No. 1 (2021) Journal of cardiorespiratory research

Статьи

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  PROBLEMS OF DIAGNOSTICS AND SURGICAL TREATMENT OF ECHINOCOCCOSIS OF HEART In 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.

  Khairulla Buranov

  61-66

  81   24

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  MODERN VIEWS OF THE OCCURRENCE OF OBSTRUCTIVE LUNG DISEASE IN CHILDREN Obstructive pulmonary disease (OBD) is commonly cited in the literature as evidence for the majority of smoking-related harm in adults over 40. Without any direct and exclusive association with active long-term smoking, some chronic obstructive pulmonary diseases in children (OBD) and adolescents progress with deterioration of lung structure and function, causing persistent (fixed) or periodic (temporary) obstruction of pulmonary blood flow secondary to genetic changes and environmental changes that cause inflammation and infection of the respiratory tract. The actions of the pediatrician are vital to the management of OBL. The clinician should suspect a disease with signs and symptoms in order to make an early and accurate diagnosis, know the risk factors and comorbidities, and assess adherence to treatment, the correct use of prescribed drugs and their side effects based on rigorous research.

  Nurali Shavazi , Alisher Allanazarov , Mukhiba Ataуeva , Djavlon Gaibullaev

  40-43

  95   23

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  STRATEGY FOR THE RATIONAL MANAGEMENT OF PATIENTS WITH GOUT, TAKING INTO ACCOUNT OPTIMAL REDUCING THERAPY ACCORDING TO MATERIALS OF THE AMERICAN COLLEAGUE OF RHEUMATOLOGISTS 2020 (ACR) The review is devoted to the management of patients with gout, taking into account the recommendations of the American College of Rheumatologists (ACR), updated in 2020, according to which it is recommended to treat exacerbations of the articular syndrome with colchicine, non-steroidal anti-inflammatory drugs (NSAIDs) or glucocorticoids. Uratus-lowering therapy (ULT) should be given to all patients with tofuses, radiological signs of joint damage, or frequent exacerbations of gout. Allopurinol is the first-line drug, including for patients with chronic kidney disease (CKD), at the initial dose (≤100 mg / day and lower with CKD), followed by titration of the dose under the control of serum uric acid (UA) and its reduction <6 mg / dl (<360 μmol / L), i.e. using the strategy "treatment to achieve the goal." Reducing therapy is strongly recommended against the background of prophylactic anti-inflammatory therapy lasting at least 3-6 months. The purpose of the review is to convey to doctors of various specialties who make decisions about the treatment of gout with reducing drugs, the necessity of compulsory achievement of the target level of UA, the prevention of new exacerbations of the joint syndrome and complications of comorbid diseases.

  Vladimir Tsurko , Tatiana Zaugolnikova , Natalya Konyshko , Tatiana Morozova

  33-39

  92   32

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  PREVALENCE OF METABOLIC SYNDROME IN PATIENTS WITH ISCHEMIC HEART DISEASE Ischemic 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.

  Eleonora Tashkenbaeva, Gulnora Abdieva, Dilrabo Khaidarova, Maksud Saidov

  85-88

  170   32

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  IMPROVEMENT OF CLINIC-LABORATORY APPROACHES IN DIAGNOSTICS OF OUT-OF-SOCIAL PROLONGED FLOW PNEUMONIA IN CHILDREN We 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

  Dono Тadjikhanova

  82-84

  66   18

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  CLINICAL AND DIAGNOSTIC FEATURES OF MYOCARDIAL INFARCTION IN YOUNG PATIENTS IN EMERGENCY MEDICINE We 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.

  Nigina Samadova, Eleonora Tashkenbaeva, Gulbahor Madzhidova, Mokhinabonu Yusupova, Sarvinoz Boltakulova

  78-81

  124   24

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  PECULIARITIES OF THE COURSE OF PULMONARY TUBERCULOSIS IN CHILDREN IN COMBINATION WITH CLAY INVASION Children 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.

  Nargiza Mamatova, Abduvaliy Ashurov, Baxrombek Abduhakimov

  74-77

  87   24

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  PECULIARITIES OF BLOOD LIPID SPECTRUM IN OBSESSED CHILDREN AS A RISK FACTOR OF METABOLIC SYNDROME In 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.

  Guldona Mahpyieva, Nigora Azizova, Furkat Shamsiev

  70-73

  98   21

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  IMPORTANCE OF SYSTOLIC AND DIASTOLIC DYSFUNCTION IN PATIENTS WITH LIVER CIRRHOSIS Cardiovascular 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.

  Xudoyor Gafforov, Nigora Vafoyeva

  67-69

  104   19

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  ENDOVASCULAR INTERVENTIONS FOR CONCOMITANT CORONARY AND CAROTID ARTERIES ATHEROSCLEROSIS Cardiovascular 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.

  Saidamir Jafarov, Guzal Mullabayeva, Ravshan Sunnatov

  9-13

  84   18

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  SURGICAL TREATMENT OF COMBINED ECHINOCOCCOSIS OF HEART AND OTHER ORGANS – TARGET In 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.

  Khairulla Buranov

  57-60

  97   17

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  SOME ASPECTS OF MEDICAL REHABILITATION OF PATIENTS WITH CHRONIC CORONARY SYNDROME AFTER STENTING Modern 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.

  Bakhrom Alyavi, Akbar Abdullaev, Djamol Uzokov , Dilbar Dalimova , Narina Raimkulova , Dildora Karimova , Shuhrat Azizov , Sherzod Iskhakov

  51-56

  144   19

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  ROLE OF INFLAMMATION MARKERS IN THE FORMATION OF PNEUMONIA IN THE BACKGROUND OF OVERWEIGHT AND OBESITY IN CHILDREN Pneumonia 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.

  Nigora Alieva, Dilfuza Turdieva, Shakhlo Aripdjanova, Barno Abrorova

  47-50

  82   33

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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 POSSIBILITIES Сurrently 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.

  Irina Agababyan, Yulduz Ismoilova, Shaxboza Sadikova

  44-46

  101   19

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  MODERN CONCEPTS OF MOLECULAR MECHANISMS AND THE IMPORTANCE OF INFLAMMATION IN ATHEROGENESIS Inflammation 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.

  Zarina Khaybullina, Nodir Sharapov, Saodat Abdullaeva

  25-32

  105   25

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  FEATURES OF MECHANISMS OF DEVELOPMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND CORONARY HEART DISEASE To 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.

  Eleonora Tashkenbaeva, Zarina Nasyrova, Maksud Saidov, Sarvinoz Boltakulova

  20-24

  147   21

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  FEATURES OF CARDIOVASCULAR DISEASES COVID-19 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%).

  Zarina Nasyrova, Zukhriddin Pulatov, Khusan Alikulov , Mamura Usmonova, Khurshida Alikulova

  14-19

  132   20

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