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1.
Khirurgiia (Mosk) ; (2): 59-67, 2024.
Article in Russian | MEDLINE | ID: mdl-38344961

ABSTRACT

OBJECTIVE: To optimize the diagnosis of abdominal pain syndrome occurring under the «mask¼ of acute pancreatitis via algorithms for clinical and laboratory examination. MATERIAL AND METHODS: We have retrospectively and prospectively analyzed patients with abdominal pain syndrome. We selected all patients with acute pancreatitis who repeatedly applied with abdominal pain syndrome to polyclinics and hospitals between 2017 and 2021. A personalized algorithm for patients with abdominal pain syndrome occurring under the «mask¼ of acute pancreatitis has been developed. This algorithm underlies an information system for decision-making support. RESULTS: An optimal diagnostic algorithm is needed in reception departments of hospitals and polyclinics. This one depends on equipment of hospitals and needs to be constantly improved. When refusing hospitalization and discharging patients with recurrent pain syndromes, physicians should orient the doctors of general network to use more informative methods. Indeed, the last ones may be unavailable in reception departments and various districts due to technical, qualification and organizational shortcomings. CONCLUSION: Advanced clinical and laboratory diagnostic methods based on the above-described algorithm are necessary for recurrent abdominal pain syndrome occurring under the «mask¼ of acute pancreatitis.


Subject(s)
Pancreatitis , Humans , Pancreatitis/complications , Pancreatitis/diagnosis , Retrospective Studies , Acute Disease , Abdominal Pain/diagnosis , Abdominal Pain/etiology , Syndrome , Algorithms
2.
Zh Nevrol Psikhiatr Im S S Korsakova ; 122(7. Vyp. 2): 60-67, 2022.
Article in Russian | MEDLINE | ID: mdl-35912558

ABSTRACT

At the onset, multiple sclerosis (MS) in children is characterized by a phase of active inflammation with extensive demyelination of the white matter of the CNS, which often mimics this nosology with a whole spectrum of inflammatory demyelinating diseases such as ADEM, anti-MOG encephalitis, ONMSD. In order to formalize the diagnostic process, the International Pediatric Multiple Sclerosis Study Group (IPMSSG) proposed diagnostic criteria for the main immune-mediated demyelinating diseases of the CNS in children, which, in theory, should simplify the diagnostic search. However, in practice, the range of nosologies in the course of differential diagnosis is much wider and often it is not possible to establish an unambiguous diagnosis in the early stages. The authors analyze their own clinical observations based on a sample of 100 pediatric patients with a referral diagnosis of «MS?¼ and describe a clinical case of the onset of highly active MS with an assessment of the dynamics of the clinical and paraclinical course of the disease.


Subject(s)
Encephalomyelitis, Acute Disseminated , Multiple Sclerosis , Child , Diagnosis, Differential , Encephalomyelitis, Acute Disseminated/diagnosis , Humans , Magnetic Resonance Imaging , Multiple Sclerosis/diagnosis
3.
Article in Russian | MEDLINE | ID: mdl-29652301

ABSTRACT

AIM: To evaluate the efficacy and safety of the interferon beta-1b bioanalogue 'infibeta' in the treatment of multiple sclerosis (MS) in comparison with other interferon beta bioanalogues and the generic drug glatiramer acetate. MATERIAL AND METHODS: The data of 500 patients with MS treated with different disease-modifying drugs were analyzed. Patients of group 1 (n=95) received infibeta; group 2 (n=108) interferon beta-1b; group 3 (n=83) genfaxon-44; group 4 (n=109) sinnovex; group 5 (n=105) aksoglatiran FS. RESULTS: In all groups, there was a significant decrease in the AARR and an increase in the EDSS score (p<0,05) after 12 and 24 months of treatment (p<0,05) with the best indicators in groups 1-3. After 12 months of treatment, the number of patients without signs of MRI activity was higher in groups 1-3 (48-61%) than in groups 4 and 5 (47, 43%, respectively) (p>0,05). After 24 months of treatment, the number of patients without signs of MRI activity decreased to 41-46% in groups 1-3, and more significantly in group 4 (27%). The percentage of NEDA-3 achieving patients did not significantly differ in the groups (23-32%) after 12 months of treatment. After 24 months of treatment the NEDA-3 declined more in group 4 (19%), least of all in groups 1 and 2 (27, 25%, respectively) (p>0,05). In most cases, the observed adverse events were mild or moderate. Flu-like syndrome was observed rarely in groups 1 and 4 (p<0,05). Injection reactions were observed most commonly in groups 3 and 5 (p<0,05). CONCLUSION: Infibeta, while retaining all the advantages of high-dose interferon beta, has the best tolerability profile, which makes it one of the optimal first line disease-modifying therapy for treatment of patients with MS.


Subject(s)
Multiple Sclerosis , Glatiramer Acetate , Humans , Interferon beta-1b , Interferon-beta , Retrospective Studies
4.
Zh Nevrol Psikhiatr Im S S Korsakova ; 116(10 Pt 2): 61-67, 2016.
Article in Russian | MEDLINE | ID: mdl-28139613

ABSTRACT

The article presents the results of international multicenter randomized double-blind, active and placebo-controlled, comparative phase 3 trial. The goal of the study was to demonstrate non-inferiority of BCD-063 (glatiramer acetate, manufactured by JSC «BIOCAD¼, Russia) to copaxone-Teva (Teva Pharmaceutical Enterprise Co., Ltd., Israel) in patients with relapsing-remitting multiple sclerosis. METHODS: 158 patients with relapsing-remitting multiple sclerosis were randomly assigned into 3 groups: BCD-063, copaxone-Teva and placebo, at a ratio of 2:2:1, respectively. RESULTS AND CONCLUSION: Efficacy analysis after 48 weeks of therapy demonstrated no differences between BCD-063 group and copaxone-Teva group in both MRI parameters and frequency of relapses. The mean (SD) of number of MRI-confirmed relapses per patient per year (the primary endpoint) in BCD-063 group was 0.098361 (0.351422), in copaxone-Teva group - 0.098361 (0, 351 422) and in placebo group - 0.178571 (0.390021). There were also no differences between the groups for all other efficacy parameters (EDSS and MSFC). Both investigational BCD-063 and copaxone-Teva demonstrated a favorable safety profile. The data obtained from the present study confirm the therapeutic equivalence of BCD-063 (CJSC BIOCAD, Russia) and copaxone-Teva, that is important for further implementation of glatiramer acetate generic in the clinical practice of multiple sclerosis therapy.


Subject(s)
Glatiramer Acetate/therapeutic use , Immunosuppressive Agents/therapeutic use , Multiple Sclerosis, Relapsing-Remitting/drug therapy , Double-Blind Method , Humans , Magnetic Resonance Imaging , Peptides , Recurrence , Therapeutic Equivalency
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