Terapevt Arkh
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Over the past decades, chronic obstructive pulmonary disease (COPD) has become a major public health problem due to increasing morbidity and mortality. COPD is characterized by airflow limitation due to inflammation of the bronchial tree and remodeling of the small airways. In 20-40% of patients with COPD, eosinophilic inflammation of the airways is observed, as in bronchial asthma. ⋯ Although the role of eosinophils in the pathogenesis of COPD is not fully understood, the level of eosinophils can be used in the prognosis and administration of corticosteroids, and their effectiveness is higher in eosinophilia. Currently, monoclonal antibodies directed against interleukins (IL-5, IL-4 and IL-13) or their receptors are being tested in the T2 endotype of COPD. This review focuses on the mechanisms of eosinophilia in COPD, the use of blood and sputum eosinophils as a biomarker, and the advisability of using monoclonal antibodies in the treatment of eosinophilic COPD.
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Review
[Current status and prospects of using the prokinetic acotiamide in gastroenterology: A review].
Acotiamide is a prokinetic with a novel mechanism of action - an antagonist of muscarinic M1 and M2 receptors and an acetylcholinesterase inhibitor. Acetylcholine is the central mediator of the tone of the muscular components of the gastrointestinal tract, increasing its motor activity. ⋯ Currently, the clinical efficacy of acotiamide in the population of patients with functional dyspepsia is demonstrated in more than 10 clinical studies in different regions of the world, demonstrating a reduction of the symptoms of the disease during treatment with this agent and an improvement in the quality of life of patients. In addition, the combination of acotiamide with proton pump inhibitors optimizes the management of patients with gastroesophageal reflux disease.
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Anxiety and anxiety disorders are important modifiable risk factors for cardiovascular and other common chronic non-communicable diseases and complications. Anxiety disorders significantly reduce the motivation and adherence of patients to lifestyle changes and drug therapy, significantly worsen the quality of life, and increase the risk of disability and the costs of the health care system. The issues of diagnosis and therapy of anxiety are relevant for the practice of physicians and cardiologists due to the high incidence of anxiety disorders in patients with cardiovascular diseases, a decrease in the quality of life and an increase in adverse outcomes, and also due to the insufficient awareness of the risks associated with the psycho-emotional state of patients. ⋯ Sedative and anti-anxiety drugs, including non-benzodiazepine tranquilizers, are more commonly used. The most studied drug from this class in therapeutic and cardiological practice is fabomotizole. The efficacy and safety of fabomotizole, including long-term use, have been studied in numerous studies in patients with cardiovascular diseases and a wide range of anxiety disorders.
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To evaluate the efficacy of vibration-controlled transient elastography (VCTE) with a controlled attenuation parameter (CAP) in a population of patients with non-alcoholic fatty liver disease (NAFLD)and to compare to US and different non-invasive indices. ⋯ The sensitivity of the US of the liver was consistent with previous studies, but the specificity was low. The HSI index had the best indicators of sensitivity and specificity in relation to the diagnosis of liver steatosis. Combination of liver US and HSI can be used in screening of liver steatosis, however, for the complete diagnosis better tools which can simultaneously evaluate liver steatosis and fibrosis should be used.
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To evaluate the efficacy and safety of a combination of virus neutralizing monoclonal antibodies in the treatment of patients with confirmed COVID-19 and risk factors for disease progression and severe disease course. ⋯ The use of a combination of neutralizing monoclonal antibodies in patients with COVID-19 reduce the average bed-day in hospitalization of patients with comorbid pathology and/or immunodeficiencies and high risk of progression of infection.