Introduction. Combat stress is characterized by extreme impact on the human mind, the psychological consequences of which are expressed in extreme manifestations in post-traumatic stress disorder (PTSD). With the participation of a large number of people in local armed and interethnic confl icts PTSD can cause health problems, complete or partial disability and lead to social disadaptation.Goal of research — objective is to identify the main psychosomatic disorders after suffering combat stress.Materials and methods. 268 men between 21 and 49 years old, combat veterans (main group), and 60 military men of the same age who did not take part in combat operations (control group) were examined. In order to study the disorders of the cardiovascular system in veterans, the following methods were used: ECG monitoring for 12 hours and for 24 hours, blood pressure monitoring, bicycle ergometry, and echocardiography, clinical and biochemical examinations, plain and contrast X-ray examinations, CT imaging of the thoracic and abdominal cavities and pelvic organs, ultrasound of the internal parenchymal organs, endoscopic examination of the hollow organs in order to detect dysadaptation in the gastrointestinal and hepatobiliary zones. Adaptation disorders in the musculoskeletal system were examined with the use of laboratory and instrumental techniques. Changes in the reproductive system were assessed in accordance with the quality of spermogram and the level of the corresponding hormones in the blood serum.Results. According to the results of the research psychosomatic disorders were observed in almost a half of the examined veterans of military operations. In the period up to 3 years after the effect of combat stress from psychosomatic disorders various manifestations of autonomic dysfunction dominated. Vegetative disorders were combined with affective disorders mainly of anxiety-depressive spectrum. In the period of long-term consequences of combat trauma polysystemic somatic nosological forms were observed due to the failure of compensation mechanisms and generalization of pathological processes. The most important aspect of the development of psychogenic pathology is the gradual loss of specifi city with the transition to nonspecifi c somatic organic pathology. This refl ects the peculiarity of the course of psychosomatic pathology in the form of a subsequent increase in «somatization» and the relevance of the search for methods of treatment.Conclusion. In this regard osteopathy based on the principles of holism is able to offer unique techniques. It is advisable to study involving of osteopathic doctors in the treatment and rehabilitation of veterans.
The goalis to evaluate the influence of meloxicam on the level of blood pressure among patients suffering from hypertension, as well as among patients without diseases of the cardiovascular system, in relation to its pro-hypertensive effect.Materials and methods.The retrospective research involved 60 patients who regularly taked meloxicam in a dose of 7.5 mg / day. There were patients who didn’t have a cardiovascular pathology in the first group. The second group consisted of patients with hypertension, taking antihypertensive drugs. Retrospectively, the level of blood pressure, measured by the Korotkov’s method, was analyzed by medical histories, before and after 3 months of taking meloxicam in both groups. The total cardiovascular risk was calculated on a SCORE scale.Results.It was determinated that long-term medication of meloxicam led to an increase of blood pressure indicators, both in patients without established diseases of the cardiovascular system, and in patients with the hypertension and an average total cardiovascular risk, who are regularly taking antihypertensive pills to achieve target blood pressure.
The aim of the study was to develop a method for diagnosing pre-nosological changes in the electrophysiological state of the myocardium in patients with somatoform dysfunction of the autonomic nervous system (SDANS) and risk factors for cardiovascular diseases using the ECG dispersion mapping method. Materials and Methods. The study involved 109 male patients, 58 of them with SDANS, and 51 were healthy subjects. The patients with SDANS had the following risk factors for cardiovascular diseases, in decreasing order: stress (71% of cases), low physical activity (59%), smoking (57%), overweight and obesity (43%), anxiety (41%), low consumption of vegetables and fruit (36%), lack of extra aerobic physical activity (36%), excessive alcohol consumption (34%), depression (26%), total cholesterol ≥5 mmol/L (23%), and heart rate ≥80 (9% of the cases). All the subjects underwent clinical examination, laboratory investigation, ECG, ECG dispersion mapping, heart rate variability monitoring. Results. Using the method of ECG dispersion mapping allowed a way for diagnosing pre-nosological changes in the electrophysiological state of the myocardium in male patients with SDANS, the basis of the pathogenesis of which is formed by the tension of the regulatory systems. Correlation between the total score according to the developed method, the RRNN value after 4 min of staying in orthostasis, and the “Myocardium” integral index has been proved. The diagnostic sensitivity of the proposed method with a threshold score of 8 was 80%, specificity — 70.8%. Conclusion. The developed method for assessing pre-nosological changes in the electrophysiological state of the myocardium which includes cardiovascular risk factors with a reclassifying potential, proves the development of pre-nosological changes in patients with SDANS in response to daily physical strain. The changes are associated with the tension of the electrophysiological state of the myocardium, an increased activity of the sympathetic division of the ANS being one of its pathogenetic mechanisms.
Aim. To study the role of markers of endothelial dysfunction, oxidative and cellular stress in the prediction of myocardial infarction (MI) in comorbid patients with stable coronary heart disease (CHD). Material and methods. The study involved 336 patients with a diagnosis of CHD. The presence of CHD was confirmed by diagnostic coronary angiography with the calculation of the Gensini index. All patients were divided into 2 groups: group 1288 patients without a history of MI, group 248 patients with a history of MI. All patients were assessed for the levels of oxidized modified proteins, high-sensitivity C-reactive protein (hs-CRP), homocysteine, heat shock protein (HSP70), and superoxide dismutase activity. Results. All patients were comparable in age. For other clinical and anthropometric characteristics, we saw significant differences (according to the MannWhitney criterion): patients with previous MI had higher BMI, waist circumference, and blood pressure. The correlation analysis revealed positive significant average strength relationships between past MI and the Gensini index, low-density lipoprotein level, total cholesterol level, homocysteine level, hs-CRP level, and the level of oxidized modified proteins; and negative significant average strength relationships between past MI and SOD activity level (r=-0.374, p=6.4 E-07) and HSP70 level (r=-0.563, p=2.6 E-15). The ROC analysis revealed that not all markers were significant in predicting the risk of MI. It is shown that the most expected characteristics were shown by the hs-СRP. However, further analysis of the predictive significance of the markers demonstrated that the addition of HSP70 to hs-CRP increases the predictive significance of hs-CRP in relation to the risk of developing MI. Conclusion. We have demonstrated that a strategy using a cumulative risk assessment consisting of 2 biomarkers (individually involved in inflammation and stress-induced cellular responses) can identify patients with an established diagnosis of CHD who have an increased risk of acute MI.
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