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Nº 3 (2015)
- Ano: 2015
- Artigos: 11
- URL: https://journals.eco-vector.com/2412-4036/issue/view/6627
Articles
OT REDAKTsII
Therapy. 2015;(3):2-2
2-2
Х NATIONAL CONGRESS OF INTERNAL MEDICINE
Resumo
14-16 октября 2015 г. в Москвє в МВЦ «Крокус Экспо» прошел X Национальный конгресс терапевтов, объединенный с XIV Европейским конгрессом терапевтов. Как и остальные мероприятия, проводимые Российским научным медицинским обществом терапевтов (РНМОТ) в 2015 г., конгресс был приурочен к 140-летию со дня рождения выдающегося отечественного клинициста и ученого М.П. Кончаловского. В работе форума приняли участие 6232 специалиста из 78 субъектов РФ и 16 зарубежных стран (из них 5752 участника, 298 докладчиков, 113 номинантов от Министерства здравоохранения РФ и 69 представителей прессы).
Therapy. 2015;(3):4-6
4-6
XIV EUROPEAN CONGRESS OF INTERNAL MEDICINE
Resumo
XIV Европейский конгресс терапевтов стал первым международным медицинским форумом столь высокого уровня, проведенным в России. Организаторами конгресса являлись Европейская федерация внутренней медицины (EFIM) и Российское научное медицинское общество терапевтов (РНМОТ) при поддержке Министерства здравоохранения РФ. Сопредседателями конгресса были президент РНМОТ А.и. Мартынов и президент EFIM Ф. Бош (Нидерланды). В мероприятии приняли участие 6138 специалистов из 363 городов Российской Федерации и 1504 зарубежных гостя из 72 стран мира. Самыми многочисленными были делегации из Турции, Португалии и Испании.
Therapy. 2015;(3):7-8
7-8
CARDIAC PATIENT ON RECEPTION AT THE THERAPIST
Resumo
Как известно, пациенты с заболеваниями сердечно-сосудистой системы - самые частые посетители терапевтов. Эффективное ведение таких Больных требует от врача общего профиля умения хорошо ориентироваться в методах обследования и диагностики, знать методы оценки и коррекции сердечно-сосудистых рисков и, конечно, делать грамотные медикаментозные назначения. Нередко эти позиции вызывают целый ряд вопросов, например, если речь идет о выборе антигипертензивных препаратов, диуретиков, длительности назначения статинов. Ответы на эти и другие вопросы можно было услышать на симпозиуме, который был посвящен особенностям работы терапевта с кардиологическим пациентом и проходил в рамках X Национального конгресса терапевтов при поддержке компании Тева.
Therapy. 2015;(3):9-12
9-12
13-26
ALGORITHM OF DIFFERENTIAL PRESCRIPTION OF CYTOPROTECTORS IN PATIENTS WITH CHRONIC HEART FAILURE AND DISORDERS OF CARBOHYDRATE METABOLISM
Resumo
An open prospective randomized 16-week study to examine the impact of cytoprotectors meldonium and 2-ethyl-6-methyl-3-hydroxypyridine succinate (EMOPS) in a combination therapy of chronic heart failure in patients with type 2 diabetes on the clinical condition of the patients, structural and functional performance of the heart, heart rate variability, the functional state of the kidneys, liver, as well as carbohydrate, lipid metabolism, insulin resistance syndromes, chronic systemic inflommotion and oxidative stress was conducted. The algorithm of differentiated destination cytoprotectors in connection with the identified features organoprotective and metabolic action. EMOPS, along with a significant hepatoprotective effect manifests more pronounced metabolic effects on lipid ond carbohydrate metabolism, insulin resistance syndrome, whereas meldonium at comparable with cardio- and EMOPS nephroprotective effects, effectively inhibits chronic systemic inflammation processes.
Therapy. 2015;(3):27-34
27-34
OPPORTUNITIES OF IMPROVEMENT OF CONTROL OF BLOOD PRESSURE IN PATIENTS WITH ARTERIAL HYPERTENSION AND ORTHOSTATIC ABNORMALITIES DUE TO TYPE 1 DIABETES
Resumo
In patients with diabetes mellitus (DM) type 1 in combination with arterial hypertension (AH), autonomic vegetative neuropathy is often manifested by orthostatic hypotension. The purpose of this study was to analyze the effectiveness of antihypertensive therapy of ACE inhibitors and antidiabetic therapy in combination with protector of veins in patients with hypertension, diabetes mellitus type 1 and orthostatic disorders (OD). 200 hypertensive patients with type 1 diabetes were examined, in 60 of which OD were revealed. Patients with hypertension, diabetes and OD were divided into two subgroups: patients from the first subgroup have received basic antihypertensive and intensify insulin therapy and additionally protector of veins in a dose of 1000 mg/day divided into 2 doses; patients from the second subgroup have been receiving only basic therapy consisting of ACE inhibitor and intensified insulin therapy. Achieving of target BP with ACE inhibitor monotherapy in patients with hypertension and type 1 diabetes was complicated by worsening existing OD. The combination of antihypertensive therapy with diosmine restores the physiological response in the active orthostatic test in patients with hypertension and type 1 diabetes, leading to the achievement of optimal blood pressure in 90% of patients.
Therapy. 2015;(3):35-38
35-38
HEART RATE VARIABILITY IN PATIENTS WITH RENAL HYPERTENSION ASSOCIATED WITH DIFFUSE KIDNEY LESIONS WITH PRESERVED RENAL FUNCTION
Resumo
In recent years o growing interest to study the role of the autonomic nervous system (ANS) in the pathogenesis of hypertension (AH), including renal hypertension associated with diffuse kidney lesions (RHADKL). The purpose of this study was to examine the heart rate variability (HRV) in patients with renol hypertension Associated with diffuse kidney lesions with preserved renol function. The study included 100 patients with chronic glomerulonephritis with hypertension syndrome (patients with RHADKL) and 36 without having preserved renal function. On the basis of the daily ECG monitoring is determined by the HRV time and frequency parameters. The study showed a decrease in HRV, indicating a reduction in the regulatory impact of VNS on the cardiovascular system in patients with RHADKL. With the worsening of hypertension syndrome, this pattern was aggravated. It is noted that this trend was accompanied by signs of activation of the sympathetic nervous system against the background of declining indicators reflecting parasympathetic effects. When one degree of absolute AG defining characteristics of sympathetic activity of VNS, with 2 and 3 degrees AG against the general decline of HRV - relative sympathic. Thus, in patients with the RHADKL preserved renal function marked signs of a decline in the overall effects of VNS on the cardiovascular system with an absolute or relative sympathetic activity.
Therapy. 2015;(3):39-45
39-45
UNDERDIAGNOSIS OF EARLY PREDICTORS OF PULMONARY EMBOLISM
Resumo
The study examined the early predictors of underdiagnosis of pulmonary embolism (PE) of the number of primary clinical indicators and their prevalence. We have reviewed 81 cases of fatal pulmonary embolism, confirmed by autopsy, in urgently hospitalized, 52 of them had the diagnosis of pulmonary embolism and 29 - did not have, It is established that the risk of a diagnostic error was raised by male gender, aggravation of ischemic heart disease, pain of any location, frequency ≤23 breaths per minute, the heart rate in the range 75-94 per minute, ESR >11 mm/h, all R-logical shifts, The risk was reduced by female gender, obesity, expressed tachypnea and tachycardia, intraventricular blocks, recent immobilization (p
Therapy. 2015;(3):46-53
46-53
CARDIAC INVOLVEMENT IN LIVER DISEASE
Resumo
The paper presents a literature review that highlights the issues of heart disorders in liver cirrhosis of different etiology (alcoholic, viral, storage diseases). Authors consider the pathogenesis and diagnosis of cirrhotic cardiomyopathy, highlight the possibility of non-invasive diagnosis of myocardial fibrosis using serum fibrosis markers and by calculating the degree of myocardial fibrosis on the basis of the ECG and echocardiography.
Therapy. 2015;(3):54-61
54-61
NEW POSSIBILITIES OF PHARMACOLOGICAL CARDIOVERSION OF NEWLY DEVELOPED PAROXYSM OF ATRIAL FIBRILLATION
Resumo
Atrial fibrillation (AF) is one of the most common cardiac arrhythmias. The review presents the current possibilities of pharmacological cardioversion of AF paroxysm, the mechanisms of action which are applied in practical cardiology antiarrhythmics (AAS) of the various classes are presented. One of these new AAS is vernakalant (drug formulation - solution for intravenous administration), the mechanism of antiarrhythmic action which is associated with selective inhibition of atrial mostly voltage-dependent potassium channels, especially potassium channels delayed rectifier current (IKur) and channels activated by acetylcholine (KAch). Furthermore, vernakalant inhibits frequency-dependent and voltage-dependent sodium channels as well localized in the atria. The data on the pharmacokinetics of vernakalant and the results of its clinical application. Evaluating the results of numerous clinical studies, we can conclude that the new AAS vernakalant is effective and safe in relieving the AF, which lasts from 3 hours to 7 days. The initial dose is 3 mg/kg is administered intravenously over 10 min, with no effect after 15 minutes possible re-introduction in dose of 2 mg/kg. However, the probability of restoring sinus rhythm in the absence of the effect of the first dose is significantly reduced. With a longer period the AF or TA effectiveness of the drug is extremely low. Good clinical effect of vernakalant, and provides for AF, occurred after cardiac surgery. Ability of vernakalant to cause ventricular arrhythmias (ventricular fibrillation, ventricular tachycardia type "feast") appears minimal. In general, the researchers indicate good tolerability of vernakalant.
Therapy. 2015;(3):62-72
62-72