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11دورية أكاديمية
المصدر: Medicina v Kuzbasse, Vol 20, Iss 3, Pp 89-92 (2021)
مصطلحات موضوعية: антифосфолипидный синдром, нереспираторные функции лёгких, финголимод, Medicine
الوصف: Objective – the role of immunosuppressive mechanisms in the correction of respiratory system dysfunctions associated with autoimmune pathology (antiphospholipid syndrome). The aim of the study was to study the effect of the immunosuppressive drug fingolimod on non-respiratory functions of the lungs in antiphospholipid syndrome. Methods. The experiments were carried out on 70 white outbred male rats. The rats of the 1st group were administered with cardiolipin antigen (0.2-0.4 mg per animal every other day for 3 weeks) to simulate antiphospholipid syndrome. Antiphospholipid syndrom in animals of the 2nd group was combined with the administration of fingolimod (1 mg / kg). The 3nd (control) group consisted of rats, which were injected with vehicle (0.9% NaCl) according to the same scheme. The complex of explored biophysical and biochemical parameters included surfactant composition and activity, pulmonary water balance and blood supply, and nitroxydergic activity of the lung. Statistical analysis of the obtained results was carried out using the SPSS 22 program. Results. We have found that, in experimental antiphospholipid syndrome, the biophysical properties of surfactant decreased simultaneously with lung hyperhydration and impaired nitroxydergic activity. Fingolimod restored the parameters of surfactant, water balance and nitroxydergic activity of the lung, altered in antiphospholipid syndrome. Conclusion. The results of the study indicate the effectiveness of immunosuppression in restoration of non-respiratory functions of the lung revealed in simulated systemic autoimmune pathology, antiphospholipid syndrome.
وصف الملف: electronic resource
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12دورية أكاديمية
المؤلفون: A. A. Shumilova, T. M. Reshetnyak, F. A. Cheldieva, A. M. Lila
المصدر: Современная ревматология, Vol 15, Iss 4, Pp 87-93 (2021)
مصطلحات موضوعية: антифосфолипидный синдром, системная красная волчанка, меланома, туберкулез легких, клинические наблюдения, Medicine
الوصف: We present two clinical cases: the first patient had combination of antiphospholipid syndrome (APS) and melanoma, and the second – systemic lupus erythematosus (SLE) and APS, melanoma, infiltrative tuberculosis and Herpes zoster. Managing patients with SLE combined with APS is really challenging. Infections and malignant neoplasms, along with kidney damage and cardiovascular diseases, are a significant cause of death in this cohort of patients. The role of antibodies to phospholipids in the onset of malignancy is still under discussion. The combination of rheumatic diseases with oncological or infectious pathology complicates therapy, limiting the use of drugs, recommended by clinical guidelines.
وصف الملف: electronic resource
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13دورية أكاديمية
المؤلفون: F. A. Cheldieva, T. M. Reshetnyak, A. M. Lila
المصدر: Современная ревматология, Vol 15, Iss 4, Pp 101-106 (2021)
مصطلحات موضوعية: антифосфолипидный синдром, шкала глобальной оценки активности антифосфолипидного синдрома (gapss), индекс повреждения антифосфолипидного синдрома (diaps), Medicine
الوصف: The review provides a brief description of the clinical and serological markers of antiphospholipid syndrome (APS), risk factors for the development and recurrence of thrombosis in APS. A complete description of the GAPSS and its simplified (corrected) version, adjusted GAPSS (aGAPSS), as well as the DIAPS, is presented. These scales allow one to determine the activity of APS and reflect the range of cumulative and/or irreversible damage due to the disease.
وصف الملف: electronic resource
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14دورية أكاديمية
المؤلفون: A. S. Potapova, O. N. Egorova, O. G. Alekseeva, A. V. Volkov, D. M. Kudinsky
المصدر: Современная ревматология, Vol 15, Iss 2, Pp 77-82 (2021)
مصطلحات موضوعية: панникулит, склеродерма-панникулит, антифосфолипидный синдром, диагностика, лечение, Medicine
الوصف: Difficulties in diagnosis and therapy of scleroderma-panniculitis (S-PN), one of the variants of the septal PN, are discussed. Feasibility of ultrasonography, magnetic resonance imaging of soft tissues and histological examination of the lesions in order to set the diagnosis of PN in time is considered. The clinical case of S-PN combined with antiphospholipid syndrome is presented.
وصف الملف: electronic resource
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15دورية أكاديمية
المؤلفون: D. D. Tsyrenov, R. S. Akchurin, K. V. Mershin, E. A. Tabakyan, E. E. Vlasova, V. V. Gazizоv, S. K. Kurbanov, I. V. Starostin
المصدر: Евразийский Кардиологический Журнал, Vol 0, Iss 1, Pp 94-104 (2021)
مصطلحات موضوعية: легочная тромбэндартерэктомия, реперфузионный отек легких, острое повреждение почек, антифосфолипидный синдром, Diseases of the circulatory (Cardiovascular) system, RC666-701
الوصف: Aim. To analyze the factors associated with a poor outcome of pulmonary thromboendarterectomy (PTE) and complications of the hospital postoperative period; on the basis of this analysis to optimize preoperative preparation and therapeutic support of the operation. Materials and methods. The study included 47 patients with operable CTEPH, who underwent PTE in the Department of cardiovascular surgery of the national medical research center of cardiology from 2010 to 2018. Patients were observed during the intrahospital period, all were evaluated for clinical, instrumental, hemodynamic, and laboratory parameters. Diagnosis and treatment of complications, assessment of the relationship of factors associated with the development of these pathological conditions were carried out. Results. A comprehensive assessment of the parameters revealed that age over 50 years, the presence of proven antiphospholipid syndrome (AFS) were independently associated with a higher frequency of adverse surgical outcomes and in-hospital complications. Older age and a history of smoking were independently associated with a greater likelihood of developing reperfusion pulmonary edema. The probability of developing transient neurological complications is independently associated with a long duration of deep hypothermic circulatory arrest (DHCA), an increased level of D-dimer. A greater age and longer duration of ventilation are independently associated with the likelihood of developing acute kidney injury (AKI). A higher level of antithrombin III and the presence of AFS were independently associated with the likelihood of developing prolonged ventilation. Conclusion. When selecting candidates for surgery, in addition to the generally accepted clinical and instrumental parameters, it is necessary to take into account a history of Smoking, an increase in d-dimer, and the presence of AFS. Patients with this pathology need a more thorough risk assessment, correction of target levels of activated partial thromboplastin time (aPTT), activated clotting time (ACT) due to their falsely inflated indicators, and further development of standards for perioperative support. The main principle of cardiological support of the operation is the earliest possible diagnosis of all known perioperative complications and the rapid start of their treatment, which ensures the stabilization of the patient’s condition in 85% of cases in the hospital period. In the postoperative period, an early transition from ventilator to independent breathing is indicated for the prevention of associated complications, including AKI.
وصف الملف: electronic resource
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16دورية أكاديمية
المؤلفون: K. S. Nurbaeva, F. A. Cheldieva, A. A. Shumilova, A. M. Lila, T. M. Reshetnyak
المصدر: Современная ревматология, Vol 15, Iss 1, Pp 98-104 (2021)
مصطلحات موضوعية: антифосфолипидный синдром, анкилозирующий спондилит, аортит, антифосфолипидные антитела, тромбозы, ингибиторы фактора некроза опухоли α, Medicine
الوصف: We presented two clinical cases with clinical manifestations of antiphospholipid syndrome (APS) and ankylosing spondylitis (AS). The peculiarity of these cases is the onset of diseases in childhood, as well as the presence of not only extra-skeletal manifestations, but also complications or manifestations of other pathology. In the first case, it was thrombosis of the superficial veins of the lower limbs with the development of postthrombotic syndrome. In the second case, aortic valve defect, as a result of aortitis with a dilatation of the ascending aorta, which led to aortic valve replacement and its subsequent dysfunction because of thrombosis of the valve prosthesis. The frequency of detection of antiphospholipid antibodies (aPL), APS and thrombosis in AS is discussed. The role of tumor necrosis factor α (TNFα) inhibitors in the induction of aPL synthesis and the development of APS in patients with AS is considered either. Separately, we discussed the role of TNFα inhibitors, which are the main drugs in the treatment of ankylosing spondylitis, in the induction of aPL synthesis and the development of APS. Data on the occurrence of aPL, the reasons for the development of thrombosis in APS and the role of TNFα inhibitors remains incomplete. Perhaps the combination of APS and AS is an underestimated problem, and the information available in the literature does not reflect the real numbers. It is obvious that further research is needed to improve the treatment of patients with AS with thrombosis.
وصف الملف: electronic resource
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17دورية أكاديمية
المصدر: Мать и дитя в Кузбассе, Vol 20, Iss 4, Pp 26-32 (2019)
مصطلحات موضوعية: антифосфолипидный синдром, невынашивание, беременности, привычный выкидыш, плазмоферез, torch-инфекции, Pediatrics, RJ1-570, Gynecology and obstetrics, RG1-991
الوصف: Objective – to study the effect of extragenital pathology on the occurrence and severity of antiphospholipid syndrome (APS) and the number of reproductive losses. Materials and research methods. 137 cards of women with a history of pregnancy termination were analyzed, divided into 2 groups according to the principle of presence/absence of plasmapheresis in the treatment regimen at the stage of pregravid preparation, followed by ranking into 2 subgroups according to the principle of presence/absence of TORCH infection activity. Results. Among extragenital pathology, the correlation of which had diagnostic, pathogenetic and statistical significance as a result of the analysis of all indicators, autoimmune thyroiditis, infectious pathology and pathology of ENT organs were identified. A strong direct correlation was observed in women with AFLS between the level of IgG to b2-glycoprotein-1 and the pathology of ENT organs. The pair «Autoimmune thyroiditis – IgG b2-glycoprotein-1» was characterized by a different level of correlation: in women with a single pregnancy loss, this relationship was characterized as a direct correlation of a weak or moderate degree. The presence of an inverse correlation between the frequency of occurrence of seasonal infectious diseases, not exceeding the average population values and the level of lupus anticoagulant, was revealed. In women with a single gestational loss, this relationship was characterized as an inverse weak correlation. In women with the usual loss of pregnancy with AFS without signs of TORCH infection, a weak negative correlation was noted. Conclusion. Changes in the correlation between the content of specific antiphospholipid antibodies in the blood and extragenital pathology in women with habitual miscarriage and a different number of gestational losses indicate additional mechanisms for the development of miscarriage in women who have had repeated miscarriages, which must be taken into account in clinical practice at the pregravid stage.
وصف الملف: electronic resource
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18دورية أكاديمية
المصدر: Атеротромбоз, Vol 0, Iss 1, Pp 92-98 (2019)
مصطلحات موضوعية: антифосфолипидный синдром, лабораторные тесты, диагностические критерии, Internal medicine, RC31-1245
الوصف: Antiphospholipid syndrome (APS) is an immune-mediated violation of coagulation, the diagnosis of which requires mandatory laboratory confirmation. Since the clinical manifestations of APS are extremely diverse, various specialists are involved in the diagnostic process – neurology, cardiologists, surgeons, hematologists, endocrinologists, laboratory medicine specialists, etc. So far, it remains an open question what specialist exactly should make the final diagnosis and supervise patient with APS. The experience of a separate diagnostic center shows the distribution of prescriptions and their compliance with the international recommendations. This study also provides data on the frequency of prescribing laboratory tests to confirm APS, which is 1.2% of all coagulation tests. Among the patients with suspected APS on the basis of clinical signs, only 12.2% of the diagnosis was confirmed. Presents the dangers of obtaining false-positive results that should be taken into account when prescribing laboratory tests.
وصف الملف: electronic resource
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19دورية أكاديمية
المؤلفون: N. V. Seredavkina, T. M. Reshetnyak, N. M. Kosheleva, A. M. Lila
المصدر: Современная ревматология, Vol 13, Iss 1, Pp 26-34 (2019)
مصطلحات موضوعية: ингибиторы фактора ха, анти-ха-активность плазмы, системная красная волчанка, антифосфолипидный синдром, Medicine
الوصف: The use of factor Xa inhibitors is justified in the therapy of thrombosis in antiphospholipid syndrome (APS) and active lupus nephritis (LN). To monitor the efficacy and safety of these drugs, plasma anti-Xa (aXa) activity is determined.Objective: to assess the aXa activity of selective and non-selective factor Xa inhibitors in patients with systemic lupus erythematosus (SLE) and APS depending on how they affect the kidneys.Patients and methods. Clinical and laboratory findings were prospectively analyzed in SLE and APS patients who long received low molecular weight heparins (LMWHs) and selective Xa inhibitors, such as fondaparinux and rivaroxaban. The investigation enrolled 70 patients (54 females and 16 males) aged 39 years (range, 31 to 43 years) with SLE (n=15 (21%)), primary APS (PAPS) (n=10 (14%)), and SLE + APS (n=45 (65%)).Results. Kidney disease was diagnosed in 33 (47%) of the 70 patients. LN was detected in 15 (25%) of the 60 patients: 10 and 5 patients with SLE and SLE + APS, respectively. APS nephropathy (APSN) was manifested by elevated creatinine and urea levels with normal urine sediment and no history of glomerulonephritis and was observed in 18 (33%) of the 55 patients: in 16 with SLE + APS and 2 with PAPS. The therapeutic aXa range of 0.1—1.5 IU/ml was found in 43 (61%) of the 70 patients, low and high aXa activities were seen in 14 (20%) and 13 (19%) patients, respectively.In patients with APSN, the creatinine clearance (CC) depended on aXa levels: the highest CC was noted in patients with aXa >1.5 IU/mL, the lowest CC was in those with aXa
وصف الملف: electronic resource
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20دورية أكاديمية
المؤلفون: T. V. Smirnova, N. I. Kozlovskaya, V. M. Sheludchenko, D. V. Andzhelova, E. E. Kazaryan, O. V. Eksarenko, I. A. Velieva, M. V. Khasyanova
المصدر: Oftalʹmologiâ, Vol 15, Iss 4, Pp 455-462 (2019)
مصطلحات موضوعية: тромботическая микроангиопатия, атипичный гемолитико-уремический синдром, злокачественная артериальная гипертензия, катастрофический антифосфолипидный синдром, цветовое доплеровское картирование, ретробульбарные сосуды, Ophthalmology, RE1-994
الوصف: Purpose. To assess the state of blood flow in retrobulbar vessels using the method of color Doppler imaging in thrombotic microangiopathy (TMA) associated with atypical hemolytic uremic syndrome (aHUS), malignant hypertension (MH) and catastrophic antiphospholipid syndrome (CAPS). Methods. The study involved 16 patients aged from 18 to 43 years with TMA associated with aHUS (13 patients), MH (2 patients) and CAPS (1 patient). All patients underwent a study of the state of blood flow in the vessels of the retrobulbar space by color Doppler imaging using a multifunctional ultrasonic diagnostic device Voluson 730 Pro and Voluson E8. The spectrum of blood flow in the ophthalmic artery (OA), central retinal artery (CRA), central retinal vein (CRV), in the medial and lateral short posterior ciliary arteries (SPCA) was recorded and the following parameters were determined: maximum systolic velocity (Vsyst), final diastolic velocity (Vdiast), peripheral resistance index (RI), pulsation index (PI). Results. The analysis of the Doppler blood flow spectrum in all patients with TMA syndrome revealed a decrease in Vsyst in the vessels of the retrobulbar space, more pronounced in the CRA, with an increase in the venous component of the Doppler spectrum. In patients with TMA associated with aHUS and MH Vdiast in the studied vessels were in normal limits or increased, RI and PI were reduced. In aHUS a statistically significant correlation was found between Vdiast in OA and the level of haptoglobin in blood serum, which is a classic marker of intravascular hemolysis. Conclusion. Color Doppler imaging of retrobulbar vessels is an important method for the diagnosis of ocular hemodynamics disorders in the syndrome of TMA. All patients with TMA syndrome are characterized with a decrease in the systolic component of the Doppler spectrum of blood flow in the vessels of the retrobulbar space, especially in the CRA, with an increase in the venous component. With aHUS and MH diastolic blood flow in the retrobulbar vessels corresponds to the norm or increases, RI and PI decrease. In TMA associated with aHUS, the final diastolic velocity of blood flow in OA depends on the level of microvascular hemolysis.
وصف الملف: electronic resource
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