RESUMEN
PURPOSE: Assessment of COVID-19 incidence and hospitalization rate of male patients with prostatic hyperplasia depending on the intake of 5-alpha-reductase inhibitors (5-ARI). MATERIALS AND METHODS: In our study, electronic medical records of 1678 patients with prostatic hyperplasia were analyzed. 1490 men aged 71 (64-76) years were selected for final analysis. Vaccination against COVID-19 was carried out in 730 patients (49%). Treatment with 5-ARI inhibitors was carried out in 269 (18.1%) patients. RESULTS: Among 1490 included patients 790 (53%) had COVID- 19 while 360 (45.7%) of them required hospitalization. During the multivariate analysis, only two factors were associated with the risk of COVID-19 in the cohort studied: vaccination (odds ratio (OR) =0.095; 95% confidence interval (CI) 0.074-0.122), i.e. a 90.5% chance reduction, p<0.001) and the fact of taking 5-ARI (OR=0.235; 95%CI=0.165-0.335; p<0.001), i.e. a 76.5% chance reduction. The duration of 5-ARI therapy was not associated with the incidence of new coronavirus infection. The severe course of COVID-19 which required hospitalization was positively associated with age (p=0.025) and the presence of coronary artery disease (p=0.004); and negatively associated with the frequency of vaccination (p<0.001) and treatment of 5-ARI (3.1% vs. 11.6%, p<0.001). In a multivariate analysis of outpatient patients with prostatic hyperplasia who had COVID-19, 5-ARI intake (OR=0.240; 95% CI 0.122-0.473; p<0.001) and vaccination (OR = 0.570; 95% CI 0.401-0.808; p=0.002). The factors associated with increased chances of hospitalization due to the severe course of COVID-19 were coronary heart disease (+43.8%, p=0.019) and older age (+1.7% by one year, p=0.046). CONCLUSION: Taking 5-ARI, along with vaccination in patients with prostatic hyperplasia is a protective factor for morbidity and the severity of COVID-19.
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COVID-19 , Hiperplasia Prostática , Humanos , Masculino , Hiperplasia Prostática/epidemiología , Hiperplasia Prostática/terapia , Hiperplasia Prostática/complicaciones , COVID-19/epidemiología , COVID-19/terapia , Inhibidores de 5-alfa-Reductasa , Estudios de Cohortes , IncidenciaRESUMEN
The present review of the foreign and domestic literature is concerned with the application of the method of enhanced external counterpulsation (EECP) therapy for the treatment of the patients presenting with various diseases. It is shown that many recent publications report extensive investigations of the clinical and neurophysiological aspects of the application of this method for the combined regenerative treatment of the patients surviving after ischemic stroke (IS). The possibility of the influence of EECP therapy on the system of regulation of the cerebral blood flow, the formation of collateral circulation in the ischemic tissue, and the cellular-humoral mechanisms are considered. It is concluded that the introduction of enhanced external counterpulsation therapy into the program of the combined rehabilitative treatment on an individual basis for the patients surviving after ischemic stroke is pathogenetically substantiated as promoting regression of clinical, neurological, and neuropsychological disorders.
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Isquemia Encefálica/rehabilitación , Contrapulsación , Rehabilitación de Accidente Cerebrovascular , Animales , Isquemia Encefálica/cirugía , Humanos , Accidente Cerebrovascular/cirugíaRESUMEN
The aim of the study was to assess the use of multispiral computed tomographic coronarography (MSCT-CG) in comparison with conventional coronary angiography. Overall 62 patients aged 45-72 years were examined, the MSCT-CG was conducted in 38 patients. The sensitivity of MSCT-CG was 92%, the specificity - 91,2%, in comparison with the CAG. The prognostic value of negative test was 95,7%, the prognostic value of positive test was 84%, overall accuracy was counted up to 91,5%. Though, the MSCT-CG showed certain overestimation in calculating the stenosis degree and, thus, false positive results, in cases with calcined atherosclerotic plaques. Main advantages of MSCT-CG were: non-invasiveness, possibility of vessel lumen, arterial wall and structure of the plaque assessment.
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Angiografía Coronaria/métodos , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Isquemia Miocárdica/diagnóstico por imagen , Tomografía Computarizada Espiral/métodos , Anciano , Humanos , Persona de Mediana EdadRESUMEN
Presented herein is a case report of a successful treatment of subtotal stenosis of the anterior interventricular artery (over 95%) using paramagnetic contrast agent Gadovist 1.0 in a female patient with a polyvalent allergy, including that to iodine-containing radiopaque substances. Immunological tests for drug intolerance according to the Demyanenko technique using Gadovist 1.0 were followed by coronography and stenting of the anterior interventricular artery. The immediate outcomes were assessed as good: the lumen of the anterior interventricular artery was restored completely, with sufficient filling in of the distal portions of the artery. The total volume of the administered contrast substance amounted to 1.8 ml/kg. No alterations in the markers of the renal function were noted. This case report demonstrates a possibility of using contrast medium Gadovist 1.0 as a radiopaque substance in an endovascular intervention, also confirming that Gadobutrol exerts no side effect on the kidneys, even if administered in high doses.
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Implantación de Prótesis Vascular/instrumentación , Angiografía Coronaria/métodos , Estenosis Coronaria/cirugía , Hipersensibilidad a las Drogas/complicaciones , Compuestos de Yodo/efectos adversos , Compuestos Organometálicos , Stents , Estenosis Coronaria/complicaciones , Estenosis Coronaria/diagnóstico por imagen , Femenino , Gadolinio , Humanos , Persona de Mediana Edad , Compuestos Organometálicos/administración & dosificación , RadioisótoposRESUMEN
The authors performed 153 reconstructive vascular operations in patients with associated atherosclerotic lesion of the coronary arteries, abdominal aorta and arteries of the lower extremities. According to the findings of ventriculography and coronarograms, in 13 patients, the inoperable form of the ischemic heart disease was revealed. In all these patients, the vascular operations were performed. The indications for the different reconstructive vascular operations in inoperable coronary pathology have been developed.