[Microcirculation impairment in periodontal tissues in patients with chronic generalized periodontitis combined with metabolic syndrome].

Using the method of laser Doppler flowmetry the study of microcirculation in periodontal tissues in patients with moderate chronic generalized periodontitis and metabolic syndrome was carried out. The analysis of microcirculation values proved not only the reduction of blood flow intensity but also the decreased vasoactivity of microvessels essential to maintain normal microcirculation in periodontal tissues, as it provides active modulation of tissue blood flow and its adaptation to local metabolic needs.

[The epidemiological relationship of periodontitis, intestinal dysbiosis, atherogenic dyslipidemia and metabolic syndrome].

The study of risk factors for cardio-vascular continuum (CVC), the influence of the digestive tract endobiosis on lipid-carbohydrate metabolism and clinical status, a retrospective analysis of 1000 medical records of patients, suffering from various diseases of internal organs (Gastrointestinal tract, coronary heart disease, type 2 diabetes, obesity) in combination with periodontitis of varying severity, aged 20 to 55 years. A statistically significant relationship is directly proportional to the severity of inflammation of periodontal tissues with body mass index (BMI), especially pronounced in patients with a BMI ≥225 kg/m2 which is the "calling card" of the metabolic syndrome - clinical model polymorbidity.

[Preventive cytoprotection in social diseases]. / Preventivnaya tsitoprotektsiya pri sotsial'no znachimykh zabolevaniyakh.

UNLABELLED: Among many cytoprotective drugs, only a few of them that have a targeted metabolic effect include agents that partially inhibit oxidation of free fatty acids, the so-called p-FOX inhibitors (partial fatty acid oxidation inhibitors). AIM: To develop a procedure for the preventive use of meldonium dihydrate in day-hospital patients with comorbidity. SUBJECTS AND METHODS: The investigation enrolled 189 patients (116 men and 73 women; mean age, 55.9±4.4 years) who were followed up for initial manifestations of cardiovascular and/or another somatic disease and were at high risk for unfavorable cardio- and cerebrovascular events, as well as complications of emergency alcohol-related conditions. The investigation of the efficacy and safety of meldonium dihydrate was planned as an open-label clinical trial in three parallel groups different in the directivity patterns of potential complications («Cardio¼, «Cerebro¼, «Alco¼). The drug's dosage averaged 500 to 1000 mg/day. RESULTS: The day-hospital use of meldonium dihydrate demonstrated high safety profile and a positive role in the prevention of cardio- and cerebrovascular catastrophes and complications of emergency alcohol-related conditions and chronic alcoholic visceropathy, leading to delayed dyslipidemia progression, diminished insulin resistance, improved blood rheological properties, and suppressed chronic systemic inflammation and also proving its role in the prevention of renal vascular injury and toxic (ethanol) encephalopathy. Meldonium therapy showed positive effects in delaying the progression of dyslipidemia, diminishing insulin resistance, improving blood rheological properties, and suppressing chronic systemic inflammation and also proved its role in preventing renal vascular injury and toxic (ethanol) encephalopathy, which confirmed the versatility of the cytoprotective effect of meldonium. CONCLUSION: The drug has proved to be effective and safe in hemodynamic, electrolytic, hepatic, and other parameters, which makes it expedient to include meldonium in the day-hospital formulary of drugs for a preventive parenteral cycle according to the developed regimen (a 10-day cycle at least 1-2 times a year) for patients at high risk for social diseases and their complications.

[Early diagnosis of Takayasu's disease (clinical case report)].

Nonspecific aortoarteritis (Takayasu s disease, obliterating aortoarteritis, disease of the missing pulse) is a systemic inflammatory disease of aorta and its branches, which leads to stenosis and ischemia of surrounding tissues. This disease is more common in young women and characterized by slowly progressive course with significant impairing quality of life. Etiology of the Takayasu's disease is unknown. Syndrome of the systemic inflammatory reaction with the clinical manifestations of the effects of lesions of the aorta and its branches at different anatomical levels (symptom: coarctation, abdominal ischemia, coronary, renovascular hypertension, lesions of the pulmonary artery) are criteria of this systematic process. Angiography can detect typical vascular changes due to a nonspecific aortoarteritis and remains the gold standard for its verification. The effectiveness of conservative therapy, surgical treatment, the prognosis for life is entirely determined by the detection of this insidious disease in the initial stages of its development. Until today, the early detection of non-specific aortoarteriite is not generally accepted and widely used, and therefore remain relevant.

[Prophylaxis of ischemic heart lesions during chronic heart failure with complex therapy using Q10 coenzyme].

Dysfunction of energy processes in the myocardium, resulting the background of ischemic syndrome, and inadequate intake of energy substrates process and/or breach of energetic cofactors of oxidation are an important pathogenetic aspects of the progression of myocardial dysfunction and congestive heart failure. Level of Q10 Coenzyme plays a key role in the functioning of the respiratory mitochondrial chains, exerting a significant influence on the synthesis of ATP. The article provides data on the use of Q10 coenzyme in the treatment of 76 patients with circulatory failure. The data obtained points on the improvement of myocardial contractility, increased exercise tolerance, reduced content of the final products of lipid peroxidation in plasma, a positive effect on blood lipid profile with the addition of Qudesan to standard therapy of heart failure.

[Using noninvasive positive pressure (mask) pulmonary ventilation in patients with acute myocardial infarction].

As of now, medical therapy for acute heart failure has achieved considerable clinical results. Nevertheless, the treatment of cardiogenic pulmonary edema (CPE) and respiratory failure remain unsolved problems, complicate the course of disease, and increase mortality among patients with acute myocardial infarction (AMI). Hospital mortality due to acute heart failure ranges from 4% and runs up to 36% in artificial ventilation-requiring situations. Noninvasive respiratory support in various modes, such as continuous positive airway pressure, pressure support ventilation (PSV), and PSV + positive end-expiratory pressure (PEEP), is an effective method for the treatment of standard medical therapy-refractory CPE in patients with AMI. Noninvasive ventilation (NV) shows clinical improvement and positive changes in the parameters of not only hemodynamics, but also gas exchange. The efficiency of various NV modes and the nature of their action on such indices, such as respiratory movement rate, heart rate, mean pulmonary artery pressure, pulmonary artery wedge pressure, peripheral tissue oxygen delivery index, pO2a, pulmonary artery pO2, and Qs/Qt, have proved similar. There is a difference in the impact of PSV and PSV+PEEP on the increase in the left ventricular stroke output index and on the reduction in arterial blood CO2 tension.

[Nitrates in the practice of treatment of cardiovascular diseases].

Mechanisms of emergence of endothelial dysfunction underlying development of ischemic heart disease with peculiarities of its 24-hour cycles are considered in detail. Data on metabolism of organic nitrates, determining basis of "replacement" therapy with nitrates in deficit of nitric oxide (endothelium dependent factor of relaxation) are summarized. Results of multicenter controlled studies on comparative assessment of therapeutic efficacy of tri-, di-, and mononitrates are discussed. High antianginal efficacy of once daily administration of a drug with original pharmacokinetics--isosorbide-5-mononitrate in good tolerability and minimal side effects is shown.

[Comparative evaluation of the cardiotropic effect of broncholytic agents]. / Sravnitel'naia otsenka kardiotropnogo éffekta bronkholiticheskikh sredstv.

The cardiotropic effect of broncholytic agents of different groups used for treatment of bronchial asthma was analyzed by using the method of determination of isoenzyme of MB creatine phosphokinase (CPK) and total CPK in the blood of the patients. A total of 125 biochemical assays on determination of CPK in the blood of the patients were made. The cardiotropic effects of three agents (adrenaline, novodrin, Berodual) were studied. Adrenomimetics adrenaline and isodrin (novodrin) were shown to increase significantly CPK activity. A combined agent Berodual insignificantly increased the activity of MB isoenzyme of CPK.

[Effect of ildamen on the heart conduction system in ischemic heart disease patients]. / Vliianie il'damena na provodiashchuiu sistemu serdtsa u bol'nykh ishemicheskoi bolezn'iu serdtsa.

Thirty-four patients with ischemic heart disease (IHD) were studied: 18 IHD patients with latent forms of disturbances of conductivity in the atrioventricular junction and sinus node sickness syndrome revealed at frequency stimulation of the heart; 16 patients with acute myocardial infarction complicated with the atrioventricular junction blockade of II and III degrees. Ildamen solution (4 mg) was slowly intravenously infused to all patients under study. Exerting the beta-stimulating effect, ildamen positively influences restoration of the disordered function of the pacemaker and conduction system of the heart: through immediate action on these systems and an increase of the coronary blood flow contributing to improvement of nutrition of the condition system of the heart.

[Nitroglycerin pharmacodynamics in myocardial infarct]. / Farmakodinamika nitroglitserina pri infarkte miokarda.

The experience of treating 2,500 patients with acute myocardial infarction enabled the authors to prove a diverse character of nitroglycerin effect: it exerts a positive inotropic action on the myocardium, improves elastic properties of the myocardium, normalizes energy balance of the myocardium, influences the system of the blood aggregate state through contractile elements of platelets producing a hypocoagulatory effect.

[Central hemodynamic characteristics of patients with acute myocardial infarct of the right ventricle]. / Osobennosti tsentral'noi gemodinamiki u bol'nykh ostrym infarktom miokarda pravogo zheludochka.

A study of central hemodynamic parameters and clinical patterns of acute right-ventricular myocardial infarction (ARVMI) is reported. Thirty-nine patients with acute inferior left-ventricular myocardial infarction were divided into 2 groups: 28 patients with electrocardiographic signs of ARVMI (group 1) and 11 patients showing no such signs (group 2). All patients were subjected to catheterization of the heart's right compartments, and their minute blood volumes were measured by thermodilution. Three patterns of ARVMI were identified on the basis of the mean pulmonary arterial blood pressure: hypo-normo- and hypertensive ones. All the three were associated with the development of prevailing right-ventricular insufficiency in group 1.

[Relation between the extent of the myocardial lesion and the state of the coronary bed in acute myocardial infarction]. / Zavisimost' mezhdu ob'emom porazheniia serdechnoi myshtsy i sostoianiem koronarnogo rusla pri ostrom infarkte miokarda.

The probability of combined lesion of both ventricles in acute myocardial infarction (AMI) is discussed. In cases of proximal stenosis or occlusion of the right coronary artery, both inferior and right-ventricular (RV) AMI may develop. ECG recordings from the V3R-V6R, V3RIII, V4RIII leads were used for the diagnosis of RV AMI. Elevated ST segment plus the formation of Q waves and a negative T wave in the recordings from these leads indicate RV AMI in the presence of inferior AMI. The extent of myocardial lesion, estimated on the basis of maximum plasma MB CPK activity, is greater in cases of inferior AMI with electrocardiographic signs of RV AMI, as compared to inferior AMI free of such signs.