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  • 1
    Online Resource
    Online Resource
    Thrombopoietin Receptor Agonists in the Treatment of Chronic Resistant Primary Immune Thrombocytopenia: Efficacy and Safety Data in Real Clinical Practice
    Consilium Medicum ; 2018
    In:  Terapevticheskii arkhiv Vol. 90, No. 7 ( 2018-07-15), p. 70-76
    Details
    In: Terapevticheskii arkhiv, Consilium Medicum, Vol. 90, No. 7 ( 2018-07-15), p. 70-76
    Abstract: Objective: To analyze the long-term efficacy and safety of ATR in adult patients with primary resistant ITP in real-world clinical practice. Materials and methods.The article contains long-term results analysis of ATR application under real clinical practice conditions in 138 patients (40 men and 98 women) whose median age at the beginning of therapy was 59 (18-86) years. Two ATR medicines-romiplostim (100 patients) and eltrombopag (38 patients) were used. Results. During the first month of therapy, the median platelet count in the romiplostim group increased from 17·109 / L to 60·109 / L (9-600·109 / L), and the elethrombopag from 16.109 / L to 56.109 / L (9-400·109 / L). The minimal response (reaching platelet counts over 30·109 / L) was achieved in 92% of cases in both groups. Partial response (achievement of platelet count more than 50·109 / L) was achieved in 91 and 84% of patients in the rhombostim and eltrombopag groups, respectively. The frequency of complete response (an increase in platelet counts above 100·109 / L) was noted somewhat more often in the rhyploistim group-69% compared to 47% in the eltrombopag group (P = NS). Most patients demonstrated a long-term stable effect in the form of an increase in blood platelet count to a safe level during months and years of ATR treatment. The achievement of at least partial remission for 3 months or more was 70 and 71% in romiplostim and elthrombopag groups, respectively. Patients who started ATR- therapy are currently continuing treatment: 51% - in romiplostim group and in eltrombopag group-39%. The main reason of discontinuation the initially effective therapy were the loss of platelet response, toxicity, withdrawal from treatment (withdrawal with preservation of remission) and patients death. The tolerability of drugs with long-term admission was satisfactory. The most common AE were headache, bone pain, thrombosis, increased blood pressure and petechial hemorrhagic eruptions. The overall incidence of complications did not differ significantly between the romiplostim and eltrombopag groups -15.6 and 15.8%, respectively. Conclusion. Long-term ATR-therapy using in patients with resistant chronic ITP is an effective and largely safe treatment option.
    Type of Medium: Online Resource
    ISSN: 2309-5342 , 0040-3660
    URL: Article
    DOI: 10.26442/terarkh201890770-76
    Language: Unknown
    Publisher: Consilium Medicum
    Publication Date: 2018
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  • 2
    Online Resource
    Online Resource
    The activity of the renin-angiotensin-aldosterone system before and after parathyroidectomy in patients with primary hyperparathyroidism
    Consilium Medicum ; 2021
    In:  Consilium Medicum Vol. 23, No. 12 ( 2021-12-15), p. 914-919
    Details
    In: Consilium Medicum, Consilium Medicum, Vol. 23, No. 12 ( 2021-12-15), p. 914-919
    Abstract: Background. The relationships between renin-angiotensin-aldosterone system (RAAS) and elevated parathyroid hormone levels in primary hyperparathyroidism (PHPT) is being actively discussed. But the way how parathyroid hormone interacts with renin and aldosterone currently is not clear. Materials and methods. Forty patients aged 18 to 70 years with a confirmed diagnosis of PHPT were involved in the study. All patients were tested for the main parameters of phosphorus-calcium metabolism and the RAAS parameters (plasma renin, plasma aldosterone) before and 2 weeks after parathyroidectomy. Results. Sixty percent of patients had any cardiovascular disease (CVD) and hypertension was the most common. Patients CVD in comparison with patients without CVD were older (61 and 41 years, respectively; p0.001), had a higher body mass index (28.9 and 21.9 kg/m2, respectively; p0.001) and had a lower aldosterone-to-renin ratio ARR (1.78 and 5.42, respectively; p=0.030). Patients with hypertension were older than patients with normal blood pressure (63 and 41 years, respectively; p0.001), had a higher body mass index (28.1 and 23.5 kg/m2, respectively; p=0.005), a lower ARR (1.46 and 5.82, respectively; p=0.001), as well higher levels of plasma renin (109.2 and 20.3 pg/ml, respectively; p=0.007) and serum total calcium (2.84 and 2.71 mmol/l, respectively; p=0.041). Correlation analysis showed that in patients with PHPT and CVD, the concentration of aldosterone is associated with the level of 24-hour urinary calcium (r=0.829, p=0.042), and in patients with symptomatic PHPT and CVD, the level of aldosterone correlated with the level of ionized calcium (r=-0.812, p=0.05). We found no significant differences between the levels of renin, aldosterone and ARR before and 2 weeks after parathyroidectomy. However, in the postoperative period, there were no differences in the levels of renin and ARR among patients with hypertension and without hypertension. Conclusion. In our study we found that the levels of plasma renin and serum total calcium were higher in patients with PHPT and hypertension compared to patients with normal blood pressure. Also, we found the associations between plasma aldosterone and levels of ionized calcium and 24-hour urinary calcium. But the relationships between RAAS parameters and parameters of phosphorus-calcium metabolism need further investigations.
    Type of Medium: Online Resource
    ISSN: 2542-2170 , 2075-1753
    URL: Article
    DOI: 10.26442/20751753.2021.12.201235
    Language: Unknown
    Publisher: Consilium Medicum
    Publication Date: 2021
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  • 3
    Online Resource
    Online Resource
    Epidemiology of multiple myeloma in city Moscow
    Consilium Medicum ; 2019
    In:  Terapevticheskii arkhiv Vol. 91, No. 7 ( 2019-07-15), p. 83-92
    Details
    In: Terapevticheskii arkhiv, Consilium Medicum, Vol. 91, No. 7 ( 2019-07-15), p. 83-92
    Abstract: Aim. To study the epidemiology of multiple myeloma in the city of Moscow and compare the results obtained with data from similar studies in other countries. Materials and methods. The study is based on information from a database of case histories of 3942 patients suffering from symptomatic MM, residents of the city of Moscow, which is maintained at the Hematologic Moscow City Center of S.P. Botkin Municipal Clinical Hospital. The control of the completeness of inclusion was carried out by cross - comparison with the data of the Moscow Cancer Register and the Register of Program 7 (beginning in 2019 - 12) of Highly Expensive Nosologies. The assessment was made according to data as of January 1, 2019. The calculations were carried out taking into account the data of Rosstat at the beginning of 2019 on the population of Moscow in different gender and age categories. Results. Among the 3942 patients with active MM 1707 men - 43% and 2241 women - 57%, the median of the current age was 68 (28-94) years. The median time of observation of patients since the diagnosis of the disease 34 (1-423) months. The peak incidence was in the age range of more than 60 years. There were no significant differences in gender ratio in different age strata with a breakdown of 10 years. The number of cases of newly diagnosed MM per year for the period from 2009 (n=219) to 2018 (n=385) increased by 75.8%. At the same time, the demonstrated increase in the incidence rate for the described period turned out to be fair only for groups of patients over 50 years old, with the maximum increase in this indicator over the described period in the age range of 60-69 years. This is mainly due to the increase in life expectancy in Moscow in recent years. The study demonstrated that over the past 10 years, the average annual mortality rate from MM has decreased in Moscow, and as a result, its prevalence has increased. The rate of 2-year overall survival of patients with MM was 76%, 5-year - old - 49%, 10-year - old - 27%. The median overall survival of patients under the age of 65 when diagnosing the disease was 79 months, and 48 months. The distribution of patients within international classifications was consistent with international data. Conclusions. The study revealed a significant dynamic of the epidemiological situation concerning MM in Moscow. Over the past 10 years there has been an increase in the incidence of MM, as a result of an increase in the life expectancy of the population. The use of modern diagnostics and therapy of MM in real clinical practice has led to a significant reduction in mortality. Due to these factors, an increase in the prevalence of MM in Moscow has taken place, and this process will no doubt progress in the future.
    Type of Medium: Online Resource
    ISSN: 2309-5342 , 0040-3660
    URL: Article
    DOI: 10.26442/00403660.2019.07.000305
    Language: Unknown
    Publisher: Consilium Medicum
    Publication Date: 2019
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  • 4
    Online Resource
    Online Resource
    Results evaluation of the implementation of the “Program for Optimizing Feeding of Children in the First Year of Life in the Russian Federation” dated 2009
    Consilium Medicum ; 2023
    In:  Pediatrics. Consilium Medicum , No. 4 ( 2023-01-18), p. 286-294
    Details
    In: Pediatrics. Consilium Medicum, Consilium Medicum, , No. 4 ( 2023-01-18), p. 286-294
    Abstract: Background. Appropriate prescribing of complementary food allows to optimize the intake of macro- and micronutrients, provides adequate indicators of growth and development of the child, reduces the risk of non-infectious pathology. Taking into account the significance of this problem, World Health Organization (WHO) experts, together with The European Society for Paediatric Gastroenterology Hepatology and Nutrition, carried out a research where they studied issues related to the appointment of complementary food for children in the European Region and their compliance with existing recommendations. Aim. To study the features of the introduction of complementary food in the Russian Federation on the basis of an assessment of the implementation of the recommendations of the "National program for optimizing the feeding of children in the first year of life in the Russian Federation", 2009 and to conduct a comparative analysis of the results obtained and the data presented in the study carried out by WHO experts. Materials and methods. A multicenter retrospective, uncontrolled, non-randomized study was conducted in 7 cities of the Russian Federation. Results. The median age at which complementary foods were introduced was 5 [46] months; vegetables (51.0%) and cereals (31.2%) were the first complementary food products; children began to receive fruit mainly (77.3%) in the second half of life; the age of introduction of meat puree was 7 [68] months, while every 4th child by 9 months did not receive meat; juices were introduced at 7 [69] months, but in 8.8% of children juices became the first product of complementary foods; median age for yolk administration was 8 [710] months, fish 9 [810] months. Only 14.0% of mothers used products of exclusively industrial production in the nutrition of their children, 33.9% prepared it themselves. Correlation analysis did not revealed any relationship between the body weight of a child at the age of 12 months and the time of introduction of the first complementary food product, as well as with the age of introduction of each of the introduced products. A connection was established between the body weight of a child at the age of 12 months and the volume of individual products that children receive between the age of 6 and 12 months. The recommendations of the National program for optimizing the feeding of children in the first year of life in the Russian Federation were generally implemented. Our analyses revealed the most frequent violations during the introduction and use of complementary food products: late start of their introduction (after the age of 6 months) in 41.3% of children, delayed prescription of meat, frequent use of home-made cereals not enriched with micronutrients, dilution of dairy-free porridge with water, irregular inclusion in the diet of egg yolk. Conclusion. The results obtained confirm the importance of implementation of the Program for Optimizing Feeding of Children in the First Year of Life in the Russian Federation updated in 2019 and approved by the Ministry of Health of Russia and indicate the need for further work on its improvement.
    Type of Medium: Online Resource
    ISSN: 2658-6622 , 2658-6630
    URL: Article
    DOI: 10.26442/26586630.2022.4.201969
    Language: Unknown
    Publisher: Consilium Medicum
    Publication Date: 2023
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