Inflammatory bowel diseases (IBD) are immune-mediated diseases and usually manifest at a young age. They are requires in a long-term treatment or surgery with a high probability of surgical intervention. IBDs are accompanied by a decrease in working capacity, impaired quality of life and social disadaptation. However, timely diagnosis with using modern diagnostic methods, the use of evidence-based immunosuppressive and biological therapy significantly changed the pathomorphosis of this disease. But despite the achievements of the pharmacotherapy, the incidence and prevalence of IBD are still increasing, a demand for surgery remains both for Crohn`s disease and ulcerative colitis throughout all the period of illness. At the same time there is a trend towards the variability of symptoms, mismatch of the clinical symptoms with the real severity of inflammation, increase of a number of patients with extraintestinal manifestations and resistance to induction and maintenance therapies. In addition to this, the observation of this group of patients is complicated due to the difficulty of the early diagnosis and differential analysis of IBD, the need of early induction treatment according to the guidelines and the lack of adherence to the therapy.
About 5% of the population suffer from chronic diarrhea. Intestinal infections are the most common cause of diarrheal syndrome. However, if they are excluded, it is necessary to check for other possible reasons: vascular, oncological, rheumatic, drug-induced, radiation diseases and other gastroenterological pathology except from inflammatory bowel diseases. When predicting and detrcting new predictors of unfavorable outcomes and progression of inflammatory bowel diseases, special attention has been recently paid to serological markers and genetic research, which have not yet entered clinical practice due to their high cost. Inflammatory bowel diseases is a diagnosis of exclusion, which is made after a comprehensive assessment of clinical, laboratory, endoscopic, and morphological data. In case of the development of complications, it needs to investigate new available prognostic markers of inflammatory bowel diseases course.
Relevance. Verification of a new coronavirus infection (COVID-19) requires clear algorithms for the diagnosis and treatment of patients, depending on clinical, laboratory and instrumental dates. Timely and informed decisions on optimizing management tactics and prescribing proactive anti-inflammatory therapy before development of a complete symptom complex life threatening conditions are needed in some cases. Aim of the study. To analyze the course and outcomes of a new coronavirus infection, depending on the initial characteristics of the patients and treatment options. Materials and methods. A preliminary analysis of the case histories of 129 people hospitalized in the center for treating patients with a new coronavirus infection at North-Western State Medical University n.a. I.I. Mechnikov was made by random sampling. Among the hospitalized patients there were 67 men (51.9%), the average age was 57.9 16.4 years, 62 women (48.1%), and the average age was 60.2 13.6 years. During hospitalization, all patients underwent standard clinical laboratory and instrumental examination, as well as determination of saturation (SpO2), markers of the cytokine storm (CRP, ferritin, AST, D-dimer, fibrinogen, lymphocytes), compute tomography (CT) of the lungs. The effectiveness and safety of therapy was evaluated by the outcome (recovery, death), as well as by the presence of adverse events in the background of the therapy. Statistical processing of the research results was carried out using the Statistica 12 for Windows application software package, the significance of differences between the two relative values was evaluated using the Student t-test (t 2, p 0.05). Results. Fatal outcomes were significantly more frequently recorded among patients of older age groups and males. The presence of concomitant diseases such as obesity, diabetes mellitus, pathology of the cardiovascular system was accompanied by more frequent fatal outcomes. That allows considering comorbidity as a risk factor for severe course and poor prognosis of COVID-19. However, in general, in the presence of the indicated forms of concomitant diseases, it was not possible to establish significant differences with the outcomes of COVID-19, which may be due to an insufficient amount of patients. Predictors of fatal outcome was low values of saturation, the presence of respiratory failure, a significant amount of lung tissue damage (CT-3-4), as well as high values of CRP, ferritin, AST, D-dimer, neutrophilia, lymphopenia, thrombocytopenia. The use of anticytokine drugs (ACD) in complex therapy can be considered a favorable predictor of outcome, which indicates the advisability of wider use. The materials of the study allow not only a preliminary assessment of the course and effectiveness of complex therapy using anticytokine drugs with COVID-19 in patients with comorbid diseases, but also to develop therapeutic and diagnostic algorithms in patients of this category.
ФГБОУ ВО «Северо-Западный государственный медицинский университет имени И.И. Мечникова» Минздрава России, Санкт-Петербург, Россия © Коллектив авторов, 2018Введение. Регулярные занятия футболом накладывают свой отпечаток на физическое развитие де-тей. Целью нашей работы было проведение анализа физического развития подростков, занимающихся футболом, с использованием региональных оценочных таблиц и Международного стандарта ВОЗ.Методы. Методом сплошной выборки было отобрано 64 воспитанника спортивной футбольной школы 2002-2005 года рождения. Основные оцениваемые параметры: рост, масса тела, индекс массы тела (ИМТ), содержание жировой, безжировой, мышечной массы и воды в организме. Сравнительный анализ полученных данных проводили с использованием региональных оценочных таблиц и Междуна-родного стандарта ВОЗ Результаты. Участники исследования были выше, имели более высокий ИМТ, но меньше жировой массы по сравнению с общепопуляционными нормами. В зависимости от использованного метода под-ростки были отнесены к разным центильным группам по росту, массе тела, ИМТ и процентному содер-жанию жира. Коэффициент корреляции согласованности КАРРА для роста согласно классификации ВОЗ и данным по Санкт-Петербургу в возрасте 12 лет составлял 0,17; в 13 лет -0,56; в 14 лет -0,75; в 15 лет и старше -0. В соответствии с общепопуляционными нормами по массе тела и ИМТ доля детей с нормальными или повышенными значениями составляла от 90 до 100 %, при этом дефицит жи-ровой массы в возрасте 13 лет был диагностирован в 30 % случаев, в возрасте 14 лет -в 50 % случаев, в возрасте 15-16 лет -в 100 % случаев. При использовании норм для детей-спортсменов дефицит жировой массы был выявлен лишь у 5 % в возрасте 12 лет, у 47 % в возрасте 13 лет и у 10 % в воз-расте 15 лет и старше.Выводы. Занятия футболом способствуют изменению пропорций тела, уменьшению жировой и уве-личению мышечной массы в организме подростков. Следовательно, для оценки физического развития подростков, занимающихся спортом, необходимо оценивать не только рост и ИМТ, но и процентное содержание жировой и мышечной массы. Использование общепопуляционных норм для оценки физиче-ского развития данной категории подростков может приводить к гипо-и гипердиагностике избыточного и недостаточного питания.Ключевые слова: физическое развитие; рост; вес; ИМТ; жировая масса; мышечная масса; подрост-ки; спорт. Introduction. Regular physical activity impacts on growth, development and health of children and adolescents. This study has been conducted with the aim of evaluating the physical characteristics of adolescents, who play football using the regional and WHO normative data. THE EVALUATION OF THE PHYSICAL CHARACTERISTICS OF YOUNG FOOTBALL PLAYERSMethods. Сomplete sample of 64 adolescents borned in 2002-2005 from the football sport school were assessed. Main study parameters: height, body mass, BMI, fat mass, skeletal muscle mass fat free mass and water. Comparison analysis was performed using the regional and WHO normative data.Results. Participants of the present study was higher and heavier...
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