scholarly journals Specific course of tuberculosis in elderly and senile patients

2020 ◽  
Vol 97 (12) ◽  
pp. 22-27
Author(s):  
L. N. Savonenkova ◽  
V. I. Ruzov ◽  
R. B. Asanov ◽  
O. V. Midlenko ◽  
B. M. Asanov ◽  
...  

The objective: to identify specific features of the clinical course of tuberculosis in elderly and senile patients under the current epidemic situation.The specific clinical course of tuberculosis was analyzed in 54 patients at the age of 61 years and older and compared with the course of 234 patients at the age from 18 to 39 years selected by the continuous sampling of all 472 patients discharged from hospital in 2018. The following features were found to be typical of patients of 61 years and older: more frequent chronic forms of the disease (37.0%) and complications (35.2%), the major complication was chronic cor pulmonale (33.3%); more frequent concurrent chronic nonspecific lung diseases (13.0%) and coronary heart disease/arterial hypertension (14.8%); more frequent deaths (31.5%), mainly due to pulmonary heart disease; less frequent generalization of tuberculosis (5.5%) and concurrent HIV infection (7.4%).

2018 ◽  
Vol 15 (3) ◽  
pp. 21-26
Author(s):  
V V Skibitsky ◽  
E V Gorodetskaya ◽  
E A Kudryashov ◽  
A V Fendrikova ◽  
A V Skibitsky

Aim - to assess the effect of different dosing regimens for combined antihypertensive therapy with the use of ACE inhibitor zofenopril or angiotensin II receptor blocker valsartan on the blood pressure (BP) profile in men and women with arterial hypertension (AH) and stable coronary heart disease (CHD). Materials and methods. 198 patients (98 men and 100 women) with AH and stable CHD (stable angina of II functional class) were examined. In men and women, the effectiveness of 3 variants of antihypertensive therapy was evaluated: a combination of metoprolol succinate/hydrochlorothiazide + zofenopril or valsartan 160 mg once or valsartan 80 mg 2 times/day. Initially and 24 weeks later, 24-hour BP monitoring was performed. Results. Among men, BP


2020 ◽  
Vol 13 (6) ◽  
pp. 33-37
Author(s):  
OLGA B. OSHCHEPKOVA ◽  
◽  
EVGENY V. ARKHIPOV ◽  
GULNAZ M. MUKHAMETGALIEVA ◽  
OLGA YU. MIKHOPAROVA ◽  
...  

2007 ◽  
Vol 28 (16) ◽  
pp. 1928-1935 ◽  
Author(s):  
P. A. Poole-Wilson ◽  
Z. Voko ◽  
B.-A. Kirwan ◽  
S. de Brouwer ◽  
P. H.J.M. Dunselman ◽  
...  

2019 ◽  
Vol 100 (4) ◽  
pp. 565-570
Author(s):  
I V Dubatova ◽  
V G Voyakina ◽  
S V Lepyavka ◽  
A V Safronenko ◽  
I A Demidov

Aim. To identify and compare the level of anxiety and depression in therapeutic patients with somatic pathology, establish the structure of the gender distribution of anxiety and depressive disorders. Methods. The study involved 126 people: 74 (58.73%) women and 52 (41.27%) men aged 21–59 years. 59 patients had diseases of the respiratory system (chronic bronchitis in the acute stage with an asthmatic component), 67 patients with cardiovascular diseases (40 subjects with coronary heart disease, 27 subjects with arterial hypertension). In 11 patients with coronary artery disease and 13 patients with hypertension, type I thyrotoxicosis was diagnosed. Clinical psychopathological, psychometric, psychological and statistical methods were used in the study. Psychometric tests were used: the Depression Scale of the Center for Epidemiological Research; Hospital Anxiety and Depression Scale and Taylor Anxiety Disorder Scale adapted by T.A. Nemchinova and V.G. Norakidze, adapted standardized multivariate questionnaire for personality research. Results. According to the severity of anxiety and depressive disorders, patients were divided into the groups: group 1 with severe level, group 2 with a moderate (subclinical) level, and group 3 with mild (not exceeding the norm) anxiety and depressive disorders. Severe and moderate disorders are most characteristic for the pathology of cardiovascular system. In coronary artery disease and arterial hypertension, abnormal (severe and moderate) anxiety and depressive disorders were observed in 24/29 (82.76%) and 20/22 (90.9%) patients, respectively. In patients with abnormal anxiety and depressive disorders, the number of women prevailed over men in the subgroup with hypertension (80% versus 20%, p=0.025) as well as in combination of hypertension with type 1 thyrotoxicosis (85.7% versus 14.3%, р=0.029). Conclusion. In patients, severe and moderate anxiety and depressive disorders are associated with the development of the pathology of cardiovascular system: coronary heart disease and arterial hypertension.


2005 ◽  
Vol 11 (4) ◽  
pp. 235-238
Author(s):  
N. P. Dorofeev ◽  
A. A. Kastanayan ◽  
S. V. Shlyk ◽  
V. V. Dorofeikov ◽  
A. A. Barbina ◽  
...  

The purpose of the Study was to search for an association of the gene polymorphism of angiotensin-converting enzyme (ACE), angiotensinogen (ATG) and type I receptors of angiotensin II with the risk for chronic heart failure in patients with coronary heart disease (CHD) and arterial hypertension (AH). A hundred persons, including 80 patients with CHD, 10 patients with hypertensive disease, and 10 healthy Individuals were examined. There was no association of the ID gene polymorphism of ACE, MT gene polymorphism of ATG, and the AC gene polymorphism of ATR1 with the risk for heart failure in patients with CHD and AH.


2015 ◽  
Vol 12 (4) ◽  
pp. 69-74
Author(s):  
O D Ostroumova ◽  
V M Fomina ◽  
E A Smolyarchuk

In the article discusses questions of application of b-blockers (b-AB) for the treatment of arterial hypertension, coronary heart disease, chronic heart failure. The data from modern Russian and European recommendations about the place of b-AB in the treatment of cardiovascular diseases. Analyzed in detail the selection of b-AB inside the class from the standpoint of pharmacokinetics, selectivity, study in clinical studies. Data about efficiency and safety of application of metoprolol succinate for the treatment of arterial hypertension, coronary heart disease, chronic heart failure.


2020 ◽  
Vol 7 (1) ◽  
pp. 38-47
Author(s):  
R. V. Royuk ◽  
S. K. Yarovoy ◽  
N. A. Guseva ◽  
Sh. L. Voskanyan ◽  
V. V. Royuk ◽  
...  

Purpose of the study. To analyze prevalence and characteristics of the cardiovascular diseases (CVD) in patients with urolithiasis, revealed for the first timeMaterials and methods. In a period between 2009 and 2018, was made a retrospective analysis of medical histories of 2311 patients with urolithiasis, which were treated in in the urology departments of the branch No. 1 of the MCHG named after N.N. Burdenko (n=1487) and GBUZ MO Krasnogorsk City Hospital No. 1 (n=824). In 67,6% of the cases (1562 patients) the diagnosis of urolithiasis was diagnosed for the first time on admission. Isolated urolithiasis was recorded in 676 cases (43,3%), in other 154 cases (9,8%) nephrolithiasis was combined with different variants of cardiovascular diseases (CVD) and diabetes. From 732 respondents with urolithiasis and associated cardiovascular diseases (CVD), were formed 3 groups, in the first group (I) were included patients (n=363) with hypertension and arterial hypertension: the second group (II; n=79) was formed from patients with isolated coronary heart disease. In the third group (III) were included 290 patients which had urolithiasis combined with hypertension, arterial hypertension and coronary heart disease. The stages of hypertension and degree of expression of arterial hypertension were given according to the recommendations of Russian science society of cardiology (2004). Stages of congestive heart failure were defined according to c NYHA (New York Heart Association) classification. Functional class of stable angina was defined according to Canadian Cardiovascular Society classification (1970,1976). The obtained data was analyzed using descriptive statistics methods.Results. Average age of patients was 65,4 +– 3,27; 78% of the patients were men. On an emergency basis were hospitalized 30,9% from group I, 27,6% from group 2, and 31,3% from group III. In group I more often were recorded hypertension I + arterial hypertension I (32,5%) and hypertension II + arterial hypertension II (40,2%). In group II effort angina was recorded in 30 cases (38%). Congestive heart failure occurred among 153 patients (20,9%); most often it occurred among patients from III – in 102 cases (35,2%). In the whole sample, congestive heart failure of I and II degrees prevailed – in 88 (12%) and 57 (7,9%) patients. Kidney stones were found in 59,4% of patients, in the ureters – in 30,9% of patients, in kidneys and in the ureters – in 9,9% of patients. Share of the patients with kidney stones in the shape of corals is 3,4% of the whole sample. Average sizes of kidney stones of the patients with congestive heart failure are 9,2–11,8 mm which is different from the sizes in whole sample – 6,9–9,5 mm.Conclusion. During the observation period, share of the patients with first time revealed urolithiasis, complicated with the cardiovascular diseases (CVD) increased in 1,9 times (16,7 versus 31,7%). Congestive heart failure, which was registered in 20,9% of patients, was charged with I and II degrees. The presence chronic cardiovascular diseases (CVD), especially complicated by congestive heart failure in patients with first time revealed nephrolithiasis, implies changes in the algorithms of metaphylactic of nephrolithiasis (regime of water loads, selection of diuretics and anticoagulants).


2021 ◽  
Vol 2-3 (35-36) ◽  
pp. 50-57
Author(s):  
D. Volynskyi ◽  

Introduction. Coronary heart disease (CHD) is one of the main causes of high mortality, disability and reduced quality of life for patients in both Europe and Ukraine. Modern drug therapy of coronary heart disease in combination with arterial hypertension (AH) does not always achieve a satisfactory therapeutic effect. The use of meldonium, which has antioxidant properties, has a positive effect on NO release and has a lipid-lowering effect is promising for patients with AH. The aim of the study. To evaluate the influence of meldonium on lipid metabolism and echocardiography parameters in combination therapy in patients with CHD with stable angina and concomitant AH. Materials and methods. We examined 66 patients with CHD, stable angina pectoris II-III functional class, 40 of them with concomitant AH stage II-III. Patients were divided into 2 groups of 40 and 26 patients, respectively. The first group included patients with CHD and concomitant AH, the second - without pre-existing hypertension. Each of the groups was further divided into 2 subgroups: 1) Patients who were prescribed meldonium at a dose of 750.0 mg/d for 6 months in addition to the basic therapy of the underlying disease (n = 20 for CHD + AH and n = 14 for CHD without hypertension). 2) Patients who continued basic antianginal, disaggregating, hypolipidemic therapy (n = 20 for CHD + AH and n = 12 for CHD without hypertension). Serum levels of triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol were assessed. Indicators of cardiac hemodynamics were determined by echocardiography with assessment of left ventricular end systolic and diastolic volumes and diameters (LVESV, LVEDV, LVESD, LVEDD respectively), the thickness of the interventricular septum and posterior wall of the left ventricle (IVST, LVPWT respectively), pulmonary artery pressure (PAP), LV myocardial mass (LVM) and LV myocardial mass index (LVMI). Results. The use of meldonium for 6 months in patients with CHD and concomitant AH led to a decrease in the concentration of total cholesterol from 5.07 to 4.34 mmol/l and LDL from 2.07 to 1.70 mmol/l. In the group of patients without concomitant hypertension there was a decrease in the concentration of total cholesterol from 4.80 to 3.93 mmol/l, LDL from 1.62 to 1.18 mmol/l and an increase in HDL from 1.18 to 1.37 mmol/l. At 6-month administration of meldonium as a part of combination therapy of patients with CHD with concomitant AH, there is a decrease in LVM from 216.90 g to 181.50 g and LVMI from 109.10 g/m2 up to 91.20 g/m2. In patients without concomitant hypertension, a decrease in LVM from 232,20 g to 183.90 g and LVMI from 121.50 g/m2 to 96.40 g/m2 was observed. Conclusions. Our study showed that meldonium has a positive effect on lipid metabolism and echocardiography. In the group of patients with coronary heart disease and concomitant hypertension on the background of additional use of meldonium for six months, we registered a decrease in TC, LDL and AI. LVPWT, PAP, LVM and LVMI also significantly decreased. In the group of patients with coronary heart disease without concomitant hypertension, we registered a decrease in TC, LDL, AI and an increase in HDL. LVM and LVMI also decreased significantly. Therefore, we consider it appropriate to use meldonium in the complex treatment of patients with coronary heart disease with stable angina and concomitant hypertension. Keywords: coronary heart disease, arterial hypertension, meldonium, echocardiography, blood lipid spectrum.


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