Vol 78, No 1 (2003)

Editorial
Editorial Column
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Abstract
Terapevticheskii arkhiv. 2003;78(1):5-5
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Current conception of cholelithiasis pathogenesis as a basis of biliary pathology prophylaxis
Galkin V.A.
Abstract
Terapevticheskii arkhiv. 2003;78(1):6-9
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Mitral prolapse in practice of therapist and cardiologist (lecture)
Bart B.Y., Benevskaya V.F.
Abstract
Terapevticheskii arkhiv. 2003;78(1):10-15
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Constipation and principles of their treatment (lecture)
Minushkin О.N.
Abstract
Terapevticheskii arkhiv. 2003;78(1):15-19
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Management of a hematological day hospital
Tsyba N.N.
Abstract
Terapevticheskii arkhiv. 2003;78(1):19-23
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Prevalence of bronchial asthma and allergic rhinitis among adult population of St-Petersburg
Fedoseev G.В., Emelyanov A.V., Sergeeva G.R., Ivanova N.I., Zibrina T.M., Maximenko I.N., Tsukanova I.V.
Abstract
Aim. To evaluate prevalence of bronchial asthma (BA) and allergic rhinitis (AR) among adult population of St-Petersburg. Material and methods. Responders to ECRHS and B. Sibbald & E. Rink questionnaires who gave at least one positive answer were examined clinically, functionally and allergologically. A total of 3634 responders aged 16 to 98 years participated in the study. Results. By the answers of the responders prevalence of BA was 7.2%, ofAR- 9.9%. Such figures were much higher than official statistics. Atopic BA was most frequent among other types - 64%. Conclusion. It became evident that BA and AR in many cases are diagnosed late or are not recognized at all. This leads to growing number of patients with moderate and severe course of these diseases and deteriorates effectiveness of BA and AR treatment.
Terapevticheskii arkhiv. 2003;78(1):23-26
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Ten year dynamics of attitude to health problems in male population of Novosibirsk
Gafarov V.V., Pak V.A., Gagulin I.V., Babina T.D.
Abstract
Aim. To evaluate changes for a decade in the attitude of men in Novosibirsk to health problems. Material and methods. WHO program MONICA has covered males aged 25-64 years (a representative sample from the population in one of the districts of Novosibirsk city). A total of 3 trials were made (in 1984, 1988 and 1994) which included questioning, registration of ECG, arterial pressure, height, body mass, biochemical tests of the blood. Results. Attitude of men to their health depended on their age. There was a trend to evaluate their health as more and more poor in men at the age of 25-43 and 35-44 years. In the group of 45-54-year-olds positive assessment of health was encountered 1.9 times more frequently, but the difference was not significant. At the age 55-64 years a growing number of men tend to assess their health as good. Since 1994 alcoholics among the elderly men grew in number as a response to the social and economic crisis. Conclusion. The change in health evaluation from negative to positive in older men may relate to less intensive work.
Terapevticheskii arkhiv. 2003;78(1):27-30
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Current medico-ecological aspects of internal medicines in urbanic North
Karpin V.A.
Abstract
Aim. To define a complex action of extreme climatic and harmful environmental factors of present-day northern industrial city on the course of chronic visceral diseases. Material and methods. Dynamics of exacerbations of basic therapeutic nosologies was studied basing on the data on 10169 inpatients treated in therapeutic departments of Surgut hospitals (Khanty-Mansi District) in 1994-1998. In parallel, ambient air of the city was controlled for 3 main climatic and 6 technogenic hazards. The analysis was made by means of medicoecological mapping of residential zones. Results. A common feature of chronic visceral diseases course was determined: maximum number of recurrences in February-March and October-November, minimum number - in July-August. There is a relationship between the recurrences and extreme climatic factors. An increase in the number of exacerbations may be related with suppression of nonspecific resistance of the northerners' organism in these seasons. Differential study of the decompensation rate of chronic noninfectious diseases in residential zones in dependence with the degree of technogenic pollution has shown that areas of the town with high hospitalization rates are exposed to high mean annual pollution with sulfur dioxide, vanadium pentoxide and carbon oxide. Areas with low morbidity had the best environment. Conclusion. A combined action of extreme climatic and environment factors of the North plays an essential role in decompensation of chronic diseases in the northerners. Dynamics of recurrent chronic noninfectious diseases may seme a sensitive marker of ecological safety of the region. Design and realization of recreation and rehabilitation measures in ecologically polluted areas of the town are effective for prevention of aggravated chronic visceral diseases.
Terapevticheskii arkhiv. 2003;78(1):30-34
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Nutrition of native rural population of the Russian North
Khamnagadaev I.I., Polikarpov L.S., Gankin M.I., Karpov R.S.
Abstract
Aim. To study actual nutrition of adult native population of the Russian North. Material and methods. We have questioned 542 men and women living in Yakutia and Evenkia by 24-hour recall method (intake of the main food products). Results. It was found that Yakutia and Evenkia population consume more proteins and fats than population of the European part of the RF and Central Siberia. 24-h energy requirements are provided with fats and carbohydrates. All the fats were animal. Simple sugars and cholesterol exceed recommended value. The quantity of the consumed fat and total cholesterol levels in blood serum correlated. Caloric value of the daily diet of Yakutia population is higher than that of Evenkia population.
Terapevticheskii arkhiv. 2003;78(1):34-37
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A 24-h arterial pressure profile in patients with arterial hypertension living in Tyumen North
Gapon L.I., Sereda T.V., Shurkevich N.P., Shanaurina N.V.
Abstract
Aim. To study a 24-h profile of arterial hypertension and affection of target organs in hypertensive population of the Tyumen North. Material and methods. 62 patients (43 men and 19 women, age 18-50 years) with arterial hypertension (AH) living in the North of the Tyumen region entered the test group. The control group consisted of 56 AH patients (36 men and 20 women) matched by age. They lived in the zone of moderate climate (in Tyumen). 24-h arterial pressure (AP) monitoring was made starting on day 2 of the patients' arrival in Tyumen. Echocardiography was made on the arrival day. The examination of the groups was conducted against "clean" background. Results. The groups did not differ significantly by age, sex, AH duration, office systolic and diastolic pressure (SP, DP). However, 37patients from the test group on arrival in Tyumen showed normalization of both office AP and mean 24-h AP. 25 patients from this group sustained high office and mean 24-h AP. An abnormal 24-h AP profile with nocturnal hypertension was recorded in 76.6% of the test group and 28.31% patients of the control group. Left ventricular hypertrophy was significantly more pronounced in the test group than in the control one. Conclusion. In 2/3 patients from the North with AH stage I and 2 office AP and mean 24-h AP normalized upon their arrival to the zone of moderate climate but their left ventricular hypertrophy was more severe and changes in a 24-h AP profile with nocturnal hypertension persisted.
Terapevticheskii arkhiv. 2003;78(1):37-40
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Various mononitrate forms in the treatment of patients with effort angina
Lupanov V.P., Kazachkina S.S., Naumov V.G.
Abstract
Aim. Clinical and device evaluation of efficacy of new dosage forms of isosorbide-5-mononitrate (ISMN) in patients with angina of effort of functional class (FC) II-III in 1-3 month treatment. Material and methods. 54 patients with ischemic heart disease (IHD) and stable angina pectoris (42 males, 12 females aged 48-70, mean age 59.4 ± 3.6 years) were examined. 16 of them had angina of effort FC II, 35 - of FC III and 3 - of FC IV. IHD was verified at stress tests and 24-h Holier ECG monitoring. In 85.2% of IHD patients the diagnosis of stenotic coronary atherosclerosis of 1-3 great arteries was confirmed by coronarography findings. The treatment effect was assessed by bicycle exercise tests, Hotter ECG monitoring, patients' records of anginal attacks before and after treatment. Results. Long-term forms of ISMN - Mono Mac Depo (100 mg) and Mono Mac 50D (50 mg) - and non-retard form Mono Mac (40 mg) produced a stable antianginal effect in 85, 80 and 75% patients, respectively. ISMN preparations given for 1 and 3 months reduced frequency of anginal attacks, improved functional condition of the patients, exercise tolerance, variability of heart rhythm. Mono Mac Depo and Mono Mac 50 D were well tolerated, induced no serious side effects. Conclusion. ISMN preparations can be recommended as monotherapy in patients of FC II-III angina or in combination with beta adrenoblockers for treatment of patients with angina FC III-IV.
Terapevticheskii arkhiv. 2003;78(1):40-45
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Effects of combined treatment ' with enalapril maleate and hypothiazide on structural-functional state of red cell membranes in hypertensive patients
Kuryata A.V., Geichenko V.P.
Abstract
Aim. To characterize changes in erythrocytic membranes (ErM) structure and function in patients with essential hypertension (EH) due to combined therapy with enalapril maleate (EM) and hypothiazide. Material and methods. Polypeptide and lipid spectra of ErM were studied by electrophoresis in polyacrylamide gel and thin-layer chromatography, respectively, the activity of transport ATP, lipid peroxidation (LPO) and antioxidant defense were studied with standard techniques in 32 EH patients before and 4 weeks after combined therapy with EM and hypothiazide. Results, rf previous EM therapy failed, combined treatment's effect was 62.5%. Molecular effects of the treatment consisted of decreased concentrations of actin and blend 5 protein, increased levels of spectrin in EM polypeptide composition, correction of phopholipid fractions imbalance, gluthationperoxidase. Transport ATP activity and chholesterin level remained unchanged. Conclusion. EH treatment with EM + hypothiazide is both clinically effective and beneficial for physico-chemical properties of the cell membranes.
Terapevticheskii arkhiv. 2003;78(1):45-48
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Prognostic significance of nocturnal fall of systolic arterial pressure in patients with mild and moderate essential hypertension (7-9-year prospective trial)
Zelveian P.A., Oschepkova E.V., Buniatian M.S., Rogoza A.N., Sergakova L.M., Varakin Y.Y., Gornostaeva G.V.
Abstract
Aim. To study a relationship between a carcadian blood pressure (BP) rhythm and cardiovascular events (CE) during 7-9 year follow-up in males with mild to moderate essential hypertension (EH). Material and methods. 50 males (mean age 48.6 + 0.7 years) with mild to moderate EH were prospectively followed up for 7-9 years (8.4 ±0.1 years). We analysed 24-h BP recordings and protocol of echocardiography performed during the first hospitalization. The patients were divided into three groups: group 1 (n = 18) with normal (10-20%) nocturnal fall of systolic BP (NF SBP) and normal left ventricular mass index (LVMI < 125 g/m2); group 2 (n = 16) with insufficient (< 10%) NF SBP and normal L УМ I; group 3 (п = 16) with L УМ/ > 125 g/m2. In these groups we assessed the prevalence ofCE: myocardial infarction (MI), stroke (S), sudden death (SD), new cases of angina pectoris (AP), transient cerebral ischemic attack (T1A). Results. No significant differences were found between the groups by mean age, body mass index, duration of arterial hypertension, mean 24-h and awake systolic and diastolic BP while significant differences were by nighttime BP profile parameters. During the follow-up 16 CE in 12 patients were documented (3 fatal and 13 nonfatal). In group 1 CE were observed in 1 patient (twice MI), in group 2-7 cases of CE (1 S, 1 TCIA, 2 Ml, 2 AP) in 6 patients, in group 3-7 cases (2 MI, 3 TIA, 2 AP) in 5 patients, 3 of them were fatal. Conclusion. Insufficient nocturnal fall ofSBP (< 10%) is an adverse prognostic factor for cardiovascular morbidity in mild to moderate essential male hypertensives.
Terapevticheskii arkhiv. 2003;78(1):48-51
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ACE inhibitor quinapril in the treatment of chronic cardiac failure
Gadzhiev A.N.
Abstract
Aim. To assess effectiveness of A CE inhibitor quinapril in patients with moderate cardiac failure of ischemic etiology. Material and methods. 20 patients received quinapril in a daily dose 20 mgfor 6 months. Clinical condition, exercise tolerance, functional and geometric parameters of the left ventricle, Hotter monitoring, heart rhythm variability, late potentials were studied before and after the treatment. Results. The treatment relieved symptoms significantly, exercise tolerance increased, positive changes occurred in systotic, diastolic functions and left ventricular geometry. Ischemic episodes, supraventricular extrasystoles reduced in number and duration. Conclusion. Quinapril is an effective drug for treatment of moderate ischemic heart failure.
Terapevticheskii arkhiv. 2003;78(1):51-55
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Efficacy of anti-inflammatory treatment with benacort of patients with chronic obstructive pulmonary disease in exacerbation
Kolesnikov V.V., Korolchuk I.S.
Abstract
Aim. To determine a course and prognostic effectiveness of corticosteroid therapy of chronic obstructive pulmonary disease (COPD). Material and methods. Long-term therapy with broncholytics (berodual) and benacort was given to 25 patients in non-infectious exacerbation, 20 patients received broncholitics of 45 COPD patients with mild and moderate ventilation disorders. Follow-up lasted for 2.5 years. Treatment effectiveness was judged by clinical indices, external respiration function, parameters of systemic immunity, cyto- gram of induced sputum and concentration of inflammatory markers in the sputum. Results. An immediate effect of two-month therapy with benacort of COPD exacerbations manifested with positive clinical dynamics and relief of endobronchial inflammation. Prognostic efficacy - with a significant reduction of the frequency of COPD exacerbations and of their mean duration more than 3-fold. Conclusion. The results of long-term follow-up support validity of inhalation corticosteroids use for eradication and prevention of noninfectious exacerbations of COPD.
Terapevticheskii arkhiv. 2003;78(1):55-58
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Significance of damage index in prediction of systemic lupus erythematosus outcome
Tarasova I.A., Ivanova M.M., Zhornyak A.P., Nasonova V.A.
Abstract
Aim. To determine the significance of the damage index (SLICC/ACR DI) in the prognosis of the outcome of systemic lupus erythematosus (SLE). Materials and methods. Correlations between the disease activity, cumulative damage and outcome were studied in 103 patients with SLE divided into two groups by the disease duration (21 to 60 months - group 1, 62 to 488 months - group 2). SLE activity was determined by Nasonova's classification, SLEDAI-1 and ECLAM. Cumulative damage was assessed by the damage index (systemic lupus international collaborating clinics/'ACR damage index). Results. We found the direct correlation between the age of the disease onset, SLE duration, degree of SLE activity and the damage index and between the maximal dose of glucocorticosteroids and the damage index. Conclusion. The results indicate that SLICC/ACR DI may be useful for outcome prediction in SLE.
Terapevticheskii arkhiv. 2003;78(1):59-62
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Correction of respiration organ impairment with Ural licorice preparations in chronic skin diseases
Palagina M.V., Dubnyak N.S., Dubnyak I.N., Zorikov P.S.
Abstract
Aim. To study alterations in lipid peroxidation, antioxidant status of the lungs and immune state of the organism in some chronic diseases of the skin and potentialities of their correction with preparation produced of Ural licorice root. Material and methods. Lipid peroxidation, antioxidant system parameters were examined in condensates of the expired air of 54 healthy subjects and 60 patients with chronic skin diseases. Immune status was studied in blood samples. The patients were given the drug made of Ural licorice root. Results. The licorice-based drug normalized antioxidant defense and immune status. Conclusion. It was found possible to correct pulmonary and immune statuses of patients with some chronic skin diseases in polluted environment with a licorice drug.
Terapevticheskii arkhiv. 2003;78(1):63-65
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Mabtera (rituximab) treatment of patients with refractory' course of B-cell lymphoma on high-dose chemotherapy with autologous transplantation of hemopoiesis precursor cells
Ptushkin V.V., Chimishkyan K.L., Zhukov N.V., Osmanov D.S., Andreeva L.Y., Tupitsyn N.N., Larionova V.В., Mkheidze D.M., Poddubnaya I.V.
Abstract
Aim. To study efficacy of htuximab in patients with resistant B-cell lymphoma on high-dose chemotherapy. Material and methods. From September 2000 to April 2002 we studied efficacy and tolerance of rituximab at different stages of high-dose chemotherapy. The treatment was given to 10 patients with histologically verified CD20+ non-Hodgkln's lymphoma: diffuse large-cell (n = 4), Berkitfs (n = 2), follicular (n - 3), mantle-cell (n = 1). Five patients with diffuse large-cell lymphoma and Berkitt's lymphoma had a primary resistant course of the disease, one patient with diffuse large-cell lymphoma had a refractory recurrence. Follicular and mantle-cell lymphomas were characterized by a resistant course and large tumar masses. The patients received 1-2 courses of induction chemotherapy with dexa-BEAM with collection of peripheral stem cells followed by high-dose chemotherapy (BEAM-9, CBV+mitoxantron-1) with transplantation of autologous stem blood cells. Rituximab infusion (375 mg/m2) was conducted before the collection of the stem cells, prior to high-dose chemotherapy and in posttransplantation period after recovery of hemopoiesis. Results. 4 patients achieved complete remission, 3 - partial remission, 2 had progression and 1 - stabilization. In mean follow-up 11 (2-20) months 7 of 10 patients were alive, overall survival being 15 + 2.4 months (95% confidence interval 10-19.7), median was not reached. 5patients are in complete remission: 2 of them without further treatment, 3 - after progression and repeat therapy including rituximab and interferon-a or rotuximab and CHOP chemotherapy. Conclusion. The addition of rituximab can improve the results of high-dose chemotherapy of patients with non-Hodgkin's lymphoma resistant to standard doses of cytostatics. Repeat use of this drug can be effective in some patients with progression after high-dose chemotherapy with rituximab.
Terapevticheskii arkhiv. 2003;78(1):65-68
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Transient myocardial ischemia in chronic ischemic disease of the heart: methods of detection and treatment policy
Мartsevich S.Y., Koltunov I.E., Kutishenko N.P.
Abstract
Terapevticheskii arkhiv. 2003;78(1):69-71
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Role of insulin resistance in pathogenesis of diabetes mellitus type 2
Balabolkin M.I., Klebanova E.M., hanov О.L., Lomonosov К.М.
Abstract
Terapevticheskii arkhiv. 2003;78(1):72-77
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Skin changes in visceral pathology (dermadromas)
Ivanov О.L., Lomonosov К.М.
Abstract
Terapevticheskii arkhiv. 2003;78(1):77-80
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V. A. Galkin - the 75th anniversary of birth
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Abstract
Terapevticheskii arkhiv. 2003;78(1):81-82
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