Aldosterone blocker – Spironolactone has anti-inflammatory, anti-proliferative and anti-oxidative effects, that is why pathogenetically it is expedient to use it in complex therapy of rheumatoid arthritis.Material and methods: 46 patients with RA took 25-50 mg/day of Spironolactone during 12 months as an addition to standard therapy, the comparison group consisted of 47 patients that got only standard therapy, all the patients were fully examined prior and post the treatment.Results: complex RA therapy leads to improved VAS, HAQ, the antioxidative potential index F; decreased blood concentrations of TNF-α, ICAM-1, FGF and VEGF in contrast to standard therapy. Complex therapy made reduced the DAS 28 more > 0.6.Conclusions: applying of Spironolactone in complex therapy of rheumatoid arthritis contributes to more pronounced improvement in indices of articular syndrome and patient’s life quality, reduce of anti-inflammatory, anti-proliferative and angiogenic cytokines, and more effectively reduces the activity of the disease comparing to standard therapy.
Ингибиторы ангиотензинпревращающего фермента (иАПФ) обладают противовоспалительными, а нтипролиферативными свой-ствами и могут влиять на процессы ангиогенеза через снижение эффектов ангиотензина II (АТІІ). Применение иАПФ в комплекс-ной терапии ревматоидного артрита (РА) может быть эффективно и для контроля активности заболевания, и для снижения ри Angiotensin-converting enzyme (ACE) inhibitors have anti-inflammatory and antiproliferative properties and can affect the processes of angiogenesis, by reducing the effects of angiotensin II (ATII). The use of ACE inhibitors in the combination
Abstract:The article presents data on the effectiveness of the impact of selenium on clinical and laboratory parameters of rheumatoid arthritis (RA) in patients with subclinical hypothyroid dysfunction (SHTD). Aim -to study the influence of selenium on the clinical and laboratory parameters in patients with RA and SHTD. Material and Methods -The study included 78 patients with RA and SHTD. All patients underwent a complete clinical and functional, instrumental and laboratory examination for RA and thyroid dysfunction. Sodium selenite was added to the standard therapy of rheumatoid arthritis drug. Results -Our study showed that RA patients with concomitant SHTD after treatment with a complex scheme, which included the preparation of sodium selenite, improved articular syndrome activity of rheumatoid inflammation, reduced levels of thyroid stimulating hormon (TSH) and antithyroidperoxidase (aTPO), reduced the number of patients with elevated levels of aTPO (p<0.05). Conclusion -The use of sodium selenite in the treatment of RA patients with SHTD is an effective method of correction of the articular syndrome, reducing the levels of markers of inflammation and autoimmune manifestations of the whole process, which is very important and necessary to prevent the progression of the disease.
Background. A lot of scientific articles have been published since the global COVID-19 pandemic was officially announced by WHO. Although different aspects of COVID-19 impact on the mental sphere were studied, some issues regarding the psychological characteristics of those who have had a coronavirus infection are still not fully revealed. It is noted by many authors that even when the main symptoms of the disease are subsided, symptoms of anxiety, depression, cognitive & mood disorders are still persistent even after the treatment. Purpose: to study cognitive and emotional spheres of patients who are recovering from coronavirus infection and currently undergoing rehabilitation procedures. Materials and methods. The study involved 100 patients undergoing medical rehabilitation, 55 of them are recovering from traumatological, neurological and cardiovascular disorders (27 male and 28 female patients, aged 57±10) and 45 patients are recovering from pneumonia caused by coronavirus infection (11 male and 34 female patients, aged 58±12). The study was conducted using the Montreal Cognitive Assessment Scale (MoCA), the Hospital Anxiety & Depression Scale (HADS), and the Health-Activity-Mood Scale (SAN). Statistical analysis of raw data had included calculation of descriptive statistics, Pearson’s correlation coefficient, Student’s t-test for independent groups, Fisher’s φ* transformation and significance of correlation coefficients differences with Fisher’s transformation & Student T-distribution, and was processed with Microsoft Office Excel 2016 build-in data analysis package. Results. Analysis of MoCA results showed that ratio of severe impairments of memory functions and attention span is higher in post-COVID group of patients. This group also had higher rate of anxiety symptoms and sub-clinical depression state. In both groups more than a half of the patients have average level of anxiety and depression, however patients from post-COVID group are more likely to experience more symptoms of anxiety than non-COVID patients. Patients from post-COVID group are significantly more likely to have a higher scores of anxiety compared to patients in the other group and at the same time they are less likely to have average anxiety level. Differences between groups were discovered for “Health” and “Mood” scales of SAN with higher scores among post-COID patients as well as lower scores for “Activity” scale. Conclusion. Statistically significant differences between the groups were found; common and specific correlations were found for both groups. The results may be useful for healthcare professionals working with post-COVID patients, and can also be used by psychologists who deal with the problems of social and psychological rehabilitation of post-COVID patients.
Background:The high incidence of ankylosing spondylite (AS) in people of working age, as well as the negative impact of the disease on the quality of life of patients, determine the need for adjuvants to reduce the severity of pain and thereby achieve the physical, psychological and emotional well-being of patients.Objectives:To study the effect of vitamin D (colecalciferol) on the quality of life and the severity of pain in patients with ankylosing spondylite.Methods:The study included 69 patients with AS, who studied the quality of life indicators according to the Medical Outcomes Study Short Form (SF-36); pain syndrome and stiffness in the spine were assessed by a visual analogue scale by patients, and by a physician - by counting the number of painful joints (NPJ), the disease activity index (BASDAI) and the Functional Index (BASFI). All patients were receiving a basic therapy in a stable dose for at least 10 months. They were divided into 2 groups, comparable in age, disease activity; Group 1 (n = 33) additionally received colecalciferol 1500 МЕ during 6 months of observation.Results:At the end of the observation period when evaluating data on SF-36: in the 1st group, the physical health component has improved - the increase in physical functioning (PF) and bodily pain (BP) by 51.4% and 37.8% from the baseline; vital activity, psychological health, and social functioning due to emotional state have also increased by 37.6%, 33.4% and 42.5%, respectively. In the 2nd group above mentioned parameters have not changed. In the 1st group the indexes of BASDAI and BASFI have decreased by 16% and 22% (p = 0.0079, p = 0.0022, respectively), and their dynamics in the 2nd group were less significant (p = 0.013, p = 0.017, respectively) Also, in patients of the 1st group have decreased the severity of morning stiffness and the pain in the spine a highly reliable (p < 0.001), and in the 2nd group they were less significant (p = 0.043, p = 0.016, respectively). Positive dynamics of NPJ in the 1st group was more significant (p = 0.003) than it was in the 2nd group (p = 0.033).Conclusion:In the group of patients treated with colecalciferol was noted improvement in indicators of quality of life (the parameters of the physical component of health, vitality and social functioning) and also more significant decrease of the intensity of pain and of morning stiffness duration, of NPJ, than in not received to colecalciferol patients. Inclusion of vitamin D in the comprehensive AS therapy promotes not only reduction the severity of the chronic pain manifestations, but also improves the quality of life of patients with this pathology.Disclosure of Interests:None declared
Клинические и экспериментальные исследования патофизиологии ренин-ангиотензин-альдостероновой системы (РААС) свидетельствуют о ее важной роли в развитии сосу-дистого воспаления, оксидативного стресса, эндотелиальной дисфункции и пролиферации фибробластов [1-3]. Установлено, что активация РААС ведет к развитию и хронизации вос-О р и г и н а л ь н ы е и с с л е д о в а н и я ГУ «Луганский государственный медицинский университет», Луганск 91045 Луганск, кв. 50-летия Обороны Луганска, 1г
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