Analysis of COVID-19 features in individuals who regularly practice aerobic training. Methods. Asymptomatic persons and patients with COVID-19 older than 30 years, 293 people (180 men and 113 women), 214 of them – inhabitants of the Moscow region (the beginning of the sampling – 2nd decade of April 2020) and 79 – inhabitants of the Belgorod region (the beginning of the sampling – 2nd decade of May 2020), adapted (27 people 1st group) and unadapted (266 – control group) to aerobic training (AT). Computer tomography of the chest, RNA test for SARS-CoV-2 in smears from the nasopharynx-oropharynx, the clinical blood sample and level of antibodies to SARS-CoV-2 were studied. The criterion for adaptation to aerobic loads was considered compliance with the rules of the American Heart Association, 2008. Results. Adapted to AT individuals, in contrast to the control group, characterized with the prevalence of asymptomatic (p = 0.045) and absence of severe forms of COVID-19, limited cataral simptoms of the disease (p < 0.001), rare pneumonia with absence (1) or presence (2) of acute respiratory failure (p1 = 0,028; p2 = 0,034), along with lower prevalence of diseases, potentiating this infection (p = 0.03). Conclusion. Patients adapted to AT have less severe course of COVID-19.
A rare observation of systemic AL-amyloidosis with a debut in old age, accompanied by diffuse alveolar-septal lesion of the lungs and mediastinal lymphadenopathy in combination with amyloid cardiomyopathy in the absence of pathology of kidney and liver function.
Популяционный принцип научного исследования позволил получить чрезвычайно важные сведения, без которых трудно было бы представить современ ную трактовку механизмов формирования такого сложного в курации (и в субъективном пережива нии) патологического процесса как бронхиальная астма (БА). Достаточно литературной справки об анализе особенностей болезни на Tristan da Cunha [1], высокой заболеваемости астмой в Барбадосе [2] или редкости патологии среди детей коренных этни ческих групп Канады (но не у детей аборигенов Австралии) [3,4], чтобы в продолжение поиска не обратиться к популяционной методологии. Сущест вующие сейчас сведения в отношении БА при ши зофрении получены, главным образом, из тех работ, что выполнены еще 40-50 лет назад. Причем в раз работке и закреплении основных международных положений, касающихся этой пульмонологической патологии, тема астмы и шизофрении осталась не рассмотренной, а в редакциях ведущего международ ного стандарта GINA неупомянутыми оказались да же те данные о подобном сочетании нозологий, ко торые были сформулированы ранее [5,6]. Между тем за последние десятилетия астма изменилась: повы силась заболеваемость, увеличился список причин, определяющих формирование и развитие болезни, трансформировались некоторые механизмы воспа лительной реакции [7]. В такой ситуации вполне обосновано дополнительное обращение к проблеме "астма-шизофрения", тем более что завершившееся недавно и наиболее цитируемое исследование из Тайваня опровергает традиционные взгляды о ред кости пульмонологической патологии при психо зе [8]. Материалы и методыБыла исследована выборка 677 больных шизофрени ей (психиатрический стационар и психоневрологи ческий диспансер). Формирование когорты и выпол нение работы проведено с соблюдением требований Комитета по этике на основании принципа, что Combination of bronchial asthma and schizophrenia: peculiarities of diagnosis and course SummaryThe study was conducted in a group of schizophrenia patients (n = 677); among them, there were 245 outpatients and 432 hospitalized patients. We investigated prevalence, peculiarities of diagnosis and course of bronchial asthma (BA) in this group. Psychically healthy patients of somatic hospitals and outpatient facilities was used as controls excepting patients from specialized services involved in care of asthma patients. We have noted that com bination of BA and psychosis was rare (0.29 %, p < 0.001), the somatic disease had a benign course even under inadequate antiasthmatic therapy. Key words: bronchial asthma, schizophrenia, allergic diseases. РезюмеВ когорте (n = 677) больных шизофренией (245 человек из психиатрического диспансера и 432 -из стационара) проведено изучение распространенности, особенностей диагностики и течения бронхиальной астмы (БА). В качестве сравнения использована выборка пси хически здоровых испытуемых: пациенты соматических стационаров и поликлиник, исключая специализированные службы по опре делению, курирующие больных БА. Установлена редкость сочетания "БА-психоз" (0,29 %; р < 0,001), благоприятное течение с...
The analysis of the mechanisms of the formation of a rare clinical combination of pulmonary embolism (PE) and diffuse alveolar hemorrhage (DAH), which are complications of systemic vasculitis associated with antibodies to the cytoplasm of neutrophils (primarily granulomatosis with polyangiitis), systemic lupus erythematosus and secondary antiphlogistic syndrome primary antiphospholipid syndrome and Goodpastures syndrome. Taking into account the chronological sequence of the occurrence of PE and DAH, 3 variants of the onset of these potentially fatal additions to the underlying disease were considered: the anticipatory DAH development of PE, delayed from DAH PE and joint (within 24 hours) formation of PE and DAH. A review of single descriptions of such a combination of complications of granulomatosis with polyangiitis is carried out, criteria are indicated, a working classification of severity is given and, taking this into account, a modern program of therapy for DAH as an independent event and in combination with PE.
SummaryA case of granulomatosis with polyangiitis is described in the article. The patient experienced 3 year paroxysmal asthma like syndrome with granu lomatous lesion of the subglottic portion of the larynx that further developed into multifocal destructive lesions of the lungs without clinical signs of glomerulonephritis and with positive response to combined therapy with cytostatic agents, rituximab and systemic steroids. The main criteria of granulomatosis with polyangiitis in this patient were high levels of ANCA and anti proteinase 3 antibodies. Therefore, granulomatosis with polyangiitis is characterized by polymorphic onset of lung disease with co existing paroxysmal respiratory syndrome, infiltrative and destructive pul monary lesions.
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