[Pharmacoeconomical rationale for switching of patients with type 1 diabetes mellitus to the short-acting insulin analogue Aspart (Novorapid*)].

The consequences of switching of patients with type 1 diabetes mellitus (DM-1) to the short-acting insulin analogue Aspart (Novorapid*) were pharmacoeconomically analyzed. The study has indicated that switching of patients with DM-1 to the short-acting insulin analogue Aspart leads in actual practice to the decreased levels of Hb Ak due to its pharmacological properties ensuring the maximum simulation of physiological pancreatic insulin secretion, which is followed by a reduction in the absolute risk of new cases and by progression of existing chronic vascular complications as compared with the use of short-acting insulin analogue Actrapid. Calculation of the cost of treatment of all prevented vascular complications due to DM has shown that the short-acting insulin analogue Novorapid is more cost-effective agent than Actrapid.

[The training programs for correction of the nutritional disturbances behavior in patients with arterial hypertension and diabetes mellitus type 2]. / Obuchaiushchie programmy korrektsii narushenii pishchevogo povedeniia bol'nykh arterial'noi gipertenziei i sacharnym diabetom 2 tipa.

The aim of the present study is to evaluate the alimentary disorders in patients with high risk for cardiovascular diseases, also in patients with arterial hypertension (AH) and njn--insulin-diabetes mellitus (DM). The results showed that patients with AH (155 patients) and DM (107 patients) have high prevalence of the alimentary disorders: high consumption of total fat--46% (DM) and 70.9% (AH), high consumption of carbohydrates--14.9% and 73%, salt intake--34.9% and 68.6%, respectively. Application of special training programs in groups provided stable modification of dietary habits and was more effective, compared with the traditional ones. These groups demonstrated better results in dietary habits modification, compared with the existing routine individual medical control groups.

[The renal transport of sodium, potassium, calcium and phosphorus in patients with a history of hemorrhagic fever with renal syndrome]. / Pochechnyi transport natriia, kaliia, kal'tsiia i fosfora u perenesshikh gemorragicheskuiu likhoradku s pochechnym sindromom.

Na, Ca, K and P renal transport was studied in 111 convalescents after hemorrhagic fever with renal syndrome. K transport was not affected. Defective distal Na reabsorption was found in 6.25% of the examinees and persisted for one year after the disease. 1-10 years after the disease 58.1% of the followed up patients developed hypercalciuria, hyperphosphaturia. These changes did not affect blood levels of the above minerals which appeared to fluctuate within normal values.

[Electrolyte excretion in patients with a history of hemorrhagic fever with renal syndrome]. / Ekskretsiia élektrolitov u bol'nykh, perenesshikh gemorragicheskuiu likhoradku s pochechnym sindromom.

Renal transportation of sodium and potassium was studied in 85 patients who sustained hemorrhagic fever complicated with renal syndrome (HFRS). The examinees were given routine diet No. 7 recommended by Pevzner. The conclusions were made on the analysis of circadian excretion and clearance of electrolytes studied and the levels of their water-load-induced tubular transportation: distal and proximal reabsorption and distal excretion of sodium, the correlation between potassium secretion and reabsorption in the distal part of the nephron. It was revealed that within the first year after the disease onset, 37.5 per cent of patients had increased levels of sodium excretion as part of the salt-loss syndrome developed due to decreased sodium reabsorption in the distal part of the nephron. Later the status was featured by moderately pronounced disorders of distal sodium reabsorption in 6.25 per cent of the patients only, mostly in those with HFRS-induced pyelonephritis. Increased excretion of potassium noted in the first months after HFRS only was the result of an increase in sodium excretion. The aforementioned disorders could be easily compensated by a routine diet and therefore a decrease in the levels of sodium or potassium avoided.

[Tubulointerstitial changes in patients with a history of hemorrhagic fever with renal syndrome]. / Tubulointerstitsial'nye izmeneniia u bol'nykh, perenesshikh gemorragicheskuiu likhoradu s pochechnym sindromom.

Altogether 85 patients with a history of hemorrhagic fever and the nephrotic syndrome (HFNS) were examined at different stages after the disease, characterizing the status of the tubulointerstitial apparatus of the kidneys. Almost half of the patients who suffered this disease manifested a decrease in the capacity of the kidneys for osmotic concentration of urine under the conditions of deprivation for 36 hours, and in acid-secretory function of the kidneys under induced acidosis and clearance of uric acid. Ultrasonic studies demonstrated that part of the patients had uni- or bilateral indurations in the renal parenchyma. In 16% of the examined, these alterations may be related to superaddition of pyelonephritis after HFNS. The nature of tubulointerstitial lesions remains unknown in other cases and thus requires a further study. The recovery of tubular functions of the kidneys following HFNS continues for 3 years. In view of this fact patients with a history of this disease need prolonged follow-up.