scholarly journals Rationale for the use of osteopathic correction in the treatment of patients with chronic lower limb vein disease

2020 ◽  
pp. 111-121
Author(s):  
A. S. Shmeleva ◽  
I. B. Mizonova
Keyword(s):  
Quality Of Life ◽  
Saphenous Vein ◽  
Lower Limb ◽  
Classification System ◽  
Main Group ◽  
Control Group ◽  
Osteopathic Treatment ◽  
Ceap Classification ◽  
Vein Disease

Introduction. Despite the constant improvement of treatment methods, chronic lower limb vein disease (CLLVD) remains an urgent and not completely solved problem. Therefore the search for new methods of this disease treatment is actual. The effectiveness of osteopathic treatment of patients with CLLVD has been shown in recent years. But despite this the use of osteopathic treatment in this area has not been widely used today because further research, generalization of results and creation of an evidence base are required.The goal of research — is to substantiate the possibility of osteopathic treatment for patients with CLLVD C1–C3 (according to the international classification system CEAP).Materials and methods. The study involved 20 patients suffering from C1–C3 CLLVD. The main group (10 people) receiving osteopathic treatment and the control group (10 people) receiving standard treatment were formed by simple randomization. At the beginning and the end of the study there were evaluated osteopathic status of study participants, changes in pain intensity by visual analogue scale (VAS), changes in quality of life according to the questionnaire CIVIQ (Chronic Venous Insufficiency Quality of Life Questionnaire), and changes in the diameter of the saphenous veins of the lower extremities.Results. Osteopathic examination of patients with CLLVD C1–C3 (according to the CEAP classification system) prior to the treatment allowed to establish the presence of somatic dysfunctions of the regional (lumbar and pelvic regions, structural and visceral), and local (diaphragm, sigmoid and caecum) level. The use of osteopathic correction in the main group compared with medical treatment in the control group leads to a statistically significant (p<0,05) decrease in the number of regional biomechanical dysfunctions of the lumbar and pelvic region, visceral components, and local somatic dysfunction of the diaphragm. The use of osteopathic correction in the main group leads to a statistically significant (p<0,01) more expressed reduction in pain intensity and improved quality of life compared to the control group receiving medication. Both osteopathic correction and standard medical treatment are accompanied by a significant (p<0,05) decrease in the diameter of the small saphenous vein of the affected limb, as well as the diameter of the large saphenous vein (only in the group that received osteopathic correction). There were no cases of adverse treatment outcome.Conclusion. The infl uence of the somatic dysfunctions osteopathic correction on the development of chronic lower limb venous disease (classes C1–C3 according to the CEAP classification system) was studied. It was shown that this infl uence is not inferior to the standard medical method of treatment. The patients′ life quality improves, the experienced pain level decreases, and the subcutaneous veins diameter decreases. In comparison with the control group using the drug method of treatment, there is a statistically significant more expressed decrease in the number of somatic dysfunctions. The obtained results suggest the possibility of osteopathic correction using for C1–C3 class CLLVD according to the international classification system CEAP.  

Results of osteopathic correction of patients with post-traumatic coccygodynia

2019 ◽  
pp. 19-27
Author(s):  
Yu. V. Antonova ◽  
A. M. Iskandarov ◽  
I. B. Mizonova
Keyword(s):  
Quality Of Life ◽  
Emotional State ◽  
Pain Syndrome ◽  
Control Group ◽  
Life Questionnaire ◽  
Treatment Area ◽  
Diffi Cult ◽  
Osteopathic Treatment ◽  
Post Traumatic

Introduction.Coccygodynia is a multidisciplinary disease which is diffi cult to treat. It seriously limits the ability to work and signifi cantly affects the quality of life of patients. The study of somatic dysfunctions in patients with coccygodynia and the analysis of the results of osteopathic treatment of such patients makes it possible to justify the necessity of osteopathic correction of coccygodynia.Goal of the study— to determine the structure of the leading somatic dysfunctions in patients with coccygodynia and to study the effectiveness of osteopathic treatment of this pathology.Materials and methods.The study involved 44 patients from 25 to 65 years old, randomly divided into two groups. The main group of 24 people (20 women and 4 men) received osteopathic treatment, in accordance with the identifi ed leading somatic dysfunctions. Patients of the control group (16 women and 4 men) were treated locally with soft manual techniques (the treatment area was limited by the pelvic region). In order to assess the results of the treatment, we examined the intensity of the pain syndrome and the psycho-emotional state of patients. The severity of the pain syndrome was assessed in accordance with the visual analogue scale (VAS). The psycho-emotional state (with physical and mental components) was assessed with the help of the SF-36 quality of life questionnaire.Results.Somatic dysfunctions typical for patients with coccygodynia have been identifi ed. Osteopathic treatment has proven to be more effective in comparison with local manual therapy of coccygodynia both in early periods and in 3 months after the end of the treatment course.Conclusion.Osteopathic treatment of post-traumatic coccygodynia is effective, and can be recommended for treatment of such patients.

A Prospective Study in Detection of Lower-Limb Lymphedema and Evaluation of Quality of Life After Vulvar Cancer Surgery

2012 ◽  
Vol 22 (6) ◽  
pp. 1081-1088 ◽  
Author(s):  
Marta Novackova ◽  
Michael J. Halaska ◽  
Helena Robova ◽  
Ivana Mala ◽  
Marek Pluta ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lower Limb ◽  
Bioelectrical Impedance Analysis ◽  
Vulvar Cancer ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Cancer Surgery ◽  
Control Group ◽  
Inguinofemoral Lymphadenectomy

BackgroundLower-limb lymphedema is one of the most disabling adverse effects of vulvar cancer surgery. Multifrequency Bioelectrical Impedance Analysis (MFBIA) is a modern noninvasive method to detect lymphedema. The first aim of this study was to prospectively determine the prevalence of secondary lower-limb lymphedema after surgical treatment for vulvar cancer using objective methods, circumference measurements and MFBIA technique. The second aim was to compare quality of life (QoL) before and 6 months after vulvar surgery.MethodsTwenty-nine patients underwent vulvar cancer surgery in our study: 17 underwent inguinofemoral lymphadenectomy (RAD), and 12 underwent sentinel lymph node biopsy (CONS). Patients were examined before and 6 months after vulvar surgery by measuring the circumference of the lower limbs and with MFBIA. A control group of 27 healthy women was also measured. To evaluate QoL, the European Organisation for Research and Treatment of Cancer (EORTC) QoL questionnaires (QLQ-C30 and QLQ-CX24) were administered to patients before and 6 months after surgery.ResultsUsing circumference measurement, 9 lymphedemas (31%) were diagnosed: 3 (25%) in the CONS and 6 (37.5%) in the RAD group (P= 0.69). After vulvar surgery, patients in the RAD group reported more fatigue and worsening of physical and role functioning. When comparing both groups, the RAD group had significantly worse parameters in social functioning, fatigue, and dyspnea.ConclusionsLower radicality in inguinofemoral lymphadenectomy shows a trend toward lower morbidity and significantly improves QoL. Multifrequency Bioelectrical Impedance Analysis was tested in these patients as a noninvasive, objective method for lymphedema detection. Detection of lymphedema based on subjective evaluations proved to have an unsatisfactory sensitivity. Less radical surgery showed objectively better results in QoL.

scholarly journals THE EFFECT OF NUTRITIONAL THERAPY ON QUALITY OF LIFE INDICATORS FOR PATIENTS WITH GASTRIC CANCER AT THE STAGE OF SURGICAL TREATMENT

2019 ◽  
Vol 6 (3) ◽  
pp. 108-114 ◽  
Author(s):  
A. D. Sergienko ◽  
V. E. Khoronenko ◽  
E. V. Gameeva ◽  
A. B. Ryabov ◽  
V. M. Khomyakov
Keyword(s):  
Quality Of Life ◽  
Gastric Cancer ◽  
Surgical Treatment ◽  
Nutritional Therapy ◽  
Main Group ◽  
Control Group ◽  
Quality Of Life Indicators ◽  
Eortc Qlq C30 ◽  
Eortc Qlq

Purpose of the study. To determine the effect of nutritional deficiency and nutritional therapy on the quality of life of patients with gastric cancer at the stage of surgical treatment. Patients and methods. In Thoracoabdominal Department of P. Herzen Moscow Oncology Research Institute within 2017– 2019 the quality of life at the stage of surgical treatment of gastric malignant neoplasms was evaluated in 62 patients (36 men and 26 women) aged 34 to 79 years (mean age 61.9 ± 9.55). At the outpatient stage, patients were divided into 2 groups: in the 1st (main) group, patients received nutritive support with specialized mixtures for 10 days before hospitalization, in the 2nd (control) group, patients were asked to follow a high-protein diet without adding specialized mixtures. The quality of life assessment was carried out on the basis of the EORTC-QLQ-C30 Questionnaire, which patients received on the day of hospitalization. Patients repeatedly filled in EORTC-QLQ-C30 Questionnaire before discharge from the hospital, which allowed to assess the dynamics of the quality of life indicators of the studied patients. The study groups were comparable in social and medical indicators. Results. The analysis of the survey results showed that the “general state of health” in the studied groups at the stage of hospitalization is estimated �bove average. Also, in both groups there is a positive dynamics in the values of the above indicator before discharge. Patients of the 1st group who received specialized nutritional mixtures, developed the statistical significance of the differences in the assessment of the quality of life upon admission and before discharge. Thus, it can be argued that nutritional therapy had a significant positive impact on the quality of life in terms of “general health”, in contrast to the control group of patients who did not receive specialized nutritional therapy. There was a general tendency toward an increase in the quality of life indicators at admission and before discharge on all scores of the questionnaire in groups. Thisis a positive assessment by patients of their condition after providing them with medical services. In this case, the discomfort from the symptoms accompanying the disease is reduced, which is confirmed by the scoring results. Statistically significant differences in the assessment of symptoms occur in the study group. Patients having received nutritional therapy noted a decrease in pain, an improvement in the processes of assimilation of food, as well as an improvement in well-being, physical condition, an increase in general tone and energy, a surge of strength and a sense of vitality. In “decreased appetite”score the indices of patients in the main group decreased by more than 3 times, i. e. their appetite improved significantly under treatment. Improving appetite in patients of the main group led to an improvement in the functioning of the gastrointestinal tract as a whole. Patients in this group noted an improvement in digestion and bowel movements. Conclusion The study showed that the quality of life of patients with gastric cancer largely depends on their nutritional deficiency, and nutritional therapy at the stages of surgical treatment, in turn, can significantly improve its results, including in the aspect of their perception by patients. Using the general EORTC QLQ-C30 questionnaire is one of the available methods for assessing the quality of life in patients with gastric cancer.

scholarly journals Minimally invasive combined surgical treatment of postcoital cystitis

2020 ◽  
Vol 21 (2) ◽  
pp. 20-25
Author(s):  
J. Sh. Inoyatov ◽  
O. V. Snurnitsyna ◽  
M. V. Lobanov ◽  
O. Yu. Malinina ◽  
Yu. L. Demidko ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Main Group ◽  
Control Group ◽  
Efficacy And Safety ◽  
Study Objective ◽  
Results Of Treatment ◽  
Main Disadvantage ◽  
Combined Technique ◽  
Treatment Profile

Introduction. Urethral transposition remains the most popular operation for postcoital cystitis, however, traumatism and complications, especially such as pudendal neuropathies, dyspareunia and anorgasmia, make us continue to search for effective, but safer techniques.The study objective is to evaluate the efficacy and safety of the proposed treatment of postcoital cystitis, including removal of urethrogymenal adhesions and subsequent paraurethral filler implantation, in comparison with isolated hymenoplasty.Materials and methods. Since 2013, 75 patients with postcoital cystitis have been treated. Patients were divided into two groups: main group – hymenoplasty (removal of urethral adhesions) with paraurethral filler implantation (n = 45), control group – hymenoplasty (n = 30). The gel was injected paraurethrically, fan-shaped, in the volume of 1–2 ml, from a point on the 6-hour conditional dial, creating a gel cushion and thus raising the meautus and distal urethra. To assess the quality of treatment, profile questionnaires were used.Results. In the main group of patient, the quality of life improved in 35 (78 %); in 5 patients, due to the process of biodegradation of the gel during 1 year, the cystitis recidivated, which required the filler reimplantation. In 5 patients, the operation was not effective. In the control group the efficiency of isolated hymenoplasty was noted in 3 (10 %) patients, relapse of cystitis occurred in 27 (90 %) patients, which later required the implantation of a filler. No complications were observed.Conclusions. The suggested combined technique allows to improve the results of treatment of patients with postcoital cystitis. The operation does not carry the risk of damage to the sprigs of the genital nerve, can serve as an alternative to traditional urethral transposition. The main disadvantage is the natural biodegradation of the gel, which may create the need for its reintroduction.

scholarly journals Twelve Weeks of Strengthening Exercise for Patients with Rheumatoid Arthritis: A Prospective Intervention Study

2020 ◽  
Vol 9 (9) ◽  
pp. 2792
Author(s):  
Bomi Sul ◽  
Kyoung Bo Lee ◽  
Young Bin Joo ◽  
Bo Young Hong ◽  
Joon-Sung Kim ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Lower Limb ◽  
Exercise Group ◽  
Activity Level ◽  
Control Group ◽  
Intervention Period ◽  
Sf 36 ◽  
Strengthening Exercise

Rheumatoid arthritis (RA) patients may benefit from exercise for several reasons. However, whole-limb strengthening exercises for such patients remain poorly studied. We hypothesized that systemic strength training that includes the upper and lower extremities would improve strength per se and enhance the quality of life. Here, we investigated the effects of 12 weeks of upper- and lower-limb strengthening exercise on the strength and quality of life of RA patients using the International Classification of Functioning, Disability, and Health model. This was a prospective, interventional controlled trial. Forty female RA patients were recruited and assigned to two groups not based on willingness to exercise, with 20 patients in the exercise group and 20 in the control group. All patients in the exercise group received once-weekly training sessions of 60 min over 12 weeks. All participants were assessed before and after the 12-week intervention period. We measured the hand grip strength and isometric quadriceps contraction, the cross-sectional area of the rectus femoris (CSA-RF) (via ultrasonography), and performed the 30 s sit-to-stand test and the 6 min walk test (6MWT). We derived the Borg scale score after the 6MWT and assessed the extent of social participation and quality of life using a Korean version of the 36-Item Short Form Health Survey (SF-36). A total of 35 subjects completed the experiment (18 in the exercise group, 17 in the control group). After the 12-week intervention period, the lower-limb strength and the CSA-RF were significantly increased in the exercise group. The activity level did not change significantly in either group. The exercise group exhibited significant improvements in the SF-36 mental health domain scores. Thus, strengthening exercise is useful for patients with RA.

scholarly journals Improving the quality of life using physical therapy to correct excess weight in women

2020 ◽  
pp. 76-79
Author(s):  
L. Odiyaka ◽  
T. Baryshok
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Physical Therapy ◽  
Young Women ◽  
Main Group ◽  
Excess Weight ◽  
Control Group ◽  
Physical And Mental Health ◽  
Overweight Women

The article deals with the problem of overweight women and the measures that can influence it. The actual problem of reducing the quality of life of overweight women and the need to take this indicator into consideration when selecting the measures of physical therapy and assessing the quality of their use are raised. The results of the study of changes in quality of life after using of programs of physical therapy for the correction of excess weight are presented. The quality of life of young overweight women was evaluated using the SF-36 survey (physical and mental health). Experimental sample size: 10 females in the main group and 10 females in the control group. Weight loss program and improving the quality of life of young women through physical therapy lasted for 6 months. Programs of physical therapy in the main group was included elements of different directions of aerobics (classical aerobics, power aerobics, aerobics using different tools, aerobics with psycho-regulatory orientation) and nutrition correction. Programs of physical therapy in the control group was also included nutrition correction and fitness workouts with the use of simulators with a focus on strength and cycling. According to recent estimates, at least one in three adults in the world is overweight and almost one in 10 is obese. Being overweight is not only an aesthetic problem, it is a health threat that entails a number of illnesses and complications, reducing the quality of life. Not everyone knows that the risk of health problems manifests itself even with a slight overweight, and increases as you gain weight. For greater results in overweight correction, it is best to use aerobic and anaerobic fitness programs. A comprehensive physical therapy program has significantly improved the health of young women and has had a positive effect on physical and mental health. We have reason to believe that the overweight correction technique of the main group has proven to be more effective in improving the quality of life of women than the control group program.

scholarly journals Assessment of the quality of life in patients with varying degrees of equalization of lower limb length discrepancy treated with Ilizarov method

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Łukasz Pawik ◽  
Malwina Pawik ◽  
Zdzisława Wrzosek ◽  
Felicja Fink-Lwow ◽  
Piotr Morasiewicz
Keyword(s):  
Quality Of Life ◽  
Lower Limb ◽  
Limb Length Discrepancy ◽  
Limb Length ◽  
Control Group ◽  
Ilizarov Method ◽  
Healthy Individuals ◽  
Self Assessment ◽  
Length Discrepancy

Abstract Background Inequalities in leg length result in functional disorders, as they impair the biomechanics of the musculoskeletal system, significantly reducing the quality of life (QoL). This study used the WHOQoL-BREF questionnaire in patients with varying degrees of lower leg shortness who had undergone treatment by the Ilizarov method, compared to a healthy control group. Methods Fifty-eight patients treated with the Ilizarov method for discrepancies in lower limb length were grouped by degree of limb equalization (group 1, 37 treated individuals with limb length discrepancy < 1 cm; group 2, 21 individuals with discrepancy ≥ 1 cm but not more than 4 cm). The control group 3 contained 61 healthy individuals. Patient quality of life (QoL) was assessed using a shortened version of the WHOQoL-BREF questionnaire, at least 24 months after the end of Ilizarov therapy. Results Control subjects obtained higher scores in all domains than subjects in both treatment groups, as well as significantly higher self-assessed QoL, and health, in the physical, psychological, social, and general lifestyle domains, as compared to those with inequalities ≥ 1 cm. Furthermore, patients with inequalities ≥ 1 cm had higher odds ratios of low self-assessment (3.28 times; p = 0.043), low self-assessment of health (4. 09 times; p = 0.047), and low physical and psychological domains (respectively 6.23 times; p = 0.005 and 8.46 times, p = 0.049) compared with patients with inequality < 1 cm. The shortened version of the WHOQoL questionnaire was used. Conclusions After at least 24 months of treatment with the Ilizarov method, patients with limb length discrepancy < 1 cm did not differ significantly from healthy individuals in the WHOQoL self-assessment of mental functioning, social, or life satisfaction.

scholarly journals Current state of antiangiogenic therapy in neuro-oncology and own experience of its use in the radiosurgical treatment of recurrent glioblastoma

2021 ◽  
Vol 27 (1) ◽  
pp. 34-43
Author(s):  
Oleksandr Y. Glavatskyi ◽  
Oksana V. Zemskova ◽  
Hennadii V. Khmelnytskyi ◽  
Konstantin A. Kardash ◽  
Iryna M. Shuba ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Antiangiogenic Therapy ◽  
Intensity Modulated Radiotherapy ◽  
Main Group ◽  
Recurrent Glioblastoma ◽  
Full Blood Count ◽  
Control Group ◽  
Significant Difference ◽  
Eortc Qlq

Objective: to study the effect of antiangiogenic therapy on the quality of life and the level of headache in patients with recurrent glioblastoma who underwent radiosurgical treatment. Materials and methods. A prospective randomized single-center study carried out at the Romodanov Neurosurgery Institute of National Academy of Medical Sciences of Ukraine in 2019-2020 involving 45 patients with GB with clinical and radiological signs of disease progression and local tumor recurrence. In this regard, patients underwent radiosurgical treatment. In the main group (BEV+) 21 patients after stereotactic radiosurgery (SRS) underwent antiangiogenic therapy with Bevacizumab (BEV). In the control group (BEV–), 24 patients did not receive antiangiogenic therapy after SRS. SRS with the use of a linear accelerator «Trilogy» (6 MeV) using intensity-modulated radiotherapy (IMRT). BEV was administered intravenously, once every 3 weeks at a dose of 10 mg / kg body weight. Antiangiogenic therapy was performed under the condition of preserved liver and kidney function, values of full blood count and blood biochemistry within normal range. Global health status and headache levels were calculated according to EORTC QLQ-C30 v. 3.0 and QLQ-BN20 before and six weeks after radiosurgery in the main and control groups. Results. There was no a statistically significant difference between the studied groups of patients’ in quality of life (p = 0.707372) and in headache level (p = 0.846660) before the SRS. Six weeks after SRS, patients in the main group had a statistically significantly higher quality of life (p = 0.000015) and a lower level of headache than patients in the control group (p = 0.000035). During the observation period in patients of both groups there were no adverse events of III-IV degree of toxicity, in particular specific complications of antiangiogenic therapy (hypertension, bleeding, thromboembolism, leukopenia, proteinuria, gastrointestinal disorders, etc.). Conclusions. Antiangiogenic therapy statistically significantly improves the quality of life and reduces the level of headache in patients who underwent radiosurgical treatment for glioblastoma recurrence.

scholarly journals Reduced Quality of Life in Elderly Patients with Glaucoma

2021 ◽  
Vol 18 (3) ◽  
pp. 527-531
Author(s):  
N. M. Agarkov ◽  
A. M. Chukhraev ◽  
O. L. Fabrikantov ◽  
N. V. Yablokova
Keyword(s):  
Quality Of Life ◽  
Elderly Patients ◽  
Practical Importance ◽  
State Institution ◽  
The Elderly ◽  
Main Group ◽  
Federal State ◽  
Individual Treatment ◽  
Control Group

Glaucoma is the most severe eye disease that leads to irreversible blindness, and is a widespread pathology among the population of different countries and especially in the elderly. The urgency of the problem increases in connection with the demographic processes occurring in industrial countries, characterized by aging of the population. The development of glaucoma in the elderly exacerbates the image and quality of life of these patients, which must be taken into account in the implementation of medical and social and specialized ophthalmological care. However, the study of the quality of life in elderly glaucoma patients by a specific questionnaire was not carried out.The purpose: to analyze the quality of life of elderly patients suffering from glaucoma for a long time.Material and methods. The study of quality of life was carried out in the Tambov branch of the S. Fyodorov Eye Microsurgery Federal State Institution. In clinical conditions, a survey of 228 patients with glaucoma aged 60–75 years, who made up the main group. The survey was conducted on a special questionnaire-National Eye Institute Visual Functioning Questionnaire among patients of the above group by direct interviewing. The results were integrated into 122 scales for processing and analysis in accordance with the requirements of this questionnaire. Similarly, for comparison, the quality of life was studied in 178 patients of the same age with no history of glaucoma and at the present time. In assessing the quality of life, arithmetic averages and their errors were calculated, and the nonparametric t-white criterion was used to determine the reliability of the differences.Results. It was found that the development of glaucoma in the elderly causes a significant decrease in the quality of life on all scales of the questionnaire, reflecting the specific manifestations due to visual impairment. At the same time, the most pronounced effect of glaucoma has on the reduction of distant vision — 19.5 ± 1.3 points against 69.5 ± 1.8 points (p < 0.001) in the control group. The defeat of glaucoma leads to a significant decrease in the quality of life of elderly patients and other indicators. In the main group, the overall score of vision (23.5 ± 1.5 points vs. 75.2 ± 1.9 points in the control), near vision (26.8 ± 1.6 points vs. 73.5 ± 2.0 points in the control), high dependence on outsiders in solving everyday problems (30.5 ± 1.6 points vs. 79.3 ± 1.8 points in the control) were significantly lower. To a lesser extent, with the development of glaucoma, color perception suffers.Conclusion. The analysis of the quality of life in elderly patients with glaucoma is of practical importance for the organization of an individual treatment and prevention plan, since it takes into account the opinion of each patient about the perception of the disease.

scholarly journals Clinical manifestation features of chronic heart failure with comorbid obesity in consideration of cytochrome P450 system CYP2D6*4 gene polymorphism

2020 ◽  
Vol 86 (1) ◽  
pp. 9-16
Author(s):  
I.C. Gasanov ◽  
I.S. Ryduk ◽  
O.O. Medentseva ◽  
T.V. Lozyk
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Cytochrome P450 ◽  
Chronic Heart Failure ◽  
Clinical Manifestation ◽  
Genetic Research ◽  
Main Group ◽  
Control Group ◽  
Cytochrome P450 System

In order to assess the characteristics of the clinical manifestation of CHF with obesity, taking into account the polymorphism of the CYP2D6*4 gene of the cytochrome P450 system in terms of patient’s quality of life a prospective randomized controlled trial was conducted, 127 people (93 men and 34 women) aged 32-87 (61) years with CHF of II—III stages, 1^1 functional class according to the classification of the New York Heart Association (NYHA) have been examined. The main group consisted of 73 patients with obesity of 1 degree and higher, the comparison group consisted of 54 patients without obesity, the control group consisted of 21 people without cardiovascular disorders. Research methods included estimation of clinical symptom score scale, 6-minute walk test, quality of life (with the Minnesota questionnaire for patients with heart failure), assessment of subjective symptoms and course of the disease, anthropometric data, determination of objective signs of the disease; instrumental methods (Doppler echocardiography, basic laboratory examination, etc.), as well as genetic research (G1846A variants of the CYP2D6 gene real-time polymerase chain reaction), statistical non-parametric methods (with 0.05 p-value thresold). It is shown, that in the clinical aspect, patients of the main group have been characterized by a tendency to more expressive pathological manifestations of CHF, especially in carriers of the heterozygous GA variant of the CYP2D6*4 gene of the cytochrome P450 system. According to the Minnesota questionnaire, the clinical condition of patients and the quality of life in case of GG polymorphism variant was better than in GA carriers of the CYP2D6*4 genotype variant of the cytochrome P450 system. Keywords: chronic heart failure, quality of life, obesity, genetic polymorphism, treatment, prognosis.

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