[Characteristics of arterial hypertension clinical course in patients with obesity and anxiety-depressive disorders].

This article covers an important subject clinical course of arterial hypertension in patients with metabolic abnormalities with obesity and anxiety-depressive disorders. Relevance of this topic is defined with high incidence of each aforementioned conditions and their influence on quality of life and social functioning of patients. Review of literature covers subjects of comorbidity and multimorbidity. Relevant data are presented which are focusing on complex management of arterial hypertension co-existing with obesity and anxiety-depressive disorders.

[Obesity in metabolic syndrome, as well as kidney dysfunction]. / Ozhirenie pri metabolicheskom sindrome i pochechnaia disfunktsiia.

The presence of metabolic syndrome (MS) in a patient allows him to be assigned to a group at high risk for atherosclerosis, cardiovascular events, coronary heart disease, and type 2 diabetes mellitus. In addition, MS negatively affects not only the heart and vessels, but also kidney function, which leads to chronic kidney disease (CKD). MS is pathogenetically associated with CKD and is an independent prognostic factor of the development of the latter, namely, the involvement of the kidney frequently determines prognosis and quality of life in these patients. The paper gives a modern view on the concept of MS and CKD and considers its main diagnostic criteria, etiology, and pathogenesis. The study of the relationships between MS and CKD may suggest that the high prevalence of kidney dysfunction in the general population is largely determined by metabolic nephropathies, including obesity-related nephropathy. The identification of risk factors and poor prognostic markers in this category of patients seems to be extremely important for the early diagnosis of the disease and their timely elimination is one of the main approaches to the comprehensive prevention of CKD in these patients.

[Azilsartan Medoxomil Capabilities in Arterial Hypertension and Obesity].

Arterial hypertension (AH) is one of the most common cardiovascular disease. Angiotensin II (AT II), the hormone of renin-angiotensin-aldosterone system, realizes its negative effects through AT 1 receptors - application point of angiotensin receptor blockers (ARB). Due to different dissociation AT 1 receptors properties some ARBs are more effective than others. Multiply multicenter randomized and observational studies approve the effectiveness and safety of azilsartan medoxomil in patients with AH 1-2 grade. Several preclinical studies have shown the additional properties of azilsartan, including increase of insulin sensitivity, cardio- and nephron protection in obesity. In our clinical case we showed the positive influence of azilsartan medoxomil on clinic and ambulatory blood pressure, 24-hour aortic stiffness parameters, longitudinal left ventricular strain in patient with AH and obesity.

[Modern antidepressants in complex management of patients with hypertension and concomitant affective disorders]. / Sovremennye antidepressanty v kompleksnom lechenii bol'nykh s arterial'noi gipertenziei s soputstvuiushchimi affektivnymi rasstroistvami.

According to results of multiple studies depression and anxiety are found in more than 50% of patients with hypertension. Presence of affective disorders elevates risk of progression of hypertension. That is why complex therapy comprising antihypertensive drugs from various groups and antidepressants takes on higher and higher significance. Modern antidepressants produce no substantial cardiotoxic effects. Combination of an antihypertensive drug (angiotensin converting enzyme inhibitor captopril or beta-adrenoblocker metoprolol) with an antidepressant affects favorably clinical course of hypertension, 24-hour blood pressure profile, characteristics of intracardiac hemodynamics, structural and geometric left ventricular parameters, allows to achieve sufficient antihypertensive effect with acceptable tolerability.

[Roentgeno-ultrasound diagnosis of acute pancreatitis and its complications]. / Rentgenoul'trazvukovaia diagnostika ostrogo pankreatita i ego oslozhnenii.

A program of combined radio-ultrasound diagnosis of acute pancreatitis was developed. Altogether 1257 patients were investigated over time, of them various complications were found in 303 (24%). The accuracy of detection of acute pancreatitis was 92%, that of purulent complications was 93%, that of false pancreatic cysts was 98.2%. Ultrasound and roentgenological semiotics of various types of complications of pancreatitis was described. Ultrasound investigation was shown to be the most important one in the diagnosis of patients with acute pancreatitis.

[Early diagnosis of acute pancreatitis]. / Ranniaia diagnostika ostrogo pankreatita.

The article discusses clinical experience of the Sklifosovsky Emergency Ambulance Service Institute in establishing early diagnosis of acute pancreatitis in the last decade. Over 3,000 patients were examined; they were admitted to the Institute for acute pancreatitis the diagnosis of which was made according to the program of complex diagnosis at the stage of the admission department and during the first three days of the hospital stage. The decisive role in establishing the diagnosis is attached to the clinical manifestations, medical history, amylasuria, and obligatory radiological and ultrasonographic examination (USE). The characteristic radiological and ultrasonic signs of various forms of acute pancreatitis are described. Radiological pleuro-pulmonary signs were found in 15.1% of patients with the edematous and in 42% of those with destructive pancreatitis. Specific indirect signs during radiography of the abdominal organs were registered in almost 80% of cases of acute pancreatitis. Informativeness of USE in acute pancreatitis was 95.4%, and it also made it possible to identify the clinico-morphological form of the disease. It is emphasized that USE must be undertaken in the first hours of the patient's admittance to the clinic. The suggested complex program of early diagnosis may be used in essence in all emergency ambulance service hospitals.