Saratov JOURNAL of Medical and Scientific Research

diabetes mellitus

Optimization of chronic kidney disease stages in patients with type 2 diabetes mellitus with the program "ChronicKidneyDiseaseDiagnostics"

Year: 2017, volume 13 Issue: №3 Pages: 484-488
Heading: Internal Diseases Article type: Original article
Authors: Yarkova N.A., Borovkov А.А., Soloviyanova E.N.
Organization: N. Novgorod State Medical Academy
Summary:

Objective: to evaluate the practical possibility of automated calculation of glomerular filtration rate (GFR) in patients with type 2 diabetes mellitus (DM) on the basis of the developed computer program «Chronic_Kidney_Disease_Di-agnostics». Material and Methods. The study included 233 patients (78 men and 155 women) with type 2 diabetes who were hospitalized in the Neuroendocrinological Department of Nizhny Novgorod Regional Clinical Hospital n.a. O. N. Semashko during the period from 2013 to 2016. The average age of patients was 57.75 years [52; 64]. According to the history the mean duration of type 2 diabetes was of 5.3 years [0.3; 8.0]. The average level of glycosylated hemoglobin (HbA1c) was 9.53% [7.0; 10.2]. All patients underwent clinical and laboratory an3 instrumental studies. The data obtained were entered into the program «Chronic_Kidney_Disease_Diagnostics» (authors: N.A. Yarkova, N.N. Borovkov, D.A. Terekhova). Statistical analysis of the results of research carried out by Statistica 7.0. Results. According to the study in patients with type 2 diabetes, chronic kidney disease has been identified in the pre-clinical stages C2 and C1 (56.2 and 25.8%, respectively). Conclusion. The program «Chronic_Kidney_Disease_Diagnostics» is intended for nephrologists, endocrinologists and therapists. It allows specialists to diagnose kidney CKD in patients in the therapeutic profile of the early preclinical stage. It is designed for quick calculation of glomerular filtration rate.

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Clinical and immunological aspects of the course of myocardial infarction associated with diabetes mellitus during hospital treatment

Year: 2015, volume 11 Issue: №3 Pages: 287-290
Heading: Internal Diseases Article type: Original article
Authors: Skorodumova Е.А., Kostenko V.A., Siverina A.V., Fedorov A.N.
Organization: Institute for Emergency Medical Care n.a. I.I. Dzhanelidze
Summary:

The aim of the study was to provide the data on the course of myocardial infarction (Ml) associated with diabetes mellitus (DM) in hospital. Material and methods. 102 patients with Ml were included in two cohorts, first with DM, second — without DM. Groups were compatible by gender, age and standard therapy. Results. Angiocoronarography data have revealed that patients of group 1 were characterized by multiple vessels lesion due to "rescue" angioplasty with stenting performed 5 times. Patients with DM demonstrated in-hospital higher rate of both acute (by Killip) and chronic (by NYHA) heart failure of advanced degrees as well as recurrent Ml, early postinfarction angina pectoris, heart rhythm disorders and hematomas due to injections. Conclusion. The previously mentioned results lead to higher mortality in this group. Significant elevation of CRP, interleukin-6 and epidermal growth factor levels proved more activated systemic inflammatory response in patients with Ml and DM playing key role in pathogenesis of complications of the disease.

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The study of the prognostic value scales of assessing the risk of adverse coronary events in patients with acute coronary syndrome without ST-segment elevation in combination with comorbid conditions

Year: 2014, volume 10 Issue: №4 Pages: 809-814
Heading: cardiac surgery Article type: Original article
Authors: Dorokhova O.V., Firsakova V.Yu., Andreev D.A., Maslennikova O.M.
Organization: State Scientific Research Center n.a. A.I. Burnasyan — Federal Medical Biophysical Center of Federal Medical Biological Agency
Summary:

Objective: to identify the most prognostically significant scale risk assessment of patients with acute coronary syndrome without ST-segment elevation in combination with diabetes mellitus type 2, chronic renal failure, multifo-cal coronarocardiosclerosis, dyscirculatory encephalopathy. Material and methods. 260 patients with acute coronary syndrome without ST-segment elevation were divided into 4 groups according to the presence of severe concomitant diseases: patients with diabetes mellitus type 2 (71 people), chronic renal failure (49), multifocal lesions of the coronary arteries (76) and patients with dyscirculatory encephalopathy of grade 2-3, including ischemic stroke (64). All patients were stratified by major scales risk: TIMI, GRACE, PURSUIT. The development of negative coronary events was assessed in hospital and during the year after discharge. On the basis of the results, all scales were studied using the criterion of Mann-Whitney and identified the most predictably significant groups of patients with specific comorbid conditions. Results. It is revealed that the significance of the scales TIMI and GRACE in the study of distant forecast (up to 6 months) is the most reliable with acute coronary syndrome without ST-segment elevation in combination with diabetes mellitus type 2. For the patients with combination with chronic renal insufficiency the best prognostic significance was obtained by the GRACE scale in the study of hospital risk and forecast up to 6 months. TIMI and GRACE scales in the study of hospital risk and forecast up to 6 months had the greatest prognostic significance for the patients with acute coronary syndrome without ST-segment elevation on the background of multifocal lesions of the coronary arteries. For the patients with dyscirculatory encephalopathy of the 2nd and 3rd grades, the greatest prognostic significance was obtained by stratification of risk on PURSUIT and GRACE scales in the study of hospital risk and forecast up to 6 months. Conclusion. The results demonstrate the necessity of a differentiated approach to the risk stratification of patients with acute coronary syndrome without ST-segment elevation depending on the grade of a severe comorbid disease.

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Features of pharmacotherapy and clinical course of atrial fibrillation in patients with type 2 diabetes in real clinical practice. Saratov Journal of Medical Scientific

Year: 2014, volume 10 Issue: №1 Pages: 178-185
Heading: Parmacology Article type: Original article
Authors: Graifer l.V., Reshetko O.V., Furman N.V., Dolotovskaya P.V.
Organization: Saratov Institute of Cardiology, Russia, Saratov State Medical University
Summary:

The aim of the study was to investigate the clinical status of patients with atrial fibrillation (AF) and diabetes mellitus (DM) type 2 and to identify differences in the treatment of AF, conducted in the cardiology departments of multidisci-plinary teaching hospitals of the Saratov city. Materials and methods. A comparative retrospective analysis of 1041 pharmacoepidemiological solid history of patients with AF who were hospitalized in emergency, and in the planning department of cardiology of 2 multidisciplinary teaching hospitals of the Saratov city consecutively in a calendar year on the AF, recorded on an electrocardiogram. Results. Among all patients with AF, patients with DM accounted for 20.2%. Among them were women, they were younger, they developed fibrillation at a younger age, they differed more severe structural heart disease, among which was significantly greater with myocardial infarction, nearly all had symptoms of heart failure. Patients with DM performed less frequently cardioversion, and to monitor heart rate often preferred a combination of beta-blockers and digoxin. 100% of patients with DM had a higher risk of thromboembolic complications (91.9% without diabetes) in both groups, oral anticoagulants (OAC) prescribed often enough. Conclusion. DM was diagnosed in every fifth patient with AF, especially among women and patients with persistent AF and is associated with the presence of more severe organic heart disease compared with patients without DM. All patients on the background DM was a high risk of thromboembolic complications, i.e. OAC must be assigned in 100% of cases, but in the surveyed hospitals OAC were appointed only in 23% of cases.

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