Terapevt Arkh
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Randomized Controlled Trial
[Modification of dietary patterns in patients with non-alcoholic steatohepatitis].
To assess efficacy of dietary patterns modification with the use of specialized food in patients with non-alcoholic steatohepatitis (NASH). ⋯ Modification of dietary patterns with the use of a specialized food in combination with low-calorie diet allows achieving significant reduction of weight and improve lipid and carbohydrate metabolism, reduce severity of cholestasis in patients with NASH.
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Historical Article
[Fabulus of the concert for the 100th anniversary of Yevdokimov Moscow State University of Medicine and Dentistry].
On the basis of critical analysis of sources the author reveals the role of doctors in opera productions, ballet and art in general. Looking through opera librettos and director's productions the author makes conclusions about characteristic human health problems, treatment methods used and the social status of doctors. About 10 percent of the four hundred opera and ballet productions performed today include doctor characters. These characters differ significantly from each other, depending on the time of creation of the work or the era reflected in the plot.
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In recent years, the harmonization of domestic and foreign clinical recommendations for the treatment of cystitis has been achieved. Nitrofurans and fosfomycin trometamol are recommended as first line therapy antibiotics, and oral 3rd generation of cephalosporins are recommended as alternative antibiotics; fluoroquinolones are excluded from the recommended medications due to an unfavorable safety profile. The main rationale for inclusion of antibiotics in the recommendations as a first line therapy of cystitis is the level of resistance of uropathogens to antibiotics, primarily Escherichia coli. ⋯ In the latest WHO document of 2021, experts divided antibiotics into three groups (ACCESS, WATCH, RESERVE) according to the priority of choice. The ACCESS group of drugs for the treatment of cystitis includes nitrofurantoin and furazidine as agents with minimal collateral effect, while fosfomycin trometamol and cephalosporins are listed in the WATCH group. Thus, from the standpoint of ecological safety, WHO experts recommend prescribing nitrofurans in the treatment of cystitis in the first line of therapy.
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According to current concepts, human immunoinflammatory diseases (IIDs), depending on the prevailing mechanisms of immunopathogenesis, are divided into two main categories: autoimmune and autoinflammatory. At the same time, both autoimmune and autoinflammatory mechanisms are involved in the pathogenesis of most IIDs, and the complex interaction of these mechanisms is reflected in the polymorphism of clinical presentation, course variants, outcomes and therapy efficacy. ⋯ Currently, anakinra, a recombinant non-glycosylated analog of the IL-1 receptor antagonist that blocks both IL-1b and IL-1a signaling, and canakinumab, a monoclonal antibody to IL-1b, are used in clinical practice to inhibit the pathological effects of IL-1. Analysis of the treatment outcomes with these drugs suggests that IL-1 inhibition should be considered a promising direction of pharmacotherapy of systemic autoinflammatory diseases and critical conditions associated with hyperinflammation in children and adults.
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Our aim was to give a comparative assessment of the effectiveness of using narlaprevir in combination with pegylated interferon-alpha-2a (Peg-IFN-alpha-2a) and interferon-free mode in patients with chronic hepatitis C (CHC). ⋯ Real clinical practice indicates that the use of narlaprevir in the non-interferon mode is not inferior in efficiency to the interferon-containing treatment regimen and demonstrates a more favorable safety profile.