[Parameters of clobal longitudinal myocardial deformation and coronary bloodflow in patients with primary hypothyroidism].

AIMS: Assessment of global longitudinal strain of left ventricle and coronary bloodflow in patients with primary subclinical hypothyroidism. MATERIALS AND METHODS: The study involved 23 women with primary subclinical hypothyroidism of age from 55 to 75 years. Physical examination, transthoracic EchoCG, coronary bloodflow assessment and global LV longitudinal strain by speckle tracking method were performed to all patients. The data obtained were compared to the results of 20 women without any thyroid diseases comparable to the main group by age and concomitant diseases. RESULTS: Patients with primary subclinical hypothyroidism have signs of diastolic dysfunction significantly more frequently than in control group, and increased values of posterior left ventricle wall and interventricular septum thickness. Global longitudinal strain of left ventricle in patients with hypothyroidism was lower than in control group and patients with hypothyroidism had higher FVI values in perforant coronary arteries. CONCLUSION: Patients with subclinical hypothyroidism demonstrated decrease of global longitudinal strain and increase of volume bloddflow rate in performant coronary arteries.

[Magnesium deficiency and anxiety-depressive syndrome in elderly patients with chronic heart failure].

The combination of a magnesium deficiency, heart failure and anxiety-depressive disorders are accompanied by the imposition of symptoms, differential diagnosis difficulties and requires special attention in treating elderly and senile patients. The study of 74 patients with chronic heart failure of 60 to 95 years in urban medical district revealed that the majority of people had depressive disorders, disturbances of electrical stability of the heart in the form of increasing the duration of the QT interval and magnesium deficiency. Frequency and severity of the latter increase with age, increase of a functional class of heart failure, worsening the severity of anxiety-depressive syndrome and prolongation QT.

[Chronic pancreatitis: quality of a life and possibilities of pharmacological correction by ethylmethylhydroxypyridine succinate].

A PURPOSE OF THE STUDY: Was to define a degree of quality of a life of patients with chronic pancreatitis by means of the scale SF-36 and also to analyse influence of medicine EMGPS on a quality of a life, level of anxiety and results of clinic-biochemical factors. THE MATERIALS AND METHODS: Biochemical investigations were done on automatic analyzer, alpha-amylase of blood and urine, lipase of blood were defined, ultrasonic research was done, an anxiety was determined on the scale of Spilberg-Khanin, a quality of a life was investigated by the questionnaire SF-36. THE RESULTS: The reliable decline of pain and index of intensity of pain was revealed in the group of the observation. The reliable decline of TC, LDL was marked in a group of the observation by the 12th week and of TG in the group accepting medicine EMGPS. Also in this group the indexes of quality of a life connected with physical and psychological components of questionnaire SF-36 became better and situational anxiety went down. THE CONCLUSION: An authentic improvement of indicators of a quality of a life and factors of lipidic spectrum was got in the group of the observation where preparation EMGPS was included in the standard treatment scheme of chronic pancreatitis.

[Iron metabolism in elderly patients with ulcer disease].

We examined 72 elderly patients with ulcer disease at the age from 55 till 79 years. We studied an iron metabolism (haemoglobin, serum iron, serum ferritin) and its correlation with a clinical current of ulcer disease. It is established that the anemic syndrome is the frequent companion of ulcer disease in elderly and old patients. Deficiency of iron negatively influences on dynamic abdominal painful and dyspepsia syndromes, considerably aggravates clinical display of a cardiovascular pathology.

[Cardiorenal interrelationships in elderly patients with arterial hypertension].

AIM: To study clinico functional characteristics of the kidney and cardiovascular system in elderly patients with arterial hypertension (AH) in comparison with corresponding data from young and middle age patients with AH. MATERIAL AND METHODS: We examined 142 patients with AH (110 patients aged 60 years and 32 patients aged 59 years). Examination included registration of parameters of echocardiography, 24 hour blood pressure monitoring, renal function testing. RESULTS: Compared with patients aged 59 years elderly patients had increased variability and augmented morning elevation of blood pressure. Diastolic dysfunction, endothelial dysfunction, microalbuminuria, and lowered glomerular filtration rate were more frequent among elderly patients.

[Long-term outcomes and formation of chronic disease of the kidneys in patients with a history of hemorrhagic fever with renal syndrome].

AIM: To evaluate renal function, persistence of renal dysfunction and probability of chronic renal pathology in convalescents of hemorrhagic fever with renal syndrome (HFRS). MATERIAL AND METHODS: A total of 370 HFRS convalescents were examined with estimation of renal functional reserve, albuminuria, uric acid clearance, activity of urine N-acetil-beta-D-hexosaminidase in the urine, 18-h deprevation test, duplex scanning of renal vessels. Correlation between prevalence of chronic renal failure in Udmurtia and HFRS incidence was analysed. RESULTS: Glomerular and tubular dysfunctions in HFRS convalescents (intraglomerular hypertension, albuminuria, regress of a concentration ability of the kidneys, impairment of tubular transport) are characterized by persistence in the presence of renal hypoperfusion and hypoexcretory hyperuricemia. 13% convalescents developed chronic disease of the kidneys (CDK) which clinically presented as chronic tubulointerstitial nephritis. HFRS may contribute to formation of population of patients with chronic renal failure in the territory of active natural foci. A significant positive correlation was registered between mean annual levels of HFRS morbidity and prevalence of chronic renal failure in different regions of Udmurtia. According to clinical data, chronic renal failure develops in patients who earlier have suffered from renal disease. CONCLUSION: Persistance of renal dysfunctions in HFRS convalescents and possible onset of chronic disease of the kidneys necessitate active follow-up of the disease convalescents.

[Rehabilitation therapy of convalescents after hemorrhagic fever with renal syndrome in outpatient clinic]. / Vosstanovitel'noe lechenie v usloviiakh polikliniki rekonvalestsentov, perenesshikh gemorragicheskuiu likhoradku s pochechnym simdromom.

AIM: To assess clinical efficacy of mineral water and perindopril in convalescents after hemorrhagic fever with renal syndrome (HFRS) in outpatient setting. MATERIAL AND METHODS: The study covered 113 HFRS convalescents. HFRS was confirmed serologically. The patients were divided into three groups: group 1 (n = 50) received no rehabilitation care; group 2 (n = 32) drank mineral water "varzi-yatchi"; group 3 (n = 31) drank mineral water and took perindopril (2 mg/day). After-treatment continued for 30-35 days. The effect was assessed by a complex of clinical-laboratory and functional tests for examination of renal functions (Reberg-Tareev, Zimnitsky tests, estimation of uric acid clearance and renal functional reserve, an 18-hour water deprivation test). RESULTS: Mineral water varzi-yatchi and perindopril had a favourable effect on clinical condition and renal functions of HFRS convalescents. Compared to the controls (p < 0.05), they had less severe weakness, lumbar pains, edema of the lower limbs; positive changes in intraglomerular hemodynamics, renal transport of beta 2-microglobulin (MG), uric acid transport. CONCLUSION: It is shown that HFRS convalescents have defective glomerular and tubulointerstitial systems of the kidneys. These disorders demand a differential therapeutic approach. Drinking mineral water improves some tubular functions. The addition of perindopril is necessary in detection of arterial hypertension, impairment of intraglomerular hemodynamics, hyperexcretion of beta 2-MG, osmoregulating renal dysfunction.

[Clinical efficacy of myocardial cytoprotector trimetazidine in peri- and postmenopausal women with ischemic heart disease]. / Klinicheskaia éffektivnost' miokardial'nogo tsitoprotektora trimetazidina gidrokhlorida v lechenii zhenshchin s ishemicheskoi bolezn'iu serdtsa v peri- i postmenopauze.

Efficacy of 3-12 month use of trimetazidine hydrochloride combined with verapamil was assessed in postmenopausal women with effort angina by repetitive exercise tests, ECG monitoring and echocardiography. The use of trimetazidine was associated with augmentation of antianginal and antiischemic action of verapamil, improvement of systolic and diastolic left ventricular function, decrease in frequency of hospitalizations because of exacerbation of ischemic heart disease. These effects were evident in all age groups throughout the period of observation and did not depend on the ischemic heart disease duration.

[Arterial hypertension, its metabolic aspects and kidney function in patients after hemorrhagic fever with renal syndrome]. / Arterial'naia gipertoniia, ee metabolicheskie aspekty i funktsiia pochek u perenesshikh gemorragicheskuiu likhoradku s pochechnym sindromom.

AIM: To characterize late convalescence after hemorrhagic fever with renal syndrome (HFRS), i.e. metabolic disorders and their relation with arterial pressure (AP) and renal function. MATERIAL AND METHODS: 202 HFRS convalescents were followed up with measurements of AP, purin, carbohydrate and lipid metabolisms, study of glomerular and tubular dysfunctions. RESULTS: A stable rise of arterial pressure registered in 24% HFRS convalescents was associated with intraglomerular hypertension, affected concentration ability of the kidneys and tubular transport of beta 2-microglobulin in the presence of metabolic disorders: hyperuricemia, hyperinsulinemia and hyperlipidemia of type IIa. A significant correlation was found between arterial hypertension and renal dysfunction and metabolic disorders. CONCLUSION: Late convalescence after HFRS is characterized by glomerular and tubular dysfunctions, persistent elevation of AP and hormonal-metabolic atherogenic and diabetogenic disturbances.

[Clinicophysiological assessment of physical performance in patients recovering from hemorrhagic fever with renal syndrome]. / Kliniko-fiziologicheskaia otsenka fizicheskoi trudosposobnosti u perenesshikh gemorragicheskuiu likhoradku s pochechnym sindromom.

Tolerance of physical load was investigated in 50 convalescents of hemorrhagic fever with renal syndrome (HFRS) at bicycle exercise test (BET). Calculations were made of maximal oxygen consumption and energy consumption at the threshold load. It is shown that for three months after HFRS physical performance of the convalescents remained low. By the end of the expected disability objective recovery of physical performance was registered only in 33-37% convalescents. More than for 3 months disability persisted in reconvalescents engaged in professions with energy consumption above 4.1 kkal/min throughout the working day. Use of BET in the practice of medical labour expertise of HFRS convalescents provides an objective assessment of their working ability and feasible job.

[Clinicofunctional characteristics of the heart in hemorrhagic fever with renal syndrome]. / Kliniko-funktsional'naia kharakteristika sostoianiia serdtsa pri gemorragicheskoi likhoradke s pochechnym sindromom.

A clinicofunctional analysis of the heart was made in 50 patients suffering from hemorrhagic fever with renal syndrome (HFRS) in the acute period and at the stage of outpatient rehabilitation. Comparison with healthy subjects was made by physical, ECG, echo-CG data, changes in the levels of creatinphosphokinase (MB-fraction) (CPK-MB), asparagine and alanine aminotransferase in the serum. Clinical symptoms of heart pathology, their incidence rate in different periods of the disease, dynamics of ECG deviations, state of heart chambers and left ventricular systolic function are described. The most manifest changes of the studied parameters were observed in acute disease and depended on the disease severity. The detected changes in the end part of the ventricular complex on ECG associated with a relative depression of left ventricular systolic function as well as a rise in the level of CPK-MB indicate affection of the myocardium. Variants of combination and dynamics of the above disorders allowed to single out the most probable syndromes of heart affection in HFRS.

[Lipid metabolism and functional status of the kidney in hypothyroid patients depending on the phase of disease]. / Lipidnyi obmen i funktsional'noe sostoianie pochek u bol'nykh gipotirozom v zavisimosti ot fazy zabolevaniia.

AIM: To evaluate renal function in correlation with lipid metabolism parameters in patients with primary hypothyroidism (HT) in compensation and decompensation. MATERIAL AND METHODS: 45 HT patients' examination included study of blood creatinine, urea, cholesterol, triglycerides, high and low density lipoproteins, urinary microalbumin, thyroid hormones and thyrotropin, beta 2-microglobulin levels, glomerular filtration rate (GFR), renal functional reserve (RFR). Also, Zimnitsky test and ultrasound investigation of the kidneys were made. RESULTS: It was found that renal dysfunction in decompensated HT is characterized by normal renal concentration function, high intraglomerular pressure (low GFR and RFR), high concentration of beta 2-microglobulin in blood. Severe HT runs with negative correlation between GFR and total blood cholesterol, LDL. Albuminuria and low RFR in decompensated HT and marked hyperlipidemia suggest development of glomerulopathy related to abnormal physicochemical processes in glomerular endothelium. CONCLUSION: Patients with decompensated HT have apparant glomerular dysfunction and disturbances in lipid metabolism. Hyperlipidemia in HT is a factor of renal damage.

[Effect of adjuvant magnesium therapy on the quality of life and emotional status of elderly patients with stable angina]. / Vliianie soprovoditel'noi magnieterapii na kachestvo zhizni i émotsional'nyi status pozhilykh bol'nykh so stabil'noi stenokardiei.

The difficulties of treatment of the chronic coronar syndrome in the elderly patients depends on the severity of the disease and multimorbidity. Administration of magnesium preparations in these patients compensates the sytemic magnesium deficit. A number of physiological effects of magnesium allows to potentiate the antianginal effect of background drugs. The study of quality of life and of psychoemotional status in elderly patients with stable angina during the treatment with magnesium has been performed. It was observed an initial decrease of quality of life accompanied by anxiety and subdepressive emotional features. Adjuvant therapy with Magnerot and magnesium sulphate was followed by significant improvement in parameters of quality of life and by positive changes in psychoemotional status of patients.

[Hepatic status in convalescent patients after hemorrhagic fever with the kidney syndrome]. / Sostoianie pecheni u rekonvalestsentov gemorragicheskoi likhoradki s pochechnym sindromom.

The assessment of hepatic function by some clinicobiochemical parameters and kinetics of rose-bengal-I-131 in 70 reconvalescents after hemorrhagic fever with renal syndrome indicated impairment of hepatic function, especially in those who had preexisting hepatobiliary disease.

[Functional renal status in patients with hypothyroidism]. / Funktsional'noe sostoianie pochek u bol'nykh s gipotireozom.

Examination of 29 patients with decompensated hypothyroidism has detected in them abnormal renal concentration, reduction of the glomerular filtration rate, elevation of the intraglomerular pressure. The detected albuminuria, decreased renal functional reserve and hyperlipidemia suggest initiation of hypothyroidism-related glomerulopathy resultant from physicochemical processes in glomerular endothelium.

[Functional loading tests in nephropathy examination in patients recovering from hemorrhagic fever with renal syndrome]. / Funktsional'nye nagruzochnye proby v kharakteristike nefropatii u perenesshikh gemorragicheskuiu likhoradku s pochechnym sindromom.

AIM: To characterize nephropathy in patients recovering after hemorrhagic fever with renal syndrome (HFRS) using functional loading tests. MATERIALS AND METHODS: In 65 HFRS convalescents we examined renal function under water deprivation, exercises and studied intraglomerular hemodynamics. RESULTS: After 2-month follow-up renal functional reserve was absent in 34% of the convalescents indicating intraglomerular hypertension. Under water deprivation most of the patients showed persistent tubulointerstitial disorders. Submaximal muscular exercises aggravated glomerular and tubular dysfunction manifesting with microalbuminuria, increased excretory beta 2-microglobulin fraction, low concentration reserve. CONCLUSION: Functional loading tests provide more detailed characterization of renal function in HFRS convalescents.

[Piracetam and tocopherol acetate ability to potentiate clinical effect of antianginal drugs in presenile and senile patients with ischemic heart disease (unstable angina)]. / Sposobnost' piratsetama i tokoferola atsetata potentsirovat' klinicheskii effekt antianginal'nykh preparatov u bol'nykh ishemicheskoi bolezn'iu serdtsa (stabil'noi stenokardiei napriazheniia) v pozhilom i starcheskom vozraste.

Potentiating ability of piracetam and tocopherol acetate was studied outpatiently in aged patients with ischemic heart disease. It was found that the addition of piracetam and tocopherol acetate to conventional antianginal drug therapy brings higher response and exercise tolerance, contributes to more effective hemodynamic and energetic support of the exercise, to positive changes in the central and peripheral hemodynamics.

[The clinico-endoscopic, psychological and physical characteristics of duodenal peptic ulcer patients using piracetam and aevit]. / Kliniko-éndoskopicheskie, psikhologicheskie i fizicheskie kharakteristiki bol'nykh iazvennoi bolezn'iu dvenadtsatiperstnoi kishki pri primenenii piratsetama i aevita.

Clinical efficacy of piracetam and polyvitamin agent aevit was studied in recurrence of duodenal ulcer. When added to standard antiulcer therapy, piracetam and aevit result in early regression of duodenal ulcer clinical and endoscopic manifestations, correction of psychopathic reactions and increased exercise tolerance.