[Nonvalvular Atrial Fibrillation and Diabetic Nephropathy: Epidemiology, Prognosis, and Choice of Anticoagulant Therapy].

In this review we present data on prevalence of atrial fibrillation (AF) among patients with type 2 diabetes (T2D), diabetic nephropathy and chronic kidney disease (CKD). Patients with nonvalvular AF and T2D combined with CKD have elevated risk of both bleeding and thromboembolic complications, as well as of all cause death. Efficacy and safety of novel oral anticoagulants (NOAC) depend on comorbidities and can be determined by the presence of T2D and/or diabetic nephropathy. Use of warfarin in CKD in some cases provides no preventive effect relative to risk of stroke and is characterized by increased risk of bleeding because of poor INR control, and possibly development of calcification of arteries. Presence of diabetic nephropathy requires monitoring of renal filtration function for correction of doses or selection of another anticoagulant. Lack of data from randomized controlled trials hampers choice of anticoagulant therapy in patients with terminal CKD on hemodialysis or after renal transplantation.

NONVALVULAR ATRIAL FIBRILLATION AND DIABETIC NEPHROPATHY: EPIDEMIOLOGY, PROGNOSIS, AND CHOICE OF ANTICOAGULANT THERAPY.

In this review we present data on prevalence of atrial fibrillation (AF) among patients with type 2 diabetes (T2D), diabetic nephropathy and chronic kidney disease (CKD). Patients with nonvalvular AF and T2D combined with CKD have elevated risk of both bleeding and thromboembolic complications, as well as of all cause death. Efficacy and safety of novel oral anticoagulants (NOAC) depend on comorbidities and can be determined by the presence of T2D and/or diabetic nephropathy. Use of warfarin in CKD in some cases provides no preventive effect relative to risk of stroke and is characterized by increased risk of bleeding because of poor INR control, and possibly development of calcification of arteries. Presence of diabetic nephropathy requires monitoring of renal filtration function for correction of doses or selection of another anticoagulant. Lack of data from randomized controlled trials hampers choice of anticoagulant therapy in patients with terminal CKD on hemodialysis or after renal transplantation.

[Physical factors in rehabilitation of patients with bronchial asthma]. / Fizicheskie faktory v reabilitatsii bol'nykh bronkhial'noi astmoi.

154 patients with moderate severity bronchial asthma (BA) received treatment including two components: electroaerosols with mineral sodium chloride water (Ust-Kachka resort) (group 1) or ward speleotherapy (group 2), standard antiinflammatory medication with beklametasone dipropionate. (BD). A control group was given BD only. Personality traits and vegetative pattern were studied before and after the treatment. General clinical response was the same in all three groups. Normalization of emotional and vegetative abnormalities was faster in groups where physical factors were employed. These findings show perspectiveness of a new line in the treatment of BA--neurorehabilitation.

[Ground-based speleo-climatic wards and the experience with their use in bronchial asthma]. / Nazemnye speleoklimaticheskie palaty i opyt primeneniia pri bronkhial'noi astme.

Ambient air in ground wards made to contain natural potassium-sodium salt is close in characteristics to the atmosphere of underground wards but has a number of specificities: daily fluctuations of concentrations of light aeroions and aerosol particles, elevated concentration of light aeroions concentration, low radiation background, minimal bacterial contamination. The stay in ground wards brings great benefit for patients with bronchial asthma. Ground speleo-climatic wards are perspective in nonpharmacological treatment of patients with allergic respiratory diseases.