[Assessment of individual risk of food interactions while taking warfarin].

AIM: To develop a questionnaire to assess the individual risk of food interactions in a patient taking warfarin. MATERIALS AND METHODS: Based on the review of 159 literature sources, a test version of the questionnaire was formed. 196 respondents took part in the pilot part of the study to assess the multiplicity and volume of food consumption. For the initial assessment of the risk limit of the diet, complications of warfarin therapy were registered no earlier than 24 weeks later. RESULTS: The final version of the questionnaire included 25 products that are most frequently consumed and significant in relation to the risk of alimentary interactions. The questionnaire contains 2 groups of products: increasing and decreasing the activity of warfarin. The volume and frequency of use of each product is evaluated in points that are calculated as the simple product of weights of frequency and volume, with a minimum value of 0 and maximum of 12. The number of points for each product is calculated separately. The points obtained are summed for a group of products that increase the activity of warfarin, and for a group of products that reduce it, and the overall risk score is calculated. The average number of points for the use of products that affect the activity of warfarin in patients with AF with complications of therapy was 75.7831.97 b. The calculation of the design validity of the questionnaire (Cronbachs a=0.864) showed a good level for confirmation purposes. CONCLUSION: A specialized questionnaire was developed, implemented as a computer program, to assess the significance of food preferences in ensuring the safety and effectiveness of warfarin therapy. Further research is required to determine the risk limit of alimentary interactions of warfarin, but now this questionnaire can be used to monitor the uniformity of consumption of products that affect its activity. The authors suggested using a questionnaire for assessing the risk of food interactions as one of the factors influencing the decision to prescribe warfarin to patients with insufficient adherence to lifestyle modification.

[Features of intestinal microbiota disorders in the development of metabolic disorders in non-alcoholic fatty liver disease].

We discussed about the term intestinal permeability like as the mucosal barrier a single structural and functional conception that includes the layer of mucus, the indigenous microbiota and the epithelium of the mucosa in this publication. Information was presented about the role of the microbiota, the composition of intestinal mucus, epithelial cells and proteins of tight junctions which lead to various metabolic diseases. The complex pathogenetic interactions are formed between the intestinal mucosal barrier, metabolic disorders such as non-alcoholic fatty liver disease and cardiovascular diseases. The complex researches and modification of this interactions will allow to create personalized approaches and to prevent of these diseases.

Clinically significant food preferences of patients with atrial fibrillation: a nosological and regional peculiarities.

AIM: The aim of the investigation was to study the peculiarities of food consumption in patients with atrial fibrillation, capable of influencing the anticoagulant therapy with warfarin, in comparison with healthy volunteers and taking into account geographical specifics. MATERIALS AND METHODS: In an open cohort study, 196 respondents (88 men, 108 women) evaluated food preferences using a questionnaire survey. The quantitative evaluation of adherence to lifestyle modification was studied by QAA-25. Statistical data processing was performed by parametric (Student's t-test) and nonparametric (Wald-Wolfowitz, Kolmogorov-Smirnov, Pearson) analysis methods. RESULTS: There were no statistically significant differences in food rations between the studied categories of respondents, both increasing [37.0±19.5 points versus 37.3±17.98 points; Wald-Wolfowitz (Z), p=0.16] and reducing the activity of warfarin [62.2±26.3 points versus 63.4±23.8 points; Wald-Wolfowitz (Z), p=0.95]. The absence of differences remained in the evaluation, taking into account regional characteristics of nutrition. The respondents were taking warfarin, there is no relationship between the level of commitment to the modification of lifestyle and diet modification. CONCLUSION: it is shown that medical recommendations aimed at correcting the eating behavior of respondents taking warfarin are not effective, which can be an independent risk factor for complications of both warfarin therapy and the underlying disease.

Quantitative assessment of adherence to treatment in patients with atrial fibrillation in real clinical practice.

AIM: To quantitatively evaluate features of adherence to treatment in patients with atrial fibrillation (AF) in Omsk region in conditions of real clinical practice. Materials and methods: in a prospective controlled study in 137 patients with AF 35-85 years quantitatively examined adherence to treatment and its structure. Statistical processing of data were performed using parametric (Student's t-test) and nonparametric (Wald-Wolfowitz, Kolmogorov-Smirnov, Pearson) analysis. MATERIALS AND METHODS: In a prospective controlled study in 137 patients with AF 35-85 years quantitatively examined adherence to treatment and its structure. Statistical processing of data were performed using parametric (Student's t-test) and nonparametric (Wald-Wolfowitz, Kolmogorov-Smirnov, Pearson) analysis. RESULTS: The most committed to treatment of AF patients older than 65 years. Regardless of age women are more committed to treatment than men. With increasing severity of AF symptoms in men, reduced adherence to treatment, in women is increasing commitment to the modification of lifestyle and drug therapy. In patients with paroxysmal AF adherence to drug therapy is higher than with a constant form. The increase in the number of comorbidities in men and women accompanied by a growing commitment to the modification of lifestyle and drug therapy, with a decrease in women adherence to medical support. If patients with AF the amount of medication increases, reduced adherence to medical support. CONCLUSION: Quantitative structural analysis of adherence to treatment in patients with AF identified previously do not consider the characteristics associated with gender, age, disease and drug therapy significantly influence treatment outcome.

Terahertz optical properties of potassium titanyl phosphate crystals.

This paper studies the terahertz optical properties of nonlinear potassium titanyl phosphate crystals with different conductivities in the spectral range of 0.2 to 2.6 THz. The observed properties are characterized by several absorption lines lying along different optical axes which represent the relevant potassium sublattice phonon modes. The peculiarities of these absorption lines are attributed to the structural order of potassium ions.

[Terahertz radiation influence on stressed Drosophila life span].

Virgin fruit fly females and males were stressed by placement into a confined space without food for 3 hours. Part of stressed flies were subjected to terahertz irradiation (0.1-2.2 THz) during 30 min. Life span of individual flies was evaluated. Terahertz radiation had some positive influence on male survival during the stage of monotonic decrease in flies number and negative effect during the stage of relatively stable number of flies. The survival of irradiated females on the stage of sharp decline in the number of flies was higher than in stressed and control females. Authors propose that terahertz radiation has an indirect effect on gene expression and signaling pathways which control the survival and life span of Drosophila.

[Terahertz radiation influence on number and development dynamics of offspring F1 of fruit fly females under stress].

Virgin fruit fly females were stressed by placement into a confined space without food for 2.5 hours. Some flies were subjected to terahertz radiation (0.1-2.2 THz) for the last 30 min. Then females were copulated with males. Offspring F1 from oocytes which were mature or immature at exposure (oviposition in 1-2 or 9-10 days after irradiation) was studied. Stress induces a rejection of the offspring maturation dynamics to imago from external control (offspring of flies which was maintained in standard conditions). In offsping from mature oocytes of irradiated flies the dynamics of male maturation to imago was different from internal control (offspring of stressed unirradiated flies). The number of imago males decreased. The dynamics of female maturation to imago coincides with laboratory control. In offsping from immature oocytes of irradiated flies the dynamics of female and male maturation and the number of flies were not significantly different from the internal control. It was concluded that only mature oocytes are sensitive to THz radiation influence.

[Survival and life span of Drosophila melanogaster in response to terahertz radiation].

Life span control is realized by an interaction of many genetic factors with environment. Due to development of new modern technologies based on non-ionized terahertz radiation (0,1-10 THz) the investigation of this radiation influence on living organisms becomes actual. In our study terahertz radiation effects on survival and life span of Oregon R line of Drosophila meanogaster were multidirectional depending on the age of the insects. Terahertz effect on survival was negative or neutral in the early life and positive in the later life. In Drosophila response to terahertz radiation sex differences were manifested. Males were not very sensitive to terahertz radiation. Irradiated female survival was increased significantly in the second half of imago life. Irradiation of Drosophila not influenced significantly on average and maximal values of life span, but the gap between the values of average life span of males and females in this group of insects was increased. Mechanisms of terahertz radiation effects on survival and life span maybe associated with changes in cellular membrane, gene expression and signaling pathways, controlling these properties.

[Pharmacological cost-efficacy of various schemes of combined antihypertensive therapy in elderly patients].

AIM: To validate optimal cost-effective pharmacological policy in combined therapy of elderly hypertensive patients. MATERIAL AND METHODS: In 150 patients of a day hospital aged 55-74 years with at least stage II arterial hypertension of 4-40 years of duration a study was made of the cost efficacy of their combined treatment. The patients received lisinopril, metoprolol, nifedipin, enalapril, hypothiaside, indapamid. Clinical efficacy was assessed by the following criteria: a fall in systolic arterial pressure to at least 139 mm Hg or at least by 20% of the baseline, a fall in diastolic pressure to at least 89 mm Hg or 10% of the baseline. Economic parameters included cost of the disease, cost/effect values. RESULTS: Combination egilok+hypothiaside was the cheapest but the least effective. Diroton+indap combination was cheaper than less effective combination cordipin-retard+hypothiaside and renitek-hypothiaside. Pharmacological and cost efficacy of diroton+indap combination was the highest. CONCLUSION: Combination of lisinopril with indapamid was most adequate as to its cost and effect and can be used as a medication of the first line in elderly hypertensive patients.

[Therapeutic efficacy of laser and electropuncture reflexotherapy in correcting the initial manifestations of cerebral circulatory insufficiency]. / Terapevticheskaia éffektivnost' lazernoi i élektropunkturnoi refleksoterapii pri korrektsii nachal'nykh proiavlenii nedostatochnosti krovoobrashcheniia.

Electrical and laser acupuncture was used in 2 groups of 50 patients each who presented initial manifestations of cerebral circulation insufficiency (CCI). It was shown that stimulating an experimentally selected combination of acupuncture points on the affected side in initial manifestations of CCI, it was possible to achieve a regionally localized action correcting the cerebral hemodynamics. Changes in the tone of the regional vessels of the brain were objectively documented with the help of echopulsography of the cerebral vessels. The findings obtained included prolongation of the blood clotting time, a decreased index of thrombin inactivation and a reduction in the spontaneous fibrinolytic activity of the blood.

[Changes in peripheral hemodynamics in patients with vertebrogenic pain syndromes during reflexotherapy]. / Osobennosti izmenenii perifericheskoi gemodinamiki pri refleksoterapii u bol'nykh s vertebrogennymi bolevymi sindromami.

The results of an analysis of circulation changes in the major vessels of the upper and lower extremities of 240 patients with vertebrogenic pain syndromes are reported. These changes were analyzed before and after treatment of the patients by the methods of acupuncture reflexotherapy (120 observations) and electron-ion reflexotherapy (the other 120 observations). Use was made of longitudinal rheovasography with contour analysis of the curves by the method of G. I. Enini (1965). It was found that the reflexotherapy produced a favourable effect on the peripheral circulation in patients with reflectory syndromes. In patients with spinal radicle compression no positive rheovasographic changes were noted.

[Electromyographic characteristics of the effectiveness of puncture reflexotherapy in vertebral osteochondrosis with neurologic syndromes]. / Elektromiograficheskaia kharakteristika éffektivnosti punktatsionnoi refleksoterapii pri osteokhondroze pozvonochnika s nevrologicheskimi sindromami.

Results of an analysis of myoelectrogenesis changes that occurred in the course of treating 240 patients with neurological syndromes of vertebral osteochondrosis are presented. The patients were given acupuncture and electro-ionic (microiontophoresis of medicinal substances into the acupuncture sites) reflexotherapy. The efficacy of these methods in the treatment of the reflectory and compression syndromes is analyzed, and so is the informative value of total electromyography in estimating the effectiveness of the treatment being given.