Klinicheskaia Meditsina[JOURNAL]
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200 papers
[The risk of cardiovascular death in type 2 diabetes].
Zeinalova NV, Kurbanov YZ, Mirzazade VA … +2 more , Rzayeva RA, Novruzova MS
Klin Med (Mosk) · 2017 · PMID 30299067
To evaluate effects of metabolic disorders on the risk of cardiovascular death in patients with type II diabetes based on Framingham risk score. We analyzed results of examination of 210 men and 210 women with type 2 dia...
To evaluate effects of metabolic disorders on the risk of cardiovascular death in patients with type II diabetes based on Framingham risk score. We analyzed results of examination of 210 men and 210 women with type 2 diabetes who applied for medical care to the VM center of Endocrinology during 1997-2014. A virtual control group was formed matching real patients in terms of the number, sex, age, and height having ideal body mass index, total cholesterol and high-density lipoprotein cholesterol levels. The average risk of cardiovascular death in patients with type 2 diabetes was equal to 4,56±0,254% compared with 0,6±1,028% in the virtual control group. The differences was significant (p <0,001). The minimum risk for the patients of the two groups was estimated at 0,001% and 0,01% respectively. The maximum risk of cardiovascular death is 34,17% in patients with diabetes and 8,24% in controls. It is concluded that type 2 diabetes and related metabolic disorders significantly increase the risk of cardiovascular death.
[Prevalence and typological characteristics of atherosclerotic lesions in carotid arteries associated with metabolic syndrome as revealed by multislice computed tomography].
Praskurnichiy EA, Aleksandrova II, Kostycheva TV … +1 more , Knyazev AN
Klin Med (Mosk) · 2017 · PMID 30299065
AIM: To study the character, prevalence, and typological structure of atherosclerotic changes in major arteries by multislice computed tomography in patients with various metabolic disorders. MATERIAL AND METHODS: Caroti...
AIM: To study the character, prevalence, and typological structure of atherosclerotic changes in major arteries by multislice computed tomography in patients with various metabolic disorders. MATERIAL AND METHODS: Carotid arteries of 78 patients with metabolic syndrome or type 2 diabetes mellitus and without carbohydrate metabolism disorders were examined by multislice computed tomography. RESULTS: The study revealed various types of atherosclerotic plaques differing in the composition of lipid, lipid-fibrotic and calcium components. The latter were especially well expressed in diabetes. CONCLUSION: All types of atherosclerotic plaques are roughly equally represented in the structure of atherosclerotic lesions of carotid arteries in patients with metabolic syndrome in the absence of type 2 diabetes. Diabetic patients had vascular lesions with especially high density of atherosclerotic plaques.
[Early diagnosis of stress-induced hypertension in young employees of state law enforcement agencies].
Evsevyeva ME, Ivanova LV, Sergeeva OV … +1 more , Orechova NV
Klin Med (Mosk) · 2017 · PMID 30299064
Psychoemotional stress is one of the leading cardiovascular risk factors. The aim of this study was to explore manifestations of arterial hypertension (AH) in young men employed in the stress associatedfield works. Mater...
Psychoemotional stress is one of the leading cardiovascular risk factors. The aim of this study was to explore manifestations of arterial hypertension (AH) in young men employed in the stress associatedfield works. Material and methods. A total of 68 young men, exposed to job stress (JS) of different severity during 1 to 5 years were surveyed. The control group was formed of persons whose daily work was unrelated to operational activities. The study included ambulatory monitoring (AM) blood pressure (BP) on different days of the week, comparing the results of the office and DMBP determination and assessment of resistance to a variety of diagnostic loads. Results. The study revealed an increase of AMBP indicators during the working day and their normalization at weekend. The comparison of the results of office and ambulatory determination of BP demonstrated that different forms of stressful AH (stable, isolated office and latent) occurred significantly more often than in the control group. These changes almost completely disappeared at weekends. The tolerance ofpsychoemotional testing was much worse than that of traditional exercises. It is proposed to more extensively use AMBP during regular medical examinations of young men exposed to JS in order to establish a timely differential diagnosis of various forms of stressful hypertension.
[Therapeutic Monitoring Plasma Imatinib to Improve Results of the Treatment of Chronic Myeloleukosis].
Savelyeva MI, Kryukov AV
Klin Med (Mosk) · 2017 · PMID 30299062
The achievement of early cytogenetic and molecular responses is the major objective of therapy and a main prerequisite for the favourable long-term outcome of the disease. The maintenance of dose intensity and management...
The achievement of early cytogenetic and molecular responses is the major objective of therapy and a main prerequisite for the favourable long-term outcome of the disease. The maintenance of dose intensity and management of adverse events are keys to successful treatment of chronic myeloid leukemia (CML) with imatinib. Therapeutic monitoring and testing the drug level in blood are the efficient tools for the treatment of patients with CML and can be usedfor analysis of treatment failure or suboptimal response to therapy, suspected noncompliance, drug interactions or unexpected adverse reactions.
[Obesity and cardiovascular system].
Verbovoy AF, Pashentseva AV, Sharonova LA
Klin Med (Mosk) · 2017 · PMID 30299061
Obesity is a serious medico-social and economic problem. Increased body mass index is associated with a rise in the general mortality rate and mortality due to cardiovascular diseases. In this article, modern views of th...
Obesity is a serious medico-social and economic problem. Increased body mass index is associated with a rise in the general mortality rate and mortality due to cardiovascular diseases. In this article, modern views of the influence of obesity on the cardiovascular system are considered.
[Criteria for granting permission for disabled persons to participate in the Ready for Labor and Defense training program].
Mashkovsky EV, Predatko KA, Magomedova AU … +2 more , Shteinerdt SV, Volodina KA
Klin Med (Mosk) · 2017 · PMID 30299059
Rehabilitation, adaptation, and social integration of the disabled are the priority issues of social welfare policy in the Russian Federation. This includes the enhancement of availability ofphysical education and adapte...
Rehabilitation, adaptation, and social integration of the disabled are the priority issues of social welfare policy in the Russian Federation. This includes the enhancement of availability ofphysical education and adapted sports programs. One of the best practices for the improvement ofphysical activity among the population is the "Ready for labour and defense" training system (GTO). However, it is not adapted for those with physical challenges and disabilities. To involve this special fraction of the population in physical activity and participation in the GTO system, disability groups eligible for this activity need to be identified. They can include individuals with visual (VI), intellectual (II), hearing (HI), and locomotor problems as well as those with transplanted organs (TO). Also, minimum disability criteria (MDC) for the participants from each group which would make them eligible to practice an adapted GTO system should be defined. The development of MDC for individuals with VI, II, HI, and TO is relatively easy as they are common for most adapted sports. However, it remains a challenge for persons with locomotor problems since they make up a very diverse group bearing in mind that the rules of the International Paralympic Committee envisage different MDC for different adapted sports. There are two possible solutions: (1) to develop specialized MDC for each sport discipline included in the GTO system, (2) to develop universal MDC for all disciplines. The next step in promoting the GTO system among individuals with physical challenges and disabilities will be the development of the para- GTO program that would be unique and adapted for all categories of the disabled individuals.
[Extragastric symptoms associated with Helicobacter pylori infection].
Akhmedov VA, Gaus OV
Klin Med (Mosk) · 2017 · PMID 30299058
This review article highlights the modern views of manifestations associated with Hp infection. The data are presented about the negative impact of the infection on the state of the musculoskeletal system, the developmen...
This review article highlights the modern views of manifestations associated with Hp infection. The data are presented about the negative impact of the infection on the state of the musculoskeletal system, the development of migraine, progression of diffuse liver disease and the risk of developing liver cancer. The paper also provides information on the possible effects of Helicobacter pylori infection on the formation of halitosis, tympanosclerosis, male reproductive health disorders, colorectal cancer, Alzheimer's and Parkinson's disease, pre-eclampsia during pregnancy, and idiopathic chronic urticaria. In addition, the negative relationship between Hp infection, bronchial asthma, and inflammatory bowel disease is considered.
[Topical problems of chronic gastritis].
Tsimmerman YS, Zakharova YA
Klin Med (Mosk) · 2017 · PMID 30299056
The authors propose the definition of chronic gastritis with a brief overview of the history of investigation of this diseases and its prevalence with special reference to (1) the bacterial profile and its role in the de...
The authors propose the definition of chronic gastritis with a brief overview of the history of investigation of this diseases and its prevalence with special reference to (1) the bacterial profile and its role in the development of infectious and inflammatory process in gastric mucosa, (2) the modern state of and new trends in the classification of chronic gastritis including their advantages and disadvantages, (3) the relationship between chronic gastritis and functional gastroduodenal dyspepsia syndrome. It is concluded that mucous microflora plays an important factor in the development ofpathology but H.pylori is not its predominant component. Modern classifications of chronic gastritis provide a basis for a deeper insight into evolution of chronic gastritis and its transformation into cancer. The diagnosis of ‘chronic gastritis with functional gastroduodenal dyspepsia syndrome‘ is invalid.
[COMPREHENSIVE DIAGNOSTICS IN PATIENTS WITH GENOTYPE 47,XXY KLINEFELTER SYNDROME].
Akbarova GA
Klin Med (Mosk) · 2016 · PMID 27522732
We undertook biochemical, hormonal, cytological analysis and sequencing CAG repetitions of androgen receptor gene in order to elucidate the cause of clinical polymorphism of Klinefelter syndrome. Elevated levels of LH (1...
We undertook biochemical, hormonal, cytological analysis and sequencing CAG repetitions of androgen receptor gene in order to elucidate the cause of clinical polymorphism of Klinefelter syndrome. Elevated levels of LH (19.8 ± 4.2 E/l), FSH (22.7 ± 6.1 U/l), total cholesterol (6.8 ± 2.6 mmol/l), triglycerides (3.3 ± 1.0 mmol/l), and glucose (9.9 ± 3.8 mmol/l) suggested disturbances of lipid and carbohydrate metabolism. Two thirds of the patients had Klinfelter syndrome associated with mental retardation and psychic disorders. Patients with cleft palate and mental retardation and with psycho-social disorders had 45 and 43 CA G repetitions respectively, those without associations 38-40 repetitions. Increased frequency of CAG repetitions was directly proportional to the level ofpsychic development, social adaptation and professional activity but inversely proportional to the development of masculine sexual traits.
[DEVELOPMENT RISK FACTORS OF EARLY METABOLIC AND VASCULAR DISORDERS IN YOUNG SUBJECTS].
Vasil'eva EM, Nikitin AV, Bulat AA … +1 more , Zhemnchuzhnikov SV
Klin Med (Mosk) · 2016 · PMID 27522731
Deterioration of health characteristics and ever increasing diabetes and cardiovascular morbidity among young subjects imply the necessity of identification ofpossible risk factors of these conditions. We evaluated the p...
Deterioration of health characteristics and ever increasing diabetes and cardiovascular morbidity among young subjects imply the necessity of identification ofpossible risk factors of these conditions. We evaluated the prevalence of hyperlipoproteinemia and adipose tissue activity based on the results of screening for resistin level, aggravated heredity, disordered hydrocarbon metabolism, overweight, arterial hypertension, behaviour (physical overstrain, hypokinesia, smoking, inadequate dietary regime). The risk of developing type 2 diabetes mellitus and overall risk of cardiovascular disorders were calculated.
[PROGNOSTIC VALUE OF THE COMBINATION OF BLOOD GROUP SPECIFICITY AND INTERLEUKIN 28B GENE POLYMORPHISM FOR ESTIMATION OF EFFICIENCY OF THERAPY WITH THE USE OF PEGYLATED INTERFERON α-2 AND RIBAVARIN IN PATIENTS WITH CHRONIC GENOTYPE 1 HEPATITIS C].
Ogurtsov PP, Kukhareva EI
Klin Med (Mosk) · 2016 · PMID 27522730
AIM: To estimate the prognostic value of the combination of blood group specificity and interleukin 28B gene polymorphism for the achievement of sustained virologic response (SVR) to antiviral therapy (AVT) with the use...
AIM: To estimate the prognostic value of the combination of blood group specificity and interleukin 28B gene polymorphism for the achievement of sustained virologic response (SVR) to antiviral therapy (AVT) with the use of pegylated interferon α-2 and ribavarin in patients with chronic genotype 1 hepatitis C (CHC-1). The secondary aim was to evaluate the influence of these genetic factors on the progress of hepatic fibrosis in case of failure of the above treatment. MATERIALS AND METHODS: A total of 146 patients with CHC-1 were examined. We studied the RNA genotype of hepatitis C virus, blood group specificity, IL-28B gene polymorphism, and severity of hepatic fibrosis (puncture biopsies). Dynamics of hepatic fibrosis was followed up in 40 patients who failed to develop the virologic response. 20 control patients did not receive AVT. The multifactor significance criterion was used to identify the initial factor that produced the highest effect on SVR. RESULTS: SVR was observed in 56.8% of the patients. Its efficiency was most significantly influenced by. the combination of blood group specificity and interleukin 28B gene polymorphism (p = 0.000024). Combination of blood group (0)1 with C/C or T/T IL-28B genotypes, A(II) with C/T or T/T and B(III) with T/G was associated with SVR in 100, 88.2, and 94.4% cases respectively. It was absent in patients with blood group A(II) in combination with double-nucleotide substitution in rs8099917 of the IL-28B gene (TG and GG genotypes); these patients suffered progressive fibrosis. SVR occurred in 83.8% of the patients with blood group B(III). CONCLUSION: The knowledge of blood group in patients with CHC-1 and IL-28B gene polymorphism treated with the use of pegylated interferon α-2 and ribavarin allows to predict SVR with a probability of 100% in case of blood group 0(1) and C/C or T/T genotypes, 88.2% in case of blood group A(II) and single-nucleotide C>Tsubstitution in rs8099917 locus of the IL-28B gene, 94.4% in case of blood group B(II) and single-nucleotide T>G substitution in the rs809991.7 locus, 83.8% in case of blood group B(III). Treatment of patients with these genetic traits with antiviral drugs of direct action has no appreciable advances over treatment with AVT in combination with pegylated interferon α-2 and ribavarin (SVR above or around 85%). Patients with blood group A(II) and single- or double-nucleotide substitution in rs8099917 (TG or GG genotypes) have minimal chances to produce SVR to the above treatment. Simultaneous progression of hepatic fibrosis suggest that such therapy is undesirable in these cases. They should be regarded as main candidates for interferon-free therapy. Combination of blood group specificity and interleukin 28B gene polymorphism is a simple and reliable predictor of SVR and dynamics of fibrosis in patients with CHC-I receiving AVT with pegylated interferon α-2 and ribavirin; also, it may be an instrument of selection of patients for interferon-free therapy.
[DYNAMICS OF METABOLIC CHARACTERISTICS, MARKERS OF OXIDATIVE STRESS AND VASCULAR WALL DAMAGE DURING TREATMENT OF OBESE PRE-DIABETIC PATIENTS].
Romanenko LA, Polyatykina T S, Mavrycheva NV … +2 more , Budnikova NV, Grinshtein VB
Klin Med (Mosk) · 2016 · PMID 27522729
We studied lipid and carbohydrate metabolism, markers of oxidative stress (plasma malonic dialdehyde and dienoic conjugates) and vascular wall damage (CRP microalbuminuria, blood desquamated endotheliocytes) before and a...
We studied lipid and carbohydrate metabolism, markers of oxidative stress (plasma malonic dialdehyde and dienoic conjugates) and vascular wall damage (CRP microalbuminuria, blood desquamated endotheliocytes) before and after 12 week treatment of obese pre-diabetic patients. The study showed positive dynamics of the above metabolic parameters with normalization of carbohydrate metabolism in 60% of the patients and angioprotective effect of prescribed therapy. The proposed treatment can be used to prevent diabetes mellitus.
[CHARACTERISTIC OF ANTIBIOTIC-ASSOCIATED DIARRHEA IN PATIENTS WITH ACUTE CEREBRAL CIRCULATION DISORDER].
Shklyaev AE, Gorbunov YV, Komissarova NV
Klin Med (Mosk) · 2016 · PMID 27522728
This full-design study included patients admitted to the Regional Vascular Centre in 2013 and was aimed to obtain more detailed information on the need for medical aid, indications for antibacterial therapy and the spect...
This full-design study included patients admitted to the Regional Vascular Centre in 2013 and was aimed to obtain more detailed information on the need for medical aid, indications for antibacterial therapy and the spectrum of the drugs being prescribed 42 patients presented with antibiotic-associated diarrhea caused by Clostridium difficile. The composition of antibiotics used for mono- and combined therapy was analysed, details of the clinical picture are described, the importance of timely diagnostics and adequate treatment is emphasized.
[EVALUATION OF ARTERIAL STIFFNESS AND POSSIBILITY TO PREDICT CAROTID ATHEROSCLEROSIS IN PATIENTS WITH ESSENTIAL HYPERTENSION BASED ON AN OUTPATIENT FACILITY].
Polipanov AG, Mamasaidov ZhA, Geleskhanova YN … +3 more , Cheskidova NB, Romanova TA, Dzhumagulova AS
Klin Med (Mosk) · 2016 · PMID 27522727
AIM: To estimate the possibility of predicting the presence and severity of coronary atherosclerosis from arterial stiffness characteristics and augmentation index (AIx) in patients with essential hypertension (EH) obtai...
AIM: To estimate the possibility of predicting the presence and severity of coronary atherosclerosis from arterial stiffness characteristics and augmentation index (AIx) in patients with essential hypertension (EH) obtained under outpatient conditions. MATERIALS AND METHODS: The general clinical examination of 15 patients aged 30-70 yr with EH was supplemented by measuring blood glucose and creatinine levels, the lipid status (LWLP, HDLP, TG), duplex scanning of carotid arteries, and evaluation of arterial stiffness by pulsed wave contour analysis. RESULTS: AIx and age were independent risk factors of coronary atherosclerosis in patients with EH and severity of its manifestations. AIx values over 25% were with high specificity (over 85%) associated with atherosclerotic lesions.
[ACUTE CORONARY SYNDROME WITHOUT ST SEGMENT ELEVATION: POSSIBILITIES FOR PREDICTING THE CLINICAL COURSE AT THE POST-HOSPITAL (6 AND 12 MONTHS) STAGE].
Klin Med (Mosk) · 2016 · PMID 27522726
AIM: To measure blood IL-6, IL-10, creatinine levels, calcium, sodium and potassium in blood and saliva, melatonin in urine of patients with acute coronary syndrome without ST segment elevation for the prediction of the...
AIM: To measure blood IL-6, IL-10, creatinine levels, calcium, sodium and potassium in blood and saliva, melatonin in urine of patients with acute coronary syndrome without ST segment elevation for the prediction of the clinical course at the post-hospital stage. MATERIAL AND METHODS: The study included 93 patients with complicated (n = 46) and uncomplicated (n = 47) coronary syndrome without ST segment elevation. Blood IL-6, IL-1, creatinine levels, calcium, sodium and potassium in blood and saliva, melatoni n in urine were determined on days 1-3 after hospitalization. 6-hydroxymelatonin was measured by HPLC in urine collected between 23 p.m. and 8 a.m., melatonin i in urine collected between 8 a.m. and 23 p.m. RESULTS: Complicated coronary syndrome was associated with increased levels of melatonin (night), blood IL-10 and Na, salivary, Na and Ca while the uncomplicated condition with increased blood melatonin (daytime), IL-6, creatinine, Ca, Na, K, and salivary K. 90 patients were followed up within 12 months after discharge. End-points developed in 36 (40%) of them. Logistic analysis yielded variables and 2 logistic regression equations The data on night melatonin +5 and +4 were included in ROC analysis. The night melatonin +5 values over 0.7453 were associated with increased risk of complications in the post-hospital period (6 months) and values of 0.7453 or lower with the enhanced probability of uncomplicated clinical course. Prognostic sensitivity was estimated at 90%, specificity at -54.39%. The night melatonin +4 values over 0.2903 were associated with increased risk of complications in the post-hospital period (12 months) and values of 0.2903 or lower with the enhanced probability of uncomplicated clinical course. Prognostic sensitivity was estimated at 77.8%, specificity at -59.26%. CONCLUSION: The night melatonin +5 and +4 models can be used to predict the clinical course of acute coronary syndrome during 6 and 12 months of the post-hospitalization period.
[PREDICTORS OF RESISTANT ARTERIAL HYPERTENSION].
Lazutkina AY, Gorbunov VV
Klin Med (Mosk) · 2016 · PMID 27522725
The paper reports results of 6 year prospective observation of 7959 members of locomotive crews engaged at the Transbaikal Railways. The study aimed to estimate the probability and time of development of resistant arteri...
The paper reports results of 6 year prospective observation of 7959 members of locomotive crews engaged at the Transbaikal Railways. The study aimed to estimate the probability and time of development of resistant arterial hypertension under effect of predictors of this disease. The data obtained are of value for diagnostic, prophylactic, and therapeutic practice.
[CONTRIBUTION OF LIPOPROTEIN(A) TO CARDIOVASCULAR RISK IN PATIENTS UNDER 40 YEARS OF AGE AFTER ACUTE MYOCARDIAL INFARCTION OR ACUTE CEREBRAL CIRCULATION DISORDER].
Korneva VA, Kuznetsova TY, Novitskaya AS … +3 more , Malygin AN, Guseva TA, Ukhanova EA
Klin Med (Mosk) · 2016 · PMID 27522724
AIM: To evaluate the importance of lipoprotein(a) for the evaluation of cardiovascular risk in patient under 40 years of age after acute myocardial infarction or acute cerebral circulation disorder. MATERIALS AND METHODS...
AIM: To evaluate the importance of lipoprotein(a) for the evaluation of cardiovascular risk in patient under 40 years of age after acute myocardial infarction or acute cerebral circulation disorder. MATERIALS AND METHODS: We analysed the data from two departments of the Regional Vascular Centre for 2013-2015 including 90 case histories of patients of different age (mean 57.8 ± 3.4 yr) and studied standard risk factors, such as age, sex, smoking habits, dyslipidemia, aggravated heredity, arterial hypertension (AH), obesity. Standard examination of 7 patients under 40 years of age was supplemented by measuring lipoprotein(a) by the immunoturbodimetric method regarding the levels over 0.3 g/l as abnormally elevated. RESULTS: The study group was dominated by young and middle-aged men (85.2 and 84% respectively). The key risk factors were increased LDLP level (88%) and smoking (70%) in patients under the age of 40 and AH in middle-aged men (100%, p < 0.004). Arterial hypertension was also diagnosed in 59% of the younger subjects. Increased LDLP levels most frequently occurred in senior patients (90%). The group of patients under 40 yr included 15% of those having a single risk factor. In this group, 22% of the patients were at high risk calculated prior to the development of vascular events, 58% at moderate and 20% at low risk. 42.8% of the patients had elevated lipoprotein(a) levels. CONCLUSION: Based on the relative risk scoring scale, 22% of the patients under 40 years of age were at risk of myocardial infarction or cerebral circulation disorders prior to the development of vascular events. However, these patients like those of other age groups frequently had traditional risk factors, such as smoking (67.5%), AH and dyslipidemia (66.6% each). Total cholesterol was elevated only in 47.6% of the patients while LDLP and LP(a) in 92 and 42.8% respectively.
[INSULIN RESISTANCE ASSOCIATED WITH METABOLIC SYNDROME AS AN INDICATOR OF CARDIOVASCULAR RISK].
Dontsov AV, Vasil'eva LV
Klin Med (Mosk) · 2016 · PMID 27522723
AIM: To study blood insulin level in patients with coronary heart disease (CHD) with and without metabolic syndrome (MS) and its relation to cardiovascular risk factors. MATERIALS AND METHODS: We examined 127 patients wi...
AIM: To study blood insulin level in patients with coronary heart disease (CHD) with and without metabolic syndrome (MS) and its relation to cardiovascular risk factors. MATERIALS AND METHODS: We examined 127 patients with stable coronary heart disease (mean age 59.4 ± 5.7 yr) including 63 with MS and 64 without it. The control group consisted of 80 practically healthy subjects. Bloods insulin was determined by immunochemoluminescence, glycated hemoglobin (HbA,) by immunoturbidimetry, total cholesterol, HDLP cholesterol and triglycerides by enzymatic colorimetric method, oxidized LDLP IL-l, IL-6, and tunour necrosis factor-α by enzyme immunoassay. The degree of depression was estimated using the Zung scale. RESULTS: Blood insulin level in healthy subjects, CHD patients with and without MS was 6.3 (6.20;6.62), 15.5 (13.96, 16.3) and 9.5 (9.2, 10.1) mcIE/ml respectively (p < 0.001). HOMA-IR directly correlated with MBI, waist circumference, HbA1-total cholesterol, triglyceride, oxidized LDLP IL-1β, IL-6, and tumour necrosis factor-α levels and negatively with the HDLP cholesterol level. CONCLUSION: In patients with CHD, metabolic syndrome is associated with a set of additional cardiovascular risk factors, viz. hyperinsulinemia, insulin resistance, increased HbA1c level, dyslipidemia, oxidative modification of LDLP activation of proinflammatory cytokines, and depressive disorders. Close correlation of HOMA-IR with certain pathogenetic factors ofCHD allow to use it as an indicator of cardiovascular risk in patients with CHD and MS.
[PECULIARITIES OF DIAGNOSTICS AND TREATMENT OF PATIENTS WITH RECURRENT MYOCARDIAL INFARCTION].
Gazaryan GA, Taraseyeva YV, Gazaryan LG … +6 more , Yevstratova SG, Makaova EM, Mazanov MKh, Nefedova GA, Alidzhanova KhG, Golikov AR
Klin Med (Mosk) · 2016 · PMID 27522722
The aim of the study was to evaluate the efficiency of invasive strategies for the treatment of 306 patients with recurrent myocardial infarction (IM) admitted to our clinic in 2003-2007. We compared the results of three...
The aim of the study was to evaluate the efficiency of invasive strategies for the treatment of 306 patients with recurrent myocardial infarction (IM) admitted to our clinic in 2003-2007. We compared the results of three approaches: various forms of transdermal coronary interventions (TDI) including delayed (24-72 hr) ones (n = 30), surgical myocardial revascularization within 8-12 weeks after the onset of recurrent myocardial infarction (n = 25), and conservative therapy (n = 251). Overall cardiovascular lethality was estimated during 5 years in 101 patients. It was shown that recurrent myocardial infarction is a predictor of high risk of death associated, in the absence of reperfusion therapy, with high intra-hospital and long-term lethality. TD1 soon after recurrent IM does not exclude possibility of its application in a later period. Various interventions including delayed ones markedly decrease the frequency of complications and lethal outcome that remains high in their absence. At the same time, severe lesions of the coronary bed in many patients with recurrent MI limit the possibility of using TDI and should be regarded as indications for planned surgical myocardial revascularization. Coronary bypass surgery after myocardial scarring prevents progress of left ventricle dysfunction, improves its contractility and increases life expectancy. Enhanced availability of reperfusion strategies in the form of TDI and/or delayed surgical myocardial revascularization opens up new possibilities for effective treatment of recurrent Ml.
[MODERN PROKINETICS AND THEIR ROLE IN THE TREATMENT OF GASTROENTEROLOGICAL PATHOLOGY].
Sheptulin AA, Belousova IB
Klin Med (Mosk) · 2016 · PMID 27522721
The importance of prokinetics (drugs stimulating motor function of the gastrointestinal tract) arises from the high prevalence of gastroenterological pathology associated with primary or secondary disturbances of this fu...
The importance of prokinetics (drugs stimulating motor function of the gastrointestinal tract) arises from the high prevalence of gastroenterological pathology associated with primary or secondary disturbances of this function in esophagus, stomach, and intestines. The main groups of prokinetics are beta-blockers of dopamine receptors, inhibitors of acetylcholine esterase (or their combination with dopamine receptor blockers), 5-HT4-receptor agonists. They find wide application for the treatment of gastroesophgeal reflux disease, functional dyspepsia and constipation, obstipational form of irritable bowel syndrome, and other conditions accompanied by motor function disorders of the gastrointestinal tract.
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