Pub Date : 2024-02-22DOI: 10.30629/0023-2149-2023-101-12-637-642
L. Eliseeva, N. Borovkova, P. S. Zubeev, G. Zubeeva, E. S. Yumanova
Aim. To assess the structure of cardiovascular pathology in patients with new coronavirus infection (NCI), to identify factors of poor prognosis in these individuals. Material and methods. The study was conducted on the basis of the COVID-19 infectious diseases hospital of the City Hospital No. 33 of Nizhny Novgorod. The study included 284 patients after applying inclusion and exclusion criteria. All subjects were divided into groups: the main group (n = 207) — patients with NCI and cardiovascular diseases (CVD), as well as comorbid diseases, the comparison group (n = 24) with NCI and CVD, the control group (n = 53) with NCI without any comorbid diseases. Demographic indicators, BMI, laboratory parameters, comorbidity and therapy were analyzed. Results. During the study, it was revealed that the most severe course of COVID-19 is characteristic of the main group, and only among them there were fatal outcomes (25% of cases). Analyzing the prevalence of CVD, it turned out that arterial hypertension was the most common in the main group and in the comparison group, coronary heart disease and heart failure were registered somewhat less frequently. The development of acute cardiovascular accidents occurred only in the main group. A mathematical model was developed to determine the risk of death in patients with NCI who are in the hospital. This model is statistically significant (p < 0.001). Conclusion. The older age of patients, the development of acute myocardial infarction, first identified atrial fibrillation and a decrease in saturation contributed to an increased risk of mortality in patients with NCI and CVD. Among drug therapy, the administration of favipiravir, tocilizumab and statins had a beneficial effect on the outcome of diseases.
{"title":"Factors of poor prognosis for new coronavirus infection in patients with cardiovacular pathology","authors":"L. Eliseeva, N. Borovkova, P. S. Zubeev, G. Zubeeva, E. S. Yumanova","doi":"10.30629/0023-2149-2023-101-12-637-642","DOIUrl":"https://doi.org/10.30629/0023-2149-2023-101-12-637-642","url":null,"abstract":"Aim. To assess the structure of cardiovascular pathology in patients with new coronavirus infection (NCI), to identify factors of poor prognosis in these individuals. Material and methods. The study was conducted on the basis of the COVID-19 infectious diseases hospital of the City Hospital No. 33 of Nizhny Novgorod. The study included 284 patients after applying inclusion and exclusion criteria. All subjects were divided into groups: the main group (n = 207) — patients with NCI and cardiovascular diseases (CVD), as well as comorbid diseases, the comparison group (n = 24) with NCI and CVD, the control group (n = 53) with NCI without any comorbid diseases. Demographic indicators, BMI, laboratory parameters, comorbidity and therapy were analyzed. Results. During the study, it was revealed that the most severe course of COVID-19 is characteristic of the main group, and only among them there were fatal outcomes (25% of cases). Analyzing the prevalence of CVD, it turned out that arterial hypertension was the most common in the main group and in the comparison group, coronary heart disease and heart failure were registered somewhat less frequently. The development of acute cardiovascular accidents occurred only in the main group. A mathematical model was developed to determine the risk of death in patients with NCI who are in the hospital. This model is statistically significant (p < 0.001). Conclusion. The older age of patients, the development of acute myocardial infarction, first identified atrial fibrillation and a decrease in saturation contributed to an increased risk of mortality in patients with NCI and CVD. Among drug therapy, the administration of favipiravir, tocilizumab and statins had a beneficial effect on the outcome of diseases.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140438128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-21DOI: 10.30629/0023-2149-2023-101-12-607-612
I. S. Zakharov, G. Kolpinsky, S. V. Beskrovny
Postmenopausal osteoporosis is an important interdisciplinary problem of modern medicine. The presented lecture highlights modern approaches to the diagnosis, prognosis and treatment of this pathology. The leading role in the detection of osteoporotic changes is played by radiation diagnostic methods that determine the level of bone mineral density - the equivalent of bone mass. In order to study metabolic disorders of bone tissue, laboratory methods are used that evaluate the activity of bone synthesis and resorption. When predicting osteoporotic fractures, the FRAX model is widely used, which determines the likelihood of fractures in the next 10 years, based on the presence of risk factors. Given the multifactorial nature of the formation of osteoporotic changes, an integrated approach to the treatment of this disease is necessary. According to the recommendations of the European Society of Endocrinology, bisphosphonates should be considered as first-line therapy. Denosumab, romosozumab, teriparatide can be used as second-line drugs. In addition, given the leading role of hypoestrogenism in the development of postmenopausal osteoporosis, the use of menopausal hormone therapy preparations occupies an important place in the prevention and treatment of osteoporotic changes. An important aspect that determines the effectiveness of the treatment of patients with postmenopausal osteoporosis is the need for interaction between doctors of various specialties, including gynecologists, endocrinologists, rheumatologists, traumatologists, doctors of radiation and laboratory diagnostics.
{"title":"Postmenopausal osteoporosis — an interdisciplinary problem of modern","authors":"I. S. Zakharov, G. Kolpinsky, S. V. Beskrovny","doi":"10.30629/0023-2149-2023-101-12-607-612","DOIUrl":"https://doi.org/10.30629/0023-2149-2023-101-12-607-612","url":null,"abstract":"Postmenopausal osteoporosis is an important interdisciplinary problem of modern medicine. The presented lecture highlights modern approaches to the diagnosis, prognosis and treatment of this pathology. The leading role in the detection of osteoporotic changes is played by radiation diagnostic methods that determine the level of bone mineral density - the equivalent of bone mass. In order to study metabolic disorders of bone tissue, laboratory methods are used that evaluate the activity of bone synthesis and resorption. When predicting osteoporotic fractures, the FRAX model is widely used, which determines the likelihood of fractures in the next 10 years, based on the presence of risk factors. Given the multifactorial nature of the formation of osteoporotic changes, an integrated approach to the treatment of this disease is necessary. According to the recommendations of the European Society of Endocrinology, bisphosphonates should be considered as first-line therapy. Denosumab, romosozumab, teriparatide can be used as second-line drugs. In addition, given the leading role of hypoestrogenism in the development of postmenopausal osteoporosis, the use of menopausal hormone therapy preparations occupies an important place in the prevention and treatment of osteoporotic changes. An important aspect that determines the effectiveness of the treatment of patients with postmenopausal osteoporosis is the need for interaction between doctors of various specialties, including gynecologists, endocrinologists, rheumatologists, traumatologists, doctors of radiation and laboratory diagnostics.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"16 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140443016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-21DOI: 10.30629/0023-2149-2023-101-12-613-622
A. V. Nikolaeva, M. V. Dudarev, L. T. Pimenov, E. V. Resnik
The article presents the review of the modern approaches and issues in management of the patients with primary hypothyroidism. To date globally multiple nonclinical and clinical studies designed to improve the substitutional therapy and quality of life of patients with primary hypothyroidism are performed. The objective of the review is to analyze the global studies for last 5 years and the modern literature concerning the new possibilities and approaches to the primary hypothyroidism treatment. To achieve this objective the systematic search in PubMed dataset with these key words using: "primary hypothyroidism treatment", "levothyroxine side effects", "primary hypothyroidism outcome", "new approaches to hypothyroidism therapy", "new formulations of levothyroxine", "hypothyroidism in elderly" for the period from 2018 to 2023 was performed. Based on this analysis the conclusions that the investigation of different disease course features and discovering of new treatment options are necessary despite the apparent simplicity of substitutional therapy were made.
{"title":"Мodern achievement and issues in primary hypothyroidism treatment","authors":"A. V. Nikolaeva, M. V. Dudarev, L. T. Pimenov, E. V. Resnik","doi":"10.30629/0023-2149-2023-101-12-613-622","DOIUrl":"https://doi.org/10.30629/0023-2149-2023-101-12-613-622","url":null,"abstract":"The article presents the review of the modern approaches and issues in management of the patients with primary hypothyroidism. To date globally multiple nonclinical and clinical studies designed to improve the substitutional therapy and quality of life of patients with primary hypothyroidism are performed. The objective of the review is to analyze the global studies for last 5 years and the modern literature concerning the new possibilities and approaches to the primary hypothyroidism treatment. To achieve this objective the systematic search in PubMed dataset with these key words using: \"primary hypothyroidism treatment\", \"levothyroxine side effects\", \"primary hypothyroidism outcome\", \"new approaches to hypothyroidism therapy\", \"new formulations of levothyroxine\", \"hypothyroidism in elderly\" for the period from 2018 to 2023 was performed. Based on this analysis the conclusions that the investigation of different disease course features and discovering of new treatment options are necessary despite the apparent simplicity of substitutional therapy were made.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140444587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-15DOI: 10.30629/0023-2149-2023-101-11-577-581
E. V. Motriy, I. S. Shepel, T. E. Neustroeva
Mirror therapy as a rehabilitation method for stroke patients. Stroke claims millions of lives every year worldwide. Its severity is associated with the damage to important brain structures and severe disruptions of various physiological functions in patients, making the investigation of methods to alleviate the consequences of stroke relevant. The aim of this study is to highlight the methods of mirror therapy, their effectiveness, and to examine some possible mechanisms underlying the positive effects of mirror therapy on the recovery of limb functions. Materials and Methods. A review and analysis of literature data were conducted. Literature search was carried out in Scopus and Pubmed databases. Technical implementation of mirror therapy. Various three-dimensional structures are used to implement the method of mirror therapy, allowing the patient to perceive the work of the working limb as the work of an immobilized leg or arm, which has a positive effect on the rehabilitation process. In many studies, the effectiveness of mirror therapy has been demonstrated both in the chronic and acute phases after stroke. Several hypotheses have been put forward by scientists about the mechanisms of the effectiveness of mirror therapy, suggesting the activation of motor neuron centers and zones in the brain cortex. Conclusion. According to the results of numerous studies, mirror therapy shows a sufficiently high effectiveness in the rehabilitation of stroke patients and improves their quality of life.
{"title":"Mirror therapy as a method of rehabilitation for stroke patients","authors":"E. V. Motriy, I. S. Shepel, T. E. Neustroeva","doi":"10.30629/0023-2149-2023-101-11-577-581","DOIUrl":"https://doi.org/10.30629/0023-2149-2023-101-11-577-581","url":null,"abstract":" Mirror therapy as a rehabilitation method for stroke patients. Stroke claims millions of lives every year worldwide. Its severity is associated with the damage to important brain structures and severe disruptions of various physiological functions in patients, making the investigation of methods to alleviate the consequences of stroke relevant. The aim of this study is to highlight the methods of mirror therapy, their effectiveness, and to examine some possible mechanisms underlying the positive effects of mirror therapy on the recovery of limb functions. Materials and Methods. A review and analysis of literature data were conducted. Literature search was carried out in Scopus and Pubmed databases. Technical implementation of mirror therapy. Various three-dimensional structures are used to implement the method of mirror therapy, allowing the patient to perceive the work of the working limb as the work of an immobilized leg or arm, which has a positive effect on the rehabilitation process. In many studies, the effectiveness of mirror therapy has been demonstrated both in the chronic and acute phases after stroke. Several hypotheses have been put forward by scientists about the mechanisms of the effectiveness of mirror therapy, suggesting the activation of motor neuron centers and zones in the brain cortex. Conclusion. According to the results of numerous studies, mirror therapy shows a sufficiently high effectiveness in the rehabilitation of stroke patients and improves their quality of life.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"16 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138970535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-15DOI: 10.30629/0023-2149-2023-101-11-582-587
A. Sheptulin, S. Kardasheva, A. A. Kurbatova
The article presents an analysis of the provisions of the consensus meeting “Maastricht-VI”, dedicated to the treatment of Helicobacter pylori (H. pylori) infection. The expediency of preliminary testing for H. pylori sensitivity to antibiotics is emphasized. Since this strategy has not yet been implemented in everyday clinical practice, empirical therapy is often carried out based on the results of the assessment of H. pylori resistance to antibiotics in this region. The sequence of administration of eradication regimens of the 1st, 2nd, 3rd, 4th lines, optimal duration of treatment, new therapy regimens (with rifabutin, double therapy with proton pump inhibitors and amoxicillin in high doses) are considered. The implementation of the new consensus meeting will contribute to improving the results of eradication therapy of H. pylori infection.
{"title":"Modern approaches to the choice of schemes for eradication of Helicobacter рylori infection (based on the materials of the consensus meeting \"Maastricht-VI\")","authors":"A. Sheptulin, S. Kardasheva, A. A. Kurbatova","doi":"10.30629/0023-2149-2023-101-11-582-587","DOIUrl":"https://doi.org/10.30629/0023-2149-2023-101-11-582-587","url":null,"abstract":"The article presents an analysis of the provisions of the consensus meeting “Maastricht-VI”, dedicated to the treatment of Helicobacter pylori (H. pylori) infection. The expediency of preliminary testing for H. pylori sensitivity to antibiotics is emphasized. Since this strategy has not yet been implemented in everyday clinical practice, empirical therapy is often carried out based on the results of the assessment of H. pylori resistance to antibiotics in this region. The sequence of administration of eradication regimens of the 1st, 2nd, 3rd, 4th lines, optimal duration of treatment, new therapy regimens (with rifabutin, double therapy with proton pump inhibitors and amoxicillin in high doses) are considered. The implementation of the new consensus meeting will contribute to improving the results of eradication therapy of H. pylori infection.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"8 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139000854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-14DOI: 10.30629/0023-2149-2023-101-11-569-576
I. Murkamilov, K. Aitbaev, V. V. Fomin, Z. Murkamilova, P. Astanin, T. F. Yusupova, F. Yusupov
Essential hypertension (EH) is the most common cardiovascular disease and the leading cause of chronic kidney disease (CKD) worldwide. The aim of the study was to investigate the frequency and nature of kidney damage in hypertension. 189 patients (69 men and 120 women) with hypertension (stages I, II, and III) aged 43 years and older were examined. The average age of the patients was 61.2 ± 8.7 years. Clinical and biochemical tests were conducted on all patients, including red blood cell indices, C-reactive protein (CRP), lipid profile, fibrinogen, electrolytes, glucose, uric acid, creatinine, and cystatin C. The duration of hypertension was also recorded for each patient. Kidney function was assessed using serum creatinine (CKD-EPI) and cystatin C (F. Houcke). Patients were categorized according to the degree of decrease in glomerular filtration rate (GFR) based on the recommendations of the Russian Nephrology Society. Patients with kidney damage were divided into two groups: Group 1 consisted of patients with hypertension without signs of CKD (GFR calculated by cystatin C ≥ 60 ml/min), while Group 2 consisted of patients with hypertension complicated by CKD. The results showed that hypertension was accompanied by target organ damage in 70.8% of cases. The prevalence of CKD among patients with hypertension was 28.5%. Proteinuria was mainly detected in patients with renal insufficiency. The frequency of GFR categories according to CKD-EPI and F. Houcke formulas was as follows: G1 — 54.4% and 13.7% (p < 0.05); G2 — 35.9% and 57.6% (p < 0.05); G3a — 5.2% and 19.5% (p < 0.05); G3b — 3.1% and 5.2% (p < 0.05); G4 — 0.5% and 3.1% (p < 0.05) and G5 — 0.5% and 0.5%, respectively. There was a strong correlation between GFR and serum creatinine (r = –0.439; p < 0.05) and cystatin C (r = –0.866; p < 0.0001). Patients in Group 2 (hypertension with kidney damage) had significantly higher levels of CRP, low-density lipoprotein cholesterol, cystatin C, and longer duration of hypertension, but lower levels of total calcium than patients in Group 1. In conclusion, CKD was present in 28.5% of patients with hypertension, and proteinuria was mainly detected in patients with renal insufficiency. Serum cystatin C levels most accurately reflect kidney filtration function.
{"title":"Kidney damage in hypertension disease","authors":"I. Murkamilov, K. Aitbaev, V. V. Fomin, Z. Murkamilova, P. Astanin, T. F. Yusupova, F. Yusupov","doi":"10.30629/0023-2149-2023-101-11-569-576","DOIUrl":"https://doi.org/10.30629/0023-2149-2023-101-11-569-576","url":null,"abstract":"Essential hypertension (EH) is the most common cardiovascular disease and the leading cause of chronic kidney disease (CKD) worldwide. The aim of the study was to investigate the frequency and nature of kidney damage in hypertension. 189 patients (69 men and 120 women) with hypertension (stages I, II, and III) aged 43 years and older were examined. The average age of the patients was 61.2 ± 8.7 years. Clinical and biochemical tests were conducted on all patients, including red blood cell indices, C-reactive protein (CRP), lipid profile, fibrinogen, electrolytes, glucose, uric acid, creatinine, and cystatin C. The duration of hypertension was also recorded for each patient. Kidney function was assessed using serum creatinine (CKD-EPI) and cystatin C (F. Houcke). Patients were categorized according to the degree of decrease in glomerular filtration rate (GFR) based on the recommendations of the Russian Nephrology Society. Patients with kidney damage were divided into two groups: Group 1 consisted of patients with hypertension without signs of CKD (GFR calculated by cystatin C ≥ 60 ml/min), while Group 2 consisted of patients with hypertension complicated by CKD. The results showed that hypertension was accompanied by target organ damage in 70.8% of cases. The prevalence of CKD among patients with hypertension was 28.5%. Proteinuria was mainly detected in patients with renal insufficiency. The frequency of GFR categories according to CKD-EPI and F. Houcke formulas was as follows: G1 — 54.4% and 13.7% (p < 0.05); G2 — 35.9% and 57.6% (p < 0.05); G3a — 5.2% and 19.5% (p < 0.05); G3b — 3.1% and 5.2% (p < 0.05); G4 — 0.5% and 3.1% (p < 0.05) and G5 — 0.5% and 0.5%, respectively. There was a strong correlation between GFR and serum creatinine (r = –0.439; p < 0.05) and cystatin C (r = –0.866; p < 0.0001). Patients in Group 2 (hypertension with kidney damage) had significantly higher levels of CRP, low-density lipoprotein cholesterol, cystatin C, and longer duration of hypertension, but lower levels of total calcium than patients in Group 1. In conclusion, CKD was present in 28.5% of patients with hypertension, and proteinuria was mainly detected in patients with renal insufficiency. Serum cystatin C levels most accurately reflect kidney filtration function.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"16 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138971011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-14DOI: 10.30629/0023-2149-2023-101-11-588-589
A. T. Kortieva, V. S. Krushelnitsky, S. A. Gabriel’, V. Dynko, A. Y. Guchetl, R. M. Tlekhuray
The frequency of gastrointestinal stromal tumors (GISTs) is 0.1–0.3% of all neoplasms in the gastrointestinal tract. The most common clinical feature of GISTs is gastrointestinal bleeding caused by ulceration of the tumor. Based on a clinical case, the eff ectiveness of capsule endoscopy in diagnosing GISTs is demonstrated.
{"title":"Capsule endoscopy in the diagnosis of exophytic gastrointestinal stromal tumor of the small intestine","authors":"A. T. Kortieva, V. S. Krushelnitsky, S. A. Gabriel’, V. Dynko, A. Y. Guchetl, R. M. Tlekhuray","doi":"10.30629/0023-2149-2023-101-11-588-589","DOIUrl":"https://doi.org/10.30629/0023-2149-2023-101-11-588-589","url":null,"abstract":"The frequency of gastrointestinal stromal tumors (GISTs) is 0.1–0.3% of all neoplasms in the gastrointestinal tract. The most common clinical feature of GISTs is gastrointestinal bleeding caused by ulceration of the tumor. Based on a clinical case, the eff ectiveness of capsule endoscopy in diagnosing GISTs is demonstrated.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"9 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138971127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-14DOI: 10.30629/0023-2149-2023-101-11-562-565
A. Fursov, N. P. Potekhin, S. A. Chernov, E. G. Zakharova, A. Gaidukov
The course of renovascular (resistant) arterial hypertension was analyzed in 60 patients (45 men, 15 women) with isolated atherosclerotic stenosis of the renal artery of more than 75% (group 1), and in 30 patients (26 men, 4 women) who, in addition to unilateral stenosis of the renal artery of more than 75%, also had stenoses of the brachiocephalic arteries up to 60% of the vessel diameter (group 2). The mean age of the examined patients in group 1 was 52.4 ± 6.9 years, and in group 2 it was 53.2 ± 7.4 years. Endovascular correction of hemodynamically significant stenosis of the renal artery leads to a significant decrease in systolic and diastolic blood pressure levels, a reduction in the number of antihypertensive drugs from 5-4 to a 3-component scheme in most cases, and an improvement in the functional state of the kidneys. At the end of the 2-year observation period, in patients with multifocal lesions of the renal and cerebral arteries (group 2), both systolic and diastolic blood pressure levels corresponded to “high normal” values, while in group 1 (isolated renal artery lesions) they corresponded to “normal” blood pressure levels. Patients in group 2 had metabolic disorders such as atherogenic dyslipidemia, hyperuricemia, and significant signs of renal dysfunction. The multifocal nature of atherosclerotic vascular lesions contributes to a more “severe” course of the disease, which should be taken into account when conducting treatment measures.
{"title":"Renovascilar hypertension against the background of multifocal atherosclerosis: impact of endovascular methods of correction on its course and optimization of remedial measures","authors":"A. Fursov, N. P. Potekhin, S. A. Chernov, E. G. Zakharova, A. Gaidukov","doi":"10.30629/0023-2149-2023-101-11-562-565","DOIUrl":"https://doi.org/10.30629/0023-2149-2023-101-11-562-565","url":null,"abstract":"The course of renovascular (resistant) arterial hypertension was analyzed in 60 patients (45 men, 15 women) with isolated atherosclerotic stenosis of the renal artery of more than 75% (group 1), and in 30 patients (26 men, 4 women) who, in addition to unilateral stenosis of the renal artery of more than 75%, also had stenoses of the brachiocephalic arteries up to 60% of the vessel diameter (group 2). The mean age of the examined patients in group 1 was 52.4 ± 6.9 years, and in group 2 it was 53.2 ± 7.4 years. Endovascular correction of hemodynamically significant stenosis of the renal artery leads to a significant decrease in systolic and diastolic blood pressure levels, a reduction in the number of antihypertensive drugs from 5-4 to a 3-component scheme in most cases, and an improvement in the functional state of the kidneys. At the end of the 2-year observation period, in patients with multifocal lesions of the renal and cerebral arteries (group 2), both systolic and diastolic blood pressure levels corresponded to “high normal” values, while in group 1 (isolated renal artery lesions) they corresponded to “normal” blood pressure levels. Patients in group 2 had metabolic disorders such as atherogenic dyslipidemia, hyperuricemia, and significant signs of renal dysfunction. The multifocal nature of atherosclerotic vascular lesions contributes to a more “severe” course of the disease, which should be taken into account when conducting treatment measures.","PeriodicalId":10439,"journal":{"name":"Clinical Medicine (Russian Journal)","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138973219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-13DOI: 10.30629/0023-2149-2023-101-11-556-561
M. D. Rudoi, E. V. Makarova, L. Strakhova, Yu. V. Ivanova
Dyslipidemia is the main factor in the initiation and progression of atherosclerosis. The search for probable factors aff ecting lipid metabolism is relevant. The aim of the study was to evaluate the parameters of lipid metabolism in the blood serum of men exposed to elevated noise levels. Material and methods. 293 men with no confi rmed atherosclerotic cardiovascular diseases were examined. Among the surveyed, 2 groups were identifi ed: 203 men who work under the infl uence of noise, and 90 men who do not come into contact with harmful production factors. Total cholesterol, triglycerides, low- and high-density lipoproteins, and the level of oxidized low-density lipoproteins were determined. Remnant cholesterol, atherogenic index and atherogenic plasma index were calculated. Results. Among persons under 55 years of age working in noise, an increase in total cholesterol (p = 0.02) and remnant cholesterol (p = 0.0006), a decrease in high-density lipoproteins (p = 0.03) and a tendency to increase the atherogenic index (p = 0.05) and the atherogenic plasma index (p = 0.07) were revealed. The prevalence of hypercholesterolemia was comparable in the main and control groups and amounted to 56.7 and 47.4%, respectively (p = 0.17). The median level of oxidized low-density lipoproteins in people working with noise did not exceed the upper limit of the norm. Conclusions. In men younger than 55 years old, working under conditions of exposure to increased noise levels, some features of the blood lipid spectrum are observed. The revealed changes may indicate an increase in the atherogenic potential of the blood serum
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Pub Date : 2023-12-13DOI: 10.30629/0023-2149-2023-101-11-531-537
A. A. Zaitsev
This publication deals with the issue of adjuvant (non-antimicrobial) therapy for community-acquired pneumonia. A critical analysis is provided on the appropriateness of using various drugs (mucolytics, non-steroidal anti-infl ammatory drugs, immunoglobulins, etc.) and physical methods of chest impact for community-acquired pneumonia, and recommendations are given for their clinical use. Special attention is paid to the use of systemic glucocorticosteroids and inhaled nitric oxide.
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