Community-acquired pneumonia remains a most widespread acute infectious disease of socio-economic significance all over the world. Up to 30% of the patients present with anemia responsible for the unfavourable prognosis and elevated mortality. Not infrequently, anemia is not diagnosed during the hospital stay und therefore remains uncorrected. Severe anemia results in enhanced hypercapnia and slowed maturation of red blood cells in the bone marrow which facilitates the development of ischemic syndrome. Hepcidin, a mediator of inflammation and iron-regulatory hormone, plays an important role in the clinical course of community-acquired pneumonia. Hepsidin production increases during inflammation; it suppresses erythtropoiesis and depletes the iron depot leading to so-called anemia of inflammation. Hypoxia and anemia activate erythtropoiesis, and the released erythropoietin inhibits hepsidin production. During pneumonia resolution, hepsidin promotes recovery from anemia by activating iron absorption. The current literature contains few data on the use of hepcidin as a diagnostic marker of anemia. The necessity of treating anemia in patients with pneumonia under hospital conditions is a matter of discussion. Direct involvement of hepcidin in iron metabolism creates a prerequisite for the treatment of anemia. Medicamental suppression of its activity by stimulating erythtropoiesis can facilitate normalization of iron metabolism and restoration of hemoglobin level.
Aim. To study the prevalence of geriatric syndromes and assess their relationship with senile asthenia in persons aged ³65 years living in Russian regions with different demographic, climatic and socio-economic characteristics.Material and methods. We examined 664 patients aged 65-107 years (mean age, 79±9 years; men, 25%) living in Moscow (n=365) and Voronezh (n=299). All patients underwent a comprehensive geriatric examination, which consisted of two stages: a survey with original questionnaire and an objective examination.Results. The prevalence of senile asthenia was 66,4%, including 47,4% in people aged 65-74, 71,1% — 75-84 years, and 82,8% — ³85 years (p for trend <0,001). Senile asthenia was associated with age (odds ratio (OR), 2,36; 95% confidence interval (CI), 1,89-2,93; p<0,001) and female sex (OR, 1,52; 95% CI 1,06-2,18; p=0,024). Patients with senile asthenia had a lower socioeconomic status. Also, close associations of senile asthenia with other geriatric syndromes (dementia, depression, vision and hearing impairment, incontinence, falls, high risk of falls, functional decline, failure to thrive) with OR from 1,32 to 7,22 were revealed.Conclusion. The first results of the EVCALIPT study indicate a high incidence of senile asthenia in persons aged ³65 years and its close association with other geriatric syndromes and socio-economic factors.
Objective. To evaluate the effectiveness of upadacitinib for improving the quality of life and correcting psycho-emotional disorders in patients with eczema.Material and methods. The study included 64 patients with eczema (mean age 58.5 ± 3.4 years, men – 43, women – 21), randomized into two groups. Patients of group 1 (n = 33) received basic drug therapy (BDT), group 2 (n = 31) – in addition to BDT, the Janus kinase 1 inhibitor upadacitinib (UPA) 15 mg per day for 2 months. The values of the patients' dermatological symptom scale index (DISS), Dermatology Life Quality Index (DLQI), anxiety, depression, functional state of patients on the WAM (wellbeing, activity, mood) scale were evaluated in dynamics after 2 months after the start of treatment.Results. In the BDT group, the value of DISS in patients after 2 months from the start of treatment decreased by 1.33 times, while in the UPA + BMT group it decreased by 2.17 times. In the BDT group, the DLQI index decreased by 1.26 times, while in the UPA + BDT group – by 1.66 times. The level of anxiety in patients in the BDT group decreased by 1.34 times, in the UPA + BDT group – by 1.64 times. The level of depression in the BDT group decreased by 1.22 times, in the UPA + BDT group – by 1.67 times. Indicators of the functional state of the WAN scale in patients with BMT increased only by 1.06, 1.03, 1.05 times, and in the UPA + BMT group, respectively, 1.4, 1.5, 1.6 times.Conclusions. BDT, while improving the clinical status of patients, at the same time has an insufficient corrective effect on the severity of anxiety, depression, WAM indicators and a reduced quality of life. Additional appointment of upadacitinib to patients was accompanied by a more pronounced positive effect on the levels of anxiety, depression, indicators of the functional state of patients, which contributed to an improvement in the quality of life compared to the results of BDT.
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