The impact of medical and psychological counseling with the use of remote technologies on the profile of the main risk factors for cardiovascular disease

Introduction: The development of new preventive approaches using medical and psychological counseling and distance technologies may contribute to better control of risk factors for cardiovascular disease (RF CVD). Aim: Evaluating the effectiveness of medical and psychological counseling using remote technologies for control and correction of the main RF CVD. Materials and methods: The study included 140 patients, average age was 53 ± 17 years (54% were men) who were included in the group of medical and psychological counseling using remote technologies (experimental group, n = 70) or in the group of standard care (control group, n = 70). At the beginning and end of the study, patients from both groups filled in specially created questionnaires. Patients of the experimental group received regular remote medical and psychological counseling by phone; information materials via internet messengers; SMS reminders. In 12 months, the severity of RF CVD in two groups was compared. Results: Medical and psychological counseling with the use of remote technologies during 12 months led to significant improvement in RF CVD: achievement of target blood pressure (p <0.01), physical activity (p <0.01), consumption of 400 g per day of vegetables and fruits (p <0.01), decrease in body mass index (p <0.001) and waist circumference (p <0.01), decrease in cholesterol level (p <0.01), in a subgroup of smoking patients - reducing the number of cigarettes smoked per day. There were no statistically significant differences in blood glucose and volume of consumed alcoholic beverages between groups. Conclusions: Medical and psychological counseling of patients with cardiovascular diseases using remote technologies (telephone calls, internet messengers, SMS reminders) can be an effective tool for monitoring and correcting various RF CVD.Введение: разработка новых профилактических подходов с использованием медико-психологического консультирования и дистанционных технологий может способствовать лучшему контролю факторов риска сердечно-сосудистых заболеваний (ФР ССЗ). Цель исследования: оценка эффективности медицинского и психологического консультирования с применением дистанционных технологий для контроля и коррекции основных ФР ССЗ по сравнению со стандартным наблюдением. Материалы и методы: Исследование включило 140 пациентов, средний возраст которых составил 53 ± 17 лет (из них мужчин 54%), которые были включены в группу медико-психологического консультирования с использованием дистанционных технологий (экспериментальная группа, n = 70) или в группу стандартного наблюдения в общемедицинской сети (контрольная группа, n = 70). Пациентами обеих групп в начале и в конце исследования были заполнены специально созданные опросники. Пациентам экспериментальной группы проведено регулярное дистанционное медико-психологическое консультирование по телефону; пересылка информационных материалов посредством интернет-мессенджеров, смс-напоминаний. Через 12 месяцев была сопоставлена степень выраженности ФР ССЗ в двух группах. результаты: Медико-психологическое консультирование с применением дистанционных технологий в течение 12 месяцев привело к достоверному улучшению профиля ФР ССЗ: достижению целевых уровней артериального давления (p<0,01), физической активности (p<0,01), увеличение доли пациентов, употребляющих 400 г. в день овощей и фруктов (р<0,01), снижению индекса массы тела (р<0,001) и уменьшению окружности талии (р<0,01), снижению уровня холестерина (р<0,01), в подгруппе курящих пациентов – уменьшению количества выкуриваемых в день сигарет. Между группами через 12 месяцев наблюдения не было статистически значимых различий по уровню глюкозы крови и объему употребляемых алкогольных напитков. Выводы: Медицинское и психологическое консультирование пациентов с сердечно-сосудистыми заболеваниями с использованием дистанционных технологий (телефонные звонки, смс-сообщения, интернет-мессенджеры) может быть эффективным инструментом контроля и коррекции различных ФР ССЗ

Supramolecular thermoplastics and thermoplastic elastomer materials with self-healing ability based on oligomeric charged triblock copolymers

Supramolecular polymeric materials constitute a unique class of materials held together by non-covalent interactions. These dynamic supramolecular interactions can provide unique properties such as a strong decrease in viscosity upon relatively mild heating, as well as self-healing ability. In this study we demonstrate the unique mechanical properties of phase-separated electrostatic supramolecular materials based on mixing of low molar mass, oligomeric, ABA-triblock copolyacrylates with oppositely charged outer blocks. In case of well-chosen mixtures and block lengths, the charged blocks are phase separated from the uncharged matrix in a hexagonally packed nanomorphology as observed by transmission electron microscopy. Thermal and mechanical analysis of the material shows that the charged sections have a T-g closely beyond room temperature, whereas the material shows an elastic response at temperatures far above this T-g ascribed to the electrostatic supramolecular interactions. A broad set of materials having systematic variations in triblock copolymer structures was used to provide insights in the mechanical properties and and self-healing ability in correlation with the nanomorphology of the materials

Traditional smoking e-smoking among medical students and students-athletes-popularity and motivation

Smoking, medical students, students-athlete

State of the art for diagnosis and treatment of orthostatic hypotension

This paper presents state of the art of the problem of diagnosis and treatment of orthostatic hypotension (OH). It focuses on the developed algorithms for diagnostics of classical orthostatic hypotension (COH), initial orthostatic hypotension (IOH) and delayed orthostatic hypotension (DOH). It describes the necessary methods for the differential diagnosis of the OH causes. Comparative analysis of the European Society of Cardiology and American College of Cardiology/American Heart Association/Society of Cardiac Rhythm was performed. The treatment options for different groups of patients with orthostatic hypotension are described

Clinical and ultrasound features of non-specific aorto-arteriitis and aortic arch branch syndrome

Aim. With duplex scanning method, to compare clinical symptoms of non-specific aorto-arteriitis (NAA) to aortic arch pathology registered. Material and methods. In total, 32 women with NAA were examined. Twenty-four patients underwent duplex scanning of aortic arch branches, carotid intima-media thickness measurement (high-definition ultrasound method; Vivid 7 device, GE, USA). All participants underwent clinical and neurological examination, with inflammation activity assessment. Results. Isolated pathology of aortic arch branches (Type I NAA) was observed in 6 (25%) out of 24 patients; Type III NAA (pathology of aortic arch branches, thoraco-abdominal aorta, and its visceral branches) - in 16 (66,7%); Type IV NAA (pulmonary artery pathology, regardless of any other lesion location) - in 2 (8,3%). Arterial hypertension (AH) was diagnosed in 18 (75%) out of 24 participants. In Type I NAA, AH clinical course was milder than in Type III and IV NAA. Functional neurological and emotional-affective disturbances were typical for NAA. Common carotid artery pathology was registered in 19 (79,2%) patients, and cerebral blood flow pathology - in 2 (8,3%) out of 24 participants. Conclusion. In NAA patients, brachiocephalic artery and common carotid artery pathology prevalence is relatively high. At the same time, strokes and transient ischemic attacks are rare

COMPARATIVE ANALYSIS OF LOSATAN AND ENALAPRIL ANTIHYPERTENSIVE EFFICACY (ELLA TRIAL)

Aim. To compare antihypertensive efficacy of АТ1 receptors blocker (losartan) and ACE inhibitor (enalapril), including their combinations with hydrochlorothiazide.Material and methods. 60 patients (30-65 y.o.) with arterial hypertension (HT) of stages 1-3 were involved in 12-week opened comparative randomized study. Patients of group-I (n=30) received losartan, patients of group-II (n=30) - enalapril. Blood pressure (BP) changes assessed on the basis of clinical measurements and ambulatory monitoring. Microalbuminuria (MAU) levels, plasma aldosterone levels and plasma renin activity were estimated.Results. Target BP levels were reached in 76,6% of patients in group-I and in 73,3% of patients in group-II. Among patients with moderate HT of stage 2 (n=50) target BP levels were reached in 96% of patients in group-I and in 72% of patients in group-II. Patients of both groups had positive changes in BP levels according to ambulatory BP monitoring. Significant reduction in MAU level and uric acid plasma concentrations were observed.Conclusion. Losartan (Losap, Zentiva) and losartan combination with hydrochlorothiazide (Losap-plus, Zentiva) demonstrated antihypertensive efficacy comparable with this of enalapril as well as nephroprotective features

Candesartan effectiveness in essential arterial hypertension and renal arterial hypertension

Aim. To study candesartan effectiveness and tolerability in essential arterial hypertension (ГАН) and AH associated with chronic renal disease.Material and methods. This 12-week open, controlled study included 14 patients (mean age 43,4±16 years) with diagnosed ГАН (n=9) or secondary AH of renal etiology (n=5). At baseline and after 12 weeks of candesartan therapy, office blood pressure (BP) measurement, 24-hour BP monitoring (BPM), vectorcardiography and decar-tography measurements of plasma renin activity, aldosterone, potassium levels and microalbuminuria (MAU) were performed.Results. Target BP level &lt;140/90 mm Hg was achieved in 6 out of 14 patients (42,8 %). Additional hydrochlorothiazide (HCT) therapy increased antihypertensive effect of candesartan. On average, MAU reduced from 63,5±16,8 to 31,7±24,4 mg/d (p&lt;0,0001).Conclusion. Candesartan therapy, especially combined with HCT, was effective in patients with mild to moderate AH, providing organo-protection. It could be recommended not only in ГАН, but also in symptomatic AH associated with chronic renal disease