[The use of nonsteroidal anti - inflammatory drugs in polymorbid pathology].

The literature review presents the possibilities of using non - steroidal anti - inflammatory drugs (NSAIDs) for polymorbid pathology. The mechanism of NSAIDs action, risk factors for the development of undesirable effects on the cardiovascular, digestive, urinary and other systems are considered; prevention measures and drug selection options are discussed, NSAIDs prescribing algorithm is considered.

[RISK FACTORS OF DEATH IN DIABETES MELLITUS].

Objective: To study risk factors of death in diabetes mellitus (DM). Materials and methods: This prospective cohort study included 337 patients with compromised carbohydrate metabolism (36 with impaired fasting glycemia or impaired glucose tolerance, 80 with type 1 diabetes, 194 with type 2 diabetes, 27 with diabetes due to chronic pancreatitis). Mean follow-up was 11.2±4.8 years (from 1 January 1995 through 31 December 2014). We investigated causes and risk factors of death in patients with impaired carbohydrate metabolism. Results: 115 patients died during the study period. The most common causes of death of patients with type 1 and 2 diabetes are cardiovascular diseases and cancer. Risk factors of death in type 1 DM include cardiovascular disease, diabetic nephropathy and retinopathy. Patients die at a younger age due to early onset of the disease. In type 2 diabetes risk factors of death are cardiovascular and oncologic diseases, nephropathy, the use of insulin. Patients die in elderly and senile age due to the late onset of diabetes. Gender differences in mortality associated with type 1 and 2 diabetes mellitus were not observed. Conclusion: Main causes of death in patients with type 1 and 2 DM are cardiovascular diseases and cancer. Risk factors of death include macro - and microvascular complications.

[Osteoarthrosis in patients with type 2 diabetes mellitus].

AIM: To estimate the frequency of a comorbidity of type 2 diabetes mellitus (DM) and osteoarthrosis (OA) in relation to patient age and to identify risk factors for degenerative and dystrophic changes in the joints. SUBJECTS AND METHODS: 160 patients with type 2 diabetes (23 men and 137 women at the age of 44 to 82 years; body mass index 33 +/- 5 kg/m2 were examined. A control group consisted of 112 age- and gender-matched subjects without type 2 DM. RESULTS: Degenerative and dystrophic changes in the joints were found in 60% of the patients with type 2 DM, which exceeded the similar values in the control subjects (42.9%; p < 0.05). Moreover, OA developed earlier in the patients with DM than in the general population, but the difference became leveled after the age 60 years. The development of OA was found to be associated with lipid metabolic disturbances: the incidence of obesity, hypercholesterolemia, and triglyceridemia was higher in the group of type 2 DM patients with OA (p < 0.05). CONCLUSION: The patients with type 2 DM showed the higher incidence of OA, the age of disease manifestation is less than in the general population. DM and overweight are risk factors for OA.

[Lymphocytic sensitization to antigens of viruses of the family Paramyxoviridae in diabetes mellitus].

The purpose of this investigation was to study cellular immunity to parotiditis and measles viruses in patients with diabetes mellitus (DM). Lymphocytic sensitization to parotiditis and measles viral antigens and insulin was determined by peripheral blood lymphocytic blast-transformation reaction (a morphological method for reaction assessment) In 10 patients with measles, 18 patients with epidemic parotiditis, 52 patients with DM (23 and 29 patients types 1 and 2 DM, respectively), and 46 apparently healthy individuals. The studies revealed lymphocytic sensitization to parotiditis and measles viral antigens and insulin in most patients in the acute phase of infection with a subsequent reduction in the intensity of proliferation until the point of complete cessation during 12 months. Unlike the controls in whom lymphocytic sensitization to the viruses of the family Paramyxoviridae was detected in 3 persons, prolonged antiviral cellular immunity was found in 17 of the 23 patients with type 1 DM and in 25 of the 29 patients with type 2 DM. Thus, prolonged cellular immunity to viral antigens (measles and/or parotiditis) Is associated with diabetes melhtus. The concordance of a lymphocytic response to viral antigens and insulin suggests that the viruses of the family Paramyxoviridae in some persons initiate a cascade of immune reactions leading to the development of diabetes, the tatter's type is determined by the nature of an immune system response to viral antigens and insulin.