Patients Of 2nd Group Research Articles

Characteristics of oxidative metabolism parameters at acute intoxication induced by surrogate alcohol

The aim of this study was to estimate the oxidative metabolism parameters in blood of patients with acute intoxication of different severity induced by surrogate alcohol. The study involved 30 people (26-40 years old) with a diagnosis of acute intoxication induced by surrogate alcohol. Two groups of patients were formed. 1st group included 10 patients with moderate intoxication (the ethanol concentration in blood - 2.5-3.5 g/l); 2nd group included 20 patients with severe intoxication (blood ethanol concentration - 3.5-5.0 g/l). The control group included 15 persons without history of alcohol abuse. In blood plasma the levels of carbonyl protein products, dityrosine containing cross-linked products of oxidized proteins and malondialdehyde were detected. In erythrocytes the concentrations of reactive carbonyl protein products and membrane-binding hemoglobin were detected. Additionally the indicators of clinical chemistry (activity of transaminases, total bilirubin, creatinine, urea, total protein) in blood were detected. The data were processed using the EXCEL statistical software package (Mann-Whitney test). In blood plasma of 1st group patients malondialdehyde and oxidized proteins concentrations were higher in comparison with control ones by 40.4 (р<0.05) and 28.4%, respectively. In blood plasma of 2nd group patients those indicators were higher in comparison with control ones by 60.6 (р<0.05) and 95.2% (р<0.01). The significant decreasing of carbonyl protein products was fixed in blood plasma of both groups of patients compared with the control persons. In erythrocytes of patients the significant increasing of carbonyl protein products were fixed by 103.4 (р<0.05) and 95.8% (р<0.05) respectively compared with the control ones. Changing of oxidative stress indicators in blood took place earlier than the augmentation of clinical chemistry indicators. Our findings emphasized the involving of the different types of oxidized proteins in patterns of the alcohol surrogates implementing mechanisms.

Phytoterapy combined with prostate chronic inflammatory diseases and their complications in persons with diabetes mellitus

The combination in patients with diabetes and chronic prostatitis, demonstrated lower urinary tract symptoms is urgent health and social issue and requires adequate diagnostic measures and medication adjustment. The aim of the study: to determine the long-term application of a combination of phytotherapy in men with lower urinary tract symptoms chronic prostatitis (CP) and diabetes mellitus (DM). Materials and methods. In the -Institute of urology of NAMS of Ukrainewere examined 63 patients with CP on the background of diabetes of 1-St and 2-nd type (mean age of 42.3±0.9 years). In the 1st group patients (n=30) were administered Pravenor 2 capsules per day after meals for 4 months with three 10-day intervals; in the 2nd group (n=33) patients taking the extract of pumpkin seeds ordinary 500 mg 2 times a day for 4 months. Control group (n=32) included almost healthy patients who did not receive treatment during the investigation period. The history of the disease CP amounted to an average of 5.2±0.8 years, SD of 12.8±0.9 years, the ratio of DM 1st / DM 2nd type 70:30%. Results. The use of drugs Pravenor® capsules and suppositories Pravenor was based on long-term medical effects on the inflammatory factor in the tissues of the pancreas. At the control examination one of the most significant indicators was the compensation of carbohydrate metabolism. During the inspection of patients of the 1st group in the control time (30 day) it was found that the use of herbal remedies Pravenor® capsules and suppositories Pravenor® provides a good clinical effect, improve the health and quality of life. Patients 1st clinical group receiving continuous combined therapy and improved almost all the indicators in comparison with the 2nd group. Thus, the maximum flow rate Vmax in patients of the 1st group improved by 24.8%, of urination for IPSS – by 20.6%, QoL – 46.5%, respectively (p&lt;0.05). Patients of the 2nd group of such dynamics have been identified. Conclusion. The use of medicinal herbal remedies Pravenor® capsules and Pravenor suppositories in patients with CP with concomitant DM is a reasonable treatment strategy, contributing to the reduction of dysuric phenomena. The obtained results allow to recommend the use of Pravenor® capsules and suppositories Pravenor for the integrated treatment of patients with chronic pancreatitis on the background of diabetes.

Study of the efficacy of the drug Novirin in the treatment of men with HPV infection

The aim of the study: to study the efficacy and safety of drug Novirin produced by «Kyiv vitamin factory» and the radio-wave knife for the treatment of men with HPV infection.Materials and methods. Under observation there were 68 patients with genital warts (GW) aged from 19 to 44 years. The duration of the disease was from 1 year to 4 years. Patients were divided into three groups: group 1 received treatment with ostonecrosis drugs; in the 2nd group patients underwent removal GW radio-wave knife; group 3 patients received complex therapy with the use of the drug Novirin and deleting GW radio-wave knife.Results. It is proved that in the 3rd group of patients compared to the 1st and 2nd groups received the most positive results of treatment: a significant decrease in the number of relapses are OK, and no chemical burns to surrounding healthy tissues during treatment.Conclusion. As a result of researches it is established that the use of the drug Novirin and the latest technology radio-wave surgery allows achieving positive clinical results and sustained clinical effect in the treatment of patients with GW. The big advantage of this type of treatment is well tolerated and ease of execution that allows the use of this method in ambulatory practice.

CERULOPLASMIN LEVEL AND ITS RELATIONSHIP WITH METABOLIC PARAMETERS IN PATIENTS WITH TYPE 2 DIABETES CONCURRENT WITH NONALCOHOLIC FATTY LIVER DISEASE

A determination of serum ceruloplasmin and its relationship with metabolic parameters in 71 patients with type 2 diabetes mellitus in combination with non-alcoholic fatty liver disease with comorbid autoimmune thyroiditis (group 1, 53 patients) or without (group 2, 18 patients) was concucted. It was revealed an increase of serum ceruloplasmin in 20.8 % of 1st group patients and 27.8 % of 2nd group patients that is regarded as a manifestation of hypoxia of hepatocytes, reduced reactivity of the antioxidant system. A direct correlation of serum ceruloplasmin with indicators of inflammation of the liver tissue, the development of obesity and hypertriglyceridemia in patients of group 1 and adipokine resistin levels in patients 2 groups was found. These regularities require further study.

Comparison of results of staged and hybrid approaches in surgical treatment of patients with coronary heart disease and cerebrovascular disease

We compared the immediate outcomes of hybrid procedure and step-by-step internal carotid artery (CA) stenting and coronary artery bypass grafting (CABG) in high-risk surgical patients with combined lesions of coronary and carotid vasculature. The indications for hybrid surgery were identified. 50 patients with combined lesions of the coronary bed and the carotid vasculature were divided into two groups. The 1st group had 30 patients (60%), who first underwent CA stenting followed by CABG. The 2nd group included 20 patients (40%), who underwent hybrid procedures (simultaneous CA stenting and CABG). Patients with atherosclerosis of aortoiliac and femoropopliteal segments (p &lt;0.0001) were by far more frequent in the hybrid procedures group. The 1st group was found to have no fatal outcomes. 3 patients (10%) experienced cerebral stroke. The hybrid procedures group had no deaths and cerebral stroke patients. 2 patients developed a myocardial infarction. None of the above indices was found to have statistically significant differences between the groups (р &gt;0.05). On average, the patients of the 1st group were in the Intensive Care Unit (ICU) for 2.91.9 days; the patients of the 2nd group stayed in the ICU for 3.96.4 days (р = 0.42). The average postoperative hospital stay for the 1 st group patients amounted to 10.84.5 days, while that for the 2nd group patients was equal to 10.85.8 days (р = 1). The groups were found to have no statistically relevant differences of complication risks, the length of ICU stay, and the total number of days spent in hospital. If patients with combined lesions of the coronary artery and the carotid artery also suffer from critical lower-extremity stenosis, a hybrid procedure allows surgeons to perform CA stenting.

2. Role of ascorbic acid & statin in reduction of the incidence of the atrial fibrillation in patients under B-blocker and undergoing coronary artery bypass graft operation in early post-operative period

Atrial fibrillation (AF) is the most common sustained arrhythmia that is associated with significant morbidity and mortality. Current available therapies remain inadequate in symptom control and secondary prevention and are often associated with significant side effects. The mechanisms underlying the pathogenesis of AF are poorly understood, although electrophysiological remodeling has been described as an important initiating step. Recently, increasing evidence implicates oxidative stress and inflammation in the pathogenesis of AF. We searched the literature for evidence to support the use of antioxidant vitamins C and anti-inflammatory statin combined with B-blocker in the prevention of AF post CABG. Antioxidant vitamin C, through its reactive-oxygen-species- (ROS-) scavenging effect, have shown a role in AF prevention post CABG. A prospective controlled randomized study will include(three hundred patients aged from 40 to 65 years of both sexes. They will be divided into three groups of patients: A hundred (CABG) patients commenced on only B-blocker for at least one week pre-operatively. A hundred (CABG) patients commenced on B-blocker & ascorbic acid for at least one week pre-operatively. A hundred (CABG) patients commenced on B-blocker & statin for at least one week pre-operatively. 24 patients out of 100 patients developed atrial fibrillation in 1st group, compared with 6 patients out of 100 patients in 2nd group, and 7 patients out of 100 patients in 3rd group developed atrial fibrillation. Combination of B-blocker with ascorbic acid & statin is better than B-blocker alone in reduction of atrial fibrillation after CABG in early post operative period.

PP.08.14

Objective: to assess data of echocardiography (ECHO) initially and their dynamics during acute pharmacological testing (aPhT) with nitric oxide (iNO) in patients with idiopathic pulmonary hypertension. Design and method: 42 pts (39 woman and 4 men, II-IV FC) with a verified diagnosis of idiopathic pulmonary hypertension. All patients underwent an aPhT with iNO (20 ppm for 10 min) under the control of echocardiography, two hours before the right heart catheterization (RHC) with aPhT. All patients were divided into 2 groups according to the international standards of positive response to aPhT during RHC: 1st group - patients with (+)aPhT (n = 20); 2nd gr. - patients with (-)aPhT (n = 22). Analysis of echocardiography included: assessment of remodeling, systolic and diastolic function of the right ventricle before and after aPhT. Results: The mPAP according to RHC decreased from the initial value 48,8 ± 7,9 mmHg to 30,5 ± 7,9 mmHg (p < 0.05) after iNO in the first group. There was no significant dynamics of mPAP (with 69,6 ± 20,8 mm Hg to 67,9 ± 20,3 mm Hg (p > 0.05) in the second group. Patients in 2nd group had more pronounced signs of remodeling in comparison to the 1st gr.: anteroposterior size of the right ventricle (RV) 4,0 ± 0,8 vs 3,2 ± 0,7sm. (p < 0.05), basal size of RV 4,4 ± 0,6 vs 3,7 ± 0,5 cm. (p < 0.05), the area of the right atrium 25,3 ± 6,7 vs 16,8 ± 3,0 cm2 (p < 0.05). Standard data of echocardiography did not change during the aPht with iNO. Systolic and diastolic RV function was worse in 2nd group than in the first: S’tv(tricuspid valve) 4,3 ± 1,3 vs 5,9 ± 1,3sm /sec (p < 0.05); E’tv 2,4 ± 1,1 vs 4,8 ± 1,4sm /sec (p < 0.05). There were significant improvement of TVI data in the first group and no changes in the second group during iNO. Peak S’ at the ring of TV of RV before/after test in the 1st gr.: 5.9/7,1sm /sec (p < 0.05). Peak E’ at the ring of TV of RV before/after test: 4.8/6.5sm/sec (p < 0.05). Conclusions: Dilation of the right ventricle was more pronounced in the 2nd group with (-)aPhT in compared with first group. Global systolic and diastolic RV function improved according to the TVI data during test with iNO in patients with (+)aPhT.

Pефлексотерапия как способ лечения боли в спине

The analysis of treatment efficiency of the patients with muscular-tonic pain syndrome of lumbosacral localization who were in outpatient treatment at the Department of therapy of pain syndromes at Russian B.V. Petrovsky Scientific Center of Surgery was carried out. Therapy was carried out in two groups. Patients of the 1st group received the Tizanidine 4-8 mg/day, the reflex therapy in 4-6 sessions each day or at intervals of 1-2 days was used for patients of 2nd group. The authors evaluated the effectiveness of complementary application of reflex therapy. The use of reflex therapy can improve the effectiveness of the treatment.

Керована гіпотензія при оперативних втручаннях на хребті у положенні на животі

Background. Deliberate hypotension during spinal surgery aims to reduce intraoperative bleeding, thus providing better surgical visualization and less requirements for transfusion. A lot of methods of controlled hypotension are used nowadays. Each of them has advantages and disadvantages.The aim of study was to examine safety and efficacy of hypotensive drug urapidil for providing deliberate hypotension for spinal surgery in prone position.Material and methods. Eighty patients were elected and divided into 2 groups. Patients of the 1st group (n=43) received urapidil for controlled hypotension intraoperatively and patients of the 2nd group did not receive hypotensive drugs intraoperatively. Hemodynamics, time of surgery and restoration of consciousness after general anesthesia (Bidway test 20 min after anesthesia).Results. Patients in urapidil group had reduction of blood pressure to desirable level without any critical drops of hemodynamics comparing to the patients of 2nd group (p&lt;0,05) whose blood pressure did not change significantly during surgery. Controlled hypotension allowed to reduce the surgery time comparing to patients without hypotension (p&lt;0,05). Awaking time (Bidway test) did not differ significantly between groups. No anesthesia complications were found during examination.Conclusion. Deliberate hypotension with urapidil is safe and effective during spinal surgery in prone position as it allows to provide good surgical visualization without adverse effects

LONG-TERM EFFECTS OF OMEGA-3 POLYUNSATURATED FATTY ACIDS ON THE COURSE OF ISCHEMIC HEART DISEASE IN PATIENTS AFTER ST-ELEVATION MYOCARDIAL INFARCTION AT THE BACKGROUND OF MULTIPLE-VESSEL LESION CORONARY ATHEROSCLEROSIS

Currently there is enough evidence for that the use of omega-3-faty acids compounds in ischemic heart disease is followed by the decrease of mortality, and the efficacy of this usage in multivessel coronary lesions after primary percutaneous intervention (PCI) has not been studied.Aim.To evaluate the efficacy of long-term intake of the omega-3-polyunsaturated fatty acids compounds on the course of ischemic heart disease at the background of multiple coronary lesion after primary PCI.Material and methods.Totally 101 patient included at the age of 35-70 y.o., who had underwent primary PCI for the myocardial infarction with ST elevation and multiple vessel lesion of coronary arteries. The patients were selected into 2 groups: 1 group (n=68) — conservative tactics with the standard pharmacotherapy; 2nd group (n=33) — Omacor was added to the standard therapy.Results.In 36 months of follow-up in the Omacor group there was significant decrease of repeated myocardial infarctions, decompensating heart failure, angina progression and rhythm disorders. In 2nd group patients during the 36-month follow-up a better antiischemic effect achieved with 80,9% decrease of angina from the baseline (p&lt;0,047) and by 27,6% of the heart failure severity. The increase of exercise tolerance by the 6-minute walking test during 36 months was the highest in the 2nd group — by 65%.Conclusion.Long-term prescription of omega-3-polyunsaturated fatty acids in ST elevation myocardial infarction with multiple vessel coronary lesions after primary PCI leads to the improvement of clinical condition, which then leads to the increase of exercise tolerance and better life quality.

Prognostic significance of endothelial dysfunctional markers of the first stage of chronic kidney disease

Non-adaptive remodeling of cardiovascular system and progressive kidney damage at chronic kidney disease (CKD) is associated with the development of endothelial dysfunction (ED) and apoptosis. The aim of this research was to study the changes of indicators of apoptosis and ED in patients with CKD 1 stage throughout 12 months. Complex biochemical, immunoferment and tool methods were applied at patient examinations. Arterial pressure of all observed patients was resolved on target values in 12 months. However, the indicators of endothelium-dependent vasodilation (EDV) increased in 55 patients (1st group), and the peak of circulating blood volume in skin microvessels in 22 patients (2nd group) wasn't changed: 134±4 % и 136±4 %, p>0.1. The level of the annexin A5 reduced from 3.5±0.47 to 1.27±0.31 ng/ml (p 0.1 in 2nd group. Diurnal excretion of sodium chloride decreased from 6.8±0.57 g/d to 2.8±0.39 g/d (p<0.05) in patients of 1st group. Dynamics of these indicators was not marked in patients of 2nd group: accordingly from 7.39±0.63 g/d to 7.01±0.65 g/d. Diurnal excretion of sodium chloride reflected the salt intake in patients with CKD 1 stage is associated with disturbance of endothelial-dependent vasodilation and apoptosis.

Modern emollients impact on the damaged skin barrier at children with atopic dermatitis

Introduction. Damaged skin barrier has significant role in the pathogenesis of atopic dermatitis (AD). Use of emollients is reasonable for skin care of AD patients. Background. To compare the clinical efficacy of Kserodian plus with traditional moisturizer (cream Unna) at children with atopic dermatitis. Materials and methods. The study included 31 children with AD. Children were divided into 2 groups: patients in group 1 (n=8) used Kserodian plus 2 times daily for skin lesions and limbs in the complex therapy, patients in the 2nd group (n=13) received combined therapy incorporating traditional dampening agent on the basis of lanolin (cream Unna) 3 times daily. All patients underwent measurement of transepidermal water loss (TEWL) (Tewameter TM 300, Multi Probe Adapter MPA 5/9, Courage + Khazaka) and the pH of the skin (SkinpHMeter, Multi Probe Adapter MPA 5/9, Courage + Khazaka) before and after 2 weeks of therapy. Results. Kserodian plus decreased erythema, dryness of the skin, itching, square of leasons in all the patients. Statistically significant decrease in the values of TEWL and skin surface pH (p

NONINVASIVE ULTRASOUND EVALUATION OF THE PARENCHYMA OF THE PARENCHYMA OF LIVER AND SPLEEN IN CHILDREN WITH INFECTIOUS MONONUCLEOSIS

The data of the examination of 73 children aged 1 to 18 years with mononucleosis of Epstein-Barr virus etiology are presented. The use of non-invasive quantitative assessment methodology of the parenchyma (Acoustic Structure Quantification) was shown to allow objectify the examination and to found that infectious mononucleosis in 1st Group patients with a minimum degree of diffuse changes of the liver proceeded without structural changes in the liver parenchyma. In the 2nd group patients the estimation of density index according to Acoustic Structure Quantification allowed to reveal the signs of cholestasis. The heterogeneity of the structure of the liver and the elevation of the parenchymal density index indicated on signs of acute hepatitis and was confirmed by the increase in ALT level in blood serum. Despite the pronounced splenomegaly no structural changes in the spleen were found in any patients.

Efficacy of carbocysteine in acute exacerbation of chronic obstructive pulmonary disease

Summary. This study was designed to evaluate clinical efficacy and safety of carbocysteine lysine salt in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). This was a prospective randomized comparative controlled trial involving 50 hospitalized patients with acute exacerbation of COPD. The patients were divided in 2 groups: the 1st group patients (n = 25) were treated with syrop of carbocysteine lysine salt (Fluifort) 4 050 mg daily during 10 days, the 2nd control group patients (n = 25) did not receive any mucoactive drugs. Clinical and spirometric parameters and C-reactive protein (CRP) level were serially assessed. At the 5th and 10th days of the treatment, clinical symptoms (cough intensity and sputum expectoration) differed significantly between groups in favor of the carbocysteine group (p &lt; 0.05). FEV1 and FVC improved in both the groups at the 10th day of therapy. Other lung function parameters and peripheral blood leukocyte number did not differ significantly between the groups to the 10th day. CRP decreased significantly to the 10th day in the carbocysteine group compared to the controls (6.8 ± 2.3 vs 9.5 ± 1.2 mg × L–1; p &lt; 0.05). Carbocysteine was well-tolerated by all the patients, serious adverse events were not registered. Therefore, addition of carbocysteine lysine salt (Fluifort), a mucoactive drug with antioxidant and anti-inflammatory properties, to a standard therapy of acute exacerbation of COPD has led to improvement of symptoms and systemic inflammatory reaction.

PO03-MO-11 Does PPARγ-agonist rosiglitazone exert nephro- and neuroprotective effects in normoalbuminuric type 2 diabetes mellitus patients?

surgical prevention of ischemic stroke. The purpose of this study was to compare the efficacy and safety of CEA and CAS. Methods: We studied thirty seven patients with ischemic stroke (27 mail and 10 female, middle age – 63.5±7.3 years). The time from stroke onset was 8 to 47 days (middle time – 25.3±7.7 days). All the patients had symptomatic stenosis of ipsilateral internal carotid artery of 70% and more. CE was performed to the patients of the 1st group (21 patients). Sixteen patients of the 2nd group were undergone to CAS using systems of distal protection. During surgery blood flow ve-locity monitoring and microembolic signals (MES) registration were performed. The neurological deficit was estimated using NIHSS scale on the 2nd day, in one month, and in one year after surgical intervention. Results: There were no complications of surgery in both groups of patients. Also there were no significant differences of NIHSS parameters in both groups in early postoperative period, in a month and in a year after surgery. Significant difference of blood flow velocity after operation was not registered in the 1st group patients (80.4±23.5 cm/sec) in comparison with the 2nd group patients (75.0±20.8 cm/sec) (p < 0.05). The quantity of MES was significant more in the 2nd group in comparison with the 1st (126.3±56.6 and 7.4±2.6, p < 0.05). Conclusions: CEA and CAS have equal efficacy and safety. Probably, difference in the quantity of MES can be explained by presence of “clinically insignificant” microbubbles.

Sonotubometry Findings in Patients with combined airway disease with and without Associated Eosinophilic Otitis Media

Background: Active opening of the eustachian tube is accomplished by contraction of the paratubal muscles. Disturbance of any of the ET functions may contribute to the development of otitis media (OM) with effusionand other middle ear diseases. Sonotubometry seems to be the most "physiologic"method for assessment of ET function and has the advantage that it can be performed on earswith an intact tympanic membrane and without the use of a pressurechamber. The aim of this study was to compare the Eustachian tube function using sonotubometry in patients with combined airway disease associated with Eosinophilic otitis media with that having combined airway disease without otitis media. Patients and methods: This study was applied on 45 patients divided into 3 groups each of 15. 1st group is the control group, 2nd group patients with combined airway disease without Eosinophilic otitis media, 3rd group patients with combined airway disease associated with Eosinophilic otitis media. Results: Our results explains that the tubal opening durations were significantly longer in patients of EOM group than in patients with combined airway disease without EOM group and also the normal control group. Conclusion: Sonotubometry can be performed in patients with or without an intact tympanic membrane and under physiological conditions. Sonotubometry is also inexpensive, painless, and easy to perform in both adults and children. Therefore, it has great potential value as a diagnostic tool for individuals with suspected ET disease.

Sonotubometry Findings in Patients with combined airway disease with and without Associated Eosinophilic Otitis Media

Background: Active opening of the eustachian tube is accomplished by contraction of the paratubal muscles. Disturbance of any of the ET functions may contribute to the development of otitis media (OM) with effusionand other middle ear diseases. Sonotubometry seems to be the most physiologicmethod for assessment of ET function and has the advantage that it can be performed on earswith an intact tympanic membrane and without the use of a pressurechamber. The aim of this study was to compare the Eustachian tube function using sonotubometry in patients with combined airway disease associated with Eosinophilic otitis media with that having combined airway disease without otitis media. Patients and methods: This study was applied on 45 patients divided into 3 groups each of 15. 1st group is the control group, 2nd group patients with combined airway disease without Eosinophilic otitis media, 3rd group patients with combined airway disease associated with Eosinophilic otitis media. Results: Our results explains that the tubal opening durations were significantly longer in patients of EOM group than in patients with combined airway disease without EOM group and also the normal control group. Conclusion: Sonotubometry can be performed in patients with or without an intact tympanic membrane and under physiological conditions. Sonotubometry is also inexpensive, painless, and easy to perform in both adults and children. Therefore, it has great potential value as a diagnostic tool for individuals with suspected ET disease.

Clinical and functional cardiovascular disorders in patients with chronic obstructive pulmonary disease and chronic heart failure

The study was aimed to investigate clinical and functional particularities of cardiovascular system in patients with COPD and chronic heart failure (CHF). We examined 1737 patients, of them, 498 with COPD (the 1st group), 721 with COPD and concomitant class I to III stable angina (the 2nd group), and 519 with class I to III stable angina (the 3rd group). All the patients also had CHF. The study included clinical assessment using modified R. Cody's scale, ECG, Holter monitoring, lung function testing, Doppler echocardiography, 6-minute walk test (6MWT). Obstructive disorders were found in 424 of the 2nd group patients (58.8 %) and 268 of the 3rd group patients (51.7 %). Number of patients with class II to IV chronic cor pulmonale was similar in all groups. The class III was determined more often in the 2nd group (36.5 %; р &lt; 0.05), the class I prevailed in the 1st group (17.8 %; р &lt; 0.05). The stage I CHF predominated in the 1st group (31.9 %; р &lt; 0.05), the stages IIА and IIБ were seen mainly in the 2nd group (51.6 % and 26.4 % respectively; р &lt; 0.05). The majority of the 3rd group patients (57.3 %) had the stage IIA CHF. According to most clinical signs, CHF was more severe in the 2nd group. 6MWT was 308.08 ± 6.03 m in the 1st group, 156.4 ± 4.38 m in the 2nd group, and 212.8 ± 5.65 m in the 3rd group (р &lt; 0.05). Low left ventricular (LV) ejection fraction was seen significantly more often in COPD patients with concomitant angina. This group as well as COPD patients had significantly higher mean pulmonary artery pressure (mPAP) (24.7 ± 0.41 mm Hg and 29.9 ± 0.27 mm Hg respectively) compared to 21.7 ± 0.07 mm Hg in the 3rd group patients. Right ventricular (RV) diastolic dysfunction was revealed in 154 patients of the 1st group (83.7 %), 194 patients of the 2nd group (91.9 %) and 72 patients of the 3rd group (43.1 %). In conclusion, all the patients had RV and LV remodeling signs. COPD patients had more prominent RV hypertrophy and dilation, angina patients had enlargement of left heart and moderate decrease in LV contractility. The patients with COPD and angina had the greatest increase in size and wall thickness of both LV and RV and low pump function of LV.

COMPARISON OF CARVEDILOL AND BISOPROLOL EFFICACY IN PATIENTS WITH CHRONIC HEART FAILURE AND DIABETES TYPES 2 AFTER MYOCARDIAL INFARCTION

Aim. To compare efficacy of carvedilol and bisoprolol in patients with chronic heart failure (CHF) and diabetes mellitus (DM) type 2 after myocardial infarction (MI). Material and methods. 60 patients (45-70 y.o.) with CHF 2-3 functional class according to NYHA and DM type 2 after MI (3-4 week) are included in the study. Patients are randomized on 2 groups. All patients received basic therapy of CHF. Besides patients of 1st group (n=30) were treated with carvedilol (Talliton, Egis) 29,0±2,5 mg daily. Patients of 2nd group (n=30) were treated with bisoprolol (6,0±0,5 mg/day). Both groups were similar on age, sex, disease severity, haemodynamic parameters and basic therapy doses. Life quality, functional reserve, echocardiography, kidney function, heart rate variability (HRV), lipid and glucose metabolism were estimated initially and in 16 weeks of treatment. Results. Carvedilol and bisoprolol therapy of patients with CHF and DM after MI resulted in improvement of clinical status, kidney function and increase in HRV. Carvedilol had clinical advantages in comparison with bisoprolol in effects on myocardial remodeling, kidney function and HRV. Carvedilol favorable effects on lipid and glucose metabolism were observed. Conclusion. Carvedilol has a number of significant advantages in comparison with bisoprolol in the therapy of patients with CHF and DM after MI.

Effects of phenoterol and histamine on lung function in patients with diabetes mellitus

The purpose of the study was to investigate airway reactivity in patients with diabetes mellitus. We examined 68 patients with diabetes mellitus of 16 to 66 years of age. Of them, 29 patients (20 with diabetes mellitus type 1 and 9 with diabetes mellitus type 2) were tested with phenoterol (the 1st group). The 2nd group patients (12 with diabetes mellitus type 1 and 27 with diabetes mellitus type 2) were examined with histamine challenge test. Bronchodilator test (ΔFEV 1 > 200 ml or > 12 % of the baseline value) was positive in 6 (20.7 %) patients, five of them had diabetes type 1. The histamine challenge test was positive in 9 patients with diabetes type 2 (23.1 %). This was an evidence of significant bronchial hyperreactivity. A qualitative analysis using Fisher's discriminant criterion revealed the following correlations: 1) between bronchial hyperreactivity and a type of diabetes mellitus; 2) between bronchial hyperreactivity and administration of oral antidiabetic drugs. Correlations between bronchial hyperreactivity, body mass index, duration of the disease and late complications of diabetes mellitus were not revealed. In conclusion, the positive bronchodilator test predominated in patients with diabetes mellitus type 1 and bronchial hyperreactivity for histamine was mainly detected in patients with diabetes mellitus type 2. This could be considered as an evidence of different mechanisms of bronchoconstriction in patients with diabetes mellitus types 1 and 2. Generally, susceptibility to bronchoconstriction may be an unfavorable factor for occurrence of nonspecific lung disease in patients with diabetes mellitus.