[Therapy of patients with the high risk of arterial hypertension with the use of telmisartan].

AIM: The study assesses the effects of therapy based on the use of telmisartan in patients with arterial hypertension and stable angina on the clinical and functional indicators of the cardiovascularvascular system. MATERIAL AND METHODS: 52 patients with a combination of arterial hypertension (AH) I and II stages and coronary artery disease II with the mean age 63.5 ± 5.4 years (79% males and 21% of females) were enrolled in the trial. The duration of AH and CAD were 17.5±3.8 and 12.5±3.1 accordingly. All patients took a daily 80 mg dose of telmisartan. The efficacy of treatment was estimated in 3,6 and 12 months. RESULTS: The use of telmisartan in complex treatment of high-risk patients with AH has led to decreasing blood pressure to the target level, increasing exercise tolerance (walking the distance from 315.5 m to 410.2 m in 6 minutes). 12 months of therapy based on telmisartan showed significant decrease in left hy­ pertrophy ventricle (LV myocardial mass index on average by 10.4%), a decrease in the total duration of depression ST segment from 9.6±2.9 to 2.7±1.5 mm and a decrease in the depth of depression from 1.5±0.3 mm to 0.3±0.09 mm, with a trend towards decrease in the number of episodes of ST-segment depression, as well as the absence of a significant change in heart rate. After 12 months of en­ dothelium-dependent vasodilation therapy, the condition of 31 (60%) patients improved, and 18 (35%) patients showed the tendency to improvement. The tests with reactive hyperemia conducted after 12 months of treatment revealed decreased linear velocity of blood flow in the brachial artery on average by 17%. CONCLUSION: The use of telmisartan in complex therapy improves the quality of life according to the EQ-VAS questionnaire by 25 points after 12 months of therapy, contributes to lowering blood pressure in 96% of patients, reduc­ ing myocardial hypertrophy, endothelial dysfunction and severity of ischemic manifestations (reducing the need for nitroglycerin intake to an average of 0,5 inhalations, as well as a decrease in the ST segment depression of 40% after 12 months of therapy).

The complex analysis of risk factors, influencing on the progression of chronic obstructive ulmonary disease.

AIM: The aim of the study is the analysis of risk factors, influencing on the progression of chronic obstructive pulmonary disease. MATERIALS AND METHODS: 259 patients with chronic obstructive pulmonary disease (COPD) I and III stages, mean age 54,3±11,7 and the duration of the disease 10,1±5,7. Patients were divided into 2 groups: I group (n=119) - with III stage of disease, II group (n=140) - COPD with I stage. 30 healthy were involved in control group. The risk factors of progression of COPD were determined with the use of regressive and correlative analyses. RESULTS: The level of markers of systemic inflammation in serum of patients with COPD: TNF-α (RR 3,25); IL-8 (RR 2,1); hs-CRP (RR 3,52) in combination with traditional risk factors (long course of the disease (RR 2,3), age (RR 1,65), smoking (RR 1,65), and also obesity (RR 2,45), early menopause (RR 3,52), hereditary respiratory predisposition (RR 3,05), and also coexisting cardiovascular pathology increase the risk of COPD progression several times. . CONCLUSION: According to the results of this trial, unmodified risk factors such as hereditary predisposition, early menopause, long course of the diseases and coexisting cardiovascular pathology contribute significantly on progression of COPD. The relative risk increases with increasing of concentration of markers of systemic inflammation (TNF-α, IL-8 and hs-CRP), that correlate with clinical manifestations of COPD: cough, shortness of breath on VAS in mm.

[The Analysis of Efficacy of The Application of Interleukin-1 Inhibitor in the Complex Therapy of Secondary Osteoarthritis Taking Into Account the Dynamics of Clinical and Functional Indicators].

BACKGRAUND: Secondary osteoarthritis (OA) adversely affects the underlying disease and can enhance clinical manifestations of articular syndrome. Early detection of comorbid pathology and early treatment with the therapy of underlying condition is of primary importance to preserve adequate functional activity in patients. The Aim is to analyze the efficacy of the application of interleukin-1 inhibitor in the complex treatment of secondary OA in addition to rheumatoid arthritis (RA). MATERIALS AND METHODS: 248 patients with secondary OA and RA were divided in 4 groups: patients of group I (n = 62) took interleukin-1 inhibitor (50 mg x 2 times per day) in combination with laser therapy on the basis of methotrexate (10-20 mg per week), group II (n = 60) received interleukin-1 inhibitor in complex with methotrexate, in group III (n = 62)--laser therapy with methotrexate and in group 4--methotrexate. We estimated the treatment efficacy in 3 and 6 months according to the dynamics of pain on VAS, indexes HAQ and KOOS. RESULTS: according to VAS group 1 showed statistical significant reduction in pain on movement in 3 and 6 months of 28.53 mm (43.6%) and 31.3 mm (48%) respectively, to values of 36.87 ± 1.56* and 33.11 ± 1.11* (p < 0.05). The results showed the statistically significant advantage of HAQ dynamics in groups I and II in comparison with groups III, IV (p = 0.03). The most prominent statistically significant (p = 0.02) results according to the dynamics of index KOOS were noted in groups of patients who took diacerein (I and II) 6 months after the complex treatment. CONCLUSIONS: the inclusion of interleukin-1 inhibitor in the complex treatment of secondary OA in patients with RA contributes to clinical improvement according to VAS (p = 0.03), index KOOS that reflects functional condition of the knee and increases the quality of life by index HAQ (p = 0.03) after 6 months therapy.

[THE COMPARATIVE ANALYSIS OF LEVEL OF OLIGOMERIC MATRIX PROTEIN OF CARTILAGE IN BLOOD SERUM OF PATIENTS WITH DISEASES OF MUSCULO-SKELETAL SYSTEM].

The osteoarthritis and rheumatoid arthritis are considered as the most prevalent diseases in the structure of diseases of musculoskeletal system. The higher social significance of these nosologies dictates necessity of searching reliable cartilage biomarkers having diagnostic validity both in discerning degenerative alterations at early stage of disease of joints and in monitoring of treatment effectiveness. The content of oligomeric matrix protein of cartilage using ELISA was evaluated in blood serum ofpatients with secondary osteoarthritis under rheumatoid arthritis (n=248). The comparison of derived results was carried out using control groups. Within the framework of study relationship was evaluated between level of oligomeric matrix protein of cartilage in patients with secondary osteoarthritis under rheumatoid arthritis with values offunctional KOOS index. The analysis of derived results established trend to increasing of level of oligomeric matrix protein of cartilage in blood serum ofpatients with secondary osteoarthritis under rheumatoid arthritis as compared with control groups. The moderate correlation interdependence between cartilage biomarker and KOOS index.

[Borderline mental disorders in schoolchildren].

OBJECTIVE: To study the frequency of borderline mental disorders in children of secondary general education schools. MATERIAL AND METHODS: We examined 1013 male and female schoolchildren, aged 12-14 and 15-17 years. In the first stage, the they completed a screening questionnaire to estimate the presence of a range of psychosomatic syndromes. An analysis of medical history and clinical examination were performed as well. The second stage included medical examination using DAWBA for the children with total scores on The Strengths and Difficulty questionnaire ≥ 16; with the score ≥ 6 on the emotional scale and with the score ≤ 5 on the social scale. RESULTS AND CONCLUSION: Generalized anxiety and depression were recorded more often in girls than in boys. Every 4-th adolescent (26.1%), regardless of gender, had problems in communication with peers. At the same time, boys showed conduct disturbances more often (p = 0.005) than girls (23.3% and 16.3%, respectively). Depression syndrome was 6.1 times more frequent in adolescents of the older group as compared with younger children (p = 0.024). Depression was associated with chronic headache (68.6% of children, mostly in girls and in the older group), abdominal pain (37.3%, mostly in girls) and back pain (39.2%).

[The analysis of dynamics of oxidative modification of proteinsin the blood sera of the patients presenting with secondary osteoarthrosis associated with rheumatoid arthritis and treated by laser therapy].

OBJECTIVE: To evaluate the indicators of oxidative modification of proteins (OMP) in the patients presenting with secondary osteoarthrosis associated with rheumatoid arthritis (RA) and to determine their dynamics under the influence of the combined treatment with the use of low-intensity laser irradiation (LILI). MATERIAL AND METHODS: A total of 50 patients with RA associated with secondary osteoarthritis and 25 healthy subjects were enrolled in this study. The patients of one study sub-group (n = 25) were given combined therapy with the use of LLLI, those in the second sub-group (n = 25) received only drug therapy. We made use of the VAS and DAS 28 scales to estimate dynamics of pain and compared serum OMP in the patients and healthy subjects. RESULTS: The analyses of the data obtained demonstrated the increased OMP in the patients with RA in comparison with the healthy subjects. The patients of sub-group 1 experienced a significant decrease in the clinical parameters of pain based on the VAS and DAS 28 scales accompanied by the marked reduction of OMP. In sub-group 2, the patients also exhibited the statistically significant dynamics of these indicators, but it was less pronounced than in sub-group 2. CONCLUSION: The patients presenting with rheumatoid arthritis are characterized by the elevated level of protein oxidative modification, a marker of oxidative stress. LlLI introduced in the combined treatment of the patients with RA not only increases the anti-inflammatory and analgesic effects but also has the antioxidant properties.

[Correction of an inflammatory process with an interleukin-1 inhibitor in the combination treatment of secondary osteoarthritis in the presence of comorbid condition].

AIM: To enhance the efficiency of treatment in patients with secondary osteoarthritis (ОА) in the presence of comorbid condition, by using an interleukin-1 inhibitor (IL-1i) and laser therapy (LT). SUBJECTS AND METHODS: A total of 248 patients aged 38 to 65 years with RA and secondary OA who had predominantly Stage II in accordance with the Disease Activity Score 28 (DAS28) were examined. According to the received therapy, the patients were divided into 4 groups: 1) IL-1i + LT + mrthotrexate (MT); 2) IL-1i + MT; 3) LT + MT; 4) MT. The efficiency of treatment was evaluated from changes in the KOOS (Knee injury and Osteoarthritis Outcome Score), DAS 28, IL-1, and cartilage oligomeric matrix protein (COMP) 6 months later. RESULTS: There were statistically significant functional improvements in KOOS and DAS28 in Groups 1 and 2 patients with secondary OA in RA. Clinical efficacy was confirmed by positive changes in serum IL-1 and COMP levels. CONCLUSION: Incorporation of an IL-1i into a therapy regimen for secondary OA in RA patients during basic therapy could not only improve the functional status of patients, but also decrease activity of the underlying disease according to the DAS 28.