EFFECT OF FERROTHERAPY ON COURSE OF ISCHEMIC HEART DISEASE ASSOCIATED WITH MILD IRON DEFICIENCY IN MEN

Aim. To assess effect of ferrotherapy on course of ischemic heart disease (IHD) associated with mild iron deficiency anemia (IDA) and latent iron deficiency (ID). Material and methods. 80 male patients, coal miners, aged 51±7.9 years, were observed. 28 patients had angina pectoris associated with the mild IDA, 23 patients experienced myocardial infarction accompanied by the mild IDA and 29 patients had angina with latent ID. Latent ID was defined in case of iron plasma level ≤12 µg/l, IDA was diagnosed in case of hemoglobin level <130 mg/l. The minimal hemoglobin level observed in patients was 107g/l. ICD clinical characteristics were compared before and after 3-week iron-based treatment in individualized doses. Results. Latent ID and mild IDA aggravated angina and increased ectopic myocardial activity in patients with IHD. Iron-based therapy with appropriate nutrition reduced angina attacks frequency, duration and intensity, decreased nitroglycerin consumption and increased exercise tolerance. Conclusion. Normalization of haemoglobin level and iron plasma concentration in the mild IDA as well as normalization of iron plasma concentration in ID in patients with IHD reduces ede-ma and dyspnea, decreases heart rate. These effects are provided due to the treatment with elementary iron in individualized course dose, which improves clinical status and minimizes the adverse reactions

ОДЫШКА, СВЯЗАННАЯ С ТРЕВОГОЙ: ОШИБКИ И ТРУДНОСТИ ДИАГНОСТИКИ

Two clinical cases that demonstrate the difficulties diagnosing the causes of shortness of breath, coupled with anxiety, are analyzed. From the standpoint of modern neurophysiology it explains the relationship of these conditions. There were revealed typical diagnostic mistakes: «the effect of precocious focusing", "the negative effect of the narrow specializationПроанализированы два клинических наблюдения, демонстрирующие трудности диагностики при-чин одышки, сочетающейся с тревогой. С позиций современной нейрофизиологии объясняется взаимосвязь этих состояний. Раскрываются характерные диагностические ошибки: «эффект ран-ней фокусировки», «негативный эффект узкой специализации»

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

DYSPNEA ASSOCIATED WITH ANXIETY: MISTAKES AND DIFFICULTIES IN THE DIAGNOSIS

Two clinical cases that demonstrate the difficulties diagnosing the causes of shortness of breath, coupled with anxiety, are analyzed. From the standpoint of modern neurophysiology it explains the relationship of these conditions. There were revealed typical diagnostic mistakes: «the effect of precocious focusing", "the negative effect of the narrow specializatio

THE INFLUENCE OF DYNAMIC AND STATIC PHYSICAL EXERCISES ON THE PARAMETERS OF INTRACARDIAC HEMODYNAMICS AND PHYSICAL ENDURANCE IN HIGHER-LEVEL SPORTSMEN

Aim. To assess the influence of dynamic and static exercises on the parameters of intracardiac hemodynamics and physical endurance in higher-level sportsmen.Material and methods. Totally, 136 sportsmen studied all males. Higher- level (qualified) sportsmen (groups of sports perfection and higher sports mastery) — 116 persons (mean age 22,07±4,10 y.; sports experience 5-15 years) depending on the type of activity were selected into groups as following: I (n=30) — wrestling, judo, II (n=27) — ski racing, biathlon, III (n=33) — powerlifting, IV (n=26)—volleyball. Group V (n=20) — controls (age 17,95±1,55 y.), with the experience not higher than 3 years. Investigation methods: electrocardiography, echocardiography (EchoCG), veloergometry. Results. By the data of ECG the parameters of intracardiac hemodynamics in sportsmen of all groups were in the normal range. There were significant differences found for the geometry of the heart between control group and higher-level sportsmen, and the controls had lower morphostructural parameters. In highly dynamic kinds of sports (ski racing, biathlon) the morphostructural changes are related to the increase of volumetric parameters of the left ventricle. Intensive static and low dynamic load in power kinds of sports (powerlifting) lead to the increase of myocardial mass, caused by thickness of the left ventricle walls. The highest values of the level of physical endurance and maximum oxygen consumption were in biathlon and ski racing sportsmen who train endurance. Conclusion. Study of the influence of dynamic and static physical exertion on the parameters of intracardiac hemodynamic, morphostructure of the heart and physical endurance is of definitive importance for the evaluation of cardiovascular adaptation potential in higher-level sportsmen. Depending on the type and intensity of the exertion adaptation mechanisms have their specifics. The obtained data can be used for on-time correction of the training regimens and for management of training-competition process in sportsmen of various kinds. That means, EchoCG and veloergometry must be included into the list of obligatory diagnostic methods that fulfill systemic dynamic control of cardiovascular system parameters in the highest achievement sportsmen, that has special significance for revealing of the signs of desadaptation and overtraining in longtime sports involvement

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