[Efficiency of neuromultivit in complex therapy of patients with rheumatoid arthritis associated with diabetes mellitus]. / Éffektivnost' neiromul'tivita v komplesnoi terapii patsientov s revmatoidnym artritom, assotsiirovannym s sakharnym diabetom.

AIM: To examine the dysregulation of the autonomic nervous system and manifestations of pain syndrome in patients with rheumatoid arthritis combined with diabetes mellitus and the possibility of their correction in patients who receive complex therapy including neurotropic vitamins (neuromultivitis). MATERIAL AND METHODS: One hundred and forty-six patients with rheumatoid disease were examined including 59 patients with diabetes mellitus. RESULTS AND CONCLUSION: When testing for the presence of neuropathic pain syndrome using the diagnostic questionnaire of neuropathic pain (DN4), a greater prevalence of these features was revealed, with a high correlation with the duration of rheumatoid arthritis (r=0,56) and duration of diabetes mellitus (r=0,82). A positive effect of combined therapy with neuromultivitis on the daily rhythm of arterial pressure with its normalization and correction of autonomic disorders was noted. There were a more pronounced decrease in the frequency and severity of parasympathetic and sympathetic failure, as well as an improvement in the adaptation of the peripheral vascular system to orthostatic changes. Improvement of quality of life is, to some extent, due to the more pronounced positive effect of combined therapy with neuromultivitis on such autonomic disorders as palpitations, heart rhythm disturbances, manifestations of lipotymic disorders and even panic attacks.

[Analysis of the state-of-the-art of consulting medical care to patients with glucocorticoid-induced osteoporosis or its risk according to the data of a questionnaire survey (GLUCOST study)].

AIM: To analyze the state-of-the-art of consulting medical care to Russian patients with glucocorticoid-induced osteoporosis (GCOP) or its risk. SUBJECTS AND METHODS: This GLUCOST study was organized and conducted by the Russian Association of Osteoporosis. A total of 1129 patients with chronic inflammatory diseases, who had been taking oral glucocorticosteroids (OGCSs) a long time (3 months or more), were examined. The patients filled out an anonymous questionnaire on their own. Whether the measures taken to diagnose, prevent, and treat GCOP complied with the main points of Russian clinical guidelines was assessed. RESULTS: 61.8% of the patients knew that the long-term treatment of GCOP might cause osteoporosis. 48.1% of the respondents confirmed the results of bone densitometry; 78.1% of the patients reported that they had been prescribed calcium and vitamin D supplements by their physician, but their regular intake was confirmed by only 43.4%; 25.4% of the patients had sustained one low-energy fracture or more. Treatment for GCOP was prescribed for 50.8% of the patients at high risk for fractures, but was actually received by 40.2%. Therapeutic and diagnostic measures were implemented in men less frequently than in women. When the patient was aware of GCOP, the probability that he/she would take calcium and vitamin D supplements rose 2.7-fold (95% Cl; 2.1 to 3.5; p = 0.001) and that he/she would follow treatment recommendations did 3.5-fold (95% Cl; 2.3 to 5.3; p = 0.001). Bone densitometry increased the prescription rate for antiosteoporotic medication and patient compliance. CONCLUSION: According to the data of Russia's large-scale GLUCOST survey, every four patients with chronic inflammatory disease who are on long-term OGCS therapy have one low-energy fracture or more. Due to inadequate counseling, the patients are little aware of their health and do not get the care required to prevent the disease. Less than 50% of patients who have GCOP and a high risk for fractures undergo examination and necessary treatment aimed at preventing fractures.

[Body structure and serum concentration of adiponectin and cytokines (IL-6, -10 and TNF-alpha) in rheumatoid arthritis combined with obesity].

In the study the comparative assessment of the main markers of body structure and serum concentrations of adiponectin and cytokines (IL-6, TNF-alpha, IL-10) has been carried out in 26 rheumatoid arthritis patients at a normal body mass index (BMI) [Me; 25; 75 percentile = 24,1 (23,5; 28,6)] and in 15 obese patients [BMI = 33,4 (31,3; 42,7)]. The control group consisted of 25 apparently healthy individuals [BMI = 23,5 (21,8; 24,4)] randomized by sex and age with the main group. The expressed increase of production of pro-inflammatory cytokines--TNF-alpha and IL-6 in both groups has been established, in the group of patients with obesity serum concentration of these cytokines 1,8-2,4 fold exceeded similar in group with a normal BMI and amounted 245,3 (89,3; 302,3) and 54,4 (18,4; 72,3) microg/ml correspondingly. Anti-inflammatory cytokine IL-10 increased more significantly at normal BMI [227,2 (143,4; 282,3) pg/ml)] in comparison with group of rheumatoid arthritis patients with obesity [122,2 (89,3; 164,3) pg/ml] while in control group its content was 60,8 (24,3; 75,4) pg/ml. It has been shown that serum concentration of adiponectin was higher in group with normal BMI [9,2 (6,3; 15,3) mcg/ml] and was lower in patients with obesity [3,2 (2,3; 8,3) mcg/ml] than in healthy subjects [7,4 (4,4; 9,2) mcg/ml]. The analysis of the body structure markers demonstrate that fatty tissue content increase both in patients with normal BMI (1,7 fold) and at obesity (2,6 fold).

[Comparative analysis of incidence and prevalence of cardiovascular diseases among military personnel and seafarers serving on the bank].

The study presents retrospective analysis of navy soldiers' cardiovascular diseases, which most often cause the growth in labor force, loss rates and navy soldiers' dismissal and mortality rates, and, therefore, are one of the most pressing problems of the military medical services. Comparative assessment conducted between emergence and pervasiveness of these diseases in navy with those of land-based soldiers. Analysis of correlation between morbidity rates and length of service in navy is also included.

[Differential approach to administration of cosaar]. / Differentsirovannye podkhody k naznacheniiu kozaara.

Effects of cosaar (MSD) on central hemodynamics and microcirculation were studied in 20 patients with arterial hypertension under acute pharmacological test and on the treatment week 2, 6 and 8. Two variants of hemodynamic response were registered: hypokinetic and hyperkinetic. Unidirectional hemodynamic changes occurred both in short- and long-term therapy. This allows to use the short course for differential choice of patients for cosaar therapy. The best effect of cosaar is expected in patients with a hyperkinetic variant of the hemodynamic response under the short treatment course.

[Extracardiac effect of nitroglycerin in chronic ischemic heart disease according to the study of microcirculation]. / Ob ékstrakardial'nom vliianii nitroglitserina u bol'nykh khronicheskoi ishemicheskoi bolezn'iu serdtsa po dannym izucheniia mikrotsirkuliatsii.

Study of the dynamics of circulation in the microvessels of the eye conjunctiva under the effect of nitroglycerin in 50 patients with chronic ischemic heart disease showed short-lived dilatation of the postcapillaries and venules in most of them. Simultaneous fall in venous pressure may be evidence of a diminution of the venous tonus with a tendency to the storage of blood in the microcirculation system. The encountered shifts in the systemic hemodynamics may possibly be due to the reaction of the microcirculation channel, the labile character of which in the various "micro-areas" of the conjunctiva testifies to the complex reorganization of microcirculation under the effect of nitroglycerin.