Резюме. Проведено сравнительное изучение уровней эндотоксинемии, фактора некроза опухо-ли α, С-реактивного белка, sE-селектина, матриксной металлопротеиназы 9 (ММР) и тканевых ин-гибиторов металлопротеиназ 4 (TIMP) у больных хронической сердечной недостаточностью (ХСН) в зависимости от стадии заболевания. Показано, что прогрессирование ХСН ассоциируется с актива-цией системного воспаления, а также дисбалансом в системе ММР-TIMP, который может приводить к нарушению структуры экстрацеллюлярного матрикса миокарда и способствовать ремоделирова-нию отделов сердца при данном заболевании.
MARKERS OF SYSTEMIC INFLAMMATION AND MATRIX METALLOPROTEINASE / TISSUE INHIBITOR OF METALLOPROTEINASES SYSTEM AT DIFFERENT STAGES OF CHRONIC HEART FAILUREAbstract. A comparative analysis of endotoxinemia grade, tumor necrosis factor α, C-reactive protein, sEselectin, matrix metalloproteinase-9 (MMP) and tissue inhibitor of metalloproteinases-4 (TIMP) levels was performed in a group of patients with chronic heart failure (CHF). An association has been shown between CHF progression and activation of systemic inflammation, like as with an imbalance in MMP/TIMP system. These alterations may represent a factor of structural disturbances in myocardial extracellular matrix, and promote a compartmental heart remodeling in this disorder.
One of the key concepts of modern medicine is the quality of life associated with health, which is influenced by the initial underlying disease, its timely diagnosis and quality treatment, as well as rehabilitation, further prevention and identification of complications that have arisen. The conditions and lifestyle of the patient play an important role, not only his physical health, but also mental health. Despite the fact that benign prostatic hyperplasia (BPH) is not a life-threatening disease, its main clinical signs are symptoms of dysfunction of the lower urinary tract, which to a greater extent cause discomfort to patients and significantly reduce their quality of life. One of the triggering factors for the development of prostate cancer is neglected cases of BPH progression. The occurrence of prostate cancer, as a consequence of BPH, undoubtedly worsens the patient's quality of life and requires timely diagnosis, detection and immediate treatment. Based on the literature data, the article analyzes the risk factors for the occurrence and the main methods of treatment for BPH and prostate cancer, which negatively affect the patient's quality of life.
The article presented an overview of literary sources, which include a description of various surgical techniques for the treatment of benign prostatic hyperplasia in different historical periods. The assessment of the disadvantages and advantages of various surgical methods for the treatment of benign prostatic hyperplasia has been made. Modification and improvement of surgical interventions, changes in methods and approaches to surgical treatment of benign prostatic hyperplasia made the surgeon’s work more accessible and of high quality. The development of surgical methods of treatment has made it possible to increase the efficiency of surgical interventions, which, in turn, has a positive effect on the quality of life of urological patients.
The use of laser technology in the surgical treatment of patients with benign prostatic hyperplasia has recently become widespread and introduced into practice. This area of surgery uses a large range of laser modifications and methods of their application when performing surgical interventions on the prostate. The article discusses laser devices for minimally invasive operations on patients with benign prostatic hyperplasia in comparison with traditional methods of BPH surgical treatment. The advantages of using laser technologies include the reduction of the time of surgical intervention, the decrease in the number of traumatic complications and bleeding, the absence of the damaging effect of the shock wave, the possibility of using it with surgical instruments of the minimum diameter, and the possibility of using it with flexible surgical instruments.
At present, the quality and availability of medical care are the aspects to which close attention is paid in the system of organizing medical care. One of the ways to achieve a high level of quality and accessibility of medical care is building up human resources, i.e. the presence of highly qualified general practitioners, sub-specialties and middle medical personnel in sufficient numbers in a medical organization. Currently, the oncological service of Russia has been assigned tasks to fulfill the instructions from the State Program for the Development of Health Care. The results of the work should lead to a decrease in mortality and an increase in the quality of life of the population. To address the issue of reducing mortality from malignant neoplasms, in particular from prostate cancer, a three-level system of oncological care has been created on the territory of the Nizhny Novgorod Region, including 1 regional center, 2 interdistrict cancer centers, 88 primary oncology rooms and 96 examination rooms. The tasks set to reduce morbidity and mortality from oncological diseases can be realized only with close interaction of the oncological service with the primary health care sector, in which the prevention should be the priority direction of work.
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