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No 5 (2016)

Articles

XXXIII World congress of internal medicine

Martynov A.I., Spassky A.A., Kokorin V.A.

Abstract

22-25 августа 2016 года на Бали (Индонезия) прошел XXXIII Всемирный конгресс терапевтов. В работе форума приняли участие более 3500 делегатов из 69 стран мира, а его девизом было «Переосмысление внутренней медицины: новые вызовы и возможности». На конгрессе было принято историческое решение о проведении XXXVI Всемирного конгресса терапевтов в 2022 году в Российской Федерации.
Therapy. 2016;(5):4-5
pages 4-5 views

OLIMPIADE «MEKSIDOL®: 20 LET V KLINIChESKOY PRAKTIKE» DAN START

- -.

Abstract

Российское научное медицинское общество терапевтов (РНМОТ) сообщает о старте III Научнопрактической олимпиады «Мексидол®: 20 лет в клинической практике», которая будет проводиться при поддержке ООО «НПК "Фармасофт’’».
Therapy. 2016;(5):6-6
pages 6-6 views

The role of the Training center of the Russian scientific medical society of internal medicine in continuing medical education

Martynov A.I., Spassky A.A., Mikhailov A.A.

Abstract

«Есть только один путь формирования врача: больной - книга, книга - больной», - говорил Евгений Михайлович Тареев, председатель правления созданного им Всероссийского научного медицинского общества терапевтов (сегодня Российское научное медицинское общество терапевтов, РНМОТ). Именно это задачу - задачу повышения уровня квалификации врачей - продолжает РНМОТ, это задача проходит красной нитью через все проводимые Обществом образовательные и научные мероприятия.
Therapy. 2016;(5):9-12
pages 9-12 views

Application of Mildronate in patients with comorbidity: focus on cardioneurology

Statsenko M.Y., Turkina S.V., Tyshchenko I.A., Fabritskaya S.V.

Abstract

The article reports the results of clinical and experimental studies of the efficacy and safety of Mifdronate® in a combination therapy of cardiovascular and cerebrovascular diseases. A brief review of mechanisms of action of the drug is presented. Analysis of the research results confirm that the addition of this cytoprotector to the basic treatment is accompanied by a positive clinical effect, which is manifested in cardio, neuro- and angioprotective action of the drug. It is concluded that the use of this drug in the complex therapy of patients with comorbid pathology is reasonable.
Therapy. 2016;(5):14-22
pages 14-22 views

Predicting the risk of development of cerebral stroke in patients in the remote period after myocardial revascularization taking into account renal risk factors

Levitskaya Y.S., Batyushin M.M.

Abstract

Formation and improvement of systems of stratification of cardiovascular risk is a priority of preventive medicine, especially for the most socially significant diseases - stroke and coronary heart disease. The study established a new marker of stroke in patients with chronic myocardial ischemia in the long term after coronary revascularization - β2-microglobulin. It is demonstrated that in the presence of β2-microglobulinuria other renal risk factors (albuminuria 30-300 mg/l, the decrease in GFR) and the presence of postinfarction cardiosclerosis have a potentiating effect on the risk of development of stroke. The findings suggest common mechanisms of progression of renal and cardiovascular pathologies.
Therapy. 2016;(5):24-30
pages 24-30 views

Influence of magnesium orotate on cardiovascular risks

Martynov A.I., Akatova Y.V., Nikolin O.P., Urlaeva I.V.

Abstract

The article discusses the role of magnesium metabolism disorders in the pathogenesis of cardiovascular diseases, and the possibility of the use of magnesium orotate (Magnerot) for their treatment. Magnesium is a natural physiological Ca2+ antagonist, a universal controller of biochemical and physiological processes in the body; it provides ATP hydrolysis by inhibiting the uncoupling of oxidation and phosphorylation; it regulates glycolysis, lactate accumulation; it promotes fixation of K+ in cells, providing a polarization of cell membrane, and controls the spontaneous electrical activity of nerve tissue and the cardiac conduction system; Mg2+ ions are involved in the activity of the anticoagulation system and control the normal functioning of cardiomyocytes, so magnesium is a universal cardioprotector. The role of magnesium deficiency in the development of mitral valve prolapse, cardiac arrhythmias, arterial hypertension, and so on is discussed. Magnesium has very essential role in the treatment of acute myocardial infarction. Successful results of use of magnesium orotate in cardiovascular diseases, caused by magnesium deficiency, are presented. Due to accumulation of knowledge and additional large-scale studies, range of indications for the use of magnesium preparations will be indisputably significantly expanded.
Therapy. 2016;(5):32-38
pages 32-38 views

Place of eplerenone in the therapy of cardiovascular diseases

Tolpygina S.N.

Abstract

The article reflects the current understanding of the place of aldosterone antagonists in the treatment of acute myocardial infarction, chronic heart failure, and arterial hypertension. The theoretical and the evidence base for the use of eplerenone in the treatment of cardiovascular disease and the necessity of its more widespread use are discussed.
Therapy. 2016;(5):39-48
pages 39-48 views

Torasemide and furosemide: similarities and differences

Cheltsov V.V.

Abstract

The aim of the article is to evaluate the efficacy and safety of loop diuretics - torasemide and furosemide in patients with chronic heart failure and arterial hypertension. Torasemide has shown to have less inter-and intra-individual variation in bioavailability and a longer duration of action compared with furosemide. In the majority of clinical trials have been shown than torasemide exerts more favorable effect on signs of disease, functional status of patients and quality of life than furosemide. Torasemide treatment induced significant decreases in left ventricular systolic wall stress and the plasma level of aldosterone. Moreover, torasemide reduces total and cardiovascular death and readmission to the hospital. New mechanisms of action of torasemide are discussed.
Therapy. 2016;(5):49-54
pages 49-54 views

Influence of the combined antihypertensive therapy on renal function and insulin resistance in patients with hypertension and type 2 diabetes

Statsenko M.Y., Derevyanchenko M.V.

Abstract

In an open prospective, uncontrolled study involving 30 patients with arterial hypertension (AH) II-III stage in combination with diabetes mellitus (DM) type 2 aged 45 to 65 years, the effect of 12 weeks of combined antihypertensive treatment with enalapril and indapamide on renal function and insulin resistance (IR) was evaluated. The findings confirm the presence of close correlation relationship between IR and renal disease. Reducing the severity of IR on combined therapy with enalapril and indapamide resulted in improvement of renal function, suggesting the possibility of slowing the progression of hypertension and type 2 DМ. Thus, the use of non-fixed combination of enalapril and indapamide is pathogenetically proved safe and highly effective option of antihypertensive therapy in patients with hypertension and type 2 DM.
Therapy. 2016;(5):56-61
pages 56-61 views

Evaluation of the influence of various factors on progression of chronic obstructive pulmonary disease and bronchial asthma: results of long-term cohort study

Tebloev K.I., Fomina K.A., Zhilyaev Y.V., Spassky A.A.

Abstract

The article presents the results of a long-term cohort study, including 177 patients with chronic obstructive pulmonary disease (COPD) and bronchial asthma (BA). An assessment of the impact of drug and non-drug factors on the rate of progression of disorders of pulmonary ventilatory function in patients with COPD and BA over time in real clinical practice was performed. The modern statistical methods were used such as univariate and multivariate analysis of the complex of drug and non-drug effects and confounding factors. According to the results of study, the use of inhaled corticosteroids, short- and long-acting β2-agonists, short-acting anticholinergics, acetylcysteine, and antibiotics do not affect the rate of decline of forced expiratory volume in 1 second (FEV1) in patients with COPD and BA in long-term follow-up. The use of systemic glucocorticoids, bromhexine, anxiolytics, and hypnotics in patients with COPD and BA, as well as the use of ACE inhibitors in patients with BA, is associated with an acceleration of the rate of decline of FEV1. The use of statins and antacids in patients with COPD and BA, as well as use of pentoxifylline in patients with COPD correlates with the slowing rate of decline in FEV1. Information on the factors and influences that can slow down or speed up the rate of decline of lung function in patients with COPD and BA can be used in clinical practice to optimize the treatment of patients with COPD and BA with comorbidity, and objectify patient's evaluation.
Therapy. 2016;(5):62-69
pages 62-69 views

Pharmacoepidemiological study of ethnic differences in the use of antihypertensive drugs for hospital treatment of residents of the Karachay-Cherkess Republic

Baturin V.A., Elkanova A.I.

Abstract

Pharmacoepidemiological evaluation of the use of antihypertensive drugs in 300 hypertensive patients who were treated in the cardiological hospital was performed. Patients were divided into three ethnic groups: the Slavs (the Russians and the Ukrainians) (45 men and 55 women), the Karachays (51 men and 49 women), and the Circassians (43 men and 57 women). Angiotensin-converting enzyme (ACE) inhibitors, diuretics and beta-adrenoblockers (BAB) were equally often prescribed to patients of all ethnic groups. The assessment of the combined use of antihypertensive drugs revealed that the combination of ACE inhibitors, diuretics and blockers was most commonly prescribed to the Circassians. The combination of ACE inhibitors and diuretics was often administered in the Slavic group and less often in Karachay ethnic group. Karachays often received BAB in combination with diuretics, and the Slavs and the Circassians -more rarely. The evaluation of the blood pressure at hospital discharge showed that the representatives of the Circassian ethnic group rarely achieved the desired effect of antihypertensive drugs despite more intensive pharmacotherapy.
Therapy. 2016;(5):70-74
pages 70-74 views

Diagnosis of anemia

Shchekotova A.P.

Abstract

Diagnosis of anemia both as a syndrome and nosological entity is presented on the basis of classification of anemia on the mean red cell volume (MCV): micro-, normo- and macrocytic anemia, generally accepted in the world. At the beginning of the lecture, diagnosis of microcytic anemia is provided, including the most common forms - iron deficiency anemia and anemia of chronic disease. This group includes sideroblastic anemia that may result from myelodysplastic syndrome or lead intoxication, as well as a separate nosology - thalassemia. Among macrocytic anemia, megaloblastic anemia mainly related to vitamin B12 deficiency is primarily discussed. Normocytic anemia is derived primarily from the loss of blood, occurs in chronic diseases, and includes hemolytic anemia (spherocytosis, sickle cell anemia), etc. In addition to the traditional approach to the diagnosis of anemia adopted in Russia, algorithms of diagnostics in different clinical groups of patients is presented (anemia of critical illness, anemia in the elderly).
Therapy. 2016;(5):76-86
pages 76-86 views

Foods: magnesium content and uptake

Gromova O.A., Torshin I.Y., Kodentsova V.M.

Abstract

The high magnesium content in certain foods is not directly correlated with the level of magnesium absorption. Foods may contain different components such as phytic acid, oxalic acid, and calcium, which significantly impede the magnesium absorption from these foods. Xanthines (contained in coffee or strong tea), synthetic nutritional supplements and alcohol lead to increased excretion of magnesium in the urine. At the same time, inulin oligosaccharides, for example, enhance the magnesium absorption from foods. Intake of foods without magnesium absorption inhibitors discussed above improves the magnesium absorption from the solution (e.g. mineral water).
Therapy. 2016;(5):87-96
pages 87-96 views

Efficiency of citicoline in the therapy of cognitive and motor disorders in patients in the early recovery period of stroke

Domashenko M.A., Sergeev D.V.

Abstract

The article presents a critical review of studies of citicoline in the treatment of cognitive disorders after stroke and chronic cerebral ischemia, as well as in the treatment of post-stroke motor disorders in the early recovery period after acute cerebrovascular events. The results of these studies indicate that citicoLine can be considered one of the most studied neuroprotective drugs. Due to the fact that citicoline can affect different stages of ischemic damage in clinical practice the drug shows effect in acute stroke and in the rehabilitation phase, thus stimulating the recovery of both cognitive and motor functions.
Therapy. 2016;(5):98-103
pages 98-103 views

Chronic back pain: potentials for the treatment and prevention

Levin O.S.

Abstract

The article presents data on the causes of chronization of back pain and the possibilities of its prevention. Along with a more rapid pain relief in the acute period, rational psychotherapy, measures aimed at correcting kinesiophobia and maladaptive pain behavior, prospects for the application of chondroprotectors to prevent chronic back pain are discussed. The data of 2-year follow-up of patients who after participating in a study of the effectiveness of Alflutop continued to regularly use the chondroprotector or stopped its use are presented. It is shown that regular use of Alflutop 2 times a year and more frequently led to significantly lower number of exacerbations, than in the absence of use of chondroprotectors.
Therapy. 2016;(5):104-109
pages 104-109 views

Alexey Petrovich Golikov - clinician, scientist, teacher

Spassky A.A.

Abstract

В этом году Алексей Петрович Голиков, выдающийся отечественный клиницист, признанный ученый в области неотложной терапии и кардиологии, талантливый организатор и педагог, академик Российской академии наук, заслуженный деятель науки Российской Федерации, профессор, отмечает 95-летие.
Therapy. 2016;(5):110-112
pages 110-112 views

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