Publications by authors named "E K Egorova"

275 Publications

Hydroxychloroquine in obstetric antiphospholipid syndrome: rationale and results of an observational study of refractory cases.

J Matern Fetal Neonatal Med 2021 May 27:1-8. Epub 2021 May 27.

The First I.M. Sechenov Moscow State Medical University (Sechenov University), Moscow, Russia.

Background: The current recommended therapy of obstetric antiphospholipid syndrome (APS) is a long-term anticoagulant therapy that affects the final event, namely, when the thrombosis has already occurred. Unfortunately, this schedule is not always effective and fails despite the correct risk stratification and an adequate adjusted dose.

Materials And Methods: From 2013 to 2020 we observed 217 women with antiphospholipid antibodies and obstetric morbidities who were treated with conventional treatment protocol (aspirin low doses ± LMWH). Among them 150 (69.1%) successfully completed pregnancy with delivery and live birth on the background of LMWH and aspirin therapy and in 67 (30.9%) women despite a traditional therapy regimen, obstetric complications were noted. Later, 56 of these 67 women became pregnant again and were offered traditional therapy plus hydroxychloroquine. Fifteen women refused HCQ treatment due to possible potential side effects. The final cohort consisted of 41 women with positive antiphospholipid antibodies and obstetric and thrombotic complications who received LMWH, aspirin low doses and HCQ at a dose of 200-400mg per day from the beginning of pregnancy.

Results: Forty-one aPL women treated with HCQ after failed previous anticoagulant therapy had live births in 32 cases (78%). Adding of HCQ to the combination of LMWH and LDA showed good overall obstetric results and increased the number of live births in another 32 women. So, a total of 182 (83.8%) of initial 217 aPL-women ended their pregnancies with live birth after adding the HCQ to the traditional therapy with LMWH and low doses of aspirin.

Conclusion: In 20-30% of cases the live birth despite anticoagulation cannot be achieved. Perhaps APS is not just anticoagulation. The study of pathophysiological mechanisms suggests that some patients will benefit from other therapy (in addition to anticoagulant). Therapy that affects the early effects of aPL on target cells (monocytes, endothelial cells, etc.) or before binding to receptors-this therapy will be preferable and potentially less harmful than the officially accepted one to date. From this point of view, HCQ looks promising and can be used as an alternative candidate for women with refractory obstetric antiphospholipid syndrome. Adding HCQ should be considered in some selected patients with failed pregnancy after treatment with anticoagulants.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/14767058.2021.1908992DOI Listing
May 2021

Photon Transport in a Bose-Hubbard Chain of Superconducting Artificial Atoms.

Phys Rev Lett 2021 May;126(18):180503

Russian Quantum Center, National University of Science and Technology MISIS, 119049 Moscow, Russia.

We demonstrate nonequilibrium steady-state photon transport through a chain of five coupled artificial atoms simulating the driven-dissipative Bose-Hubbard model. Using transmission spectroscopy, we show that the system retains many-particle coherence despite being coupled strongly to two open spaces. We find that cross-Kerr interaction between system states allows high-contrast spectroscopic visualization of the emergent energy bands. For vanishing disorder, we observe the transition of the system from the linear to nonlinear regime of photon blockade in excellent agreement with the input-output theory. Finally, we show how controllable disorder introduced to the system suppresses nonlocal photon transmission. We argue that proposed architecture may be applied to analog simulation of many-body Floquet dynamics with even larger arrays of artificial atoms paving an alternative way towards quantum supremacy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1103/PhysRevLett.126.180503DOI Listing
May 2021

[Foreign body in the esophagus as a reason to assess the medical aid quality during the forensic medical examination].

Sud Med Ekspert 2021 ;64(1):48-50

Bureau of Forensic Medicine Moscow Health Department, Moscow, Russia.

The Aim Of The Study: Was to investigate in detail the case of a combination of esophageal injury and aortic aneurysm from the standpoint of the perspective of medical care. It was established that the circumstances of the improper provision of medical care in this case were the subjective nature in the form of insufficient and incorrect provision of it. It is shown that continuous training of doctors and mid-level medical workers within the continuing medical education is a gurantee of proper medical care.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.17116/sudmed20216401148DOI Listing
February 2021

[The prognostic value of ASXL1 mutation in primary myelofibrosis. Literature review and clinical case description].

Ter Arkh 2020 Sep 1;92(7):95-99. Epub 2020 Sep 1.

National Research Center for Hematology.

Primary myelofibrosis is a myeloproliferative neoplasm that occurs de novo, characterized by clonal proliferation of stem cells, abnormal expression of cytokines, bone marrow fibrosis, hepatosplenomegaly as a result of extramedullary hematopoiesis, symptoms of tumor intoxication, cachexemia, peripheral blood leukoerythroblastosis, leukemic progression and low survival. Primary myelofibrosis is a chronic incurable disease. The aims of therapy: preventing progression, increasing overall survival, improving quality of life. The choice of therapeutic tactics is limited. Allogenic hematopoietic stem cell transplantation is the only method that gives a chance for a cure. The role of mutations in a number of genes in the early identification of candidates for allogeneic hematopoietic stem cell transplantation is being actively studied. The article describes the clinical case of the detection ofASXL1gene mutations in a patient with prefibrous primary myelofibrosis. The diagnosis was established on the basis of WHO criteria 2016. The examination revealed a mutation ofASXL1. Interferon alfa therapy is carried out, against the background of which clinico-hematological remission has been achieved. Despite the identified mutation, the patient is not a candidate for allogeneic hematopoietic stem cell transplantation. Given the unfavorable prognostic value of theASXL1mutation, the patient is subject to active dynamic observation and aggressive therapeutic tactics when signs of disease progression appear.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.26442/00403660.2020.07.000788DOI Listing
September 2020

[Adverse drug reactions of local anesthetics used in dentistry].

Stomatologiia (Mosk) 2020 ;99(6):82-88

Medical Academy n. a. S.I. Georgievsky of Vernadskjy CFU, Simferopol, Republic of Crimea, Russia.

The aim. Study the adverse drug reactions (ADR) that occur when using local anesthetics (LA) in patients living in the Republic of Crimea and registered during the period 2010-2018.

Material And Methods: The objects of the study were 122 notification forms about LA ADR recorded in the regional base (Register) of spontaneous reports called ARCADe (Adverse Reactions in Crimea, Autonomic Database). In most cases, ADR was associated with the use of amide LA Lidocaine - 69 cases (56.55% of the total number of cases for LA ADR), less often, ADR was caused by combinations containing Articaine (34 cases, 27.87%). Rare cases of ADR were reported for Novocaine/Procaine (9 cases, 7.38%), Bupivacaine (8 cases, 6.56%) and Mepivacaine (2 cases, 1.64%). The main clinical manifestations of reactions were hypersensitivity-like reactions (38 cases), cardiac and vascular disorders (29 cases) and central nervous system disorders (19 cases). Lack of effectiveness of LA occurred in 13 cases (10.66%).

Results: A study of the outcome of ADR revealed a high incidence of life-threatening conditions associated with LA use - 31 cases (25.4%), which indicates the severity of the event and the need to cancel the suspected drug and prescribe additional medications for correction. The need for hospitalization or prolongation of hospitalization was necessary in 7 cases (5.8%), and temporary disability of patients was revealed in 5 cases (4.1%). Of particular interest are 2 cases (1.6%) of the development of a fatal outcome as a result of the suspected anaphylactic shock (1 case) and disorders of the central nervous system (convulsions, development of respiratory failure).

Conclusion: The high frequency and severity of unwanted effects resulted from the use of LA requires healthcare professionals to make rational choices and strictly monitor patient safety.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.17116/stomat20209906182DOI Listing
December 2020