Belarusian State Medical University

In recent years, understanding of the key role of epithelial cytokines (IL-25, IL-33, and TSLP) in the development of respiratory tract inflammatory diseases has significantly expanded. These molecules, released by airway epithelium in response to allergens, pathogens, and damaging agents, act as alarmins, initiating a cascade of the Th2-mediated inflammation that leads to the IgE-mediated reactions, eosinophilic infiltration, and tissue remodeling. Beyond classical allergic processes, epithelial cytokines play a crucial role in the virus-induced exacerbations of respiratory diseases and pathogenesis of chronic obstructive pulmonary disease (COPD). Monoclonal antibody therapeutics targeting these cytokines have demonstrated efficacy in treating severe asthma. This review summarizes current data on contribution of TSLP, IL-33, and IL-25 to the respiratory tract inflammation and discusses the prospects of their targeted inhibition to improve therapeutic efficacy.

Resume. The use of memantine has long been the basis of modern symptomatic therapy for patients with moderate and severe dementia with Alzheimer's disease. At the same time, the effectiveness of the drug in the treatment of mild dementia in this pathology remains the subject of wide discussion.The purpose of this open-label observational study is to analyze the relationship between clinical, neuroimaging markers and response to memantine therapy in patients with mild Alzheimer's dementia. Materials and methods. 40 patients (66.7 [60.8; 71.5] years old) received memantine at a dose of 20 mg/day for 3 months. The MRI parameters (overall severity of cerebrovascular changes, Medial Temporal lobe Atrophy (MTA)), the results of the Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MCA), Addenbrooke's Cognitive Examination, revised (ACE-R), Interlocking finger test (IFT), Free and Cued questionnaires were analyzed Selective Reminding Test – Immediate Recall (FCSRT-IR), Global Rating of Change Scale (GROC), the presence and characterization of side effects. Multiple linear regression models with calculation of β-coefficients were used to analyze the relationship between the response to therapy and the main analyzed parameters. Results. A significant improvement in cognitive function according to a number of tests was recorded after 2 months of treatment (MoCA, IFT, MMSE). Significant improvement in the ACE-R questionnaire (78.4 ± 2.7 vs 83.1 ± 2.7 points) was noted after 3 months of therapy. No significant changes in FCSRT-IR values were recorded during the follow-up period. The majority of patients regarded the improvement from the therapy as "moderate" and "pronounced" (GROC: 26/65%). There was no refusal of further treatment due to the development of adverse events. The most significant factors influencing the success of memantine therapy were OVCI (-0.552 (-0.034–0.814), MTA (-0,417 (-0,015–0,811)), the presence of diabetes mellitus (0.481 (0.028–0.825)) and urinary disorders (-0,414 (-0,074–0,997)). Conclusions. Short-term use of memantine in the treatment of mild Alzheimer's type dementia is effective and safe. The presence of concomitant marked atrophy of the medial frontal lobe, significant cerebrovascular changes according to MRI data, as well as urinary disorders are negative predictors of successful treatment of cognitive disorders, while in patients with diabetes mellitus, the effectiveness of memantine treatment was more pronounced.

В статье представлен анализ клинико-лабораторного статуса недоношенных с бронхолёгочной дисплазией (БЛД) в первые сутки жизни. Обследовано 59 новорождённых со сроком гестации от 23 до 30 недель. Выделено 2 группы: основная с БЛД тяжёлой степени (n=23) и группа сравнения с БЛД лёгкой и средней степени (n=36). Установлена связь ряда клинических и лабораторных показателей периферической крови со степенью тяжести БЛД. This article presents an analysis of the clinical and laboratory status of premature infants with bronchopulmonary dysplasia (BPD) in the first day of life. Fifty-nine newborns with gestational ages ranging from 23 to 30 weeks were examined. Two groups were identified: a study group with severe BPD (n=23) and a comparison group with mild to moderate BPD (n=36). A relationship between peripheral blood laboratory parameters and the severity of BPD was identified

Пациент 34-летнего возраста был госпитализирован с диагнозом «внебольничная левосторонняя пневмония средней тяжести». Диагноз был подтвержден совокупностью лабораторных признаков воспаления (лейкоцитозом, высоким уровнем СРБ и прокальцитонина, а также повышенной скоростью оседания эритроцитов) и рентгенологическими изменениями в легких. Обнаружено присутствие жидкости в плевральной полости с двух сторон. На КТ брюшной полости в правой доле печени было выявлено гиподенсивное образование с неровными, нечеткими контурами размером 64×53×95 мм, неоднородной структуры со множественными перегородками, неоднородно, мозаично накапливающее контраст. Комплексное диагностическое обследование пациента для выяснения природы патологического образования в печени включало оценку функциональных тестов печени, онкомаркеров (таких как альфа-фетопротеин и раково-эмбриональный антиген) и серологических тестов на вирусный гепатит (HBsAg, анти-HCV). Отрицательные результаты этих исследований в сочетании с отрицательным результатом на антиэхинококковые антитела позволили провести дифференциальную диагностику с такими распространенными причинами поражений печени, как гепатоцеллюлярная карцинома, холангиокарцинома или эхинококковые кисты. Эндоскопические исследования, включая эзофагогастродуоденоскопию и колоноскопию, исключили первичные опухоли желудка или толстой кишки и подтвердили отсутствие метастазов в печень. Несмотря на отсутствие положительных результатов посева крови, общая клиническая картина в сочетании с результатами биопсии печени и данными КТ дала возможность установить диагноз «абсцесс печени». Отсутствие четкого первичного источника поражения и трудность точной идентификации возбудителя представляют определенную диагностическую проблему у таких пациентов и требуют их динамического наблюдения на этапе амбулаторного лечения. A 34-year-old patient was hospitalized with a diagnosis of moderate community-acquired left-sided pneumonia. The diagnosis was confirmed by a combination of laboratory signs of inflammation (leukocytosis, elevated C-reactive protein and procalcitonin levels, and an increased erythrocyte sedimentation rate) and radiological changes in the lungs. A moderate bilateral pleural effusion was revealed. A CT scan of the abdomen showed a hypodense lesion in the right lobe of the liver, measuring 64×53×95 mm, with ill-defined borders. The lesion had a heterogeneous structure with multiple septations and demonstrated heterogeneous mosaic pattern contrast enhancement. A comprehensive diagnostic workup to determine the nature of the liver lesion included liver function tests, tumor markers (such as alpha-fetoprotein and carcinoembryonic antigen), and serological tests for viral hepatitis (HBsAg, anti-HCV). The negative results of these tests, combined with a negative test for anti-echinococcal antibodies, helped rule out common causes of liver lesions, such as hepatocellular carcinoma, cholangiocarcinoma, or echinococcal cysts. Endoscopic studies, including esophagogastroduodenoscopy and colonoscopy, ruled out primary tumors of the stomach or colon and confirmed the absence of liver metastases. Despite the absence of positive blood culture results the overall clinical picture combined with liver biopsy findings and CT imaging, led to a diagnosis of a liver abscess. The absence of a clear primary source of the lesion, combined with the difficulty in accurately identifying the causative agent, posed a diagnostic challenge in such patients and required their dynamic follow-up during outpatient treatment.

Abstract Background Type 2 diabetes (T2D) is associated with an increased risk of cardiovascular disease (CVD) and CV mortality. Additionally, multiple modifiable risk factors (obesity, dyslipidemia, hypertension) can further increase the risk of a poor outcome. Hence early identification of CVD risk factors in patients with T2D is crucial for proactive management and primary prevention. Objectives Assessment of cardiovascular risk factors and stratification of CVD risk in patients with newly diagnosed T2D. Methods A retrospective study was conducted among newly diagnosed T2D patients attending the outpatient clinic. Anthropometric measurements (BMI, WHR), biochemical parameters (lipid panel, HbA1c) and past medical history were analyzed. Control group included patients matched by gender and age, without diabetes. The stratification of CVD risk was performed using SCORE2-Diabetes and SCORE2 in patients with T2D and controls respectively. Results 100 patients with T2D were enrolled (50F, 50M), median age 52 years [IQR 47-55]. Glycemic control was optimal with median HbA1c—7.1% [6.7-7.5]. Obesity was observed in 45% of T2D patients and 32% were overweight with BMI 30.6 [25.6-36.4] and WHR 0.95 [0.82-1.09]. Dyslipidemia was found in 61% of T2D patients with LDL—3.6 [2.97-4.1] mmol/L and triglycerides—1.76 [1.3-2.12] mmol/L that were significantly higher vs controls with LDL—2.7 [2.39-3.37] mmol/L and triglycerides—1.19 [0.93-1.49] mmol/L (P < .5). In addition to a higher level of HDL—1.3 [1.09-1.63] mmol/L was observed in controls vs T2D patients HDL—1.12 [0.96-1.32] mmol/L (P < .5). Co-occurring hypertension was present in 78% of T2D patients with systolic BP 141 [134-146] mmHg. Upon CVD risk evaluation in T2D patients—83% were at high/very high risk (41% and 42% respectively) and only 17% had moderate risk, whereas in the control group—35% had moderate risk and 65% of patients had low risk. Furthermore, none of the high and very high-risk patients had target LDL and only 23.5% of moderate risk patients were within their target LDL level. Conclusions Our findings show the prevalence of high/very high CVD risk (83%) and illustrate a constellation of modifiable CVD risk factors in patients with newly diagnosed T2D, which subjects them to an increased risk of major cardiovascular events. This emphasizes the significance of timely metabolic management alongside proper glucose control.