ВТОРИЧНАЯ ПРОФИЛАКТИКА СЕРДЕЧНО-СОСУДИСТЫХ ЗАБОЛЕВАНИЙ, АССОЦИИРОВАННЫХ С ТРЕВОЖНЫМИ И ДЕПРЕССИВНЫМИ РАССТРОЙСТВАМИ: ПУТИ ОПТИМИЗАЦИИ

Somatic and psychological risk factors (RF) were studied in 835 patients with arterial hypertension (AH) and ischemic heart disease (IHD) who had been admitted to the Borderline Department of MHRI SB RAMS for severity of neurotic and affective disorders provoked by previous psychosomatic events (psychosocial stress). Earlier the patients had been under control of cardiologists and therapists in general medical institutions. Systemic analysis of interrelation between somatic, psychic, and psychosocial factors defining the mechanisms of psychosomatic correlation formation in the patients with CVD with depressive disorders was applied.На клиническом материале, включающем 835 пациентов с артериальной гипертонией и ишемической болезнью сердца, госпитализированных в отделение пограничных состояний НИИПЗ СО РАМН в связи с выраженностью невротических и аффективных расстройств, обусловленных предшествующими психотравмирующими событиями (психосоциальным стрессом), изучены соматические и психосоциальные факторы риска. Ранее пациенты наблюдались в общемедицинских учреждениях у кардиолога или терапевта. В исследовании применен системный анализ взаимосвязи соматических, психических, психосоциальных факторов, определяющий механизмы формирования психосоматических соотношений у больных сердечно-сосудистыми заболеваниями с тревожными и депрессивными расстройствами для оценки кардиоваскулярного риска и выбора стратегии вторичной профилактики в общемедицинской практике

Management of MDR-TB in HIV co-infected patients in Eastern Europe: Results from the TB:HIV study

Objectives Mortality among HIV patients with tuberculosis (TB) remains high in Eastern Europe (EE), but details of TB and HIV management remain scarce. Methods In this prospective study, we describe the TB treatment regimens of patients with multi-drug resistant (MDR) TB and use of antiretroviral therapy (ART). Results A total of 105 HIV-positive patients had MDR-TB (including 33 with extensive drug resistance) and 130 pan-susceptible TB. Adequate initial TB treatment was provided for 8% of patients with MDR-TB compared with 80% of those with pan-susceptible TB. By twelve months, an estimated 57.3% (95%CI 41.5\u201374.1) of MDR-TB patients had started adequate treatment. While 67% received ART, HIV-RNA suppression was demonstrated in only 23%. Conclusions Our results show that internationally recommended MDR-TB treatment regimens were infrequently used and that ART use and viral suppression was well below the target of 90%, reflecting the challenging patient population and the environment in which health care is provided. Urgent improvement of management of patients with TB/HIV in EE, in particular for those with MDR-TB, is needed and includes widespread access to rapid TB diagnostics, better access to and use of second-line TB drugs, timely ART initiation with viral load monitoring, and integration of TB/HIV care

COGNITIVE IMPAIRMENT TREATMENT IN ARTERIAL HYPERTENSION WITH DIABETES MELLITUS 2ND TYPE

Aim. To develop the method and media for cognitive impairment correction in patients with arterial hypertension, combined with diabetes mellitus 2nd type.Material and methods. Totally 120 included with essential arterial hypertension (EAH), associated with diabetes 2nd type, with insufficient blood pressure (BP) level control. Patients with AH had 2nd grade of BP increase with mild of moderate compensated DM 2nd type with the level of glycosylated hemoglobin about 6,25%. The patients had quite high number of concomitant diseases and risk factors. All patients received basic antihypertensive therapy (beta-blockers, ACE inhibitors, calcium channel blockers, angiotensin receptor inhibitors). Also the patients took the drugs for concomitant pathology (hypolipidemic drugs, nitrates, glucose lowering drugs). The necessary criteria for inclusion was informed consent. At outpatient stage of the study, first visit and in a year the complex of events was done: anamnesis and complaints clarification; palpation and auscultation of the heart and major vessels; BP measurement on upper extremities by Korotkov; ECG registration, Echocardiography. The biochemical sampling of fasting plasma was done: the level of glucose was measured, of glycosylated hemoglobin, lipid profile (cholesterol, triglycerides, LDL, HDL), clotting parameters (INR, APTT, fibrinogen), electrolytes (K, Mg). Also the patients completed medical questionnaires of a specific purpose. The score of psychic status was used: MINI-MENTAL STATE EXAMINATION (MMSE) M.F. FOLSTEIN, S.E. FOLSTEIN, P.R. HUGH, 1975. And if there were prominent cognitive disorders Kudesan® was prescribed — mitochondrial coenzyme Q10 — at the dosage of 60 mg per day during the next 2 months. Dosage of the drug used according to medical instructions.Results. The data witnesses that clinical effect was achieved in patients with Kudesan®: the significant improvement of cognitive functions in patients by MMSE score. The effectiveness of Q10 compound was measured by the clinical properties matching after the treatment. Before the treatment the clinical data compared were identical with the absence of statistical significance among them (p>0,01).Conclusion. The positive influence of complex therapy is shown on the cognitive functions in patients with AH at the background of diabetes 2 type. The study showed that the inclusion of Q10 compound into the standard treatment of arterial hypertension with diabetes 2nd type is associated with positive clinical effect, especially in relevant cognitive function improvement, significant decrease of systolic and diastolic BP, relevant decrease of blood pressure variability, significant of glucose and glycosylated hemoglobin level decrease, significant Mg level increase

METHOD AND MEANS OF ANXIETY-DEPRESSION DISORDERS CORRECTION IN PATIENTS WITH ARTERIAL HYPERTENSION ASSOCIATED WITH 2ND TYPE DIABETES

Aim. To elaborate the method and means for correction of anxiety-depression disorders in patients with arterial hypertension (AH) associated with 2nd type diabetes mellitus.Material and methods. Totally 120 patients included with essential arterial hypertension (AH), associated with 2nd type DM, non-sufficient control of В P. Patients with AH had the second grade of BP increase at the background of 2nd type DM of mild or moderate severity compensated according to the levels of glycosilated hemoglobin 6,25%. Patients had quite high amount of comorbidities and risk factors complicating AH. All patients were taking basic ant hypertension therapy, mostly a variety of combinations of drugs (beta-blockers, ACE inhibitors, calcium antagonists,angiotensine receptor blockers II). Also the patients took the drugs for comorbidities treatment (hypolipidemic drugs, nitrates, glucose lowering drugs). The necessary criteria was patients' consent.In outpatient conditions, at the 1st visit and in 1 year we performed a complex of events: anamnesis collection, clarification of complaints; palpation and auscultation of the heart and main vessels; BP measurement by Korotkov on upper extremities; ECG recording, echocardiography. Biochemical analysis of the whole plasma was done, fasting: we measured glucose level, glycosilated hemoglobin, lipid spectrum (cholesterol, triglycerides, LDL, HDL), clotting system parameters (PI, APTT, fibrinogen), electrolites (K, Mg). Also patients by themselves completed medical questionnaires of a special purpose. We used HADS questionnaire and self-assessment for depressions CED-S. If the increased levels of anxiety and depression were found we prescriben Qudesan® — mitochondrial coenzyme — coenzyme Q10 in dose 60 mg daily for 2 months. The dosage was calculated according to the drug sheet.Results. The data we collected witnesses that clinical efficacy was reached in patients at the background of Qudesan® intake: significantly positively changed psychological status of patients — depression decreased by the scales of specialized questionnaires. Scoring of the influence of that drug was done by comparison of clinical characteristics after treatment. Before treatment the parameters studied were identical that is also confirmed by the absence of significance of their difference (p>0,01).Conclusion. The study led to obtainment of a new data on that inclusion of Q10 containing drug into the standard treatment of AH with 2nd type DM has positive clinical effect that, particularly, leads to a significant decrease of systolic and diastoiic blood pressure, significant decrease of BP variability, significant decrease of blood glucose levels and glycosilated hemoglobin, significant increase of Mg level in blood. Also the positive influence of complex therapy noted on the decrease of anxiety and depression level in patients with AH and DM 2 type

Secondary prophylaxis of cardiovascular diseasses associated with anxiety and depressive disorders: ways of optimization

Somatic and psychological risk factors (RF) were studied in 835 patients with arterial hypertension (AH) and ischemic heart disease (IHD) who had been admitted to the Borderline Department of MHRI SB RAMS for severity of neurotic and affective disorders provoked by previous psychosomatic events (psychosocial stress). Earlier the patients had been under control of cardiologists and therapists in general medical institutions. Systemic analysis of interrelation between somatic, psychic, and psychosocial factors defining the mechanisms of psychosomatic correlation formation in the patients with CVD with depressive disorders was applied

ВТОРИЧНАЯ ПРОФИЛАКТИКА СЕРДЕЧНО-СОСУДИСТЫХ ЗАБОЛЕВАНИЙ, АССОЦИИРОВАННЫХ С ТРЕВОЖНЫМИ И ДЕПРЕССИВНЫМИ РАССТРОЙСТВАМИ: ПУТИ ОПТИМИЗАЦИИ

Somatic and psychosomatic risk factors (RF) were studied in 835 patients with arterial hypertension (AH) and ischemic heart disease who had been admitted to the Department of Borderline conditions of MHRI for severity of neurotic and affective disorders provoked by previous psycho-traumatic events (psychosocial stress). Earlier the patients had been under medical supervision of cardiologists or therapeutists at general medicine institutions. Systemic analysis of correlation between somatic, psychic and psycho-social factors responsible for the mechanisms of formation of psychosomatic correlation in the CVD patients with anxiety and depressive disorders in order to estimate the cardiovascular risk and to choose the strategy of the secondary prophylaxis available in the general medicine practice.На клиническом материале, включающем 835 пациентов с артериальной гипертонией (АГ) и ишемической болезнью сердца (ИБС), госпитализированных в отделения пограничных состояний НИИПЗ СО РАМН в связи с выраженностью невротических и аффективных расстройств, обусловленных предшествующими психотравмирующими событиями (психосоциальным стрессом), изучены соматические и психосоциальные факторы риска (ФР). Ранее пациенты наблюдались в общемедицинских учреждениях у кардиолога или терапевта. В исследовании применен системный анализ взаимосвязи соматических, психических, психосоциальных факторов, определяющий механизмы формирования психосоматических соотношений у больных ССЗ с тревожными и депрессивными расстройствами для оценки кардиоваскулярного риска и выбора стратегии вторичной профилактики в общемедицинской

Toward the Ultra-incompressible Carbon Materials. Computational Simulation and Experimental Observation

The common opinion that diamond is the stiffest material is disproved by a number of experimental studies where the fabrication of carbon materials based on polymerized fullerenes with outstanding mechanical stiffness was reported. Here we investigated the nature of this unusual effect. We present a model constituted of compressed polymerized fullerite clusters implemented in a diamond matrix with bulk modulus <i>B</i>₀ much higher than that of diamond. The calculated <i>B</i>₀ value depends on the sizes of both fullerite grain and diamond environment and shows close correspondence with measured data. Additionally, we provide results of experimental study of atomic structure and mechanical properties of ultrahard carbon material supported the presented model