Objective: to test the patented “Method for determining a high risk of atherosclerosis in rheumatoid arthritis” on patients with rheumatoid arthritis.Materials and methods: 74 patients with RA who underwent inpatient treatment were examined. Gender composition of respondents: 77% women and 23% men. Mean age 54.1±9.1 years. The duration of RA is from 1 year to 26 years. 85.1% were diagnosed with a high degree of disease activity. Erosive arthritis was detected radiographically in 41 patients (55.4%). 83.7% (n=62) were seropositive for RF, 81% for ACCP (n=60). All received basic anti-inflammatory therapy. Systemic glucocorticoid therapy was received by 33.7%. All patients were calculated cardiovascular risk according to SCORЕ and mSCORЕ Also, all patients underwent duplex scanning of the BCA to detect atherosclerosis.Results: no significant increase in traditional factors of cardiovascular diseases was found among patients. When CVR was stratified according to SCORE, the frequency of low risk was 32.4%, moderate — 59.5%, high — 5.4%, very high — 2.7%. When using mSCORE, low risk was found in 27%, moderate — 56.7%, high — 13.5%, very high — 2.7%. Atherosclerotic plaques (ASP) in the carotid arteries in patients stratified according to SCORE for moderate, high and very high risk was detected in 68%, in persons with similar risks according to mSCORE — in 66.7%. With a score of 4 or more when using the tested method, ASP was found in 77.8%. Sensitivity for the detection of ASP in the carotid arteries using SCORE was 0.77, with mSCORE and the tested method 0.81 and 0.95, respectively. Specificity 0.47, 0.4 and 0.6 respectively. Positive predictive power for SCORE — 0.68, mSCORE — 0.67, tested method — 0.77. Negative predictive power for SCORE — 0.58, mSCORE — 0.6, tested method — 0.9.Conclusion: the study showed that our proposed method, which uses traditional clinical markers, significantly increases the sensitivity, specificity, and negative predictive power of calculation methods for identifying a group of individuals with a high risk of atherosclerotic lesions of extracranial arteries against the background of rheumatoid arthritis compared with using the SCORE and mSCORE parameters.
Авторами представлен обзор современных данных об особенностях развития и течения остеоартрита (ОА) у пациентов с коморбидными заболеваниями (сахарный диабет, сердечно-сосудистая патология, артериальная гипертензия). Наличие коморбидных заболеваний создает трудности в выборе адекватной терапии ОА. Выполнен анализ современных рекомендаций по рациональному применению нефармакологических, фармакологических и хирургических методов лечения больных с различной локализацией ОА. Особое внимание уделено показаниям к применению и результатам исследования эффективности внутрисуставного применения препаратов гиалуроновой кислоты, а также преимуществам их сочетания с традиционной терапией. В статье описаны механизмы действия препаратов гиалуроната натрия, обсуждаются особенности их применения в клинической практике. Приведены результаты клинических и экспериментальных работ, подтверждающих рациональность применения 1% протеза синовиальной жидкости (Ферматрон ®) для коррекции повреждений мелких суставов и связочного аппарата, в т. ч. дегенеративных поражений суставов первого пальца кисти (ризартроз) и болезни де Кервена. Данный обзор предназначен для врачей первичного звена здравоохранения. Представленная в обзоре информация поможет в осуществлении выбора адекватной терапии у пациентов с основными вариантами течения дегенеративно-дистрофических поражений суставов.
It is generally accepted that the diagnostic criteria for hemodynamically significant compression of the left renal vein are the anteroposterior size of the renal vein determined by ultrasound examination in the narrowed area of 1.5–2.5 mm or less. Purpose of the study: determine the features of the work of the aorto-mesenteric "forceps" on the basis of mathematical analysis. A polypositional ultrasound examination of the kidneys, renal arteries and veins was carried out in 6 positions (standing, sitting, on the back, on the stomach, on the right and left sides). The parameters of the aorto-mesenteric "forceps" (AMP) were determined on the basis of ultrasound and mathematical analysis. Research results: In different positions of the body, the velocity indicators of arterial and venous blood flow, the diameter of the renal (PV) vein in the main part, at the gate and in the AMP change. Pressure fluctuations in the left renal vein are position-dependent and are a factor influencing the work of the aorto-mesenteric forceps.
Objective: to estimate of the effect of diosmin in complex antihypertensive therapy on renal function in patients with hypertension and impaired renal venous blood flow.Materials and methods: we observed 147 patients with hypertension aged 40.86±8.27 with signs of bilateral impairment of venous blood flow in the kidneys, which, depending on the amount of therapy, were divided into 2 groups and 2 subgroups. The comparison group consisted of 57 AH patients with unchanged venous blood flow in both kidneys.Results: in the presence of impaired venous blood flow in the renal veins, the use of additional administration of diosmin allows maintaining or improving the filtration capacity of the kidneys. Additional monitoring of patients with impaired venous blood flow in the kidneys is required to assess the effectiveness of antihypertensive therapy with individual drugs with and without venoactive agents.Conclusion: the additional inclusion of diosmin in the complex antihypertensive therapy of patients with arterial hypertension and impaired venous blood flow to the kidneys can preserve and improve kidney function with normalization of GFR.
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