[The role of long emotional stress during gastroenterological diseases].

The objective of this article was to study the interrelationships between long emotional stress and gastroenterological diseases (cirrhosis of liver, chronic hepatitis, chronic cholecystitis, ulcerous disease, chronic colitis, ulcerative colitis). The psychological well-being among Abkhazian refugees and their health problems have been investigated. It was found relationship between psychological problems and clinical outcomes in patients with gastroenterological diseases. Emotional stress contributes to gastroenterological illness.

[Some aspects of the clinical use of lercamen (lercadipine)].

The paper deals with the comparative study of the effects of lercamen (lercadipine) and amlodipine, two third-generation long-acting calcium channel blocker medicine of the dihydropyridine type used in the treatment of hypertension. 80 patients of both sexes, aged from 48 to 76 were treated with lercamen (10-20 mg) or amlodipine (10 mg) for twelve weeks. Some adverse reactions of the above mentioned drugs such as headache, ankle oedema and others were observed and studied with great care. A two-week treatment with lercamen (10 mg) resulted in significant decrease of both systolic and diastolic blood pressure in 74% patients. Further decrease of blood pressure was observed during the following 10 weeks. The doze of lercamen had to be doubled for 26% of patients. After 12 weeks blood pressure in lercamen group was 126+/-4.5/80.4+/-5.3 mmHg (p<0.01 versus baseline). Amlodipine caused similar decrease of blood pressure. Sympathetic activation occurs neither with lecramene not with amlodipine during chronic therapy. Less adverse drug reactions were observed among lercamen group, which equaled with 12% than among the amlodipine group, which was 26,3%. We believe that adverse reactions are weakly expressed in lercamen group than in amlodipine group due to high lypophility and unique membrane kinetic of lercamen. Lercamen has proved not only better efficiency but also better endurance in chronic treatment of essential hypertension in patients.

[The relation of the activity of postheparin lipoprotein lipase with the CBC parameters in patients with acute coronary syndrome].

The aim of presented investigation was to study of the relation of the activity of postheparin lipoprotein lipase (LPL) with the blood test parameters in patients with acute coronary syndrome(ACS) during first 6-12 hours after appearance of acute anginous pain. 47 patients with the disease of coronary arteries (DCA) have been investigated. Acute form of ACS was revealed in 27 patients (mean age--62.9+/-11.7 years), chronic form--in 20 patients (mean age 67.9+/-14.0 years). The study was carried out in the first 6-12 hours after appearance of acute anginous pain. Control group consisted of 23 healthy subjects (mean age--37.5+/-8.9 years). Postheparin activity of LPL has been determined in whole cohort by potentiometric method. Blood test was carried out by standard method. The acute coronary syndrome was confirmed by electrocardiographic findings. In ACS group the activity of LPL significantly correlated inversely with the value of leukocytes (r=-0.4022, p=0.038), stab (r=-0.4808, p=0.011) and segmental leukocytes (r=-0.5853, p=0.001), erythrocyte sedimentation rate (r=-0.4188, p=0.030). Corning to the comparative analysis of chronic and acute forms of DCA, the activity of LPL was significantly lower in patients with chronic form compared to the acute form (p=0.043). Therefore, based on the obtained data it should be concluded that in 6-12 hours after development of acute coronary syndrome during worsening the inflammatory reaction (which reflected on the parameters of blood test) together with endothelial dysfunction it is expressed the decrease of the activity of endothelial enzyme LPL.

[Peculiarities of postprandial activity of lipoprotein lipase in coronary heart disease].

The aim of investigation was to study the peculiarities of activity of lipoprotein lipase (LPL) and serum lipid spectrum after fat test meal in patients with coronary heart disease (CHD). 42 persons have been investigated. The main group consisted of 27 patients with CHD (13 males, 14 females). 15 almost healthy subjects (5 males, 10 females) were unified in control group. Parameters of lipid metabolism have been studied by biochemical technique both in basal state and at 3 hours after standard test meal. In parallel, the levels of LPL activity have been investigated by potentiometric method. The values of LPL activity in patients with CHD both in basal and in postprandial states were significantly lower in comparison with analogous values of control subjects. Its postprandial level in CHD patients did not change significantly (percentage increment was 1,0+/-0,9%), but in control group - was increased by 22,3+/-4,4%. Obtained results suggest that LPL activity is not increased at increased postprandial atherogenic lipemia in patients with CHD. LPL activity should be considered as a metabolic marker of atherogenesis and CHD.

[The influence of psychosocial factors in developments of ischemic heart disease and arterial hypertension in persons with genetic predisposition].

The purpose of the work was to investigate the influence of psychosocial factors on the development of ischemic heart disease and arterial hypertension in persons with genetic predisposition to cardiovascular disease. Three groups of patients were investigated: 72 patients with AH, 175 patients with IHD (74 with angina pectoris and 101 with angina pectoris and myocardial infarction) and 164 patients with IHD and AH. In nearest relation of 283 (69/03%) patients from 410 were found the presence of high arterial hypertension, myocardial infarction, diabetes and obesity. In this persons reliable relationship were found between psychosocial and genetic factors (in persons with genetic predisposition to cardiovascular disease were found high rate of anxiety, frequent stressful situations at work and in family, psychoemotional overloads). On the basis of our investigations it may be concluded that the genetic and psychosocial factors together play important role in the development of IHD and AH, that perhaps caused from influence of genetic factors on capable of to overcome the stress.

[Some peculiarities of the activity of postheparin lipoprotein lipase and parameters of lipid metabolism at ischaemic heart disease].

The study of the relation of atherosclerosis with lipid metabolism (LM) remains still very important. The aim of presented work was the investigation of peculiarities of lipoprotein lipase (LPL) and LM at IHD in different age and sex groups; also the search of possible relation of LPL activity changes with myocardial contractility function and coronarography data at IHD. 47 patients (15 females, 32 males) with IHD were investigated. They were divided on 3 groups: 1 -<50 years (n=14); 2 - 50-59 years (n=14); 3 - >/=60 years (n=19). Patients were investigated by coronarography and echocardiography. Main parameters of LM were determined by enzyme-linked immunoassay. LPL activity was defined by potentiometric method. It was observed significant difference between levels of LPL activity of different age groups (p(1-2)=0,027, p(1-3)<0,001, p(2-3)=0,035). Significant difference in this parameter by sex feature did not observed. The degree of damage in anterior descending branch of left coronary artery negatively correlated with LPL activity (r=-0,5598, p<0,001). Ejection fraction (EF) revealed positive correlation with LPL activity (r=0,4362, p=0,002). The degree of damage of left coronary artery, in particular, medial segment of circumflex branch correlated with LM parameters. EF positively correlated with high-density lipoprotein cholesterol blood level (r=0,3548, p=0,036). LPL activity in patients with IHD significantly decreased with aging. From obtained results it will be supposed that LPL activity and LM parameters influences on the damage degree, basically, left coronary artery.

[Occurrence of pathologies of the psychic sphere among the patients in the period of the angioplasty on coronary blood vessels].

The aim of our study was to reveal pathologies of the psychic sphere (symptomatology of alarm disorders, depression and sleep disturbance) in several days after the angioplasty on coronary blood vessels. There have been examined 70 patients (20 women and 50 men) at 3-5 days after the angioplasty on coronary blood vessels. Their age ranged from 40 to 75 years. The main cause of hospitalization of these patients was the acute coronary syndrome in 50% of the cases, non-stable stenocardia in 20% and acute myocardial infarction on 30% of the cases. There has been studied the percentage rates of alarm disorders, depression and sleep disturbance among these patients. It was revealed that alarm disorders in high level occurred in 54,28%, depression in 32,85% and sleep disturbance in 72,85%. Among the majority of these patients the degree of coronary occlusion was from 70 to 90%. On the basis of the above-mentioned indices there can be concluded that there exists a considerable correlation between the degree of coronary occlusion and the occurrence of pathologies of the psychic sphere.

[Role of psychological factors in the developments of heart disease].

The main purpose of the study was the evaluation of the role of various types of the fixed predisposition in the patients with ischemic heart disease (IHD) and arterial hypertension (AH) in different groups of patients to find statistically significant associations between the types of fixed predisposition and risk factors of IHD. Three groups of patients were investigated: 72 patients with AH, 175 patients with IHD ( 74 with angina pectoris and 101 with angina pectoris and myocardial infarction) and 164 patients with IHD and AH. Reliable relationship were found between crude-dynamic type of the fixed predisposition and IHD and AH. No significant associations were revealed between types of the fixed predisposition and well-known risk factors of IHD and AH. On the basis of our investigations it may be concluded that the specific types of the fixed predisposition represent independent risk factors of IHD and AH. Determination of such risk-factors has great importance for the risk assessment of the heart diseases.

[A type behavior as a risk factor in siblings with diabetes mellitus].

The objective of the study was to investigate the prevalence of the "a" type behavior among close relatives (including siblings) of the subjects with diabetes mellitus. For this purpose there were examined 50 practically healthy siblings aged between 20 and 40, among them 27 (54%) females and 23 (46%) males. The method of the structural interview was applied. In addition to this, they were subjected to the tests of glucose tolerance. The considerable number of the siblings (46%) showed the "a" type behavior of various kinds, and 44% -- the disruption of glucose tolerance, which produces the preliminary conditions for the diabetes manifestations and gives us the grounds for applying further preventive activities.

[Behavioral risk factors in patients with diabetes mellitus type II].

Sixty patients with diabetes mellitus of the second type and thirty healthy persons were investigated. Structural interviews by Friedman, Rosenmann and Spilberger methods were conducted in all subjects. According to the results, out of four groups "0" group was related to the healthy subjects, who showed behavior of type "b". For the rest 1, 2, 3 groups, they reflected the pathological state of the "a" type behavior of various degrees. This type was documented in 90% of patients with diabetes mellitus. Severe "a" type behavior was mostly seen in males rather than in females that indicate to the males' deficiency in the development of the emotional sphere. These specific health aggravations are directly connected with the duration of the disease, its stage and emotional-expressive receptivity of the "a" type.

[Parameters of circadian heart rate variations, night sleep profile and structure during the Holter monitoring procedure in the groups of students with different adaptation potential].

Circadian heart rate variations, night sleep profile and structure during ECG Holter monitoring process have been studied in practically healthy students with various adaptation potential to estimate the role of the dynamics of these parameters for evaluation of functional condition of cardiovascular system and whole organism. Statistically significant differences have been revealed for the functionally distinguished groups for the following parameters: P average/day, Circadian Index, sleep profile and sleep duration. When the mechanisms of adaptation are very strained, P average/day is high and circadian profile is strengthened, which indicates to the increase of sympathetic influence on the heart rhythm in persons who have primary high level vagotonia. With increasing of the strength of the adaptation mechanisms the sleep duration (sleep profile as well) is reducing, which may be one of the causes of asthenization.

[Genetic burden of psychosomatic diseases and exogenous risk-factors of cardiovascular diseases in healthy students with different physiological and psychological adaptation abilities].

Exogenous risk factors of cardiovascular diseases and genetic burden of psychosomatic pathologies have been studied in practically healthy students with various physiological and psychological adaptation abilities for differential analysis of the risk for development of cardiological diseases. The complex of genetic burden of psychosomatic pathologies and exogenous risk factors was significantly more frequent in practically healthy students with strong profile of adaptation mechanisms, increased circadian profile, zero type and weak persistence of fixated set.

[Characteristics of the mechanisms of psychological adaptation of patients with ischemic heart disease and hypertension]. / Osobennosti mekhanizmov psikhologicheskoi adaptatsii bol'nykh ishemicheskoi bolezn'iu serdtsa i gipertonicheskoi bolezn'iu.

A fixed orientation principle was used for the examination of 203 patients with coronary heart disease (CHD) and 123 patients with essential hypertension. Psychological adaptation mechanisms and variation therein were studied in relation to the form, severity, pattern and stage of the disease. The fixed orientation method is based on evoking illusory perception in a subject. Basic fixed orientation types are identified depending on the way one gets rid of the orientation. Variable-stable orientation mediating high motivation, dominance, impulsiveness and aggressiveness in prevalent in CHD irrespective of its form. In hypertensive patients, variable-labile orientation prevails that features impulsiveness, inconsistency, anxiety, psychasthesnia and depression. The occurrence of these parameters was unrelated to form, severity and stage of the disease. Premorbid nature of these features is postulated. The fixed orientation method is recommended as a highly informative way of identifying psychological adaptation mechanisms.

[Character peculiarities in patients with various forms of ischemic heart disease and hypertension]. / Kharakterologicheskie osobennosti bol'nykh razlichnymi formami ishemicheskoi bolezni serdtsa i gipertonicheskoi bolezn'iu.

A total of 202 patients with coronary heart disease and 115 patients with hypertension were examined to study their specific and frustration characteristics. Isenk's questionnaire and Rosentsveig's test were used. In CHD and postinfarction cardiosclerosis extraversion prevailed, in hypertension intraversion was more common. The indicator of neuroticism was high among all the patients under study. The choleric temperament prevailed in angina pectoris. Choleric and melancholic peculiarities were typical of patients with postinfarction cardiosclerosis and hypertension. Extrapunitive reactions were clearly revealed by Rosenzweig's test in all the study groups.

[Psychological profile of patients with ischemic heart disease and its association with various exogenous risk factors]. / O psikhologicheskom profile bol'nykh ishemicheskoi bolezn'iu serdtsa i ego sviazi s nokotorymi ekzogennymi faktorami riska.

Males with coronary heart disease (CHD) aged 35 to 60 years were studied. The patients were divided into three groups: 32 patients with angina of effort and at rest (test group I), 39 survivors of myocardial infarction (test group II) and 50 clinically healthy people (control group). The relationship was established between a certain behavioural complex of CHD patients and some exogenic risk factors. The study was aimed at elucidating the premorbid characteristics of the personality of CHD patients. Individuals with the variable type of orientation were predominant in both test groups. The data from Eisenk's questionnaire revealed the predominance of extraverts in group I and introverts in group II. It is suggested that the variable character may prove to be the premorbid, basic property of the personality determining the specific mechanism of psychologic adaptation and the entire complex of behavioural characteristics of CHD patients.