology of HEV, to establish possible routes and mechanisms of infection of this new infection for the Voronezh region. Results. The overwhelming majority of patients (93.9%) did not leave their place of residence for at least six months before the onset of the disease. The proportion of icteric forms among patients with acute hepatitis E who were hospitalized in the Voronezh Regional Infectious Diseases Hospital was 71.4%. Hepatitis E was mostly of moderate and mild severity (71.4% and 20.4%, respectively), but there was also a severe course. No patients felt any improvement after the onset of jaundice. Laboratory findings were typical of acute viral hepatitis. Conclusion. As our research has shown, viral hepatitis E is a typical natural focal disease for the Voronezh region. The seasonality features of hepatitis E in the Voronezh region that we have identified are difficult to explain today. In our opinion, the reason lies in the lack of knowledge among practitioners of this new zoonotic infection of our region and, as a consequence, in the incomplete collection of epidemiological anamnesis in patients with viral hepatitis E. Since the clinical and biochemical data for hepatitis E are practically indistinguishable from those for other acute viral infections hepatitis, and the collection of epidemiological history by doctors regarding this new infection in the region still remains unsatisfactory, the only reliable method for diagnosing HEV in the region at the moment remains laboratory serological diagnosis.