ABSTRACT
In spite of considerable success in the study of basic pathogenetic mechanisms of arrhythmias development in patients without diabetes mellitus 2 type (DM), the problem of impact of DM on disorders of the cardiac rhythm of patients with acute myocardial infarction is still not resolved. Disorders of the cardiac rhythm have been analyzed in all groups of patients. So, the first group of patients, for certain, had more patients with fibrillation and palpitation of auricles, i.e. hypoglycemia more frequent induced the development of supra ventricular disorders of cardiac rhythm. Fibrillation of auricles, for certain, was more frequently observed in the group of patients with Hba1c less than 7 mkmol/l (P < 0,001). Single VE (ventricular extra systoles) and SVE (supra ventricular extra systoles) prevailed in the 2nd group. Patients with Hba1c more than 9 mkmol/l and hyperglycemia episodes prevailed with ventricular disorders, namely ventricular extra systoles of high degree. Thus, hypoglycemia provokes the development of supra ventricular disorders of the cardiac rhythm in a greater degree, while hyperglycemia results in the development of ventricular disorders of the cardiac rhythm.
Subject(s)
Arrhythmias, Cardiac/etiology , Diabetes Mellitus, Type 2/complications , Myocardial Infarction/complications , Aged , Arrhythmias, Cardiac/epidemiology , Arrhythmias, Cardiac/metabolism , Carbohydrate Metabolism , Diabetes Mellitus, Type 2/epidemiology , Diabetes Mellitus, Type 2/metabolism , Electrocardiography , Female , Humans , Male , Middle Aged , Myocardial Infarction/epidemiology , Myocardial Infarction/metabolism , Obesity/complications , Obesity/metabolism , Retrospective Studies , Smoking/adverse effectsABSTRACT
HIV-infection morbidity rates continue to increase in Moscow, the Moscow Region, and in the whole country. The epidemiological situation associated with tuberculosis concurrent with HIV infection remains tense in Moscow and its region, as judged from the data of an analysis of this disease at tuberculosis hospital seven (TH-7) over 9 years. A total of 411 patients with tuberculosis concurrent with HIV infection were treated at TH-7 in 1996 to December 2004. Among them, 49.6% were Moscow residents, 15.1 and 26.5% of the patients lived in the Moscow Region and other regions of the Russian Federation, respectively; 6.8% were homeless persons and 2% foreigners. The number of patients with tuberculosis concurrent with HIV infection has been annually increasing at TH-7. Among the total number of patients, their proportion was 13.4% in 2004. In the structure of patients with comorbidity, the proportion of surgical patients has been on the rise and it was 51.8% in 2004. Among the surgical patients with tuberculosis concurrent with HIV, the proportion of patients with generalized (multiple organ) tuberculosis has increased; it was 50% in 2004. Patients with tuberculosis concurrent with HIV infection need a greater scope of surgical interventions al number of patients for therapeutic and diagnostic purposes.
Subject(s)
HIV Infections/epidemiology , Hospitals, Chronic Disease/organization & administration , Tuberculosis, Pulmonary/epidemiology , Tuberculosis, Pulmonary/rehabilitation , Adult , Female , Hospitals, Chronic Disease/statistics & numerical data , Humans , Male , Moscow/epidemiology , Needs Assessment , PrevalenceABSTRACT
The results of surgical treatment were analyzed in 31 patients with complicated abdominal tuberculosis in 2001 to 2003. Before 2003, a surgical intervention was mainly palliative and reduced to the suturing of perforative tuberculous ulcers limited to the resections of the small intestine and to the separation of adhesions (Group 1, n=17). Then radical surgical interventions were undertaken in the volume of extended right-sided hemicolectomies, by removing caseously changed mesenteric lymph nodes (Group 2, n=14). Postoperative peritoneal lavage was performed, by using antituberculous agents. Twelve and 5 patients died in Groups 1 and 2, respectively. The authors suggest that radical surgical interventions for complicated abdominal tuberculosis can improve the outcomes of treatment of this disease.
Subject(s)
Tuberculosis, Gastrointestinal/surgery , Antitubercular Agents/therapeutic use , Colectomy , Gastrointestinal Hemorrhage/etiology , Humans , Intestinal Fistula/etiology , Intestinal Obstruction/etiology , Intestinal Perforation/etiology , Lymph Node Excision , Palliative Care , Peritoneal Lavage , Peritonitis/etiology , Postoperative Care , Treatment Outcome , Tuberculosis, Gastrointestinal/complications , Tuberculosis, Gastrointestinal/mortalityABSTRACT
Results of surgical treatment of 31 patients with complicated forms of abdominal tuberculosis treated in 2001-2003 were analyzed. Before 2003 surgery was mainly palliative and managed by suturing of perforated ulcers or economic resection of the small intestine (group 1--17 patients) was made. Since 2003 radical right-sided hemi-colectomies with removal of caseous mesenterial lymph nodes is used (group 2--14 patients). Peritoneal lavage with antituberculosis drugs was performed after surgery. From 17 patients of group 1--12 died, from 14 patients of group 2--5. It is concluded that radical surgery in complicated forms of abdominal tuberculosis permits to improve results of surgical treatment of this disease.
