[Physical work ability in patients with type 1 diabetes].

Physical work ability was assessed in 128 patients with a long duration of type 1 diabetes mellitus and 36 practically healthy people by K. Wasserman stepwise standard loading test with permanent monitoring of the load, oxygen consumption, and respiratory coefficient. Oxygen consumption was calculated per 1 kg body mass, and anaerobic metabolism threshold was determined. The patients were divided into three groups: Group 1 consisting of patients without clinically detectable microangiopathic complications, Group 2 with initial, and Group 3 with advanced manifestations of late diabetic syndrome. Average levels of maximum oxygen consumption, the achieved load, oxygen consumption per 1 kg body mass at the peak of physical load, and anaerobic threshold were significantly lower in all the three groups compared to controls. Respiratory coefficient at the peak of loading testing was significantly higher in diabetic patients than in controls. The study demonstrated that microangiopathic alterations significantly reduced physical work ability in patients with type 1 diabetes mellitus. Nevertheless, this study demonstrated low physical exercise tolerance in a large part of young diabetics without clinically detectable microvascular complications of endocrinopathy. A decrease in maximum oxygen consumption in these patients may be of multi-factor nature and may be a result of both central (hemodynamics) and peripheral (microcirculation, muscular metabolism) mechanisms limiting the function of the gas transport system.

[The condition of external respiratory mechanics in patients with type 1 diabetes].

External respiratory mechanics was studied in 141 patients with type 1 diabetes mellitus (DM1) and 36 healthy controls using computed analysis of flow-volume loop and total body plethysmography. The DM1 patients were divided into 4 groups: group 1 consisted of patients without clinical signs of microangiopathic complications; groups 2 and 3 consisted of patients with initial and advanced manifestations of late diabetic syndrome (LDS), respectively; group 4 consisted of patients suffering from severe endocrinopathy with end-stage chronic renal failure. The velocity and volume parameters in groups 1 and 2 did not differ significantly from those in the controls. Significant reduction in the vital capacity, forced expiratory volume in one second, and total lung capacity was noted in patients with advanced LDS and uremia. Forced expiratory volume in one second decreased in proportion to reduction in lung vital capacity, which did not cause Tiffno index to leave the reference range. The authors came to the conclusion that DMI causes restrictive ventilatory defect, associated with advanced clinical manifestations of microangiopathic alterations.

[Essential measures of an organizational-medical character aimed atdecreasing the incidence of diseases of the circulatory system and mortality caused by them in modern Russia]. / Neobkhodimye meropriiatiia organizatsionno-meditsinskogo kharaktera, napravlennye na umen'shenie zabolevaemosti bolezniami sistemy krovoobrashcheniia i smertnosti ot nikh v sovremennoi Roccii.

Mortality caused by diseases of the circulatory system is analyzed on the basis of files of the Ministry of Health and of the State Statistical Committee of Russia and the results are correlated to the objective parameters reflecting the potentialities of cardiological service in Russia and the actual status of prophylaxis, including regular check-ups. Conclusions are drawn and recommendations offered.

[Mechanisms of the effects of physical training on the functional state of blood platelets in patients with ischemic heart disease]. / Mekhanizmy vliianiia fizicheskikh trenirovok na funktsional'noe sostoianie trombotsitov u bol'nykh ishemicheskoi bolezn'iu serdtsa.

The platelet-vascular hemostasis and lipid peroxidation were examined in 60 male patients with coronary heart disease during their 30-day daily bicycle ergometric exercise performance. During the exercise, the patients were demonstrated to have a lower platelet aggregability. The factors that contribute to a physical training-induced decrease in the functional activity of platelets include lower levels of cholesterol, thrombin, lower blood oxidative activity and higher concentrations of prostaglandin I2 and high density lipoproteins.

[Mechanical resistance of erythrocytes in hypertension]. / Mekhanicheskaia rezistentnost' éritrotsitov pri gipertonicheskoi bolezni.

Mechanical resistance of red cell membranes was assessed in 97 patients with Stages I-III essential hypertension and in 20 normal subjects by the ultrasonic method. Parallel with these studies red cell cholesterol and phospholipid levels were measured and these cells' deformability assessed by the viscosimetric technique. The findings evidence that red cell mechanical resistance increases with the patient's age and depends on the disease stage and duration. Red cell deformability was found decreased in essential hypertension patients vs. the norm. A direct correlation was revealed between red cell mechanical resistance (from the time of hemolysis) and the value of arterial pressure in essential hypertension (r = 0.505, p less than 0.001).

[Changes in the hormonal profile in patients with ischemic heart disease during physical training]. / Izmenenie gormona'lnogo profilia u bo'lnykh ishemicheskoi bolez'niu serdtsa v protsesse fizicheskikh trenirovok.

Changes in blood insulin, thyroxine, triiodothyronine, thyrotropin, somatotropin, corticotropin, cortisol, and aldosterone were defined in 46 male patients with coronary heart disease during daily graded exercises performed on a bicycle ergometer for 30 days. The exercises led to improvement of health in 44 patients. There was a significant reduction in baseline insulin and aldosterone levels and a tendency to lower corticotropin and triiodothyronine concentrations. The amounts of somatotropin, thyrotropin, thyroxine, and cortisol failed to greatly change during the exercise.

[Use of prolecofen in the treatment of arrhythmia in patients with ischemic heart disease]. / Primenenie prolekofena dlia lecheniia aritmii u bol'nykh ishemicheskoi bolezn'iu serdtsa.

A new antiarrhythmic drug, prolecofen (class Ic), was used in 74 patients with various forms of coronary heart disease, involving heart rhythm disorders. The drug's clinical efficiency and effects on platelet activity, lipid peroxidation, blood prostacyclin, thromboxane, cAMP and cGMP were assessed. Prolecofen is shown to be an effective agent for the treatment of ventricular and supraventricular arrhythmias in coronary patients. It contributes to the inhibition of platelet activity, a drop of cAMP and cGMP levels and a rise of the cAMP/cGMP ratio.

[Changes in the levels of various classes of cholesterol lipoproteins in patients with ischemic heart disease during physical training]. / Izmenenie soderzhaniia kholesterina lipoproteidov razlichnykh klassov u bol'nykh ishemicheskoi bolezn'iu serdtsa pod vliianiem fizicheskikh trenirovok.

Forty-six male coronary patients and 10 normal subjects underwent a course of rationed exercise (30 daily bicycle ergometric sessions). Total cholesterol (CS), triglycerides and CS of lipoproteins, belonging to different classes, were measured before and after exercise. Total CS was shown to decline under the effect of regular exercise drills in coronary patients with hyperlipoproteinemia (HLP) types IIa and IIb, while high-density lipoprotein CS increased in patients with HLP types IIb and IV. It is suggested that exercise may be an effective instrument of controlling HLP as a coronary risk factor.

[Changes in thrombocyte-vascular hemostasis and cyclic nucleotide levels after anti-arrhythmia therapy in patients with ischemic heart disease]. / Izmeneniia trombotsitarno-sosudistogo gemostaza i soderzhaniia tsiklicheskikh nukleotidov pod vliianiem antiaritmicheskoi terapii u bo'lnykh ishemicheskoi bolez'niu serdtsa.

Platelet-vascular hemostasis and cyclic nucleotide levels as well as the effects of mexitil, ritmilen and prolecofen on those were examined in 58 coronary patients with various heart rhythm disorders. The patients showed considerably increased platelet activity, low prostacyclin level and high thromboxane and cyclic nucleotides levels, particularly in patients with high-grade ventricular extrasystoles. Mexitil did not essentially affect the parameters in question. Ritmilen produced a significant increase in 6-keto-PGF1 alpha and a decrease of platelet activity. In prolecofen-treated patients, platelet activity decreased significantly, cAMP and cGMP dropped while the cAMP/cGMP ratio went up; prostacyclin and thromboxane changes were not significant. This may be a mechanism of prolecofen's antiarrhythmic action.

[Use of the antioxidant ubinon in the complex treatment of patients with ischemic heart disease]. / Primenenie antioksidanta ubinona v kompleksnom lechenii bo'lnykh ishemicheskoi bolez'niu serdtsa.

A new Soviet antioxidant drug, ubinon, has been used in 75 patients with coronary heart disease (CHD) of functional classes I-III, including 12 patients with ventricular extrasystoles. Treatment with placebo in 10 patients produced no improvement and had no effect on their stress tolerance. Ubinon, taken as 90 and 135 mg/day doses, was shown to produce clinical improvement and raise stress tolerance, mostly in first- and second-class cases. In coronary patients with ventricular extrasystoles, ubinon enhanced antiarrhythmic effect of mexitil. The use of ubinon was accompanied by a drop in blood oxidant activity and a rise in antioxidant activity, an increase in blood 6-keto-PGF1 alpha, a fall in TxB2 and a suppression of platelet activity. In addition, coronary patients with ventricular extrasystoles showed reduced cAMP and cGMP content and elevated cAMP/cGMP ratio.

[Effect of physical training on the clinical course and the status of blood coagulation hemostasis in patients with ischemic heart disease]. / Vliianie fizicheskikh trenirovok na klinicheskoe techenie i sostoianie koaguliatsionnogo gemostaza u bol'nykh ishemicheskoi bolezn'iu serdtsa.

The effect of intensive rationed exercise on coagulation hemostasis was assessed in 92 males, including 10 normal subjects and 82 coronary patients. Twenty male coronary patients, treated with antianginal drugs, were taken as controls. There were no significant changes in coagulation hemostasis between normal subjects after an exercise course and coronary patients on antianginal treatment. Intensive rationed exercise normalized coagulation hemostasis in coronary patients, as evidenced by reduced thrombinemia owing to smaller concentrations of factors VIII and X and an increase in protein C content.

[Effect of polyunsaturated fatty acids on the functional properties of the thrombocytes and on lipid peroxidation in ischemic heart disease patients]. / Vliianie polinenasyshchennykh zhirnykh kislot na funktsional'nye svoistva trombotsitov i perekisnoe okislenie lipidov u bol'nykh ishemicheskoi bolezn'iu serdtsa.

Platelet function, lipid peroxidation, and levels of cholesterol, triglycerides, high density lipoprotein (HDLP) cholesterol and PGE1 and PGF2 alpha were assessed before and after 28-day administration of polyunsaturated fatty acids (PUFA), contained in olive, corn and cod oil, in 80 coronary patients. The use of PUFA is shown to have a favorable effect on platelet function, decreasing aggregation and increasing disaggregation of platelets. This effect may be due to increased PGE1, producing an antiaggregation effect, while cod oil may also increase HDLP. Additional administration of vitamin E and HDLP prevents unfavorable effects of increased lipid peroxidation.

[Effect of physical training on lipid metabolism and the rheologic properties of the blood of patients with ischemic heart disease]. / Vliianie fizicheskikh trenirovok na obmen lipidov i reologicheskie svoistva krovi u bol'nykh ishemicheskoi bolezn'iu serdtsa.

A therapeutic rationed exercise course (30 daily sessions of bicycle ergometry) was carried out in 30 male coronary patients and 11 normal subjects. Central hemodynamic parameters, lipid metabolism and blood rheologic properties were examined before and after exercise. Regular exercise was shown to bring down erythrocyte membrane levels of triglycerides, fibrinogen and cholesterol and raise the level of high density lipoprotein cholesterol in coronary patients. There was a direct correlation between triglycerides and total peripheral resistance, and an inverse correlation between triglycerides and the cardiac index and another one between fibrinogen and the stroke index. The demonstrated decrease of blood viscosity is evidence of favorable clinical and hemodynamic changes in coronary patients.

[Rheological properties of the blood in hypertension patients]. / Reologicheskie svoistva krovi u bol'nkyh gipertonicheskoi bolezn'iu.

Blood rheologic properties, and serum and erythrocyte membrane lipids were studied in 65 patients with essential hypertension, stage II-III, and 20 normal subjects. Essential hypertension was shown to be associated with marked rheologic disorders, such as increased packed cell volume and plasma viscosity. A greater rigidity of the erythrocyte membranes was also demonstrated.

[Vasopressin content of the blood in ischemic heart disease patients and its interrelation with other hormones]. / Soderzhanie vazopressina v krovi bol'nykh ishemicheskoi bolezn'iu serdtsa i ego vzaimosviaz' s drugimi gormonami.

Blood vasopressin, tri-iodothyronine, total thyroxine, thyrotrophic hormone, cortisol, ACTH and insulin levels were measured in 60 chronic coronary patients aged 35 to 70. Coronary patients showed elevated blood vasopressin, particularly in the presence of frequently recurring anginal attacks. There was no significant difference in vasopressin levels of patients with and without attendant essential hypertension, those with atherosclerotic and postinfarction cardiosclerosis, or in relation to body weight. Insulin, cortisol, adrenocorticotrophic and thyrotrophic hormones were significantly increased, and tri-iodothyronine and total thyroxine, significantly decreased, in coronary patients as compared to the controls.

[Cholesterol-acceptor properties of high-density lipoproteins with respect to erythrocyte membranes in patients with ischemic heart disease]. / Kholesterin-aktseptornye svoistva lipoproteidov vysokoi plotnosti bol'nykh ishemicheskoi bolezn'iu serdtsa po otnosheniiu k membranam éritrotsitov.

A capacity of high density lipoproteins (HDL), isolated from blood of patients with ischemic heart disease, to accept cholesterol of erythrocyte membranes was studied by means of monitoring, using spectra of electron paramagnetic resonance, a disease in the correlation period of rotation, in the patterns of regularity of stearic acid nitroxyl derivatives introduced into the membranes and by a decrease in the molar ratio "cholesterol/phospholipids" in erythrocytes. HDL2 and HDL3, isolated from blood plasma of the patients, were shown to bind cholesterol less effectively after incubation with erythrocytes as compared with the corresponding lipoproteins from blood plasma of healthy persons. Relationship between the phenomenon observed and the physico-chemical properties of HDL in ischemic heart disease are discussed.

[Changes in the content of fibrinogen and its high-molecular derivatives as affected by the physical training of ischemic heart disease patients]. / Izmenenie soderzhaniia fibrinogena i ego vysokomolekuliarnykh derivatov pod vliianiem fizicheskikh trenirovok u bol'nykh ishemicheskoi bolezn'iu serdtsa.

Two groups of male patients with CHD were examined. The first group (30 persons) was treated with a 30-day therapeutic course of physical training on a bicycle ergometer, the second group received nitrates of prolonged action and beta-blocking agents. Eleven healthy men receiving a course of physical training were entered into the control group. The content of fibrinogen, soluble fibrin and fibrinogen degradation products in the blood plasma was investigated prior to and after a therapeutic course. An analysis of the blood plasma protein spectrum was performed using gel-filtration on a chromatographic column as well as separate disk-electrophoresis of the blood plasma proteins and isolated fractions in polyacrylamide gel. Regular physical training of the CHD patients resulted in a significant decrease in the content of fibrinogen, soluble fibrin and fibrin degradation products in the blood that might be conducive to the improvement of microcirculation and hence to lessening the number of angina attacks in these patients.