Antibodies specific to β-Glucocerebrosidase were selected from phage displayed naïve scFv libraries. Biopannings were performed against recombinant human protein β-Glucocerebrosidase immobilized on ...polystyrene surface, specific phages were eluted with 50% ethylene glycol in citrate buffer (pH 6.0). Several specific binders were discovered and converted to full-size hIgG1 antibodies leading to highly stable binders with dissociation constants (Kd) in the range 10–40 nM. The antibodies were used further as ligands for affinity chromatography, where efficient and selective recovery of biologically active β-Glucocerebrosidase from cultured media of Chinese hamster ovary cells was demonstrated. β-Glucocerebrosidase was purified to nearly homogeneous state and had specific activity comparable to the commercially available preparations (40–44 U/mg protein). The obtained immunoaffinity sorbents have high capacity and can be easily regenerated.
•Monoclonal antibodies specific to β-Glucocerebrosidase were found and characterized.•The antibodies found are compatible for immunoaffinity sorbent production.•Using the sorbent allows highly pure β-Glucocerebrosidase preparation in single step.
Introduction. Secondary upper-extremity lymphedema is most commonly caused by lymphadenectomy and radiotherapy (RT) of regional lymph nodes. Lymphatic edema differ in the fact that they lead to ...fibrotic changes in tissues, as the lymph contains up to 2–4% of protein, which causes a specific histopathological response. Proteins, as well as tissue protein-polysaccharide complexes, undergo transformations leading to pathological collagenization, and then to hyalinization and sclerosis. A vicious circle of pathological processes stemming from biophysical and chemical changes in proteins and polysaccharides with metabolic disorders occurs. Compression therapy is the most important component of the fight against both upper- and lower-extremity edema of various origins at any stage of the disease.The aim is to assess the postoperative stabilization of the upper-extremity edema state due to the patient’s self-bandaging using inelastic bandages and the possibility of personalized adjustment of pressure to be applied at the required level. The article provides indications for the use of an adjustable inelastic compression bandage to stabilize edema, and reviews a clinical example of its postoperative use in a patient with grade 4 secondary right upper-extremity lymphedema. Particular emphasis is placed on the versatility of adjustable inelastic compression bandage and the expediency of its widespread use in clinical practice.Conclusion. Simplicity and ease of use with an option to self-adjust and maintain the stable level of therapeutic pressure throughout the entire period of medical rehabilitation, as well as minimization of doctor’s involvement, allow us to recommend the adjustable inelastic compression bandage for effective use in wide clinical practice.
The literature review describes various methods for treating patients with lymphedema of the extremities. Statistics show an increase in the incidence and disability of patients with this pathology. ...However, the possibilities of therapeutic measures in lymphedema are far from perfect.
The analysis of literature data showed that the basis of treatment for lymphedema of the extremities is comprehensive conservative therapy with the use of pathogenetically grounded physical, mechanical, and medical methods. In complex schemes of conservative treatment for lymphedema, physiotherapy methods occupy a prominent place. The most common technique among them is regular combined decongestive therapy. This method is recognized by leading experts as the main one in treating patients with lower extremity lymphedema. Commitment of patients to treatment and their social and psychological counseling are of great importance. The choice of the volume and method of surgical intervention requires a difficult and individual assessment of pathological changes developing throughout the course of the disease.
Despite certain improvements in treatment methods, lower extremity lymphedema is still an unsolved issue. The experience of most specialists involved in lymphedema treatment demonstrates a reasonable balance between basic conservative and surgical treatment methods. Undoubtedly, results of evaluation of these methods will improve the choice of an optimal technique for treating patients with lymphedema of the extremities.
Introduction. The prevalence of hemorrhoids in the adult population, according to various authors, ranges from 15 to 90%. In case of exacerbation of external hemorrhoids, conservative or surgical ...treatment can be applied. Of particular and important interest is homeopathic ointment, has an analgesic, antimicrobial, anti-inflammatory effect, and also affects the tone of the venous vessel. The purpose of our study was to study the effectiveness of Fleming’s ointment for the treatment and prevention of patients with acute hemorrhoids. Materials and methods. A prospective comparative study was conducted with the participation of 154 patients with acute hemorrhoids. In the main group (n = 76) of patients, treatment was carried out using diosmin and homeopathic ointment, which was applied 2 times a day for 7 days. In the control group (n = 78) patients, treatment was carried out using enteral administration of diosmin at a dosage of 1000 mg 1 time per day for 30 days and direct-acting anticoagulants in the form of an ointment 2 times a day for 7 days. Results. Within 3 months after the end of treatment, 4 (5.3%) patients of the main group and 12 (15.4%) patients of the control group had exacerbations of hemorrhoids. After 3 months, a statistically significant difference was revealed in the indicator of the subjective impact of hemorrhoidal disease on everyday life, which is associated with the development of exacerbations of hemorrhoids. Conclusions. Homeopathic ointment is an effective and pathogenetically justified remedy for the conservative treatment of patients with acute hemorrhoids. Its use leads to a significant decrease in the severity of clinical symptoms of the disease and an improvement in the indicators of objective research methods with good tolerability, the absence of undesirable effects and better long-term results compared to the standard treatment regimen.
The most common clinical manifestation of peripheral arterial disease is intermittent claudication due to insufficient blood supply to the affected limb. The article summarizes and systematizes the ...latest achievements in the field of conservative treatment of patients with intermittent claudication. In accordance with the requirements of evidence-based medicine, an overview of modern promising trends in conservative therapy presented in the latest Russian and foreign consensus documents, is given. The basis of the complex treatment of patients with peripheral arterial diseases is: non-drug and drug treatment to relieve the symptoms of chronic ischemia, pharmacotherapy for the secondary prevention of cardiovascular complications, open or endovascular revascularization to increase the distance of painfree walking. With the development of atherosclerosis, disturbances in the peptide composition of the endothelium occur, which reduce the ability of the vascular wall to resist inflammation and the associated triggering of pathological processes. It has been experimentally proven that the use of a complex of peptides obtained from the vessels of healthy and young animals in this situation restores the endothelial function of the arteries, affecting the main links of pathogenesis. Decrease in oxidative stress, decrease in atherogenic and lipidemic action, normalization of vascular tone and blood coagulation parameters, increase in the microvascular bed – these are the mechanisms that justify the indication of peptides to patients with atherosclerosis obliterans. Angioprotector based on a complex of polypeptides isolated from blood vessels can become an important part of the treatment of patients with obliterating diseases of the arteries of the lower extremities, providing a complex pathogenetic effect. It is necessary to further study in multicenter clinical trials the duration of the therapeutic effect of a drug in a longer period after a course of treatment, its effect on long-term outcomes of the disease, the possibility of using repeated courses, in chronic obliterating diseases of the arteries of the lower extremities III-IV stages according to the Fontaine classification, as well as the use drug for the treatment of systemic atherosclerosis of various arterial basins.
Introduction
. Symptomatic peripheral arterial disease (intermittent claudication) is the main cause of disability and loss of mobility in patients and thus has a significant negative impact on their ...quality of life. Conservative treatment of these patients should be aimed at improving local blood flow, tissue metabolism and blood rheology. Cilostazol is the only drug with a Class I (Evidence A) recommendation for the treatment of intermittent claudication.
Objective
. Тo evaluate the clinical efficacy and safety of the use of cilostazol in patients with a combination of obliterating atherosclerosis of the arteries of the lower extremities and diabetes mellitus.
Materials and methods
. In 2021–2022, 102 patients were treated. Men – 78, women – 24, the average age was 62 ± 2.8 years. All patients were prescribed basic treatment of atherosclerosis of the arteries against the background of diabetes mellitus. In the first group (n = 52), cilostazol was additionally prescribed 100 mg 2 times a day. In the second group (n = 50), pentoxifylline was additionally prescribed 600 mg 2 times a day. The severity of the pain syndrome, the pain-free walking distance, the maximum walkable distance, the change in the ankle-shoulder index and partial oxygen pressure in the capillary blood of the foot tissues, the presence of negative outcomes were assessed after 1, 3, 6 months of treatment.
Results and discussions
. In group 1 patients, a more pronounced decrease in pain syndrome was noted compared to group 2, both in patients with IIA degree and in patients with IIB degree of lower limb ischemia according to Fontaine. The increase in pain-free walking distance and the maximum walking distance in group 1 were more significant than in group 2, starting from the 3rd month of treatment. The ankle-brachial index practically did not change, both in group 1 and in group 2. Negative outcomes of treatment after 6 months in the 1st group – 1.9%, and in the 2nd group – 8%.
Conclusions
. If it is impossible to revascularize the limb in patients with obliterating atherosclerosis of the arteries on the background of diabetes mellitus, the inclusion of cilostazol in the treatment regimen shows better final results than the appointment of pentoxifylline. The use of cilostazol significantly improved the quality of life and functional ability of the lower extremities in patients with intermittent claudication.
Aim.
To describe a clinical case of pregnancy and healthy labour in a young female patient with uncomplicated diverticular disease (DD).
Key points.
In recent years, DD is more frequently observed in ...younger patients. A 37-yo woman manifested the symptoms of periodic intense abdominal pain and constant abdominal discomfort. Colonic DD was diagnosed with irrigoscopy. A high-fibre diet, rifaximin-α at 400 mg twice a day for one week, once a month for six months, and topical anti-inflammatory therapy were prescribed. Clinical symptoms were eradicated upon the treatment. Unaware of pregnancy, the patient had another course of rifaximin-α at the second week of gestation, after which the therapy was stopped. Rifaximin-α, which has a poor intestinal absorption, did not affect the foetal development. A caesarean childbirth was healthy, the newborn was delivered on term with no complications (Apgar score 8).
Conclusion.
DD should be included in differential diagnosis for patients with non-specific symptoms (abdominal pain, bloating and discomfort), regardless of young age. No protocols are currently accepted for the DD management during gestation. In the clinical case reported, a patient having diverticular disease and a rifaximin-α therapy at an early term of gestation proceeded without complications for herself and the foetus.
to evaluate the effectiveness of modern approaches to the treatment of purulent wounds with the use of foam-based wound coatings with the Hydrofiber technology in comparison with the traditional ...method of wounds.
An analysis of the results of treatment of 34 patients with purulent wounds of various etiologies was performed. Patients were divided into two groups: control and basic. In the main group, local treatment of wounds was carried out using a foam-based wound coating with Hydrofiber technology. In the control group, local treatment of wounds was carried out using traditional methods with the use of gauze bandages.
With the use of foam-based wound coatings with Hydrofiber® technology, the inflammation process in the wound and surrounding tissues is more rapidly eliminated, the periods of purification and microbial decontamination in the purulent focus are reduced.
Clinical and biochemical status of patients with ulcerative collitis Khalitova, Yu. A.; Myakisheva, Yu. V.; Katorkin, S. E. ...
Vestnik medicinskogo instituta «Reaviz». Reabilitaciâ, vrač i zdorovʹe/Vestnik medicinskogo instituta "REAVIZ". Reabilitaciâ, vrač i zdorovʹe,
11/2022
5
Journal Article
Recenzirano
Odprti dostop
Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), are chronic inflammatory conditions of the gastrointestinal tract characterized by a relapsing and ...remitting course.
Aim
- to analyze clinical data and the most significant hematological and biochemical blood parameters used for diagnosis in patients with ulcerative colitis.
Materials and methods
. Between 2020 and 2021 examined 50 patients with the diagnosis "Ulcerative colitis" living in the Samara region. The diagnosis of ulcerative colitis was confirmed by a combination of clinical, radiological, endoscopic, and histopathological criteria generally accepted for inflammatory bowel diseases. A hematological blood test was performed on an automatic hematological analyzer Sysmex KX-21N, Japan, and a biochemical blood test was performed on an automatic biochemical analyzer Hitachi 902, Japan.
Results
. In the biochemical analysis of blood, an increase in the content of C-reactive protein in the blood is expected in 64% of patients. In 40% of patients, the concentration of total protein and electrolytes decreases. An increase in glucose levels was revealed in 44% of patients, in 10% of cases, a decrease in creatinine concentration, an increase in the activity of ALAT and ASAT was noted in 6 and 4% of cases, respectively. Reduced urea levels are noted in 6% of patients.
Conclusion
. As a result of the study, the data necessary for the diagnosis and monitoring of the effectiveness of the treatment of ulcerative colitis were obtained.
Introduction.
Treatment of thrombophlebitis should be complex and, along with mandatory compression, include both systemic and local use of drugs.
Aim.
To evaluate the efficacy and safety of the ...standardized use of the combined drug indomethacin/troxerutin in gel in real clinical practice in the treatment of superficial vein thrombophlebitis.
Materials and methods.
The study included 71 patients with varicose veins complicated by superficial vein thrombophlebitis. In group I patients (n = 35), topical drugs were not used. In group II patients (n = 36), combined drug indomethacin/troxerutin in gel was used daily. The drug was applied to the skin of the lower extremities three times a day, 4–5 cm of gel. Its total daily amount did not exceed 20 cm of gel. The observation period was 10 days. A dynamic scoring of clinical symptoms was performed using a linear analog scale and thermometry of the skin of the lower extremities.
Results
. On day 10, patients of the main group showed a statistically significant decrease in thermographic parameters in the area of thrombophlebitis: Tmin – 33.23 ± 0.12 °C, Tmax – 39.86 ± 0.24 °C, Tmean – 40.01 ± 0.16 °C (p ≤ 0.05). When assessing the symptoms of thrombophlebitis using a linear analog scale after 10 days of treatment, there was a general decrease in the number of points in the control group to 16.4 ± 0.12 and in the main group to 12.3 ± 0.16 points (p ≤ 0.05).
Conclusion
. Combined drug indomethacin/troxerutin in gel is an effective and safe combined drug for the treatment of patients with thrombophlebitis of the superficial veins of the lower extremities.
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