[Heart rate variability in patients with thyrotoxicosis before and after thyroid resection].

AIM: To evaluate parameters of variation pulsometry, heart rate variability (HRV) before and after surgical treatment of patients with thyrotoxicosis. MATERIAL AND METHODS: Enzyme immunoassay measured blood levels of TTH and free thyroxin (T4f), HRV was traced for 5 min with variation pulsometry, frequency and time course analysis in 124 patients (37 males, 87 females, age 20-74, mean age 50.4 +/- 1.7 years) with manifest (n = 73) and complicated (n = 51) thyrotoxicosis in diffuse (n = 36) or multinodular (n = 88) toxic goiter before and 7 days after thyroid resection. RESULTS: Aggravation of thyroxinemia with progression of thyrotoxicosis was accompanied with sympathicotonia change for vagotonia showing depletion of adaptive mechanisms in a complicated form of the disease. The weaker was sympathicotony in manifest thyrotoxicosis and the stronger was parasympathetic tension in complicated thyrotoxicosis, the higher were SDNN, RMSSD, TF, HF and LF/HF. Early after surgery (thyroid resection) thyrotoxicosis relieved with attenuation of thyroxinemia, vegetative regulation rearranged for adaptation up to achievement of vagosympathetic balance. This was more frequent in a manifest (56.1%) than in a complicated form of the disease (41.1%). CONCLUSION: HRV provides an objective assessment of the effects of surgical treatment on the status of the autonomic nervous system.

[Peculiarities of ulcerous and erosive lesions of gastroduodenal zone in patients with arterial hypertension].

The aim of the research was to evaluate peculiarities of ulcerous and erosive lesions of gastroduodenal zone (UELGDZ) in patients with arterial hypertension (AH). The authors studied clinical and endoscopic parameters in 442 patients with UELGDZ and AH, and 160 patients without AH (control group). The feature of the AH group was more frequent HP-invasion, aggravation of ulcerous process, development of complicated and atypical forms of the disease. In the patients with AH the clinical manifestations of chronic erosive gastritis were more diverse and severe; unfavorable clinical course prevailed. Risk of cardiovascular complications varied from low to very high, correlating with the severety of AH and UELGDZ.

[Circular disorders in the common carotid artery bed and associated psychovegetative and hemodynamic disturbances in hypertensive patients]. / Vyrazhennost' tsirkuliatornykh rasstroistv v basseine obshchei sonnoi arterii i sviazannye s nimi psikhovegetativnye i gemodinamicheskie narusheniia u bol'nykh arterial'noi gipertenziei.

AIM: To specify circulatory disorders in the bed of common carotid artery (CCA) in hypertensive patients and these disorders influence on psychovegetative and hemodynamic disturbances. MATERIAL AND METHODS: Ultrasonic dopplerography of the region of common carotid artery, ECG, examinations of central hemodynamics, vegetative regulation of cardiac rhythm and psychic status were performed in 200 patients with arterial hypertension (AH). RESULTS: AH patients with unaffected CCA circulation have common central and cerebral hemodynamics, hyperkinetic circulation, retain psychovegetative adaptation. Left ventricular myocardial hypertrophy is absent. In impaired elasticity and tonicity of the vascular wall there was hypokinetic circulation, left ventricular hypertrophy, anxiohypochondria in high sympathetic activity. In stenotic CCA the patients have hypokinetic circulation, left ventricular hypertrophy and dilation and resultant asthenodepressive disorders and vegetative dystonia. CONCLUSION: Aggravation of cerebrovascular insufficiency goes in parallel with AH progression and arterial atherosclerosis. Changes of circulation variant, left ventricular cardiodynamic rearrangement are accompanied with changes in psychovegetative homeostasis.

[Anxiety and hemodynamics: correlations in hypertensive patients]. / Vyrazhennost' trevozhnykh rasstroistv i sostoianie krovoobrashcheniia u bol'nykh gipertonicheskoi bolezn'iu.

AIM: Syndrome analysis of functional relationships between personality disorders, autonomic regulation and psychic performance in relation to hemodynamic condition of hypertensive patients. MATERIALS AND METHODS: MMP1, Tailor's anxiety scale, Burdon and Schulte tables, variation pulsometry, tetrapolar chest rheography were used in examination of 86 patients with stage I and II hypertension. RESULTS: In early hypertension, weak anxiety and subclinical emotional disturbances, dominant was a parasympathetic trend of the vegetative tone without central control of the cardiac rhythm in hyperkinetic circulation. Changes in cortical neurodynamics manifested with minor attenuation of the ability to focus attention. Progression of angiospasticity and anxiety gave rise to psychic maladjustment in the form of anxiety-depression disorders with autonomic dysfunction in hypokinetic circulation, overcentralization of cardiac rhythm control. This was associated with a decline in mental performance. CONCLUSION: Systemic investigations of the emotional sphere, central hemodynamics and autonomic regulation of cardiac rhythm enable assessment of multilevel structure and severity of psychocardiac syndrome in hypertensive patients which is important both for therapeutic and expert practice.

[The emotional status and indices of cortical neurodynamics in hypertension patients]. / Emotsional'noe sostoianie i nekotorye pokazateli korkovoi neirodinamiki u bol'nykh gipertonicheskoi bolezn'iu.

At early stages of essential hypertension (EH) clinical psychological examinations of 96 EH patients revealed predominance of anxiety-hypochondriac responses controlled by will. Changes in cortical neurodynamics were evident from a decline in attention concentration. At EH stage II persistent hypertension and prolonged psychogenias gave rise to psychic disadaptation occurring as anxious-depressive conditions. Damage to cortical neurodynamics brought about mnestic and thinking disorders.

[The possibilities of preventing hypertension and the characteristics of the psychological set for its management in rural inhabitants]. / Vozmozhnosti profilaktiki gipertonicheskoi bolezni i osobennosti psikhologicheskoi ustanovki na ee povedenie u sel'skikh zhitelei.

At examination of 360 hypertensive subjects living in rural areas it was found that the examinees were quite indifferent to their health. This is explained by poor knowledge of hypertension and its complications, inadequacy of the patients psychophysical condition, lack of medical prevention activity. A questionnaire survey of the physicians-in-charge revealed that 24% of them were unaware of the risk factors, 68% did not care for relevant correction, though they had diagnosed the risk factors in themselves. In self-rating the physicians were not confident, showed indifference to own health and future. The authors believe that the condition of the patients was in many respects due to social and psychological dysadaptation of their physicians who had lost their interest in preventive medicine.

[Neuro-psychological status and its role in the formation of adaptive-compensatory reactions in patients with myocardial infarction]. / Nervno-psikhicheskoe sostoianie i ego rol' v formirovanii adaptatsionno-kompensatornykh reaktsii u bol'nykh infarktom miokarda.

The course of adaptative and compensatory responses are associated not only with the extent of myocardial lesion, but with the status of ++psycho-autonomic regulation. Lack of true psychogenias and nervous and mental disorders, mainly the adrenomedullary pattern of sympathetic activation in the acute period of the disease contribute to stabilization of cardiovascular values and an uncomplicated course of myocardial infarction. On the contrary, asthenization of the ++neuro-mental sphere due to premorbid conflict was accompanied largely by a noradrenaline++ sympathetic activation and reversible complications of myocardial infarction. Prolonged psychogenias and neurotic personality disadaptation promotes the development of depressive and hypochondriacal disorders in the acute period of the disease; these are followed mainly by parasympathetic autonomic responses and concurrent with severe myocardial infarction.

[Characteristics of psycho-autonomic regulation in patients with myocardial infarction and circulatory failure]. / Osobennosti psikhovegetativnoi reguliatsii u bol'nykh infarktom miokarda s nedostatochnost'iu krovoobrashcheniia.

Three hundred and fourteen patients with myocardial infarction were studied by using psychodiagnostic tools and measuring blood levels of neuromediators and neurohormones. It was ascertained that the hemodynamic status determined not only various clinical syndromes, but also contributed to the development of psychoemotional and vegetative and humoral abnormalities. Situation-induced anxiety and moderate activation of the sympathetic-adrenal+ system were observed in uncomplicated myocardial infarction; astheno-hypochondriac disorders and prevalent parasympathetic regulation were seen in cardiogenic shock; pulmonary edema displayed depressive and phobic reactions and activation of the both autonomic nervous system portions with predominant adrenocortical function; congestive decompensation exhibited anxiety and depressive disorders and sympathetic activation at the normal and mediatory levels. This leads to the conclusion that it is necessary to perform multimodality therapy with regard to the status of psychovegetative control.

[Importance of correlating catecholamines and acetylcholine in the acute period of complicated and uncomplicated myocardial infarct]. / O znachenii sootnosheniia katekholaminov i atsetilkholina v ostrom periode oslozhnennogo i neoslozhnennogo infarkta miokarda.

The data obtained by the author testifies to the fact that in various clinical forms of myocardial infarction, there are definite correlations between biologically active substances, reflecting the reactivity of the cholinergic and adrenergic systems. In non-complicated myocardial infarction the predominance of catecholamines is noted, as a rule. In complicated course of the disease with a favourable outcome, the absolute content of the biologically active substances is at maximum and the predominance of catecholamines remains; in some cases, however, the predominance of acetylcholine is observed. In myocardial infarction with a fatal outcome, there is practically no stable predominance of this or that substance with a distinct tendency to the growth of the acetylcholine content and an inadequate change in the content of catecholamines.