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Biomedical subjects

A A Demin

Publications and source records attributed to A A Demin.

At least 37 records · Page 2Linked to original sources
PubMed2000

[Infectious endocarditis in intravenous drug abusers].

Clinical course of infectious endocarditis (IE) was analysed for 43 intravenous drug abusers. 42 of them had primary IE, one patient--secondary. Acute course and high activity of the disease were registered in 86% of the patients. IE was provoked by Staphylococcus aureus (50%), Staphylococcus epidermidis 920%), Staphylococcus haemolyticus (11%), E. coli (8%), Pseudomonas aeruginosa (2%), Candida albicans (2%), mixed microflora (7%). Vegetations were detected on the tricuspid, mitral and aortic valves (52, 23 and 19%, respectively), on more than one valve (6%). Pneumonia, pleuricy, hydrothorax, enlargement of the liver, spleen, nephritis and anemia were found in 76, 44, 9, 100, 75, 70 and 88% of the patients, respectively. Cardiac failure aggravated the disease in half of the patients, lethality was 18%. Thus, IE in intravenous drug abusers is characterized by a primary form, acute active course, prevalent damage to the tricuspid valve, polyorganic involvement, high lethality. IE cure in such patients is feasible only in adequate antibacterial therapy, timely surgical correction and giving up drug abuse.

Acute Disease↗
PubMed1998

[Ceftriaxone in the treatment of staphylococcal endocarditis].

Efficacy and safety of ceftriaxone (Oframax, Ranbaxy, India) in the treatment of 25 patients with Staphylococcus endocarditis (SE) were studied. The drug was administered intravenously in a dose of 2-4 g a day for 4 weeks and simultaneously gentamicin was used intramuscularly in a dose of 2-3 mg/kg body weight a day every 8 hours for 2 weeks. The treatment was followed by observation of the patients for up to 2 years under the hospital or dyspensary conditions. The disease was due to S. epidermidis (17 patients) or S.aureus (8 patients). The efficacy was controlled in the dynamics. The criteria of the therapy efficacy were disappearance of the disease clinical signs, normalization of the blood count and urinalysis and the pathogen eradication by the results of the control bacteriological blood analysis. The cure without any surgical correction was observed in 68 per cent of the patients and that with the valve replacement was stated in 24 per cent of the patients. The lethal outcome due to bacteriotoxic shock was recorded in 8 per cent of the patients. The SE relapsing was stated in 28 per cent of the patients 3 or more months after the ceftriaxone therapy completion. 10 patients (40 per cent) with evident clinicolaboratory improvement were discharged from the hospital 2 (4 patients) and 3 (6 patients) weeks after the therapy start for the treatment with ceftriaxone as outpatients. In 2 patients nausea as the adverse reaction was observed. Therefore, the complex clinicolaboratory investigation showed that the combined use of ceftriaxone and gentamicin was efficient and safe in the treatment of SE. Ceftriaxone may be considered as a basic drug for the therapy of SE. In some patients with SE the treatment with ceftriaxone may be completed under outpatient conditions.

Adolescent↗
PubMed1997

[Ceftriaxone in treatment of streptococcal endocarditis].

The authors studied efficacy and safety of ceftriaxone given intravenously for 3-4 weeks in a dose 2-4 g/day to patients with streptococcal endocarditis (SE). Of them, 8, 8 and 1 patients were infected with Streptococcus viridans, Streptococcus pyogenes, Pneumococcus, respectively. Hospital trial and follow-up lasted up to 2 years. Cure without surgical correction occurred in 7 patients, valvular replacement was needed in 4 patients, 1 patient died, 4 patients developed recurrences 3 and more months after therapy with ceftriaxone. The drug was safe and well tolerated. 33% of the patients were discharged from hospital with obvious improvement after 2-3 week treatment to continue it outpatiently for 1-2 weeks.

Adult↗
PubMed1996

[Synchronizing therapy with plasmapheresis and cyclophosphamide in rapidly progressing systemic lupus erythematosis with kidney involvement].

12 patients with rapidly progressive systemic lupus erythematosus (SLE) combined with renal failure were treated for 6 months according to the following scheme: 3 consecutive procedures of plasmapheresis (60 ml/kg x 3), 3 consecutive pulse doses of cyclophosphamide (400 mg/m2 x 3), 3 prednisolone infusions (2 mg/kg x 3), oral cyclophosphamide (100-250 mg/day) and prednisolone (0.5 mg/kg with subsequent dose reduction). Dose of the drugs was controlled by blood leukocyte count and creatinine clearance. The patients were included in the trial in the preset time. All the patients had active SLE (33.5 +/- 2.7 U according to SLAM). 75, 25, 58.3, 33.4, 8.3% of patients had mixed, nephrotic, mesangiocapillary, mesangioproliferative, membraneous nephritis, respectively. 26 weeks of the treatment produced a response in 83.3% of the patients. The disease activity lowered to 12.8 +/- 2.9 U. Four-year survival reached 81%. Cytopenia developed in 25% of patients, deep hemopoiesis depression was not observed. Septic candidiasis arose in one woman on the third year of the follow-up. Clinical validity of the above method is stated in severe SLE.

Adult↗
PubMed1995

[A multicenter evaluation of efficacy and tolerance in the local treatment with dolgit cream of patients with osteoarthrosis].

A 2-week clinical trial of cream dolgit efficacy and tolerance in 76 patients with primary osteoarthritis in 8 rheumatological centers showed this preparation to reduce local pain syndrome in 70.1%, palpation pain sensitivity in 79.2%, joint swelling in 75.5% of patients. Unwanted reactions in the form of skin itch at the site of application were reported in 7.8% of cases.

Administration, Topical↗
PubMed1992

[Amyloidosis in systemic lupus erythematosus].

Based on the authors' experience from 1982 to 1990 it was noted that out of 26 cases of renal amyloidosis in the presence of nonpurulent and purulent conditions 2 patients (7%) demonstrated the association with systemic lupus erythematosus (SLE). It was also noted that amyloidosis developed in the patients with a long history of the disease. Long-course immunosuppression treatment could be regarded as the other factor-of-risk for amyloidosis development. Histochemical examination of both patients demonstrated that amyloid deposits in the renal glomeruli were resistant to the potassium permanganate effect and consisted of AL-protein. The results obtained indicated the possibility of appearance of immunoglobulins AL--the proteins of the primary amyloidosis--synthesized in the spectrum in the SLE presence as well as their deposition in the renal glomeruli. As a possible cause of proteinuria and the nephrotic syndrome in SLE patients amyloidosis should be diagnosed in the life time and be regarded in the choice of therapeutic policy as well as in the assessment of pulse immunosuppressive therapy practicability.

Adolescent↗
PubMed1991

[The overdiagnosis of bacterial endocarditis].

The diagnosis of bacterial endocarditis (BE) is analyzed in 255 patients. After examination, the diagnosis of BE was verified but in 92 patients (36.1%). Of these, BE was overdiagnosed in 163 patients (63.9%). The main causes of the overdiagnosis were body temperature rise in 134 patients (52.6%), heart murmur in 163 patients (63.9%), and positive hemoculture in 57 patients (22.3%). Three cases of BE overdiagnosis are provided. Exaggeration of the specificity of body temperature rise in patients with heart murmur often leads to BE overdiagnosis. Mitral valve prolapse is one of the predisposing BE factors. At the same time it is a cause of overdiagnosis of BE in patients with fever, BE overdiagnosis often results in unbased long-term antibacterial therapy, while other causes of the symptoms are not considered. Ineffectiveness of antibacterial treatment (no clinical improvement, continuous or recurrent fever) points to the necessity of further diagnostic search.

Adolescent↗
PubMed1991

[Kidney involvement in infectious endocarditis (hematuria)].

As many as 113 patients suffering from infectious endocarditis (IE) were placed under observation. Renal damage was discovered in 28 patients (24.7%). Hematuria was the common laboratory sign of renal damage. 15% of patients showed microhematuria, 9.7 had macrohematuria. In 15% of patients with IE, hematuria was due to diffuse glomerulonephritis, in 5.3% to renal infarction, and in 4.4% to focal glomerulonephritis. In 3.5% of patients, the nephrotic syndrome developed at the disease onset, it was attended by hematuria and was thus a cause of erroneous diagnoses. The appearance of hematuria at the IE onset, attesting to involvement of the kidneys into the pathological process, complicates the diagnosis and early treatment institution. Detection of the hematuric syndrome in patients with a verified diagnosis of IE requires specification of the character of renal damage. The latter one contributes to a graver and prognostically unfavourable course of IE. In 2 out of 8 patients with associated IE and renal damage, the death was caused by progressive chronic renal failure. Postmortem examination confirmed mesangioproliferative glomerulonephritis in all the subjects; in 4, it was coupled with renal infarction. 14.1% of the patients manifested complete and 3.5% partial disappearance of hematuria under the influence of adequate antibacterial therapy of IE.

Adult↗
PubMed1988

[Bacterial endocarditis: its current course and diagnosis].

Investigations have shown that the etiology of bacterial endocarditis (BE) has notably changed, with the prevalence of highly virulent agents which alter a course of disease and often determine a lethal prognosis. A positive NBT-test permits more rapid and accurate detection of systemic bacterial infection than investigations of hemoculture, indicates a high phagocytic activity of neutrophils at the active stage of BE irrespective of a course of disease and permits earlier use of antibacterial therapy. A high activity of antibodies to teichoic acids indicated much earlier and more accurately Staphylococcus aureus as an etiological agent than investigations of hemoculture. It permits early etiotropic chemotherapy when it is more effective. Investigations of antibodies to teichoic acids over time makes it possible to assess the effectiveness of therapy of BE as at the inactive stage of disease the test becomes negative. Enzyme immunoassay of antibodies to native and denatured DNA reveals an active autoimmune process in BE patients, ongoing alterative processes--all of them can be used for characterization of a course and prognosis of disease. Etiotropic therapy alters the nature of a BE course, increasing the number of patients with a chronic course of disease in whom remissions are alternated by recurrences.

Antibodies, Bacterial↗
PubMed1985

[Stimulation of restorative processes in stomach and duodenal ulcers].

The effects of RNA preparations and symptomatic agents (antacids and cholinolytics) were studied and compared in patients with peptic ulcer of the stomach and duodenum. It was shown that the use of RNA preparations led to a more rapid disappearance of the endoscopic, x-ray and morphological signs of ulceration, epigastric symptoms, nausea and vomiting, anorexia, "latent" blood in the feces. Altogether 92% of the patients responded to RNA preparations, and 72% to the symptomatic treatment. The rate of relapses it the patients on RNA was 8%, that in the patients on the symptomatic agents amounted to 20%. The mechanism of action of RNA preparations in patients with peptic ulcer of the stomach and duodenum lies in stimulation of protein biosynthesis in the mucous membrane of the involved stomach and intestine, which leads to intensification of the reparative processes.

Adolescent↗