[Influence of physical rehabilitation on quality of life after renal transplantation].

BACKGROUND: Aim of this study was to evaluate the role of physical rehabilitation to improve the quality of life (QOL) of people after kidney transplantation. PATIENTS AND METHODS: Analyzes the results of treatment of 57 recipients (mean age 35 +/- 9.65 years) donor kidney at different times of the postoperative period. Depending on the physical rehabilitation program allocated 3 groups of patients: group II--physical rehabilitation was carried out only in the first week after surgery to prevent early postoperative complications, in group I--during the year; in group III combined 30 relatively healthy people do not need an organ transplant and with a mean age 33.7 +/- 8.7 years, leading a normal life, not engaged in regular recreational physical culture. Quality of life was assessed using a questionnaire SF36 at 1, 3, 6 and a 12 months after surgery. RESULTS: One year after surgery in both groups compared with preoperative indicators marked improvement according to all scales of the questionnaire. However, in group I indicators of quality of life were higher than in group II from 11.4 to 19.7%, and even some items questionnaire SF-36 is higher than in group III which is associated with the physical rehabilitation. CONCLUSION: It has been shown that exercises is an important component of treatment and rehabilitation after kidney transplantation and help improve both the psychological and the physical component of quality of life.

[CYP2C9 and VKORC1 gene polymorphism and acenocoumarol anticoagulant activity in Russian patients at high risk of thromboembolic complications].

The study included 25 patients at high risk of thromboembolic complications. All of them were treated with acenocoumarol for 6 months under control of the frequency of hemorrhage and episodes of severe hypocoagulation (a more than 3-fold rise in INR). All the patients underwent CYP2C9 and VKORC1 genotyping. It was shown that the presence of CYP2C9*2 and CYP2C9*3 alleles in the CYP2C9 locus and the AA genotype of the polymorphous G-1639(3673)A marker of the VKORC1 gene was not associated with the development of severe hypocoagulation episodes (p = 0.261--for CYP2C9, p = 0.616 and 0.361 for VKORC1 in the total group and a subgroup of patients having the CYP2C9*1/*1 genotype respectively and treated with acenocoumarol. The search for other genetic markers of efficacy and safety of this drug should be continued.

[Anticoagulant action and safety of warfarin dosing based on pharmacogenetic testing: results of the first Russian prospective pilot study].

Aim of the study was to compare numbers of episodes of excess hypocoagulation and bleeding with warfarin dosing based on pharmacogenetic testing and traditional method in patients with high risk of thromboembolic complications. In 76 patients (43 men and 33 women aged 60.3 +/- 12.3 years) warfarin was administered starting with the dose calculated according to the gage algorithm with consideration of results of pharmacogenomic testing (genotyping of CYP2C9 and VKORC1). Control group comprised 78 patients aged 63.4 +/- 9.4 years who had participated in an earlier retrospective study in which they received warfarin according to traditional scheme with starting dose of 5 mg/day. In both groups we analyzed data obtained during 6 months after start of drug administration. Genotyping was carried out by polymerase chain reaction. Episodes of excess hypocoagulation (international normalized ratio above therapeutic range) and bleeding accurred more rarely with the use of pharmacogenetic approach to dosing of warfarin compared with standard method (17.1 vs 56.4%, p = 4.1 x10(-7), and 4 vs 18%, p = 0.009 respectively).