The objectives of this investigation were to study the effects of thigh cuffs (bracelets) on cardiovascular adaptation and deconditioning in 0 g. The cardiovascular parameters of six cosmonauts were measured by echocardiography, Doppler, and plethysmography, during three 6-month MIR spaceflights. Measurements were made at rest during preflight (-30 days), inflight (1, 3-4, and 5-5.5 months) without cuffs (morning) and after 5 h with cuffs, and during postflight (+3 and +7 days). Lower-body negative pressure (LBNP) measurements were performed 1 day after each resting session. Inflight values of left ventricle end-diastolic volume and stroke volume measured without the thigh cuffs (-8 to -24% and -10 to -16%, respectively, both P < 0.05) were lower than corresponding preflight values. The jugular and femoral vein cross-sectional areas (Ajv and Afv, respectively) were enlarged (Ajv: by 23-30%, P < 0.001; Afv: by 33-70% P < 0.01). The renal and femoral vascular resistances (Rra and Rfa, respectively) decreased (Rra: by -15 to -16%, P < 0.01; Rfa: by -5 to -11%, P < 0.01). Inflight, the thigh cuffs reduced the Ajv (by -12 to -20%, P < 0.02), but enlarged the Afv (Afv: by 9-20%, P < 0.02) and increased the vascular resistance (Rra: by 8-13%, P < 0.05; Rfa: by 10-16%, P < 0.01) compared to corresponding inflight, without-cuffs values. During LBNP (-45 mmHg, where 1 mmHg = 133.3 N/ m2), Rfa and the ratio between cerebral and femoral blood flow (Qca/Qfa) increased less inflight and postflight (+25% for Rfa and +30% for Qca/Qfa) than during preflight (60% for Rfa and 75% for Qca/Qfa, P < 0.01). This reduced vasoconstrictive response and less efficient flow redistribution toward the brain was associated with orthostatic intolerance during postflight stand tests in all of the cosmonauts. The calf circumference increased less inflight and postflight (6% P < 0.05) than preflight (9% P < 0.05). The vascular response to LBNP remained similarly altered throughout the flight. The thigh cuffs compensated partially for the cardiovascular changes induced by exposure to 0 g, but did not interfere with 0 g deconditioning.
Aim. To study the associations of the frequency and values of parameters of the main risk factors (RF) of cardiovascular diseases (CVD) and the degree of transnosological polymorbidity (PM) in patients with nonalcoholic fatty liver disease (NAFLD).Material and methods. The analysis of 3667 medical records (men, women) treated in the clinic of Research Institute of Experimental and Clinical Medicine (Novosibirsk) was carried out. Index of polymorbidity was evaluated by the number of nosological forms in accordance with the International Classification of Diseases, 10th revision (ICD-10). The following risk factors were assessed according to clinical and laboratory tests: arterial hypertension, dyslipidemia, hyperglycemia, obesity.Results. Both among men and women with increasing index of PM there was identified growth of the parameters that determine the main RF: systolic BP, diastolic BP, obesity (both in men and women), atherogenicity index (in women), glucose concentration in the blood serum (in women). Frequency of AH occurrence in persons with a high degree of PM among men was 49%, and among women — 69% higher, compared with persons with a low degree of PM. Among men, there was an increase in the incidence of AH (by 9%) and obesity (by 9%) in individuals with a high degree of PM, compared with individuals with an average degree of PM. Among women, there was an increase in the incidence of AH (by 15%), obesity (by 9%), hyperglycemia (by 11%) in persons with a high degree of PM, compared with individuals with an average degree of PM.Conclusion. There was established the role of risk factors for cardiovascular diseases, arterial hypertension mainly, in the development of polymorbidity in patients with NAFLD. The findings indicate the need for personified prevention and treatment of such patients with mandatory identification and correction of modifiable CVD RF.
Purpose. To study regional features of the association of frequency of occurrence and the magnitude of the indices of the main risk factors for chronic non-communicable diseases (RF CNCD) with the degree of transnosological polymorbidity (PM) in male residents of the Novosibirsk Region (NR) and Saha (Yakutia) Republic. Methods. The analysis of 10 187 medical records of patients with therapeutic profile (men), examined and treated in the clinic of the Federal Research Center for Fundamental and Translational Medicine, Novosibirsk was carried out. The index of transnosological polymorbidity was assessed by the number of nosological forms in accordance with the ICD-10. According to the clinical and laboratory examination, the following RF CNCD were assessed: high blood pressure, increased blood levels of total cholesterol, low-density lipoprotein cholesterol, triglycerides, glucose, uric acid, decreased blood level of low-density lipoprotein cholesterol, obesity. Results. Both among the residents of the NR and of the Yakutia, with an increase in the index of polymorbidity, there was an increase in the severity and frequency of occurrence of the studied RF CNCD. There was an increase in the frequency of occurrence in persons with high PM in comparison with those with a low degree of PM: arterial hypertension among residents of NR and of the Yakutia - by 2 times (p < 0.001), increase in total cholesterol in the blood among residents of the NR and of the Yakutia - by 1.2 times (p < 0.001, p = 0.003 respectively), obesity - for residents of the NR by 2.4 times, for residents of the Yakutia - by 1.7 times (p < 0.001), hyperglycemia - in residents of NR - by 2 times (p < 0.001), hyperuricemia - among residents of NR - by 1.5 times (p < 0.001). Conclusion. The role of some hemodynamic and metabolic risk factors of RF CNCD in the development of polymorbid pathology among residents of the regions of Siberia and the North has been established. The obtained data indicate the need to take into account the region of residence of such patients in the course of personalized prophylaxis with mandatory detection and correction of the modifiable RF CNCD.
Aim of the study was to investigate the peculiarities of the relationship of polymorbid pathology in arterial hypertension with disorders of lipid, purine and carbohydrate metabolism. Material and methods. Patients with arterial hypertension with the presence of polymorbid pathology, who underwent examination and treatment at the clinic of the Federal Research Center for Fundamental and Translational Medicine (Novosibirsk), were examined. A total of 9775 people were examined. The patients were divided into 2 groups: with arterial hypertension in the dyslipidemia absence (n = 561(252 men (44.9 %), 309 women (55.1 %), average age 57.1 ± 0.60 years) and in the dyslipidemia presence (n = 9214 (3879 (42.1 %) men, 5335 (57.9 %) women, average age 57.82 ± 0.12 years). Results and discussion. Hyperglycemia and hyperuricemia were more common in patients with arterial hypertension with dyslipidemia; the indicators were statistically higher: total serum cholesterol, low-density lipoprotein cholesterol, triglycerides, atherogenic index, serum glucose, uric acid compared with patients with arterial hypertension without dyslipidemia. In patients with dyslipidemia, compared with patients without dyslipidemia, arterial hypertension was more often combined with diseases of the endocrine system, nutritional disorders and metabolic disorders, and other diseases of the circulatory system. Conclusion. The data obtained can serve as a theoretical basis for the concept of care for polymorbid patients, based on the impact on the main key pathogenetic mechanisms of diseases, and new approaches to complex treatment, rehabilitation and personalized prevention, taking into account the impact on modifiable risk factors.
Полиморбидность представляет собой актуальную проблему современной медицины, связанную с ухудшением по сравнению с изолированной патологией прогноза заболевания, увеличением тяжести течения, количества осложнений, трудности и стоимости диагностики и лечения. Изучение качества жизни (КЖ) больных с полиморбидностью необходимо для грамотного распределения ресурсов здравоохранения. Цель исследования -изучить влияние транснозологической полиморбидности (ТПМ) на компоненты КЖ у пациентов терапевтической клиники. Материал и методы. На базе клиники ФГБНУ «Федеральный исследовательский центр фундаментальной и трансляционной медицины» (г. Новосибирск) проведено обследование 116 мужчин и женщин в возрасте от 20 до 75 лет. ТПМ оценивали по среднему количеству нозологий, соответствующих трехзначной рубрификации МКБ-10, показатели КЖ -с применением валидизированного опросника SF-36. Для анализа количества и тяжести хронических заболеваний в структуре полиморбидности использовали систему CIRS (Cumulative Illness Rating Scale). Результаты. В зависимости от степени выраженности ТП сформировано 3 группы больных: с низким (n = 42), средним (n = 52) и высоким уровнем ТПМ (n = 22). Сравнительный анализ показал значимое уменьшение уровня физического функционирования (на 27 %), физического и психического компонентов здоровья (на 26,3 и 15,8 % соответственно), интегрального показателя КЖ (на 19,2 %) у пациентов с высоким уровнем ТПМ по сравнению с больными с низким уровнем ТПМ. Корреляционный анализ подтвердил наличие статистически значимой связи между увеличением ТПМ и снижением основных показателей КЖ. Заключение. Возрастание степени ТПМ значимо связано с уменьшением основных показателей КЖ.Ключевые слова: полиморбидность, качество жизни, хронические заболевания.Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.
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