All articles - Cardiovascular System and Cardiology
Number of articles: 482
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ESTIMATION OF EFFECTIVENESS OF IMMUNO-CORRECTIVE THERAPY IN PATIENTS WITH CHRONIC OBSTRUCTIVE BRONCHITISChronic obstructive bronchitis (COB) is part of chronic obstructive pulmonary disease (COB) and is the most common of all forms of COB. COB is considered an unfavorable variant of COB due to increasing impairment of pulmonary ventilation, gas exchange and the development of severe complications. The study examined the clinical and immunological effectiveness of the immunomodulator of bronchomunal in patients with chronic obstructive bronchitis. The study involved 20 patients suffering from chronic obstructive bronchitis aged 15 to 35 years. The results of the study showed that the clinical and immunological effectiveness of bronchomunal allows the use of these drugs in the treatment of chronic obstructive bronchitis. Clinical indicators for the appointment of bronchomunal in patients with COB are frequent exacerbations with relapses of respiratory tract infections.
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POTENTIAL RISK FACTORS IN THE DEVELOPMENT AND PROGRESSION OF NONSPECIFIC INTERSTITIAL PNEUMONIACurrently, the interest of a number of domestic and foreign researchers in the problem of timely diagnosis and treatment of respiratory diseases has sharply increased. Nonspecific interstitial pneumonia (NPSI) was considered an orphan disease. Currently, there is a significant increase in this pathological condition, in particular, it is associated with the coronovirus pandemic, where interstitial pneumonia is a serious complication. The prevalence of NSAIDs is approximately the same as that of ILF. The prevalence of NSIPs is about 40 patients per 100 thousand people. Potential risk factors include viruses, smoking, diabetes mellitus, gastroesophageal reflux, organic and inorganic dust, heredity, etc. With NSAIDs, chronic inflammation and persistent viral infections can synergistically support autoimmune lesions that were previously described as ILF / idiopathic fibrosing alveolitis. However, causative antigens in NSIP remain unknown.
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INFLUENCE OF BEDAQUILINE ON THE EFFECTIVENESS OF COMPLEX TREATMENT OF TUBERCULOSIS OF THE RESPIRATORY SYSTEMThe problem of treating patients with multidrug-resistant tuberculosis (MDR-TB) has been one of the world's leading problems in the field of Phthisiology since the early 2000s. In 2013, the world health organization approved bedaquiline as a new antimicrobial drug with a new mechanism of action. The aim of the work was to evaluate the possibility of improving the clinical effectiveness of treatment of respiratory tuberculosis by prescribing the drug bedaquiline. The presented results were obtained on the basis of dynamic observation and treatment of 58 patients with drug-resistant tuberculosis of the respiratory system who were treated in the Samarkand regional TB dispensary from 2017 to 2020. Positive efficacy when using the drug bedaquiline (stopping the release of mycobacteria and closing the decay cavity) was noted in newly identified patients with infiltrative pulmonary tuberculosis and disseminated pulmonary tuberculosis. Administration to patients who have not previously taken the drug bedaquiline can reduce the clinical symptoms of the disease, significantly reduce the inflammatory process and the volume of the decay cavities.
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CLINICAL AND IMMUNOLOGICAL FEATURES OF THE COMBINATION OF BRONCHIAL ASTHMA AND CHRONIC OBSTRUCTIVE LUNG DISEASEThe study was conducted on the basis of the Samarkand city medical association. We examined 80 patients with a diagnosis of bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD). Bronchial asthma (BA) and Chronic obstructive pulmonary disease (COPD). Among them, the male gender prevailed and amounted to 51 (63.75%), women, respectively, were 29 (36.25%). Patients were randomized into 3 groups: group 1 comprised 27 (33.75%) patients with BA, group 2 27 (33.75%) patients diagnosed with COPD and 26 (32.5%) patients had a combination of these two diseases. In COPD and BA , changes in the immune system occur, which differs significantly from each other, primarily due to a significant increase in the content of cytotoxic lymphocytes in the blood of patients with COPD.
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STUDY OF POLYMORPHISM OF IL-1 T / C 511 GENE IN PROGRESSION OF UNSTABLE STENCARDIA IN PATIENTS WITH COMORBIDE PATHOLOGIESThe study was conducted at the Samarkand branch of the Republican Center for Emergency Medicine. The study included 205 patients with a diagnosis of unstable angina. The average age of patients was 62.4 years. In our study, the female gender prevailed and amounted to 58.1%. In our study, we studied IL-1 β gene polymorphism — replacing cytosine (C) with thymine (T) at position –511. DNA was isolated from peripheral blood lymphocytes by perchlorate extraction with ethanol precipitation. Gene variants carrying point nucleotide substitutions — IL-1 β (–511) in the C / T promoter region. In our study, the relationship of pro-inflammatory cytokines with pathological T / T and C / T genotypes of IL - 1β 511 (rs16944) was established. It should be noted that patients with IL-1β 511 gene polymorphism (rs16944) had frequent anginal attacks, cases with ST segment elevation and depression, or T wave inversion. Patients with the T / T genotype were mostly included in the group of patients with high depression and hard to treat.
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SIGNIFICANCE OF FUNCTIONAL DISORDERS OF THE KIDNEYS IN PATIENTS WITH MYOCARDIAL INFARCTION ON THE BACKGROUND OF TYPE 2 DIABETES MELLITUSThe aim of the study was to study the role of kidney dysfunction in the weighting of acute myocardial infarction (MI) clinic against the background of type 2 diabetes mellitus (DM 2). 104 patients with acute myocardial infarction were examined: 40.4% of women and 59.6% of men. 65.4% of patients had type 2 diabetes. It was found that in type 2 diabetes, MI often develops in women of relatively older age (over 60 years), with a duration of diabetes of more than 5 years, with a subcompensated or decompensated course of the disease. In type 2 diabetes, impaired renal function is a risk factor for developing and exacerbating the severity of MI. Signs of nephropathy proteinuria, cylinduria and a decrease in glomerular filtration below 80 ml / min are the background for the development of myocardial infarction. Lowering the GFR in MI patients with type 2 diabetes below 60 ml / min may contribute to fatal outcomes.
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STUDY OF SERUM CYTOKINE LEVELS IN VARIOUS FORMS OF SEVERE BRONCHIAL ASTHMABronchial asthma (BA) is considered as a heterogeneous pathogenetic disease, which can be based on both immunological and non- immunological mechanisms United by a common pathogenetic link. The study of cytokine levels provides information about the functional activity of various types of immunocompetent cells, the severity of the inflammatory process, its transition to the systemic level, and the ratio of activation processes of T-helper types 1 and 2. For this purpose, 45 patients with AB were examined. The first group included 17 patients with allergic BA (ABA), the second group included 11 patients with non – allergic BA (NBA), and the third group consisted of 17 patients with mixed BA (MBA). The level of IFN-γ, IL-4 in blood serum was determined using test systems for quantitative determination by solid-phase IFA.The obtained results show some dependence of IL-4 and IFN-g levels in patients with AB with a pathogenetic variant of the disease, the distinctness of which is more pronounced in patients with ABA. In patients with ABA and MAB, there is a pronounced inhibition of IFN-γ production, while in patients with AB with a predominantly allergic mechanism of the disease, a significant increase in the level of IL-4 is registered.
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QUALITY OF PRIMARY MEDICAL CARE IN PATIENTS WITH CHRONIC HEART FAILUREThe article presents the analysis of the quality of medication therapy for patients with chronic heart failure of various degrees of severity, observed at general practitioners, and the performance of the prescribed treatment by patients. The evaluation of quality and efficiency of medication treatment of CNS patients by general practitioners and factors influencing the observance of patients' medical recommendations has been carried out. The retrospective research was conducted in four family policlinics of Samarkand. The study included 78 men and 63 women diagnosed with CNS of I-IV functional class (FC) at the age of 47 to 83 years (average 66.4±7.8 years). There were 19.3% of patients with I FC, 35.7% with II FC, 37.9% with III FC and 7.1% with IV FC. As shown by the results of the study, medication treatment prescribed by general practitioners, met modern standards in 38.6% of patients: 54.5% of patients with CNS I-II FC and 19% of patients with III-IV FC. The most frequent drawbacks of treatment were insufficient prescription of IAPF, BAB, diuretics. Implementation of medication recommendations by CNS patients was not complete enough.
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EVALUATION OF ARTERIAL BLOOD PRESSURE DAILY MONITORING INDICATORS IN PATIENTS WITH CHRONIC GLOMERULONEFTRITISArterial hypertension (AG) is one of the most common forms of pathology and one of the most serious problems of modern medicine. Hypertension is a major risk factor for the cardiovascular system, and its provalehce is leading to increased disablitily and reduced life expactancy for people around the world. Kidney-related hypertension accounts for approximately 4-5% of all hypertensive patients and the largest group of secondary hypertensives. A special examination was performed on 50 patients with chronic glomerulonephritis (SGN) and the medical history of 70 patients was studied. In addition to general clinical examinations, patients underwent daily monitoring and ECG of AQB . AG in SGN is characterized by a violation of chronobiological parameters of blood pressure-an increase in blood pressure during the day, night and day, with insufficient blood pressure at night and high blood pressure. This circulatory disturbance is associated with kidney damage and decreased nitrogen excretion. AG in SGN is characterized by a violation of chronobiological parameters of blood pressure-an increase in blood pressure during the day, night and day, with insufficient blood pressure at night and high blood pressure. This circulatory disturbance is associated with kidney damage and decreased nitrogen excretion
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ENDOVASCULAR INTERVENTIONS FOR CONCOMITANT CORONARY AND CAROTID ARTERIES ATHEROSCLEROSISCardiovascular diseases continue to lead among the statistics of world mortality. Among the variety of risk factors that increase the likelihood of their occurrence, the problem of multifocal atherosclerosis is one of the most urgent today. It is generally accepted that in more than half of the cases, the cause of death of patients from diseases of the cardiovascular system is simultaneous damage to the coronary and carotid arteries. At present, stenting of the carotid arteries in case of the need for simultaneous revascularization of the carotid and coronary beds (especially in the absence of the possibility of performing an operation on a beating heart) can be considered an equal alternative. Various combinations of myocardial revascularization techniques (CABG / endovascular intervention) and carotid arteries (ICA and CEAE stenting) allow developing an individual approach to each patient. However, large multicenter randomized trials are required to determine the role of stenting of both carotid and coronary arteries in the treatment of patients with multifocal atherosclerosis of the coronary and carotid beds.
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One of the most common co-morbidities of SARS or MERS is cardiovascular disease. Cardiovascular disease is a common comorbidity seen in patients infected with SARS or MERS (with a prevalence of 10% and 30%, respectively). A series of reports on the clinical characteristics of COVID-19 patients described similar results. Early reports from China indicated that cardiovascular disease and associated risk factors such as hypertension and diabetes were common pre-existing conditions in COVID-19 patients, but the definition of cardiovascular disease used in each study was vague. In an early report from Wuhan of 41 patients hospitalized with COVID-19 by 2 January 2020, the prevalence of any comorbidity was 32%, and the most common underlying conditions were diabetes (20%), hypertension (15%) and other cardiovascular diseases (15%). -
FEATURES OF MECHANISMS OF DEVELOPMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND CORONARY HEART DISEASETo date, the role of C-reactive protein as a major marker of inflammation is best understood in atherosclerosis. It was found that one of its fractions is capable of activating the complement system, which damages blood vessels and myocardium. It acts through various pathogenic mechanisms: stimulation, aggregation and degranulation of neutrophils, increased production of tissue factor and procoagulants that promote thrombus formation. Most often, CRP is able to activate complement after binding to ligands, which can also be lipoproteins. The role of systemic inflammation in COPD is particularly important. It has been shown that various cytokines: interleukin-1, tumor necrosis factor (TNF) and others - change the structure and function of endothelial cells. An association has been established between an increase in CRP, which is considered a marker of systemic inflammation, and impaired endothelium-dependent endothelial vasodilation, as well as between TNF, impaired expression of adhesive molecules, and the development of endothelial dysfunction in patients with COPD. It is known that COPD is characterized by an increase not only in the level of CRP, but also in proinflammatory cytokines both in the stage of exacerbation and in the stage of remission. Their synthesis causes the mobilization and activation of leukocytes in the peripheral blood, which, in turn, can lead to rupture of atherosclerotic plaques, vasoconstriction and thrombus formation, as well as exacerbation of coronary heart disease.
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MODERN CONCEPTS OF MOLECULAR MECHANISMS AND THE IMPORTANCE OF INFLAMMATION IN ATHEROGENESISInflammation is one of the leading factors of atherogenesis, and taking this factor into account is absolutely necessary in assessing both the current state of atherosclerosis and its prognosis. The data carried out over the past two decades of studies have proven the important role of C-reactive protein, tumor necrosis factor alpha, interleukins- 1, -6, -8, -17, -10, 12, progression of atherosclerosis, in the processes of destabilization of atherosclerotic plaque, in assessing the risk of sudden death, development of an acute coronary event and its complications. Numerous studies have shown an inextricable link between systemic inflammation, oxidative stress and metabolic syndrome, which is currently considered one of the leading causes of the initiation and progression of atherosclerosis. The heterogeneity of the initiation of the systemic inflammatory response in atherosclerosis makes it necessary to study the factors of inflammation and their correlation with traditional metabolic disorders accompanying atherosclerosis.
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FEATURES OF THE COURSE OF ISCHEMIC HEART DISEASE ON THE BACKGROUND OF IRON DEFICIENCY ANEMIA OF VARIOUS DEGREE OF SEVERITY AND CORRECTION POSSIBILITIESСurrently comorbidity is relevant in the outcome of many diseases. In particular,we are talking about IHD,unstable angina and anemia of varying severity. In 30 patients with coronary artery disease in combination with anemia, 3-valence iron was changed, the drug Sufer (Yuria- Pharm Ukraine) at a dose of 5.0 ml intravenous for 5 days against the background of standard therapy. Normal hemoglobin levels increase blood flow to the coronary arteries and meet the heart muscle's need for oxygen. This provides the energy balance needed for the heart to function effectively as a pump, and increases resistance to physical stress. At the same time, the combination of stable stress angina and varying degrees of anemia is one of the most pressing issues in the treatment and prevention of comorbidities.
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ROLE OF INFLAMMATION MARKERS IN THE FORMATION OF PNEUMONIA IN THE BACKGROUND OF OVERWEIGHT AND OBESITY IN CHILDRENPneumonia is one of the leading causes of death and morbidity in children under 5 years of age, especially in developing countries. Obesity is the most common public health problem and clinically complicating risk factor among hospitalized children with pneumonia. Objective: to study markers of inflammation in children with pneumonia against the background of overweight and obesity. Materials and methods: children (62) with pneumonia against the background of overweight and obesity under 5 years old were examined. The patients were divided into 3 groups: group 1 (24) included children with pneumonia and overweight, group 2 included children (26) with pneumonia and obesity, group 3 included children (12) with pneumonia with normal weight and height index. Conclusions: Childhood obesity is an independent risk factor for severity and morbidity among pediatric patients with lower respiratory tract infections. This demonstrates the importance of obesity prevention for the child population.
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SOME ASPECTS OF MEDICAL REHABILITATION OF PATIENTS WITH CHRONIC CORONARY SYNDROME AFTER STENTINGModern medical advances in the treatment of chronic coronary syndrome (CCS), in particular, the use of high medical technologies have necessitated a more thorough study and implementation of complex medical rehabilitation of this category of patients into clinical practice. Purpose of the study: to study the effectiveness of complex medical rehabilitation with the inclusion of the herbal preparation Myocard in patients with CCS who underwent coronary artery (CA) stenting. Materials and methods: patients with CCS with stable exertional angina who underwent CA stenting (40) and received standard therapy were examined. The patients were divided into 2 groups: group 1 (20 patients) received additional herbal preparation Myocardin (APOLLO PHARM MED, Uzbekistan), group 2 received only standard treatment. Conclusions: Cardiac rehabilitation is an important method of prevention and treatment of CCS, a factor in improving health and improving the quality of life. Complex cardiac rehabilitation of patients with CCS who underwent stenting with the inclusion of Myocardin increases the efficiency and safety of treatment and medical rehabilitation of this category of patients.
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SURGICAL TREATMENT OF COMBINED ECHINOCOCCOSIS OF HEART AND OTHER ORGANS – TARGETIn the article there was reviewed results of diagnostics methods and surgical service 56 patients with echinococcosis of heart. The patients were divided on two groups depending on nature of involvement: the 1st group – it was insulated echinococcosis of heart/pericardium. The 2nd group – it was combined echinococcosis of heart and other organs – target (lungs or liver). Basic diagnostic technique was echocardiogram and MRI. In 64,2% case the patients were operated under cardiopulmonary bypass; in 35,7% - without cardiopulmonary bypass. Postoperative mortality was 8,9%. Spontaneous perforation and anaphylactic shock were observed in 3,5% cases. Among not fatal complication there often were observed rhythm disturbance.
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PROBLEMS OF DIAGNOSTICS AND SURGICAL TREATMENT OF ECHINOCOCCOSIS OF HEARTIn the article there was reviewed results of diagnostics metods and surgical service 73 patients with echinococcosis of heart. The patients were shared on two groups depending on nature of involvement: the 1st group — it was insulated ehinococcosis of heart/pericardium. The 2d group — it was combined ehinococcosis of heart and organs — target (lungs or liver). Basic diagnostic technique was echocardiogram and MRI. In 75% case the patients were operated in cardiopulmonary bypass; in 25% - without recourse cardiopulmonary bypass. Postoperative lethality was 6,8%. Spontaneous perforation and anaphylactic shock were observed in 4,3% cases. Among not fatal complication there often were observed rhuthms disturbance. In cases of combined echinococcal lesions of the heart, it is recommended to perform simultaneous simultaneous sequential surgical intervention for hepatocardial, cardiopulmonary and pericardio-pulmonary echinococcosis.
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IMPORTANCE OF SYSTOLIC AND DIASTOLIC DYSFUNCTION IN PATIENTS WITH LIVER CIRRHOSISCardiovascular system damage is accompanied by metabolic-type disorders in the heart muscle and is described as "cirrhotic cardiopathy" ("myocardial dystrophy"). There was an increase in the parameters of the left ventricle, such as the end systolic volume, the end diastolic volume, the end systolic dimension and the end diastolic dimension (ESV, EDV, ESD,EDD). Indicators such as the final systolic and diastolic size of the left ventricle, the final systolic and diastolic volume are signs of significant damage to the heart muscle and profound changes in blood circulation. Targeted clinical, radiological, ECG and EchoCG examinations in patients with cirrhosis of the liver allow to detect heart damage in 85.0% of cases. Left ventricular hypertrophy and myocardial dystrophy are the main indicators of heart damage. This, in turn, leads to a decrease in myocardial contractility, systolic and diastolic function. Heart damage, of course, leads to chronic circulatory disorders, increases the level of portal hypertension, exacerbates the level of liver failure, remains a major cause of hepatorenal syndrome and aggravates the general condition of patients.
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PECULIARITIES OF BLOOD LIPID SPECTRUM IN OBSESSED CHILDREN AS A RISK FACTOR OF METABOLIC SYNDROMEIn children with metabolic syndrome, an increase in indicators was found: total cholesterol, triglycerides, LDL and a decrease in HDL. It was found that the severity of changes in the lipid spectrum of blood in obese children is associated with insulin resistance. Purpose of the study: to study the features of the lipid spectrum in obese children and to develop rational ways to prevent the development of metabolic syndrome. Materials and methods: a comparative analysis of the parameters of the lipid spectrum of blood in obese children with normal body weight was carried out. The studies were carried out in two groups: 1 - the main group - 48 observations and 2 - the control group - 18. Conclusions: in children, obesity is closely associated with insulin resistance and the high prevalence of atherogenic combined dyslipidemia described here. Among obese children, the severity of changes in the lipid spectrum of blood depends more on the nature of obesity than on the degree of excess body weight.
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PECULIARITIES OF THE COURSE OF PULMONARY TUBERCULOSIS IN CHILDREN IN COMBINATION WITH CLAY INVASIONChildren and adolescents are most susceptible to the development of tuberculosis, especially in the presence of concomitant diseases that lead to a decrease in both humoral and cellular immunity. One of these concomitant diseases is helminthic invasion. It has been shown that the body's immune response to infection with worms is reduced, which, in turn, contributes to the emergence of various infections, including tuberculosis. The aim of the study is to study, based on the analysis of case histories of patients undergoing treatment in the Samarkand regional center of phthisiology and pulmonology and archival case histories, the structure and features of the clinical course of primary tuberculosis in combination with helminthic invasion in children. The most common types of helminthiasis are hymenolepiasis - 40%, enterobiasis - 33%, less often - giardiasis (22%) and ascariasis (5%). Signs of intoxication and lesions of the bronchopulmonary system are detected during infection with worms in patients with primary tuberculosis. The presence of infection with worms adversely affects the treatment of patients with pulmonary tuberculosis, therefore, treatment measures should be consistent with the course of both diseases.
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CLINICAL AND DIAGNOSTIC FEATURES OF MYOCARDIAL INFARCTION IN YOUNG PATIENTS IN EMERGENCY MEDICINEWe analyzed 40 histories of young patients with myocardial infarction (under the age of 45 years). The most common risk factors were obesity disorders, lipid metabolism, smoking. More than half of the young patients did not have heart disease in the Anamnesis. The main variant of the course is anginal, on the depth of the injury - a large focal. The complications and cause of death of patients were determined.
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The aim of the study was to study the risk factors for congenital heart defects in newborns. 374 newborns with congenital heart defects were examined. When determining the significance, according to the questionnaire with a codifier of 42 features, modifying risk factors for the development of congenital heart defects were identified by socio-hygienic, medico-biological, the influence of intrauterine infections, taking medications by the mother during pregnancy, and obstetric and gynecological indicators. -
IMPROVEMENT OF CLINIC-LABORATORY APPROACHES IN DIAGNOSTICS OF OUT-OF-SOCIAL PROLONGED FLOW PNEUMONIA IN CHILDRENWe have studied the peculiarity of clinical manifestations of community-acquired pneumonia of a protracted course in children, depending on concomitant diseases. A total of 120 children with community-acquired pneumonia at the age from 1 to 15 years old who were admitted for inpatient treatment in the pulmonology department of the Republican Scientific and Practical Medical Center of Pediatrics of the Ministry of Health of the Republic of Uzbekistan were examined. From the anamnestic data, it was revealed that in the group of children with CAP, 66.5% of those examined had a burdened heredity for somatic diseases, of which 37.0% for bronchopulmonary pathology. 37.5% of mothers have suffered from acute respiratory infections during pregnancy
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PREVALENCE OF METABOLIC SYNDROME IN PATIENTS WITH ISCHEMIC HEART DISEASEIschemic heart disease (CHD) is one of the most common causes of death in the modern world [1]. In a study, low HDL, high fasting plasma glucose (high FPG), high blood pressure and high triglyceride levels were reported as the highest risk factors for coronary heart disease [10]. Based on the above-mentioned evidence, the diagnosis of metabolic syndrome and its components in patients with coronary artery disease can influence the prevention of the disease and treatment tactics [20, 21]. Therefore, this study was aimed at studying the prevalence of metabolic syndrome and its individual components in patients with coronary artery disease who underwent elective coronary angiography.
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