Chronic obstructive pulmonary disease and cardiovascular diseases: pathogenetic mechanisms of comorbidity and pharmacological interactions
D.Yu. Ruzanov, E.I. Davidovskaya, A.A. Pleshko, E.A. Grigorenko, I.V. Buynevich
The publication provides a brief overview of the most significant pathogenetic and pathophysiological mechanisms that will explain the phenomenon of comorbidity of chronic obstructive pulmonary disease (COPD) and cardiovascular pathology (CVD). Moreover, in this review is considered the potential impact of the recommended treatment of COPD on the risks and course of cardiovascular diseases from the perspective of evidence-based medicine. It has been shown that COPD and cardiovascular diseases share single risk factors, common pathogenetic mechanisms, unidirectional pathophysiological processes, similar clinical symptoms and effects synergistically with respect to adverse events and outcomes, which allows us to attribute this combination to category of comorbid pathology. The presented results of randomized clinical trials and meta-analyzes demonstrate that currently no COPD guidelines contain detailed clinical recommendations for assessing cardiovascular risk in this category of patients, nor are there enough guidelines for the treatment of COPD in patients with cardiovascular disease or vice versa. In terms of international experience, it is substantiated that the comorbid pathology of COPD and CVD should not be considered isolated from each other.
2020 Том 4, №2
Current aspects of drug therapy of chronic heart failure syndrome
T.V. Statkevich, N.P. Mitkovskaya
Chronic heart failure (CHF) is an important problem for the country, which has both medical and socio-economic aspects. The presence of the syndrome not only significantly increases the risks of an unfavorable course of diseases underlying its etiological basis, but in itself, through the development of decompensation, causes a high frequency of deaths. Despite all the advances in pharmacotherapy, the prognosis of heart failure remains poor. More than 40% of patients die within 4 years after the diagnosis of heart failure, and the one-year mortality rate for patients with severe CHF (NYHA class IV) exceeds 50%. The foregoing determines the need and importance of using all possible drug and non-drug therapy technologies aimed at reducing mortality, increasing the duration and quality of life of patients with CHF, as well as reducing the number and likelihood of decompensation and related hospitalizations, and makes this direction one of the priorities in medicine. The article describes current approaches to the treatment of patients with CHF syndrome from the perspective of evidence-based medicine and taking into account the recommendations of leading international organizations for the treatment and prevention of cardiovascular diseases. The drugs used were analyzed in terms of their influence on clinical symptoms, quality of life of patients, the risk of hospitalization due to decompensation of CHF, and mortality rates. The emphasis is made on the possibilities, mechanism of action and further prospects for the use of a new class of drugs in the treatment of CHF, acting at the level of the renin-angiotensin-aldosterone system and the system of neutral endopeptidases – inhibitors of angiotensin-neprilisin receptors.
2020 Том 4, №2
The pathogenesis of cell aging: gene polymorphism and renin-angiotensin-aldosterone system activity
O.S. Pavlova, I.Yu. Korobko, M.M. Liventseva, O.A. Barbuk, I.I. Russkikh, M.G. Kaliadka, A.M. Gorkavaya, S.E. Ogurtsova
The aim of the study was to determine the correlation of genetic polymorphism and renin-angiotensin-aldosterone system (RAAS) components with the relative leukocyte telomere length (TL) in individuals with normal or optimal blood pressure.
2020 Том 4, №1
Cholin and its metabolite feasibilities in hyperhomocysteinemia correction and cardiovascular pathology decrease
O.V. Panasiuk, E.V. Mogilevets, А.V. Naumov
Homocysteine is a cyto- and neurotoxic amino acid. The raise of its level in blood plasma is called hyperhomocysteinemia. This pathological state leads to the development and progressive course of cardiovascular diseases. Homocysteine utilization involves its transulfurization to cysteine or remethylation to methionine. Choline and its metabolite (betaine) increased intake leads to enhanced processes of remethylation and decreased homocysteine level in blood plasma. Thus, choline and betaine may be considered as substances capable of influencing hyperhomo-cysteinemia and lowering the level of cardiovascular disease development.
2020 Том 4, №1
Risk assessment and venous thromboembolism prophylaxis strategy in neurosurgical patients
L.N. Gavrilenko, I.S. Romanova, I.N. Kozhanova, O.G. Sadovskaya, A.E. Baranovsky
Venous thromboembolism (VTE) causes 25,000 in-hospital deaths every year in the United Kingdom. Approximately one-third of the total of 150,000 to 200,000 of VTE-related deaths per year in the United States occur following surgery. The VTE risk varies widely in neurosurgical patients depending on the type of intervention, the patient’s condition, comorbidity, and methods of thromboprophylaxis used. Neurosurgical patients’ characteristics (high prevalence of hypovolemia and hemoconcentration, paralysis and paresis, the use of high doses of glucocorticoids, the long duration of surgical interventions), high bleeding risk associated with pharmacological prophylaxis, and relatively few high-quality studies require development of a uniform decision-making approach regarding thromboprophylaxis in neurosurgery. This article presents a VTE prophylaxis strategy in neurosurgical patients developed on the basis of the latest international guidelines.
2020 Том 4, №1
Modern opportunities for diagnosis and treatment of systemic vasculitis with kidney involvement in children: review of literature (part 1)
I.A. Kazyra, A.V. Sukalo
The article presents current literature data on the problem of systemic vasculitis (SV) with kidney involvement in children. SV is rare in childhood, but is characterized by a severe progressive course, ultimately leading to early disability. This is a group of diseases with a wide range of clinical manifestations, the most important pathomorphological sign of which is inflammation of the blood vessel wall with the development of thrombosis, necrosis, and sclerotic lesions.
2020 Том 4, №1
Sepsis in children: clinical and laboratory diagnosis
E.N. Serhiyenka, O.N. Romanova
Diagnosis of sepsis in intensive care requires an interdisciplinary approach. There is no doubt that the clinical picture is also important when making a diagnosis. However, signs such as fever, tachypnea, tachycardia, etc. are not specific. This is why the use of integrated diagnostic and prognostic scales and monitoring of metabolism, hemodynamics, microcirculation, and specific biomarkers are more important for practitioners.
2020 Том 4, №1
Possibilities of the volume sphygmography method in identification of atherosclerotic arterial damage markers in elderly and senile people
E.А. Siamushina, L.A. Zhilevich, L.M. Sychik
The article describes the potential of the method of volume sphygmography (VS) using the VaSera VS-1500N apparatus (Fukuda Denshi, Japan) in identifying a combination of markers of atherosclerotic arterial lesions in centenarians. For this purpose, we conducted a survey of 36 centenarians at the Republican Clinical Hospital for Disabled Veterans of the Great Patriotic war named after P. M. Masherov.
2019 Том 3, №2
Psychometric analysis of the questionnaire «the quantification inventory for somatoform syndromes» (QUISS)
Т.Е. Tomashchyk
Somatoform disorders represent a group of psychiatric disorders manifested primarily in physical symptoms, which are clinically unexplained. Diagnosis of somatoform disorders requires taking into account not only the somatic symptoms and their severity, but also additional emotional, cognitive, behavioral and psychosocial aspects. The questionnaire “The quantification inventory for somatoform syndromes” (QUISS) meets the above-mentioned requirements. The questionnaire exists in the English version and requires standardization for the Belarusian population of patients, as well as compliance with current psychometrics.
2019 Том 3, №2
Structural features of the valvular apparatus of the human heart in early embryogenesis
A.R. Rombalskaya
The article presents the data on the structural features of the development of atrioventricular valves (tendon chords, papillary muscles) in early embryogenesis and shows the development of fleshy trabeculae as structures from which papillary muscles are formed. The stages of development of these structures are described. It has been found that fleshy trabeculae in the form of a reticular plexus are the first to be visualized the first in the ventricles of the heart of embryos of 6 mm parietal-coccygeal length (TCD), and some of them, protruding into the ventricular cavity, form papillary muscles. As the size of the human embryo heart increases, the leaflets of atrioventricular valves and papillary muscles move away from each other and strands with a muscular component appear between them – future tendon chords (in embryos 18–19 mm TCD). Gradually, the muscle tissue in the tendon chords and atrioventricular valves is replaced by connective tissue and intraventricular formations approach the definitive structure (in embryos 65–70 TCD).
2019 Том 3, №2
History of telemedicine in the Russian Federation
P.N. Shepel, A.V. Kutcher, T.V. Vakhovskaya, O.M. Drapkina
In the article the authors conducted a retrospective analysis of the periodization of the history of telemedicine in the Russian Federation by evaluating the data presented in scientific publications, Internet publications and monographs. In the process of writing the article the information resources of the library were used Тhe analysis of the existing normative-legal acts of the Russian Federation, defining the concept of “telemedicine”, the development of telemedicine in the Russian health care at the present stage and the concept of telemedicine technologies. Generalization and systematization of the revealed facts in the history of telemedicine allowed to determine the degree of development of telemedicine technologies in health care, both in Russia and abroad.
2019 Том 3, №2
Influence of metal complex derivatives of alkenyl imidazole on the survival of mice under conditions of hypobaric hypoxia
E.V. Udovenko, O.F. Kraetskaya, O.N. Ryneiskaya, S.N. Borisevitch
To study the influence of five metal complex compounds, derivatives of alkenyl imidazole, and two pharmaceutical drug products with the antihypoxic properties (hypoxen, mexidol) on the lifespan of mice under conditions of acute hypobaric hypoxia (AHBH).
2019 Том 3, №1
Possibilities of atomic force microscopy in studying the structural and functional properties of blood cells in acute coronary syndrome
N.L. Tsapayeva, E.V. Mironova, A.S. Chizik, G.B. Melnikova, T.N. Tolstaya, P.F. Chernoglaz, D.I. Yurlevich
To study structural and functional characteristics of platelets and erythrocytes in the pathogenesis of acute coronary injury of the myocardium in patients with acute coronary syndrome within three years.
2019 Том 3, №1
Tonsilogenic cardiomyopathy: unsolved issues in diagnosis and treatment
A. S. Vaidzelevich, Zh. V. Kolyadich, N. P. Mitkovskaya
High prevalence of chronic tonsillitis among the population makes it possible to call this disease socially significant. Due to the polymorphism of this pathology, as well as a high risk of occurrence and development of metatonsilogenic diseases and complications, doctors of various specialties (otorhinolaryngologists, cardiologists, rheumatologists, immunologists, therapists) deal with the problem of chronic tonsillitis, which indicates a multidisciplinary nature of chronic tonsillitis. This article outlines the general concepts of chronic tonsillitis (classification, etiology, pathogenesis mechanisms, treatment tactics, tonsilogenic disorders). Attention is focused on the study of tonsillogenic lesions of the heart (tonsillogenic cardiomyopathy), the mechanisms of their development and diagnostic methods. From the review it follows that tonsillectomy is the only effective method of treatment, as well as prevention of the development of metatonsilogenic complications of chronic tonsillitis.
2019 Том 3, №1
Pathogenetic basis of treatment strategies for patients with decompensated chronic heart failure
D.S. Gerasimionak, D.V. Pilipchuk, N.P. Mitkovskaya
The article deals with the problem of chronic heart failure (CHF) and its effect on renal function. The basic mechanisms of cardiorenal relationships are discussed. Information about modern pathogenetic tactics of CHF treatment concerning the renal effects is presented. The article describes research data related to the treatment of congestive heart failure resistant to diuretic drugs with the use of auxiliary equipment for dehydration.
2019 Том 3, №1
Differential diagnosis of vegetative crises and panic attacks
E.G. Koroleva
This article discusses the relationship between such terms as “vegetative crises” and “panic attacks”, their clinical picture, mental disorders with them, issues of diagnosis and, accordingly, approaches to treatment. One of the important activities of the Department of Vegetative Pathology under the guidance of the famous professor A.M. Wayne was the study of vegetative crises, which gradually became known by many as panic attacks. As far as the terms “vegetative crises” and “panic attacks” are equivalent, what do they have in common and how do they differ? What is the proportion of mental disorders with them? So far, in general practice there are no exact diagnostic criteria for these concepts. In this regard, it is often unclear what specialists should be engaged in them. In this regard, the purpose of this review is to conduct a more accurate differential diagnosis of these clinical forms, which manifestations unite them and whether they should be considered as independent disorders requiring different therapeutic approaches.
2019 Том 3, №1
Coordination and control of interregional cardiovascular care: an experience in Ontario, Canada
Dr. Patrick Tiffy MD FRCP
The manuscript presents the experience of increasing the availability of diagnostic and invasive therapeutic procedures for the heart using the example of The Ontario model for Cardiac Care / CorHealth Network with the aim of maintaining and improving medical care for a large population or a specific geographical region. Throughout Ontario, new PCI centers have been set up, and new medical protocols have been introduced for patients with UTI, which will improve access to specialist care.
2019 Том 3, №1
Cardiovascular risk stratification in patients with chronic obstructive pulmonary disease
D.V. Lapitski
Objectives. To perform cardiovascular risk stratification and comorbidity assessment, to find out forced desaturation impact on the cardiovascular system in patients with chronic obstructive pulmonary disease (COPD) and to improve COPD patients’ management tactics based on the data obtained.
2018 Том 2, №2
The role of vascular and metabolic factors in the pathogenesis of nontraumatic avascular necrosis of bone tissue
N.A. M artusevich, E.V. G udkevich, A.E. Murzich
Avascular necrosis of bone is a disease affecting predominantly men of working age. It steadily progresses to secondary osteoarthritis. The rate of disability is high because hip joint is most commonly affected by avascular necrosis; moreover, the rate of bilateral hip joint involvement is also high. The aim of the present review is to analyze and discuss several pathophysiological mechanisms of avascular necrosis in the context of metabolic syndrome and bone turnover. Avascular necrosis occurs due to critically decreased blood flow to the bone, which results from a) vascular occlusion with local thrombi, emboli, vasospasm or b) extrinsic compression of intraosseous vessels due to increased pressure within the bone. It is important to discuss the components of metabolic syndrome pathogenesis, which may possibly lead to avascular necrosis due to both aforementioned mechanisms. Particularly, in patients with metabolic syndrome avascular necrosis may be caused by endothelial dysfunction, dyslipidemia, increased intraosseous pressure and development of osteoporosis. The recent findings demonstrate that in avascular necrosis there is a possible interaction between bone turnover and vascular pathology, which occurs through OPG/RANK/RANKL axis. This fact represents a new concept of understanding avascular necrosis pathways.
2018 Том 2, №2

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