The aim: To analyse data from recent studies, dedicated to the use of non-steroidal anti-inflammatory drugs (NSAIDs); to evaluate the best clinical practice in the use of NSAIDs in order to prevent side effects (SEs) in different clinical scenarios; to optimise treatment of patients at risk of NSAIDs-related SEs. Materials and methods: A comprehensive bibliographic search was performed using the keywords “NSAIDs”, “NSAID gastropathy”, “NSAID enteropathy”, “complications of NSAID therapy”, “cardiovascular disease”, “cardiovascular risk” in the PubMed, Web of Science, Cochrane Library, Google Academy databases. Conclusions: NSAID-induced gastrointestinal lesions are а relevant problem of internal medicine, this is due to the fact that the pathogenic mechanisms of this process are still unclear. All the gastrointestinal tract (GIT) related risk factors(RFs) for gastro- and enterocolonopathies associated with the use of NSAIDs should be taken into consideration by physicians of all specialties. The examination and diagnostic of the GIT should be performed regularly to prevent complications. Uncontrolled, long-lasting, unprescribed NSAID usage should draw the attention of doctors, especially in patients with comorbid states.
The aim: To analyze and calculate CVR in patients with T2DM and concomitant obesity. Materials and methods: The selection of patients was carried out based on the Uzhhorod District Clinical Hospital, in the period from November 2016 to January 2020. All patients were divided into 3 groups: 1 (n=93) with T2DM and concomitant obesity, 2 (n=87) with T2DM, 3 (n=39) with obesity. The treatment period lasted 1 year and included dosed exercise for at least 30 minutes per day and dietary recommendations. Patients in groups 1 and 2 received metformin 850 mg twice daily in combination with dapagliflozin 10 mg once daily. CVR was determined at the time of enrollment and after 1 year of treatment using: American College of Cardiology / American Heart Association Guideline on the Assessment of Cardiovascular Risk (2013) (ASCVD Risk) and Framingham Risk Score (FRS). Results: The data obtained as a result of the study revealed the highest CVR in patients of group 1, in contrast to group 2 and 3 (p<0.05). After 1 year of complex treatment, CVR indicators were statistically significantly reduced in all experimental groups (p<0.05). Conclusions: Determining CVR parameters and exposure to them within 10 years can remove unwanted cardiovascular complications.
Introduction: According to the World Health Organization, depression is a common mental disorder characterized by despair, loss of interest or joy, feelings of guilt and low self-esteem, sleep disturbance or appetite, lethargy, and poor concentration. There is a series of studies that show the presence of depressive disorders in patients with obesity concomitant type 2 diabetes mellitus, but in our study, we wanted to demonstrate the degree of severity of these changes. The aim: Diagnose depression in patients with obesity and concomitant type 2 diabetes mellitus. Materials and methods: Examine patients with obesity and concomitant type 2 diabetes mellitus and select them for research. For the diagnosis of depression were used: Patient Health Questionnaire – 2 and 9, Hospital Anxiety and Depression Scale and Hamilton Depression Scale. Along with hypoglycemic therapy, all patients with diagnosed depression were given individual psychotherapy: cognitive behavioral therapy - 12 sessions per week, interpersonal therapy - 12 sessions per week and bibliotherapy. Results: Using the questionnaires scales, we found depressive disorders in patients with obesity and concomitant type 2 diabetes mellitus. Along with the diagnosis of depression, we managed to correct it using individual psychotherapy. Conclusions: Patients with obesity and concomitant type 2 diabetes mellitus are in a cohort with an increased risk of depression and should be diagnosed early. Given these patients polypharmacotherapy, treatment for depression should begin with non-drug therapy.
Вплив біологічної терапії у хворих з неспецифічним виразковим колітом при супутньому ураженні суглобів ДВНЗ «Ужгородський національний університет», факультет післядипломної освіти та доуніверситетської підготовки, кафедра терапії та сімейної медицини, м. Ужгород, Україна
The aim: Is to compare the effects of tofacitinib, adalimumab and budesonide clinical and laboratory signs of patients with moderate UC with concomitant articular syndrome. Materials and methods: 100 patients with moderately severe UC. Patients were divided into 2 groups. The I group consisted of patients with UC, which were treated with tofacitinib 10mg bid (TOF; n=28). II group consisted of patients who were treated with adalimumab with a starting dose of 160 mg and 80 mg on the 2nd week of treatment, after which they received a subsequent dosage of 40 mg per week (ADA; n=32). Patients in the III group received budesonide 9mg qd (BUD; n=40). Results: As a result of treatment in the TOF research group, leukocyte and CRP levels decreased compared to readings before treatment (from 13.6±2.4*109/l and 1698 14.0±1.4mg/l to 10.6±1.2*109/l and 11.0±2.1 mg/l respectively, p<0.05). Hemoglobin levels in this group slightly increased (from 104.2±9.2 g/l to 126.1±10.2 g/l, p<0.05). Among ADA patients, there was also an improvement in laboratory signs: leukocyte and CRP levels decreased (from 13.8±2.8*109/l and 16.0±1.2 mg/l to 6.0±2.2*109 /l and 11.8±1.2 mg/l respectively, r<0.05), hemoglobin increased (from 103.8±8.2 g/l to 118.6±8.6 g/l/l r<0.05). Conclusions: Tofacitinib and adalimumab in the treatment of patients with ulcerative colitis of moderate severity with concomitant joint damage showed a higher clinical and laboratory effectiveness compared to treatment with budesonide.
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