Исходы новой коронавирусной инфекции COVID-19 у 68 пациентов с воспалительными заболеваниями кишечника

Background. COVID-19 is an infectious respiratory syndrome with a wide range of manifestations and outcomes. Patients with inflammatory bowel disease (IBD) generally have a higher risk of infection, especially if they receive immunosuppressive therapy. Aim to describe the manifestations of COVID-19 in patients with IBD and to determine the risk factors for severe COVID-19. Methods. The analysis included 68 patients with an established diagnosis of Crohns disease (CD) or ulcerative colitis and a confirmed new coronavirus infection. The diagnosis of coronavirus infection was established when SARS-CoV-2 was detected by PCR using nasopharyngeal smears, and computer tomography (CT) of the chest revealed inflammatory changes characteristic of coronavirus lung damage or high IgG and IgM titers based on the results of immunological blood analysis. Results. 68 patients with IBD and COVID-19 were observed in the Department of IBD, including 27 (39.7%) patients with CD, 41 (60.3%) patients with UC. Among patients diagnosed with pneumonia, 100 % of patients received therapy with thiopurines and infliximab. 8 (11.8%) patients were diagnosed with COVID-19 during hospitalization for a severe IBD attack. There was no statistically significant difference between UC and CD patients in terms of disease activity (p = 0.13) during the period of coronavirus infection. In 37 patients (26 UC, 11 BC) with pneumonia (100%), there was an exacerbation of IBD. Statistical significance was found between the development of more severe lung damage (CT 34) and IBD activity at the time of diagnosis of COVID-19 (p 0.001), the presence of comorbidities (p 0.001) and taking GCS (p 0.001) at the time of detection of COVID-19. However, the use of biological and immunosuppressive therapy was not associated with a higher risk of severe lung damage and the need for a ventilator. It was shown that the age of patients over 65 years was statistically correlated with the need for a ventilator (p = 0.02). Conclusion. The exacerbation of the disease, especially in elderly patients with comorbidities, the use of glucocorticosteroids was associated with negative consequences of COVID-19, while biological and immunosuppressant drugs used for the treatment of IBD did not have such a negative effect.Обоснование. COVID-19 это инфекционный респираторный синдром с широким спектром проявлений и исходов. Пациенты с воспалительными заболеваниями кишечника (ВЗК) имеют больший риск инфицирования SARS-CoV-2, в особенности если они получают иммуносупрессивную терапию. Цель исследования описать проявления COVID-19 у пациентов с ВЗК и определить факторы риска тяжелого течения COVID-19. Методы. В анализ были включены 68 пациентов c установленным диагнозом болезни Крона (БК) или язвенного колита (ЯК) и подтвержденной новой коронавирусной инфекцией. Диагноз коронавирусной инфекции устанавливался при выявлении SARS-CoV-2 методом ПЦР назофарингеальных мазков, выявлении при компьютерной томографии (КТ) органов грудной клетки воспалительных изменений, характерных для коронавирусного поражения легких, или высокого титра IgG и IgM по результатам иммунологического анализа крови. Результаты. 68 пациентов с ВЗК и COVID-19 наблюдались в отделении лечения Московского клинического научно-практического центра имени А.С. Логинова, из них 27 (39,7%) пациентов с БК, 41 (60,3%) пациент с ЯК. Не было выявлено статистически значимого различия между пациентами ЯК и БК в отношении активности заболевания (p = 0,13) в период коронавирусной инфекции. У 37 пациентов (26 с ЯК, 11 с БК) с пневмонией (100%) имелось обострение ВЗК. У 8 (11,8%) пациентов был диагностирован COVID-19 во время госпитализации по поводу тяжелой атаки ВЗК. Была выявлена статистическая значимость между развитием более тяжелого поражения легких (КТ 34) и активностью ВЗК на момент диагностирования COVID-19 (p 0,001), наличием сопутствующих заболеваний (p 0,001) и приемом ГКС (p 0,001) на момент выявления COVID-19. При этом применение биологической и иммуносупрессивной терапии не было связано с более высоким риском тяжелого поражения легких и потребностью в ИВЛ. Было показано, что возраст пациентов более 65 лет статистически коррелировал с потребностью в ИВЛ (p = 0,02). Заключение. Обострение заболевания, в особенности у пожилых пациентов с сопутствующей патологией, и прием глюкокортикостероидов имели зависимость с негативными последствиями COVID-19, в то время как препараты биологической и иммуносупрессорной терапии, применяемые для лечения ВЗК, не оказывали такого негативного влияния

Brand marketing trends in Russia social media

In the paper, the authors have reviewed common actions, an aim of which is consumer engagement in interactions with a brand in social media. They have also reviewed engagement types and effects of their use. Based on a literature review, in a clearer way, the authors have presented attributes of Internet marketing and explored brand-marketing challenges on the Internet. Authors have summarized the information on Russian users' efforts in social media. Based on empirical data, the researchers have made a portrait of media actors and the audience in Russian social media, identified target groups among consumers by a number of criteria. They have also completed an analysis of common ways for promotion of companies (brands) and their products and services, taking into account a structure of social media users and specifics of communication channels. Findings include identified most common lines of business for promotion in a competitive social media based on efficiency of the engagement response (rate) per brand/product-specific page or post. These data have made it possible to formalize strategic goals and possible results of brand marketing for various types of social media

Clostridium difficile при язвенном колите. Ретроспективное исследование

Aim: To study epidemiology and risk factors of Clostridium difficile infection (CDI) and its association with colectomy rates in patients with ulcerative colitis (UC). Materials and methods: We retrospectively analyzed medical files of 1179 patients with inflammatory bowel disease who had been treated from January 1 to December 31, 2017, in the Loginov Moscow Clinical Scientific Center (Moscow, Russia). UC was diagnosed according to the International Classification of Diseases, v. 10 (ICD10: K51). Final analysis included data from 400 UC patients. Depending on the presence of preliminary CDI diagnosis, the patients were divided into two groups: 79 (19.75%) patients with UC had at least one confirmed CDI episode, whereas 321 (80.25%) patients had no history of CDI. Results: CDI prevalence in UC patients was 19.75%, and 88.6% of the infectious episodes were community-acquired, whereas only 5.1% occurred in the inpatients. Mean (± SD) age at CDI occurrence in patients with inflammatory bowel disease was 37.8 ± 12.9 years. Only 13.4% of the patients with UC and associated CDI had the history of antibiotic therapy, and 40.5% had been previously treated with steroids. Prolonged immunosuppressive therapy in UC patients was associated with CDI: 41.8% of those with CDI had been treated with azathioprine/6-mercaptopurin for a long time, while among those without CDI this treatment had been administered only to 14.6% (p 0.001). CDI prevalence in the UC patients who had been treated with mesenchymal stromal bone marrow cells was significantly lower than in those who had been treated with genetically engineered biological agents, both with and without immunosuppressants (p 0.05). Surgery (colectomy) was necessary in 3 out of 4 patients with extremely severe UC associated with CDI, and in 2 out of 18 patients with extremely severe UC exacerbation without CDI. Conclusion: Young UC patients are more susceptible to CDI and often do not have any conventional CDI risk factors. In UC patients, other risk factors than in the general population, may have a significant impact on the CDI occurrence. UC patients with CDI more often have a history of salicylate failure, they more frequently require biological treatments, have lower mean albumin levels and higher activity of the inflammation. Extremely severe UC episode associated with CDI significantly increases the risk of colectomy.Цель – изучить эпидемиологию, факторы риска возникновения клостридиальной инфекции (КДИ),  связанной  с Clostridium  difficile, частоту колэктомии  у пациентов  с язвенным  колитом (ЯК). Материал и методы. В ретроспективном исследовании было проанализировано 1179 медицинских карт пациентов с воспалительными заболеваниями кишечника, лечившихся с 1 января по 31 декабря  2017 г. в ГБУЗ МКНЦ имени А.С. Логинова ДЗМ. Диагноз ЯК устанавливали согласно критериям Международной классификации  болезней  10-го пересмотра (МКБ-10: K51). В окончательный анализ включены данные 400 пациентов с ЯК. В зависимости от наличия предварительного диагноза КДИ пациентов разделили на две группы: 79 (19,75%) пациентов с ЯК имели хотя бы 1 подтвержденный  эпизод КДИ, 321 (80,25%) не имел перенесенной в прошлом КДИ. Результаты. Частота КДИ среди пациентов   с  ЯК  составила  19,75%,  при  этом 88,6% инфекций были внебольничными  и лишь 5,1% возникли в медицинских учреждениях. Средний возраст возникновения КДИ у пациентов   с  воспалительными   заболеваниями кишечника   составил   37,8 ± 12,9   года.   Только у  13,4%   пациентов   с  ЯК,   ассоциированным с КДИ, в анамнезе  были указания на использование антибиотиков, а 40,5% ранее  применяли стероиды. Длительная иммуносупрессивная терапия  у пациентов  с ЯК  оказывала  влияние на развитие КДИ: среди пациентов с КДИ 41,8% длительно получали азатиоприн/6-меркаптопурин, без КДИ – 14,6% (p 0,001). Частота КДИ у больных  ЯК,  получавших  терапию  мезенхимальными, стромальными клетками костного мозга,  была статистически значимо  ниже,  чем у больных ЯК,  получавших терапию  генно-инженерными биологическими  препаратами,  как в комбинации с иммуносупрессорами, так и без них  (p 0,05).  Хирургическое   вмешательство (колэктомия)  потребовалось  3  из  4  больных со сверхтяжелым ЯК, ассоциированным с КДИ, и 2 из  18 пациентов  со сверхтяжелой  атакой без КДИ. Заключение. Пациенты с ЯК молодого возраста  более  восприимчивы  к КДИ и часто не  имеют традиционных  факторов  риска. Значимую роль  в  развитии  КДИ  у пациентов с ЯК могут играть другие факторы риска,  чем в общей популяции. У больных ЯК с КДИ в анамнезе чаще отмечается неэффективность терапии салицилатами, чаще требуется назначение биологической  терапии, они имеют более низкое  среднее  значение  альбумина  и более высокую активность воспалительного  процесса.  Сверхтяжелая  атака ЯК,  ассоциированного с КДИ, статистически значимо  повышает риск колэктомии

WIF-1 gene methylation in cervical squamous intraepithelial lesions

Objective. To evaluate the diagnostic value of WIF-1 gene promoter region methylation in the development of cervical intraepithelial neoplasia. Subjects and methods. The investigation included 62 patients aged 18 to 55 years who had come to the Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of the Russian Federation, in the period February to August 2016 for examination and undergone liquid-based cytology, quantitative and qualitative tests for human papillomavirus (HPV), histological examination of cervical biopsy specimens, and extended colposcopy. Bisulfite sequencing was used to study the level of WIF-1 promoter methylation in 62 samples of cells taken from the cervical canal with a cervix brush. Results. The normal mean level of WIF-1 promoter region methylation was 2.3±5.4%. The women diagnosed with high-or low-grade squamous intraepithelial lesions were observed to have a more statistically significant than normal value (p < 0.0001), abnormal WIF-1 gene promoter region hypermethylation at mean frequencies of 29.2±17.2 and 54.8±18.7%, respectively. Conclusion. The findings suggest that the level of WIF-1 gene promoter region methylation significantly correlates with the stage of HPV-associated cervical disease. Thus, evaluation of the WIF-1 gene methylation status may be regarded as a potential diagnostic marker for cervical carcinogenesis and a predictive clinical marker during combination treatment for cervical cancer. © 2017, Bionika Media Ltd. All rights reserved

WIF-1 gene methylation in cervical squamous intraepithelial lesions

Objective. To evaluate the diagnostic value of WIF-1 gene promoter region methylation in the development of cervical intraepithelial neoplasia. Subjects and methods. The investigation included 62 patients aged 18 to 55 years who had come to the Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of the Russian Federation, in the period February to August 2016 for examination and undergone liquid-based cytology, quantitative and qualitative tests for human papillomavirus (HPV), histological examination of cervical biopsy specimens, and extended colposcopy. Bisulfite sequencing was used to study the level of WIF-1 promoter methylation in 62 samples of cells taken from the cervical canal with a cervix brush. Results. The normal mean level of WIF-1 promoter region methylation was 2.3±5.4%. The women diagnosed with high-or low-grade squamous intraepithelial lesions were observed to have a more statistically significant than normal value (p < 0.0001), abnormal WIF-1 gene promoter region hypermethylation at mean frequencies of 29.2±17.2 and 54.8±18.7%, respectively. Conclusion. The findings suggest that the level of WIF-1 gene promoter region methylation significantly correlates with the stage of HPV-associated cervical disease. Thus, evaluation of the WIF-1 gene methylation status may be regarded as a potential diagnostic marker for cervical carcinogenesis and a predictive clinical marker during combination treatment for cervical cancer. © 2017, Bionika Media Ltd. All rights reserved