scholarly journals Preoperative Preparation Of Elderly Patients With Concomitant Hypertension In The Practice Of Ophthalmic Surgery

2020 ◽  
Vol 02 (11) ◽  
pp. 8-15
Author(s):  
Mansur Muratovich Matlubov ◽  
◽  
Jasur Tolibovich Yusupov ◽  
Nigina Ulugbekovna Mukhamedieva ◽  
◽  
...  
Keyword(s):  
Heart Rate ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Preoperative Assessment ◽  
Cataract Extraction ◽  
Risk Groups ◽  
Clinical State ◽  
Ophthalmic Surgery ◽  
Age Related ◽  
Department Of Ophthalmology

Background: The relevance of the problem of arterial hypertension (AH) is determined by its high frequency in the population, the influence on the state of health, working capacity and longevity of the population. Persons of old and old age, as a rule, have a significant amount of risk factors for cardiovascular diseases, very often there are lesions of target organs and associated clinical conditions, therefore, the majority of painful AHs of these age-related categories belong to high and very high-risk groups. Purpose of the research: To optimize the existing methods of managing elderly and senile patients with hypertension during cataract extraction, including preoperative assessment of patients' condition and preparation, intraoperative protection. Materials and methods: Clinical observations cover 150 patients aged 60 to 89 years (74.7 ± 0.5), who were required for surgical treatment for age-related cataracts in the department of ophthalmology at the Sam clinic. Depending on the method of anesthesiology, all patients were divided into 2 groups. Results: All patients with hypertension on the background of an antihypertensive therapy have clinically achieved the target numbers for arterial pressure. . Arterial hypertension before surgery in patients of the II group testified to a pressurized reaction of the cardiovascular system (CCC) in response to psycho-emotional irritation and a short-term associated with it. After the operative period, indicators of the functional state of the CVS improved, however, tachycardia of the heart rate of 85.4 ± 1.4 use of antihypertensive and pain-relieving drugs. In patients of the I-group, the SAD stabilized at 87.7 ± 3.7 mm Hg, heart rate 66.2 ± 3.4 beats. in minutes at the I-stage already after premedication. Conclusion. The results of the study suggest that conducting adequate antihypertensive therapy in combination with drugs that reduce mental and emotional stress in the preoperative period, exclusion of eye contact, psychoemotional stress through sedation and neuroleptanalgesia in waiting rooms allows to stabilized the clinical state of patients, clearly correlating with an improvement in hemodynamic parameters.

PSYCHOVEGETATIVE PREREQUISITES FOR ARTERIAL HYPERTENSION SYNDROME INUNDERGROUND WORKERS

2021 ◽  
Author(s):  
S.V. Paramonova ◽  
◽  
N.N. Malyutina ◽  
N.S. Sedinina
Keyword(s):  
Arterial Hypertension ◽  
Cardiovascular System ◽  
Clinical Laboratory ◽  
Vegetative State ◽  
Negative Relationship ◽  
Risk Groups ◽  
Main Group ◽  
Laboratory Diagnostics ◽  
Aged People ◽  
Age Related

Abstract: We examined 109 men working at а mining enterprise exposed to occupational and psychosocial factors. The patients were divided into two groups: the main group - 60 men working in underground conditions, the conditions are assigned to classes 3.3 - 3.4; comparison group - 49 men performing ground work, whose conditions are classified as 3.2. In connection with the established diagnosis of "Syndrome of arterial hypertension" in middle-aged people of the main group, it was divided into two subgroups in terms of age - people under 45 years old (n = 20, age 38.45 ± 2.95 years), and people older 45 years old (n = 40, age 50.90 ± 1.46 years.). Purpose: to study the prerequisites for the development of hypertension based on the psychovegetative status and some changes in the biochemical and functional indicators of the CVS, depending on the age-related changes in these indicators. Materials and methods: the patient underwent a study of the psycho-vegetative state with an assessment of the level of neuropsychic stress, personal and situational anxiety, attention function, subjective reflection of psycho-vegetative distress. The state of the cardiovascular system was investigated according to the results of functional and clinical laboratory diagnostics. Results: A decrease in attention, an increase in personal anxiety and an increase in the number of psychovegetative complaints were significantly more often detected in the group of patients with hypertension (OR 7.50; 95% CI 2.39-23.58; OR 11.06 95% - CI - 4.35 - 28.10; CI 22.50; 95% CI - 7.09 - 71.41). Adaptive psychovegetative phenotypes were distinguished in two subgroups. In patients over 45 years old, a negative relationship was established between age, experience and some parameters of psycho-vegetative status, as well as a direct relationship between these parameters and some indicators of homeostasis in the diagnosis of hypertension syndrome in 95% of patients in this subgroup. Conclusions: with an increase in age and experience, there is a transformation of the adaptive psychovegetative phenotype with an inversion of connections with psychovegetative parameters against the background of increased functional disorders of the cardiovascular system. Diagnostics of the transformation of this phenotype makes it possible to assess the risk of developing arterial hypertension and contributes to the prevention of hypertension by forming risk groups.

scholarly journals CATARACT

2010 ◽  
Vol 17 (03) ◽  
pp. 416-419
Author(s):  
SARFRAZ HUSAIN SYED ◽  
MUHAMMAD ARIF ◽  
DR. MUHAMMAD SULTAN
Keyword(s):  
Intraocular Pressure ◽  
General Population ◽  
Cataract Extraction ◽  
Topical Administration ◽  
Eye Drops ◽  
Post Operative Period ◽  
Age Related ◽  
Extraction Study ◽  
Department Of Ophthalmology ◽  
Applanation Tonometer

Objective: To observe the tendency of corticosteroids to raise the intraocular pressure after prolonged use of 0.1% dexamethasone eye drops during post operative period of cataract extraction. Study Design: Observational study. Period: From August 2008 to December 2009. Subjects and Setting: In the study 50 patients were included. These patients had age related cataract in one or both eyes. The IOP of every patient was measured preoperatively with the help of Goldman applanation tonometer. After cataract extraction, every patient received 0.1% dexamethasone eye drops four times a day for one month. The IOP was measured fortnightly. Setting: Department of Ophthalmology, Allied Hospital, Faisalabad and the clinics of the authors. Results: Topical administration of 0.1% Dexamethasone Eye Drops ,four times a day for one month after age related cataract extraction caused elevation of intraocular pressure more than 21 mm Hg in 8% of general population.

scholarly journals Arterial hypertension: modern advances in metabolomics

2021 ◽  
pp. 10-22
Author(s):  
S. K. Zyryanov ◽  
O. I. Butranova ◽  
M. A. Grishin
Keyword(s):  
Blood Pressure ◽  
Amino Acids ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Antihypertensive Drugs ◽  
Significant Proportion ◽  
Subsequent Development ◽  
Risk Groups ◽  
Effective Control ◽  
Metabolite Markers

Early diagnosis and effective pharmacotherapy of arterial hypertension are urgent problems, a significant contribution to the solution of which can be made by metabolomics. The etiology of hypertension remains unknown for the majority of patients with high blood pressure; the diagnosis for 90% is defined as essential (primary) hypertension. This population is characterized by disturbance of the metabolic pathways of lipids, glucose, biogenic amines and amino acids, which may manifest with hyperlipidemia, hyperglycemia, and insulin resistance with the possible subsequent development of type II diabetes mellitus. The study of the metabolomic signature can provide a clue to the identification of biomarkers of hypertension and contribute to the effective development of preclinical diagnosis and identification of risk groups, as well as a more complete understanding of the etiological and pathogenetic mechanisms of increased blood pressure. Published studies indicate the existence of metabolome characteristic of hypertensive patients, distinguishing them from normotensive subjects. The most typical are changes involving amino acids, polyunsaturated fatty acids, carnitines, phosphatidylcholines, and acylglycerols.The variability of the response to antihypertensive therapy does not allow achieving effective control of blood pressure in a significant proportion of patients. The peculiarities of changes in the metabolome under the use of various pharmacological groups can be used to identify metabolite markers of the response to the main classes of antihypertensive drugs, as well as markers of the development of side effects of drug therapy. Thus, individualization of the pharmacotherapeutic approach based on pharmacometabolomics can significantly increase the efficacy and safety of antihypertensive therapy.This review aims to study the main groups of metabolites identified in published trials as predictors of the development of hypertension, as well as metabolite markers of response to antihypertensive therapy.

scholarly journals Choice of optimal antihypertensive therapy in patients with diabetes mellitus type 2

2022 ◽  
Vol 7 (4) ◽  
pp. 62-69
Author(s):  
V. A. Tsvetkov ◽  
E. S. Krutikov ◽  
S. I. Chistyakova
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Target Blood Pressure ◽  
Group I

Aim of the study: to develop personalized approaches to combined antihypertensive therapy in patients with type 2 diabetes mellitus and arterial hypertension, depending on the parameters of the daily blood pressure profile and heart rate variability.Material and methods. We examined 322 patients with type 2 diabetes and arterial hypertension who had not previously received antihypertensive drugs on a regular basis. At the first stage, patients were prescribed Perindopril 10 mg per day and Indapamide retard 1,5 mg per day. In the absence of reaching target blood pressure (BP) levels after 28 days, a third antihypertensive drug was added — Amlodipine 5 mg per day, followed by titration to 10 mg 1 r per day (group I) or a b-blocker — Carvedilol at a dose of 12,5 mg 2 r per day, also followed by titration up to 25 mg 2 r per day (group II). Daily monitoring of BP and ECG was carried out, the average daily heart rate (HR), circadian index (CI), as well as heart rate variability were determined.Results and its discussion. Patients with type 2 diabetes have a high variability of blood pressure throughout the day, high pulse blood pressure, as well as a rigid circadian profile of heart rate. The appointment of a standard two-component antihypertensive therapy, including Perindopril 10 mg and Indapamide retard 1,5 mg per day, allows reaching the target blood pressure only in 46% of patients. The addition of amlodipine or carvedilol significantly increases the effectiveness of therapy, allowing more than 80% of patients to achieve the target blood pressure. At the same time, the use of amlodipine leads to a greater extent to a decrease in pulse pressure, and the inclusion of carvedilol improves the circadian profile of blood pressure and heart rate, and has a positive effect on heart rate variability.

The influence of osteopathic correction on the rate of various rhythms of the body

2019 ◽  
pp. 64-71 ◽  
Author(s):  
A. E. Chernikova ◽  
Yu. P. Potekhina
Keyword(s):  
Heart Rate ◽  
Respiratory Rate ◽  
Age Groups ◽  
Biomechanical Properties ◽  
Dispersion Analysis ◽  
The Body ◽  
Body Tissues ◽  
Age Related ◽  
Significant Difference ◽  
Before And After

Introduction. An osteopathic examination determines the rate, the amplitude and the strength of the main rhythms (cardiac, respiratory and cranial). However, there are relatively few studies in the available literature dedicated to the influence of osteopathic correction (OC) on the characteristics of these rhythms.Goal of research — to study the influence of OC on the rate characteristics of various rhythms of the human body.Materials and methods. 88 adult osteopathic patients aged from 18 to 81 years were examined, among them 30 men and 58 women. All patients received general osteopathic examination. The rate of the cranial rhythm (RCR), respiratory rate (RR) heart rate (HR), the mobility of the nervous processes (MNP) and the connective tissue mobility (CTM) were assessed before and after the OC session.Results. Since age varied greatly in the examined group, a correlation analysis of age-related changes of the assessed rhythms was carried out. Only the CTM correlated with age (r=–0,28; p<0,05) in a statistically significant way. The rank dispersion analysis of Kruskal–Wallis also showed statistically significant difference in this indicator in different age groups (p=0,043). With the increase of years, the CTM decreases gradually. After the OC, the CTM, increased in a statistically significant way (p<0,0001). The RCR varied from 5 to 12 cycles/min in the examined group, which corresponded to the norm. After the OC, the RCR has increased in a statistically significant way (p<0,0001), the MNP has also increased (p<0,0001). The initial heart rate in the subjects varied from 56 to 94 beats/min, and in 15 % it exceeded the norm. After the OC the heart rate corresponded to the norm in all patients. The heart rate and the respiratory rate significantly decreased after the OC (р<0,0001).Conclusion. The described biorhythm changes after the OC session may be indicative of the improvement of the nervous regulation, of the normalization of the autonomic balance, of the improvement of the biomechanical properties of body tissues and of the increase of their mobility. The assessed parameters can be measured quickly without any additional equipment and can be used in order to study the results of the OC.

The association between heart rate variability and biatrial phasic function in arterial hypertension

2014 ◽  
Vol 8 (10) ◽  
pp. 699-708 ◽  
Author(s):  
Marijana Tadic ◽  
Cesare Cuspidi ◽  
Biljana Pencic ◽  
Tamara Marjanovic ◽  
Vera Celic
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Arterial Hypertension

Complex and irregular heart rate dynamics in fetuses compromised by maternal anemia as a high-risk pregnancy

2015 ◽  
Vol 43 (6) ◽  
Author(s):  
Young-Sun Park ◽  
Jeong-Kyu Hoh
Keyword(s):  
Heart Rate ◽  
High Risk ◽  
Approximate Entropy ◽  
Risk Groups ◽  
Adverse Outcomes ◽  
Maternal Anemia ◽  
Risk Pregnancy ◽  
Heart Rate Dynamics ◽  
Study Population ◽  
Normal Controls

AbstractTo examine how complex and irregular fetal heart rate (FHR) dynamics differ between fetuses of normal pregnancies and those of pregnancies complicated by maternal anemia (MA), and to place this in the context of high-risk pregnancies.Our study population consisted of 97 pregnant women affected by MA, 118 affected by pregnancy-induced hypertension (PIH), 88 affected by gestational diabetes mellitus (GDM), 53 with preterm premature rupture of membranes (pPROM), and 356 normal pregnancies as controls. We calculated approximate entropy (ApEn), sample entropy (SampEn), and correlation dimension (CD) to quantify irregularity and the chaotic dynamics of each FHR time series.The ApEn in the fetuses of the MA and PIH groups was significantly lower than that of the normal controls (P<0.05). The SampEn was significantly lower in the high-risk groups, except for the pPROM group, than in the normal controls (P<0.05). The CD in the PIH and severe MA groups was significantly lower than that of the normal controls (P<0.05, respectively). In the MA group, the dynamic indices showed a highly significant positive correlation with hemoglobin (Hb) levels (P<0.0001).The decreased complexity and/or irregularity in the FHR from pregnancies with MA may reflect abnormalities in the complex, integrated cardiovascular control. The irregularity and complexity of the FHR increased together with Hb levels in pregnancies with MA. Our data suggest that the integrity of the nervous system in the fetuses compromised by severe MA might result directly in adverse outcomes.

Postoperative endophthalmitis

2021 ◽  
pp. 185-187
Author(s):  
I.A. Frolychev ◽  
◽  
N.A. Pozdeyeva ◽  
◽  
◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Silicone Oil ◽  
Angiogenesis Inhibitor ◽  
Cataract Extraction ◽  
State Institution ◽  
Federal State ◽  
Postoperative Endophthalmitis ◽  
Ophthalmic Surgery ◽  
Corrected Visual Acuity

Surgical treatment of postoperative endophthalmitis is an urgent problem of ophthalmic surgery. Purpose.The aim of the study was to analyze the results of treatment of patients with postoperative endophthalmitis using perfluorodecalin and antibiotic solutions for vitreal cavity tamponade. Materials and methods. For the period 2016-2020, 35 patients (35 eyes) were operated in the Cheboksary branch of the S. Fyodorov Eye Microsurgery Federal State Institution. In 26 patients, this complication occurred after cataract extraction, in 7 after vitreoretinal operations, in 2 after intravitreal administration of an angiogenesis inhibitor. Visual acuity before treatment of endophthalmitis in 3 patients was to 0.02– 0.08, in 16 – counting of fingers in the face, in 13 – pr.l.certa, in 3-pr. l. incerta. All patients underwent vitrectomy with perfluorodecalin tamponade of the vitreal cavity for up to 14 days and intravitreal administration of vancomycin 1 mg and ceftazidime 2.25 mg at the end of the operation. On day 2-3, all patients underwent additional intravitreal administration of antibiotics, depending on the detected pathogen. Further, in 22 patients, the removal of perfluorodecalin and the remaining preretinal and peripherally located exudate was performed, in 13 patients - tamponade of the vitreal cavity with silicone oil. Results. As a result of the treatment according to the developed method, it was possible to preserve visual functions in 32 patients (91%) out of 35. At discharge, the corrected visual acuity was from 0.1 to 0.7 (0.28±0.2). After 6 months, the corrected visual acuity in 32 patients was from 0.1 to 0.9 (0.36±0.2). Visual acuity (above 0.3) was achieved in 26 cases (74.3%). Conclusion. Clinical results demonstrate the effectiveness of the developed method of surgical treatment of endophthalmitis. Key words: postoperative endophthalmitis, perfluorodecalin, intravitreal administration of vancomycin and ceftazidime.

Leptinemia, parameters of heart rate variability, and prognosis in patients with essential arterial hypertension with obesity

2014 ◽  
Vol 18 (4 (72)) ◽  
Author(s):  
O. Radchenko ◽  
N. Bek ◽  
V. Potapov
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Essential Hypertension ◽  
Arterial Hypertension ◽  
Cardiovascular Events ◽  
Serum Leptin ◽  
Ventricular Systole ◽  
Essential Arterial Hypertension

An examination of 103 patients with essential hypertension and obesity showed the dependence of autonomic cardioregulation, electrical ventricular systole, and prediction of adverse cardiovascular events on the serum leptin concentration (hyper-, normo – or hypoleptinemia).

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