Понятие качества жизни положено в основу новой парадигмы понимания болезни и определения эффективности методов ее лечения. Целью исследования являлась оценка влияния анемии на качество жизни больных с ранними стадиями диабетической нефропатии. Обследовано 127 больных с сахарным диабетом 2 типа, осложненным хронической болезнью почек (ХБП) 1-3 стадий. Изучение качества жизни с использованием методики SF-36 показало, что анемия, вне зависимости от стадии ХБП, ассоциирована со снижением показателей по шкалам ролевого функционирования, обусловленного физическим состоянием, и ролевого функционирования, обусловленного эмоциональным состоянием. У больных с анемией и ХБП 3 стадии наблюдалось также снижение качества жизни по шкалам общего состояния здоровья, физического функционирования, интенсивности боли, жизненной активности и психического здоровья. В работе обсуждаются возможные причины выявленных изменений качества жизни и их значение с медицинских и гуманитарных позиций. Ключевые слова: качество жизни, сахарный диабет, диабетическая нефропатия, хроническая болезнь почек, анемия.
Introduction and purpose. The article presents data on the obesity and endothelial dysfunction, on influence of smoking on the developing of endothelial dysfunction. Material and methods. Examined 108 patients (90 women and 18 men) with obesity aged 45 to 65 years old (middle age 54.62±0.43) with different degrees of obesity. Vasomotor endothelial function was evaluated by the method of Celermajer et al. Analyzed early markers of endothelial dysfunction in patients with metabolic syndrome. Statistical processing of the data using a nonparametric Wilcoxon-Konovalov and Mann-Whitney. Conclusions. Based on the study preliminary conclusions can be made of the importance of identifying early markers of endothelial dysfunction in these patients and how smoking influences on developing of vascular pathology in patients with obesity.
The features of gut microbiota in metabolic syndrome (MS) and ways to correct it using autoprobiotics, based on indigenous bacteria obtained from fecal samples of the host, remain unexplored. The aim of the study was to investigate the effectiveness of an indigenous consortium (IC) of fecal bacteria in treatment of patients with MS. The study was carried out on 36 patients with MS, manifested with abdominal obesity, eating disorders, dyslipidemia, and hypertension. The control group was formed by 20 healthy volunteers. Samples of IC and gut microbiota content were examined by qPCR and metagenome (16S rRNA) analysis before and after therapy. The decrease in anthropometric parameters of obesity, liver enzyme level correction, reduction in C reactive protein and triglyceride concentrations were revealed after IC usage. The decrease in genera Bifidobacterium, Enterobacter, Paraprevotella, and Prevotella, as well as an increase in Bacteroides fragilis and Oscillospira spp. populations were shown after consumption of IC. A negative correlation between the quantity of B. fragilis and the anthropometric parameters of obesity (r = −0.48) and C reactive protein level (r = −0.36) in serum was established. Thus, IC can be considered as a potential functional personified product for the therapy of MS.
The authors consider anatomical/physiological characteristics and a role of different autonomic CNS regions, including insula cortex, amygdala complex, anterior cingulate cortex, ventral medial prefrontal cortex, hypothalamus and epiphysis, involved in the regulation of cardiovascular activity. The damage of these structures, e.g., due to the acute disturbance of cerebral blood circulation, led to arrhythmia, including fatal arrhythmia, in previously intact myocardium; systolic and diastolic dysfunction, ischemic changes considered in the frames of cerebro-cardial syndrome. On the cellular level, the disturbance of autonomic regulation resulted in catechol amine excitotoxicity, oxidative stress and free radical myocardium injury.
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