[Clinical Features of Comorbid Cluster and Premorbidly Manifestations in Patients with High Vascular Risk in the Middle Age Category with the Presence of Multifocal Atherosclerosis].

OBJECTIVE: to study clinical and cluster features of cardiovascular burdening taking into account the comorbid polymorbid background in patients of middle age (45-60 years) with the presence of multifocal atherosclerosis (MFA). MATERIALS AND METHODS: Patients were examined in the Regional Vascular Center of Ufa (RVCU). Depending on the predominant localization of lesions in the vascular bed patients were divided into 3 clusters by the method of hierarchical analysis of categorical variables according to the clinical manifestation of atherosclerotic lesions of the heart, brain and lower limb arteries confirmed by coronary angiography, ultrasound Doppleroscopy of main arteries of the head and lower extremities. Ninety-six patients had predominant lesions in the heart (1st cluster), 96 - in carotid arteries (2nd cluster), and 96 patients had ischemia of lower extremities (3rd cluster). Examination during hospitalization in RVCU included when indicated echocardiography, magnetic resonance imaging of the chest and abdomen, ultrasound studies of abdomen, kidney, and pelvis. RESULTS: According to data obtained the following conditions were most often observed in different combinations and with varying degrees of severity of clinical manifestation.Claster 1. Clinical manifestation of atherosclerotic heart disease mainly due to stage III hypertension, history of myocardial infarction were combined with pneumonia, chronic obstructive pulmonary disease with the outcome in pneumosclerosis and emphysema, as well as the presence of cholecysto-cardial syndrome, chronic gastritis, chronic cholecysto-pancreatitis, abdominal ischemic syndrome, rheumatoid arthritis, diabetes mellitus, and chronic pyelonephritis.Claster 2. Hemodynamically significant lesions of brachiocephalic arteries mainly with acute ischemic disturbance of cerebral circulation were combined with bronchial asthma, (the development of which was associated with prolonged persistent eosinophilic inflammation), worsening of chronic kidney disease with urolithiasis, angionephropathy and iron deficiency anemia, as well as the presence of dorsopathy associated with stenotic atherosclerosis of brain vessels.Claster 3.Hemodynamic ischemia with clinical manifestation of vascular lesions of lower extremities was accompanied by type 2 diabetes, chronic cholecysto-pancreatitis, erosive and ulcerative lesions in the stomach and duodenum, polyosteoarthrosis, abdominal-ischemic syndrome. Type 2 diabetes prevailed in patients with occlusion of right posterior tibial artery and trophic ulcer of the right foot. CONCLUSION: Interdependence of comorbid and polymorbid background and cardiovascular burdening changes their clinical picture and course, increases number of complications and their severity.

[The trends in disability of adult and children population of the Republic of Bashkortostan in 2000-2015].

The article considers dynamics and main indices of primary and total disability of adult and children population in the regions in 2005-2015 as compared to similar indices of the Russian Federation on the basis of the data of Medical Informational Analytical Center of the Ministry of Health Care of the Republic of Bashkortostan, the territorial Agency of Federal Service of State statistics of the Republic of Bashkortostan. The characteristics of indices and their dynamics, structure of leading causes of disability of adult and children population and differences in levels of disability were established. The established tendencies of dynamics of indices of disability in the Republic of Bashkortostan can be taken as a principle in development of programs of prevention of disability and rehabilitation of disable individuals.

[Dynamics of tumour necrosis factor-alpha and clinical signs of osteoarthrosis during the treatment with alflutop in combination with peloid applications under conditions of health resort].

The objective of the present work was to develop indications for the combined treatment of patients presenting with osteoarthrosis including the use of peloid applications and intramuscular injections of alflutop. The study was based at Yakty-Kul' health resort and included 94 patients at the age from 40 to 59 years. The proposed method was shown to have beneficial effect on the patients' clinical conditions. In addition, the treatment caused a decrease in the level of tumour necrosis factor-alpha (TNF-alpha) that turned out to be related to the articular index.

[Circadian rhythm of the pituitary-adrenal system in rheumatoid arthritis]. / K voprosu tsirkadnoi periodichnosti gipofizarno-nadpochechnikovoi sistemy pri revmatoidnom artrite.

Two hundred and fifty-five patients with rheumatoid arthritis (RA) were examined for the levels of free cortisol and corticotrophin as well as for their circadian rhythms. It was established that the lowering of the daily average cortisol level and corticotrophin elevation in the blood as well as the desynchronization types of circadian rhythms depended on the RA gravity and the disease clinical variety. The most pronounced decrease in the cortisol level and destabilization of pituitary-adrenal function were found in the visceral RA pattern, particularly in subjects treated with corticosteroids and in those with hormone-dependent RA. Triamcinolon gave rise to a more substantial lowering of free cortisol as compared to prednisolone. It is assumed that impairment of the synchronization role of hypothalamic formations is of importance in the genesis of neuroendocrine dysfunction in RA patients.