[Factors affecting efficacy of proton pump inhibitors in NAID-induced gastric ulcers].

AIM: To determine factors which may influence efficacy of therapy with proton pump inhibitors (PPI) in gastric ulcer (GU) induced by nonsteroid anti-inflammatory drugs (NAID). MATERIAL AND METHODS: Two groups of GU patients treated with PPI in 2001-2005 were identified: 41 cases when ulcer healing was not achieved for 3 weeks and more (study group) and 218 cases treated for this time successfully (controls). The groups did not differ significantly by gender (females 84.6 and 78.6%) and age (59.2 +/- 16.8 and 58.7 +/- 12.4 years). RESULTS: The patients of the study group had ulcers of 10 mm and more in size much more frequently than the controls (OR 12.5, CI 5.8-26). Also, rheumatoid arthritis (RA), ulcer history, intake of glucocorticosteroids, cytotoxic drugs, ineffective preventive treatment with PPI (OR 5.3, CI 3.4-8.4; OR 3.1, CI 1.5-6.0; OR 3.1, CI 1.6-6.0; OR 3.4, CI 1.7-6.7; OR 2.7, CI 1.3-5.6, respectively) were recorded in the study group more often. Helicobacter pylori was absent in 75.6% patients of the study group but these findings can not be compared with those in the controls as the majority of them had not been examined for gastric H. pylori. CONCLUSION: Large ulcer, RA, ulcer history, treatment with GCS, cytotoxic drugs, PPI and, probably, the absence of H. pylori decrease efficacy of PPI in gastric ulcer induced by NAID.

[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.

[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.

[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.

[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 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.

[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.

[Effect of probucol on lipid metabolism and the clinical course of ischemic heart disease and arteriosclerosis obliterans of the vessels of the lower extremities]. / Vliianie probukola na lipidnyi obmen i klinicheskoe techenie ishemicheskoi bolezni serdtsa i obliteriruiushchego ateroskleroza sosudov nizhnikh konechnostei.

Thirty-eight men with chronic coronary heart disease (CHD) aged 38 to 65 years (ten patients with attendant obliterating atherosclerosis of lower extremity vessels) were treated with the hypolipidemic drug probucol in a dose of 1000 mg/day for three months. Probucol exerted a beneficial effect on the clinical course of CHD and obliterating atherosclerosis of the lower limb vessels. The drug has a marked hypocholesterolemic effect in CHD patients with high cholesterol levels in the blood serum which warrants the advisability of its use in type IIa and IIb hyperlipoproteinemia. The probucol therapy is associated with a decrease in the cholesterol/erythrocyte membrane phospholipids molar ratio which improves the rheological properties of the blood in CHD patients. The drug produces no side effects.