RESUMO
AIM: The study assesses the effects of therapy based on the use of telmisartan in patients with arterial hypertension and stable angina on the clinical and functional indicators of the cardiovascularvascular system. MATERIAL AND METHODS: 52 patients with a combination of arterial hypertension (AH) I and II stages and coronary artery disease II with the mean age 63.5 ± 5.4 years (79% males and 21% of females) were enrolled in the trial. The duration of AH and CAD were 17.5±3.8 and 12.5±3.1 accordingly. All patients took a daily 80 mg dose of telmisartan. The efficacy of treatment was estimated in 3,6 and 12 months. RESULTS: The use of telmisartan in complex treatment of high-risk patients with AH has led to decreasing blood pressure to the target level, increasing exercise tolerance (walking the distance from 315.5 m to 410.2 m in 6 minutes). 12 months of therapy based on telmisartan showed significant decrease in left hy pertrophy ventricle (LV myocardial mass index on average by 10.4%), a decrease in the total duration of depression ST segment from 9.6±2.9 to 2.7±1.5 mm and a decrease in the depth of depression from 1.5±0.3 mm to 0.3±0.09 mm, with a trend towards decrease in the number of episodes of ST-segment depression, as well as the absence of a significant change in heart rate. After 12 months of en dothelium-dependent vasodilation therapy, the condition of 31 (60%) patients improved, and 18 (35%) patients showed the tendency to improvement. The tests with reactive hyperemia conducted after 12 months of treatment revealed decreased linear velocity of blood flow in the brachial artery on average by 17%. CONCLUSION: The use of telmisartan in complex therapy improves the quality of life according to the EQ-VAS questionnaire by 25 points after 12 months of therapy, contributes to lowering blood pressure in 96% of patients, reduc ing myocardial hypertrophy, endothelial dysfunction and severity of ischemic manifestations (reducing the need for nitroglycerin intake to an average of 0,5 inhalations, as well as a decrease in the ST segment depression of 40% after 12 months of therapy).
Assuntos
Hipertensão/tratamento farmacológico , Telmisartan/uso terapêutico , Idoso , Pressão Sanguínea , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , VasodilataçãoRESUMO
Nine-dimensional potential energy surface (PES) and dipole moment surface (DMS) of the germane molecule are constructed using extended ab initio CCSD(T) calculations at 19â¯882 points. PES analytical representation is determined as an expansion in nonlinear symmetry adapted products of orthogonal and internal coordinates involving 340 parameters up to eighth order. Minor empirical refinement of the equilibrium geometry and of four quadratic parameters of the PES computed at the CCSD(T)/aug-cc-pVQZ-DK level of the theory yielded the accuracy below 1 cm-1 for all experimentally known vibrational band centers of five stable isotopologues of 70GeH4, 72GeH4, 73GeH4, 74GeH4, and 76GeH4 up to 8300 cm-1. The optimized equilibrium bond re = 1.517â¯594 Å is very close to best ab initio values. Rotational energies up to J = 15 are calculated using potential expansion in normal coordinate tensors with maximum errors of 0.004 and 0.0006 cm-1 for 74GeH4 and 76GeH4. The DMS analytical representation is determined through an expansion in symmetry-adapted products of internal nonlinear coordinates involving 967 parameters up to the sixth order. Vibration-rotation line intensities of five stable germane isotopologues were calculated from purely ab initio DMS using nuclear motion variational calculations with a full account of the tetrahedral symmetry of the molecules. For the first time a good overall agreement of main absorption features with experimental rotationally resolved Pacific Northwest National Laboratory spectra was achieved in the entire range of 700-5300 cm-1. It was found that very accurate description of state-dependent isotopic shifts is mandatory to correctly describe complex patterns of observed spectra at natural isotopic abundance resulting from the superposition of five stable isotopologues. The data obtained in this work will be made available through the TheoReTS information system.
RESUMO
BACKGRAUND: Secondary osteoarthritis (OA) adversely affects the underlying disease and can enhance clinical manifestations of articular syndrome. Early detection of comorbid pathology and early treatment with the therapy of underlying condition is of primary importance to preserve adequate functional activity in patients. The Aim is to analyze the efficacy of the application of interleukin-1 inhibitor in the complex treatment of secondary OA in addition to rheumatoid arthritis (RA). MATERIALS AND METHODS: 248 patients with secondary OA and RA were divided in 4 groups: patients of group I (n = 62) took interleukin-1 inhibitor (50 mg x 2 times per day) in combination with laser therapy on the basis of methotrexate (10-20 mg per week), group II (n = 60) received interleukin-1 inhibitor in complex with methotrexate, in group III (n = 62)--laser therapy with methotrexate and in group 4--methotrexate. We estimated the treatment efficacy in 3 and 6 months according to the dynamics of pain on VAS, indexes HAQ and KOOS. RESULTS: according to VAS group 1 showed statistical significant reduction in pain on movement in 3 and 6 months of 28.53 mm (43.6%) and 31.3 mm (48%) respectively, to values of 36.87 ± 1.56* and 33.11 ± 1.11* (p < 0.05). The results showed the statistically significant advantage of HAQ dynamics in groups I and II in comparison with groups III, IV (p = 0.03). The most prominent statistically significant (p = 0.02) results according to the dynamics of index KOOS were noted in groups of patients who took diacerein (I and II) 6 months after the complex treatment. CONCLUSIONS: the inclusion of interleukin-1 inhibitor in the complex treatment of secondary OA in patients with RA contributes to clinical improvement according to VAS (p = 0.03), index KOOS that reflects functional condition of the knee and increases the quality of life by index HAQ (p = 0.03) after 6 months therapy.
Assuntos
Antraquinonas/administração & dosagem , Artrite Reumatoide/complicações , Interleucina-1/antagonistas & inibidores , Osteoartrite do Joelho , Qualidade de Vida , Adulto , Anti-Inflamatórios/administração & dosagem , Artrite Reumatoide/fisiopatologia , Artrite Reumatoide/psicologia , Terapia Combinada/métodos , Monitoramento de Medicamentos , Quimioterapia Combinada/métodos , Feminino , Humanos , Imunossupressores/administração & dosagem , Terapia a Laser/métodos , Masculino , Metotrexato/administração & dosagem , Pessoa de Meia-Idade , Osteoartrite do Joelho/diagnóstico , Osteoartrite do Joelho/etiologia , Osteoartrite do Joelho/fisiopatologia , Osteoartrite do Joelho/terapia , Gravidade do Paciente , Recuperação de Função Fisiológica/efeitos dos fármacos , Resultado do TratamentoRESUMO
The combination of clinical and instrumental methods with non-invasive markers of ulcerative colitis allows to predict the incidence of this disease and optimize conditions and quality of medical care. To-day, the use of non-invasive markers is a topical issuesince itprovidesa most informative screening test for the high-accuracydetermination ofresidual faecal calprotectin.
Assuntos
Colite Ulcerativa , Fezes , Inflamação , Mucosa Intestinal/imunologia , Complexo Antígeno L1 Leucocitário/análise , Biomarcadores/análise , Colite Ulcerativa/diagnóstico , Colite Ulcerativa/imunologia , Colite Ulcerativa/fisiopatologia , Colonoscopia/métodos , Ensaio de Imunoadsorção Enzimática/métodos , Feminino , Humanos , Inflamação/diagnóstico , Inflamação/imunologia , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Índice de Gravidade de DoençaRESUMO
Deterioration of health characteristics and ever increasing diabetes and cardiovascular morbidity among young subjects imply the necessity of identification ofpossible risk factors of these conditions. We evaluated the prevalence of hyperlipoproteinemia and adipose tissue activity based on the results of screening for resistin level, aggravated heredity, disordered hydrocarbon metabolism, overweight, arterial hypertension, behaviour (physical overstrain, hypokinesia, smoking, inadequate dietary regime). The risk of developing type 2 diabetes mellitus and overall risk of cardiovascular disorders were calculated.
Assuntos
Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Hipercolesterolemia , Hipertensão , Obesidade , Fumar , Adolescente , Idade de Início , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/prevenção & controle , Comportamento Alimentar/fisiologia , Feminino , Humanos , Hipercolesterolemia/diagnóstico , Hipercolesterolemia/epidemiologia , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Masculino , Atividade Motora/fisiologia , Obesidade/diagnóstico , Obesidade/epidemiologia , Medição de Risco , Fatores de Risco , Federação Russa/epidemiologia , Fumar/efeitos adversos , Fumar/epidemiologia , Adulto JovemRESUMO
A simultaneous use of the full molecular symmetry and of an exact kinetic energy operator (KEO) is of key importance for accurate predictions of vibrational levels at a high energy range from a potential energy surface (PES). An efficient method that permits a fast convergence of variational calculations would allow iterative optimization of the PES parameters using experimental data. In this work, we propose such a method applied to tetrahedral AB4 molecules for which a use of high symmetry is crucial for vibrational calculations. A symmetry-adapted contracted angular basis set for six redundant angles is introduced. Simple formulas using this basis set for explicit calculation of the angular matrix elements of KEO and PES are reported. The symmetric form (six redundant angles) of vibrational KEO without the sin(q)(-2) type singularity is derived. The efficient recursive algorithm based on the tensorial formalism is used for the calculation of vibrational matrix elements. A good basis set convergence for the calculations of vibrational levels of the CH4 molecule is demonstrated.
RESUMO
AIM: To enhance the efficiency of treatment in patients with secondary osteoarthritis (ÐÐ) in the presence of comorbid condition, by using an interleukin-1 inhibitor (IL-1i) and laser therapy (LT). SUBJECTS AND METHODS: A total of 248 patients aged 38 to 65 years with RA and secondary OA who had predominantly Stage II in accordance with the Disease Activity Score 28 (DAS28) were examined. According to the received therapy, the patients were divided into 4 groups: 1) IL-1i + LT + mrthotrexate (MT); 2) IL-1i + MT; 3) LT + MT; 4) MT. The efficiency of treatment was evaluated from changes in the KOOS (Knee injury and Osteoarthritis Outcome Score), DAS 28, IL-1, and cartilage oligomeric matrix protein (COMP) 6 months later. RESULTS: There were statistically significant functional improvements in KOOS and DAS28 in Groups 1 and 2 patients with secondary OA in RA. Clinical efficacy was confirmed by positive changes in serum IL-1 and COMP levels. CONCLUSION: Incorporation of an IL-1i into a therapy regimen for secondary OA in RA patients during basic therapy could not only improve the functional status of patients, but also decrease activity of the underlying disease according to the DAS 28.
Assuntos
Antraquinonas/farmacologia , Anti-Inflamatórios/farmacologia , Artrite Reumatoide/terapia , Proteína de Matriz Oligomérica de Cartilagem/sangue , Interleucina-1/antagonistas & inibidores , Interleucina-1/sangue , Terapia com Luz de Baixa Intensidade/métodos , Osteoartrite/terapia , Adulto , Idoso , Antraquinonas/administração & dosagem , Anti-Inflamatórios/administração & dosagem , Artrite Reumatoide/sangue , Artrite Reumatoide/complicações , Terapia Combinada , Comorbidade , Feminino , Humanos , Masculino , Metotrexato/administração & dosagem , Metotrexato/farmacologia , Pessoa de Meia-Idade , Osteoartrite/sangue , Osteoartrite/etiologia , Avaliação de Resultados em Cuidados de Saúde , Índice de Gravidade de DoençaRESUMO
The use of immunodepressants in the medical practice provided tens of thousands of favourable outcomes of the liver, kidney or heart transplantation and significant success in the treatment of a number of autoimmune diseases. Calcineurine inhibitors (cyclosporine A and tacrolimus) provoke a number of adverse reactions. Among them nephrotoxicity is clinically most dangerous. Complex estimation of the immunological and biochemical indices in the treatment with calcineurine inhibitors is an important precondition for increasing the efficacy of immunodepressive therapy and decreasing the frequency and level of the adverse reactions.
Assuntos
Ciclosporina/efeitos adversos , Inibidores Enzimáticos/efeitos adversos , Imunossupressores/efeitos adversos , Transplante de Órgãos , Insuficiência Renal/patologia , Tacrolimo/efeitos adversos , Caderinas/genética , Caderinas/imunologia , Calcineurina/metabolismo , Inibidores de Calcineurina , Regulação da Expressão Gênica/efeitos dos fármacos , Taxa de Filtração Glomerular/efeitos dos fármacos , Humanos , Terapia de Imunossupressão , Rim/efeitos dos fármacos , Rim/imunologia , Rim/patologia , Linfotoxina-alfa/genética , Linfotoxina-alfa/imunologia , Insuficiência Renal/induzido quimicamente , Insuficiência Renal/imunologiaRESUMO
This article gives evidence of the effectiveness of chromo- and laser therapy (using infrared and green wavelenth radiation) in combination with basal pharmacotherapy in the patients presenting with combined pathology. The analysis of the data obtained indicates that the proposed approach makes it possible to accelerate normalization of the clinical characteristics, reduce arterial pressure, improve the parameters of external respiration, and increase the duration of remission periods.
Assuntos
Cromoterapia/métodos , Hipertensão , Terapia com Luz de Baixa Intensidade/métodos , Doença Pulmonar Obstrutiva Crônica , Adulto , Idoso , Feminino , Humanos , Hipertensão/complicações , Hipertensão/fisiopatologia , Hipertensão/terapia , Masculino , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Doença Pulmonar Obstrutiva Crônica/terapia , Indução de RemissãoRESUMO
We present the first detailed analysis of the infrared spectrum of methane (12)CH4 in the so-called Tetradecad region from 2.1 to 1.6 µm (4760-6250 cm(-1)). New experimental high resolution FTIR spectra at 78 K and at room temperature combined with improved theoretical modeling have allowed quantum assignments to be greatly extended in this region. A global fit of all assigned lines of (12)CH4 in the 0-6200 cm(-1) region has been performed. In the end, 3012 line positions and 1387 intensities of 45 individual subbands of the Tetradecad were modeled up to J = 14. The root mean square deviations were 0.023 cm(-1) for line positions and 13.86% for line intensities in the Tetradecad region itself. Although this analysis is still preliminary, it is already sufficient to characterize the stronger bands throughout the whole of the Tetradecad. The calculated integrated intensity of the polyad is 1.399 × 10(-19) cm(-1)/(molecule cm(-2)) at 296 K. A "definitive" theoretical modeling of this spectral region of methane requires further work, but the present success substantially improves our understanding of methane spectroscopy as needed to interpret planetary atmospheres. Lines pertaining to three-fourths of the 60 sub-vibrational bands in this polyad have been assigned.
RESUMO
The data on the mechanism of action, efficacy and safety of the drug fingolimod are presented. Further study of the molecular, biochemical and cellular mechanisms of action of pharmacological regulators of phospholipid mediators' signal transduction is an important basis for developing new immunomodulators and antitumor agents.
Assuntos
Antineoplásicos , Imunossupressores , Fosfolipídeos/metabolismo , Propilenoglicóis , Transdução de Sinais/efeitos dos fármacos , Esfingosina/análogos & derivados , Animais , Antineoplásicos/farmacocinética , Antineoplásicos/farmacologia , Cloridrato de Fingolimode , Humanos , Imunossupressores/farmacocinética , Imunossupressores/farmacologia , Propilenoglicóis/farmacocinética , Propilenoglicóis/farmacologia , Esfingosina/farmacocinética , Esfingosina/farmacologiaRESUMO
Due to its major interest for the chemistry of planetary atmospheres and exobiology, accurate spectroscopy data of phosphine are required for the search of signatures of this molecule in astronomical observations. In this work, high resolution infrared laboratory spectra of phosphine were analyzed for the first time in the full Tetradecad region (3769-4763 cm-1) involving 26 rotationally resolved bands. Overall, 3242 lines were assigned in spectra previously recorded by Fourier transform spectroscopy at temperatures 200 K and 296 K, using a combined theoretical model based on ab initio calculations. The total nuclear motion Hamiltonian of PH3 including ab initio potential energy surface, was reduced to an effective Hamiltonian using the high-order contact transformation method adapted to vibrational polyads of the AB3 symmetric top molecules, followed by empirical optimization of the parameters. At this step, the experimental line positions were reproduced with a standard deviation of 0.0026 cm-1 that provided unambiguous identification of observed transitions. The effective dipole transition moments of the bands were obtained by fitting to the intensities obtained from variational calculations using the ab initio dipole moment surface. The assigned lines were used to newly determine 1609 experimental vibration-rotational levels up to Jmax = 18 with energy in the range 3896-6037 cm-1 that represents significant extension towards higher energies compared to previous works. Transitions for all 26 sublevels of the Tetradecad were identified but with noticeably fewer transitions for fourfold excited bands because of their weaker intensity. At the final step, pressure-broadened half widths were attached to each transition and a composite line list adopting ab initio intensities and empirical line positions corrected to the accuracy of about 0.001 cm-1 for strong and medium transitions was validated against experimental spectra available in the literature.
RESUMO
We apply laser puncture to influence biological active points with infra red laser ionizing at scheme with effect of treatment of asthma bronchial with chronic accompanied by rhino sinusitis. The clinical effectiveness of treatment was seen in positive dynamics of clinical, instrumental and spirographycal indices regarding bronchial asthma and concomitant rhinitis as well, which was confirmed by X-ray examination. Application of laser punctureto treat the elderly patients with asthma bronchial accompanied by rhino sinusitis is an effective method having no side effects that can be used in an ambulatory and in a hospital.
Assuntos
Asma/terapia , Terapia com Luz de Baixa Intensidade/métodos , Rinite/terapia , Sinusite/terapia , Idoso , Asma/complicações , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Rinite/complicações , Sinusite/complicações , Resultado do TratamentoRESUMO
The effectiveness assessment of using EHF-acupuncture to prevent the attacks in the patients of mixed forms of bronchial asthma is given. The article presents the special scheme of treatment of patients of different age groups in different phase of the disease using the points of acupuncture with the application of EHF.
Assuntos
Asma/terapia , Micro-Ondas/uso terapêutico , Pontos de Acupuntura , Idoso , Asma/sangue , Asma/diagnóstico , Terapia Combinada , Feminino , Humanos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Testes de Função Respiratória , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
The practical value of metabolic syndrome is defined by it's great popularity, which becomes an epidemy, sometimes--by fatal complications sideways cardiovascular system and by capability of their prevention in conditions of forehanded diagnostics and individual correction of metabolic disorders. The authors, investigated 76 patients with indications of complete metabolic syndrome, for the first time analyzed genetic factors of risk of cardiovascular diseases and proposed the ways of optimization of diagnostics, prophylaxis and treatment of metabolic syndrome and syndrome diseases.
Assuntos
Predisposição Genética para Doença , Síndrome Metabólica , Índice de Massa Corporal , Restrição Calórica , Dislipidemias/genética , Dislipidemias/metabolismo , Dislipidemias/prevenção & controle , Exercício Físico , Feminino , Humanos , Hipertensão/genética , Hipertensão/metabolismo , Hipertensão/prevenção & controle , Masculino , Síndrome Metabólica/genética , Síndrome Metabólica/metabolismo , Síndrome Metabólica/terapia , Pessoa de Meia-Idade , Polimorfismo GenéticoRESUMO
Analysis of 146,521 autopsy protocols in Moscow in 2001-2005 showed that the incidence pulmonary thromboembolism (PTE) as a direct cause of death was 3.8-7%. PTE was not diagnosed during life in 20-28% of the patients who had died at hospitals and in 68-72% of those who had died at home. PTE was 2-3 times more common in females than in males, the age of the deceased patients was old and senile. The sources of PTE were thrombi of the leg deep veins (93.2%), small pelvic veins (3.4%), and right heart chambers (1.1%). Thrombophilic states were one of the main causes of the poor course and outcome of PTE. Based on the studies performed, an algorithm was developed for the diagnosis and treatment, which was successfully used at the N.N. Burdenko Main Military Clinical Hospital. The introduction of the results could reduce the incidence venous thrombosis from 39% to 17%, that of cava-filter thromboses from 24% to 3.7%, and recurrent TELA from 15% to 5.6%.
Assuntos
Embolia Pulmonar/patologia , Trombose Venosa/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Embolia Pulmonar/mortalidade , Estudos Retrospectivos , Fatores Sexuais , Trombose Venosa/mortalidadeAssuntos
Antivirais/uso terapêutico , Hepacivirus , Hepatite C/tratamento farmacológico , Oligopeptídeos/uso terapêutico , Prolina/análogos & derivados , Antivirais/efeitos adversos , Interações Medicamentosas , Humanos , Oligopeptídeos/efeitos adversos , Prolina/efeitos adversos , Prolina/uso terapêuticoAssuntos
Antibacterianos , Cefalosporinas , Infecções Comunitárias Adquiridas/tratamento farmacológico , Pneumonia Bacteriana/tratamento farmacológico , Dermatopatias Bacterianas/tratamento farmacológico , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Cefalosporinas/farmacologia , Cefalosporinas/uso terapêutico , Humanos , CeftarolinaRESUMO
AIM: To study efficacy of infrared laser radiation on the adrenal projection region in patients with bronchial asthma (BA). MATERIAL AND METHODS: The adrenal region of BA patients was exposed to infrared laser radiation. The effect was stated after blood count, examination of the urine and sputum, blood biochemical tests, blood hydrocortisone assay. RESULTS: Positive clinical response to laser therapy manifested with improvement of clinical, device and spirometric indices in BA patients. Blood levels of hydrocortisone normalized. CONCLUSION: Infrared laser radiation of adrenal projection region reduced the number of asphyxia attacks, improved bronchial drainage, shortened the disease duration. The method is well tolerated, safe, easy to make and suggested for use in combined treatment of BA.
Assuntos
Glândulas Suprarrenais/efeitos da radiação , Asma/terapia , Raios Infravermelhos/uso terapêutico , Terapia com Luz de Baixa Intensidade/métodos , Adolescente , Adulto , Asma/tratamento farmacológico , Terapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
The aim of the study was to compare the hypotensive effect and safety of carvedilol, a non-selective alpha-beta blocker, and monopril, an angiotensin-converting enzyme inhibitor (ACEi), in patients with arterial hypertension and a chronic renal disease. The main group (MG), 26 patients, was treated with carvedilol, which was administered as a hypotensive agent instead of the ACEi. The control group (CG) included 24 patients on a "standard" therapy with hypothiazide 12.5 mg a day, amlodipine 10 mg a day, and monopril 20 mg a day. Patients who received carvedilol displayed an earlier hypotensive effect (HE). Together with HE realization, the patients of both groups displayed a moderate increase in glomerular filtration (not more than by 10 ml/min), and an increase in creatinine blood level (not more than by 15%) during the first two weeks, which can be explained by a decrease in intraglomerular hypertension. A significant decrease in total cholesterol level and a more pronounced regress of left ventricular myocardial hypertrophy were noticed in the MG vs. the CG. Measurement of the serum levels of cortisol, aldosterone, and angiotensin I showed that the patients of the MG displayed a significant decrease in aldosterone level together with a clear tendency of cortisol level increase. The concentrations of these hormones in CG patients did not change significantly. The result demonstrate that prolonged administration of carvedilol leads to a noticeable decrease in the serum level of aldosterone, an increase in cortisol level, and electrolyte changes, such as an increase in sodium level and a decrease in potassium level in blood plasma.