[Analysis of healthcare for patients with cardiovascular diseases in Russian Federation in comparison with the practice of Europe and USA].

The medical community, researchers and healthcare organizers are constantly challenged by comparing key indexes reflecting the effectiveness of cardiovascular care, primarily for the dynamic assessment and implementation of the world's best practices to reduce cardiovascular mortality. The analysis of health care for patients with cardiovascular diseases (CVD) is a complex, multicomponent process, the structure and key tools of which differ from country to country. Using different data sources, methodological and analytical approaches creates certain limitations and barriers to the assessment. In order to update the ideas about the modern coordinate system and tools for assessing cardiovascular care, the authors presented practices for analyzing major indexes in Russia, European countries, and the United States. The review presents sources of statistical data, principles for assessing risk factors, cardiovascular morbidity and mortality, and specific features of monitoring the availability and quality of cardiovascular care.

[Sleep disordered breathing in patients with chronic heart failure: prognosis and management]. / Narusheniya dykhaniya vo vremya sna u patsientov s khronicheskoi serdechnoi nedostatochnost'yu: prognoz i vozmozhnosti terapii.

Sleep disordered breathing is a frequent comorbidity (50-75%) in patients with chronic heart failure, but it is usually underestimated. This review analyzes sleep disordered breathing in patients with chronic heart failure, demonstrates pathogenetic relationships and the prognostic role of sleep apnea. The authors present modern treatment options for sleep apnea in this cohort (from non-invasive ventilation to implantable devices), highlight the role of drug therapy and outline perspectives of different treatment approaches. This clinical problem is designated as multidisciplinary, which requires a dialogue between researchers and doctors of various specialties to organize comprehensive effective care for this cohort of patients.

[Sleep disorders and stroke: data of the esse-rf study]. / Narusheniia sna i insul't: dannye issledovaniia ÉSSE-RF.

AIM: To assess the association between stroke and self-reported sleep disorders in the epidemiological studies of cardiovascular diseases in various regions of Russia (ESSE-RF). MATERIAL AND METHODS: A questionnaire survey included unorganized male and female population, aged 25 to 64 years, from 13 regions of the Russian Federation. In the analysis, answers to the question related to history of stroke: 'Did the doctor ever tell you that you had / had the following diseases?' (the 'Diseases' module) were included. The authors also evaluated answers about sleep duration, insomnia complaints, and sleepiness (the 'Sleep assessment' module). RESULTS AND CONCLUSION: Of 20 357 respondents, 422 (2%) confirmed the history of stroke. Both short and long sleep duration were not associated with stroke. Complaints of sleep disorders (snoring, sleep apnea, difficulty falling and maintaining sleep, as well as their combinations) were more frequently correlated with stroke. After adjustment for gender, age, body mass index, office blood pressure, the regression analysis showed that odds ratio was not significant for all complaints, except the combination of sleep apnea with frequent daytime sleepiness (1.7 (95% CI 1.04-2.8) (p=0.034). Therefore, symptoms of sleep-disordered breathing and insomnia are more common in respondents with the history of stroke. The combination of sleep apnea and frequent sleepiness complaints may indicate more severe sleep disorders in post-stroke patients.

[Galectin-3, Markers of Oxidative Stress and Renal Dysfunction in Patients With Chronic Heart Failure].

OBJECTIVE: to determine levels of galectin-3, markers of renal dysfunction, and plasma oxidative stress; to assess their correlation in patients with chronic heart failure (CHF) of various severity. MATERIAL AND METHODS: We included in this study 157 CHF patients (with documented prior myocardial infarction. Patients were divided into 3 groups according to their NYHA functional class (group 1 - class II n=60, group 2 - class III n=52, group 3 - class IV n=45). All patients underwent clinical examination, echocardiography. Laboratory parameters included measurement of plasma levels of galectin-3, NT-proBNP, as well as markers of oxidative stress (oxidized low density lipoprotein cholesterol [oxLDLC], SH-groups) and renal dysfunction (creatinine, uric acid, cystatin-C). RESULTS: The level of galectin-3 (median) in groups 1, 2, and 3 was 10, 19 and 38 ng/ml respectively. There were significant differences between groups (p<0,001). In all groups levels of galectin-3 significantly (p<0.01) correlated with those of oxLDL (positively) and SH-groups (negatively): r1=0.52, r2=0.59, r3=0.63, p<0.01, and r1=-0.58, r2=-0.65, r3=-0.71, respectively. Correlation analysis also revealed close and moderate correlations between galectin-3 and cystatin-C, glomerular filtration rate, and uric acid. CONCLUSIONS: In patients with CHF and prior myocardial infarction plasma concentration of galectin-3 was associated with severity of CHF and significantly correlated with markers of renal dysfunction and plasma oxidative stress.

[Prevention of cardiovascular complications in patients undergoing aortic-iliac reconstructions by correction of inflammation and endotoxemia].

There were presented the results of examination and treatment of 130 patients with atherosclerosis. Objective is to study the role of atorvastatin in correction of inflammation, endotoxemia and prevention of cardiovascular complications in patients with atherosclerosis undergoing aorto-iliac reconstruction. There were observed initial and postoperative activation of inflammation, endotoxemia in patients with multifocal atherosclerosis. We found that short-term therapy with atorvastatin 60 mg per day had a significant advantage over low-dose in correction of pre- and postoperative endogenous inflammation, endotoxemia and prevention of cardiac events after aorto-iliac reconstruction.

[Experience of application of multiplex qPCR for differential diagnostics of intestinal viral infections].

AIM: Evaluate the effectiveness of multiplex reverse transcription (RT) and polymerase chain reaction with fluorescence detection in real time mode (qPCR) methods for differential detection of 11 groups of intestine viruses (adenoviruses, enteroviruses, polioviruses, hepatitis A and E viruses, group A and C rotaviruses, orthoreoviruses, noroviruses, sapoviruses and astroviruses) in various biological samples. MATERIALS AND METHODS: Panels of virus isolates and clinical samples characterized by reference methods were used to evaluate sensitivity of detection of various intestine viruses. Nucleic acids were isolated from study samples and multiplex RT and qPCR were carried out. RESULTS: Sensitivity of laboratory reagent kit (LRK) when compared with results obtained from reference methods was 100% for rotavirus A, adenovirus, enterovirus and norovirus, 88.9% for hepatitis E virus and 92.3% for hepatitis A virus, and diagnostic specificity - 99.4%. During analysis of 697 clinical samples from patients with acute intestine infection symptoms nucleic acids of various intestine viruses were isolated in 71.7%. CONCLUSION: Multiplex qRT-PCR was shown as an effective method of etiologic diagnostics of an intestine viral infection. Use of LRK was demonstrated to establish etiology of intestine diseases in 63 - 72% and in children with watery diarrhea - in approximately 90% of cases.

[Pharmacological protection of the myocardium with reamberin in coronary artery bypass grafting in patients with postinfarction angina].

AIM: To assess efficacy of reamberin in preoperative preparation and after coronary bypass (CB) in patients with macrofocal myocardial infarction (MI) complicated with postinfarction angina. MATERIAL AND METHODS: A total of 45 patients with Q-positive MI complicated with postinfarction angina pectoris entered the trial. The study group consisted of 20 (44.4%) patients given 200-400 ml injections of 1.5% reamberin solution for 3 days before coronary artery bypass grafting (CABG) and 3-5 days after it. The control group consisted of 25 (55.6%) patients given basic therapy without cardioprotection. ECTG-60, echocardiography, CM-ECG, laboratory tests were made before CABG. CABG was made in conditions of artificial blood circulation in all the patients. RESULTS: Clinical stabilization was observed after direct myocardial revascularization in hospitalized 25 (100%) patients of the study group and 22 (88%) patients of the control group. Early postoperative acute cardiac failure (ACF) developed in 3 (12%) patients from the study group and 9 (36%) from the control group (p = 0.04), arrhythmia occurred in 2(8%) and 8(32%) patients, respectively (p = 0.03). Two (8%) control patients died in early postoperative period from acute cardiac failure. Perioperative MI occurred in 2(8%) control patients. After 12 months of the follow-up, patients of the study group had no recurrent angina pectoris, while among the controls 4(16%) patients had recurrent angina of FC III. After surgical intervention at discharge and 12 months after treatment patients of both groups improved systolic and diastolic functions of the left ventricle. Normalization of the diastolic function was registered in 80% patients of the study group (p < 0.001) and in 44% from the control group (p < 0.001) after 1 year follow-up. CONCLUSION: Reamberin reduces the number of postoperative complications, ischemic damage to the myocardium, significantly improves systolic and diastolic functions of the left ventricle.

[Molecular mechanisms of effects of rosuvastatin on systemic oxidative stress and endogenous inflammation in patients with atherosclerosis].

Aim of the study was to investigate peculiarities of effects of rosuvastatin on the state of oxidative stress and endogenous inflammation in patients with extensive atherosclerosis. Patients with extensive atherosclerosis included into the study (n=46, mean age 56.5 +/- 2.2 years) were distributed to 2 equivalent according to clinico-instrumental data groups. To patients of group 1 (n=24) standard therapy was prescribed (antiaggregants, ACE inhibitors, b-adrenoblockers, and nitrates when indicated), patients of group 2 (n=22) in addition to standard therapy took rosuvastatin (10 mg/day). Investigations included measurement of parameters of serum lipid profile, content of thiol groups of blood serum proteins, activity of enzyme glutathione peroxidase, in vivo oxidation of whole blood serum and HDL, concentration of 3-nitrotirosine, high sensitivity C-reactive protein and interleukin-6, activity of type 2IIA secretory phospholipase A2. It was found that level of 3-nitrotirosine and activity of secretory phospholipase A2 together with high sensitivity C-reactive protein appear to be effective markers of systemic oxidative stress and endogenous inflammation in patients with extensive atherosclerosis. Treatment with rosuvastatin in moderate doses significantly suppressed activity of endogenous inflammation and oxidative stress by way of activation of antioxidant system of plasma, decrease of oxidation of fractions of lipoproteins, suppression of " nitrotirosine " stress, as well as partial inhibition of efficacy of action of secretory phospholipase A2, lowering of content of C-reactive protein and interleukin-6.

Modern methods for diagnosis of Gardnerella infection.

Comparison of morphological, bacteriological, serological, and genetic methods for diagnosis of Gardnerella infection in vaginosis showed that the first three methods are preferable, while the genetic method (polymerase chain reaction) is more efficient for identification of Gardnerella vaginalis in culture.

[Assessment of central hemodynamics during long microsurgical interventions using beforal in children]. / Otsenka tsentral'noi gemodinamiki pri dlitel'nykh mikrokhirurgicheskikh operatsiiakh u detei s primeneniem beforala.

Beforal was used for anesthesia in 21 children aged 4 to 14 years and weighing 15 to 65 kg. Surgical interventions lasted for 2.5 to 9 hours. The basic dose of beforal was 0.5 to 1 mg/kg. Anesthesia was maintained with half or third of the basic dose in combination with inhalations of nitrogen oxide and relanium (diazepam) in a dose of 0.3 to 0.4 mg/kg. Beforal as the only analgesic component of anesthesia effectively protected the organism of a child from surgical shock and its use was associated with stability of the studied hemodynamic parameters.

[THe treatment of patients with chronic disease: the viewpoint of the physician and of the patient (exemplified by rheumatoid arthritis)]. / Lechenie bol'nykh khronicheskim zabolevaniem: tochka zreniia vracha i bol'nogo (na primere revmatoidnogo artrita).

The opinions of the experts and the patients with rheumatic arthritis in relation to the disease treatment and preventive measures have been analyzed. The views of the physicians coincided more frequently than those of the patients. It is emphasized that patients benefit from group and individual training, especially from individual conversations.

[The dynamics of dermatomycetes in the Bashkir ASSR in 1979-1987]. / Dinamika dermatomitsetov v Bashkirskoi ASSR v 1979--1987 gg.

Analysis of changes in dermatomycetes incidence in Bashkiria in 1979-1987 has shown the predominance of zoophilic fungi in the latest 9 years, while the share of anthroponotic fungi has made up but 8.6%. The major agent of dermatophytosis in the republic was Microsporum canis. The incidence of Trichophyton verrucosum and Trichophyton mentagrophytes v. gypzeune has grown of late, this necessitating the detection of new epidemiologic factors, contributing to dissemination of these mycoses and the development of appropriate prophylactic measures.