Saratov JOURNAL of Medical and Scientific Research


Comorbidity in patients with acute coronary syndrome in real (everyday) clinical practice

Year: 2019, volume 15 Issue: №3 Pages: 821-825
Heading: Cardiology Article type: Original article
Authors: Furman N.V., Dolotovskaya P.V., Malinova L.I., Reshetko O.V.
Organization: Saratov State Medical University

The purpose of the study was to assess prevalence of comorbidity in the population of patients with acute coronary syndrome in Saratov region. Material and Methods. Inpatient and outpatient records of 484 patients with acute coronary syndrome (ACS) were analysed (64% of them residents of Saratov). Cases of cardiac and non-cardiac comorbidity were evaluated, Charlson Comorbidity Index (CCI) was calculated. Results. Only 20.5% of patients were without cardiac or non-cardiac comorbidity. Comorbid non-cardiac diseases were observed in 37.5% of patients (the most common diseases of the digestive system — 43% of all cases of non-cardiac comorbidity). Comorbid cardiovascular diseases were detected in 76.9% of patients, among the most common ones were arterial hypertension (88.4% of all cases of non-cardiac comorbidity) and documented hypercholesterolemia 42.2%). A correlation was found between the CCI and an unfavorable hospital outcome (0.227, P<0.0001). Conclusion. Patients with ACS in the vast majority of cases have at least one concomitant disease (cardiovascular or non- cardiac) that can significantly affect their prognosis. To determine individual prognosis for ACS patients with concomitant diseases, it is advisable to calculate the Charlson comorbidity index.

2019_03-1_821-825.pdf293.79 KB

Prognostic value of level of brain natriuretic peptide in patients with acute coronary syndrome without symptoms of heart failure

Year: 2017, volume 13 Issue: №1 Pages: 041-046
Heading: Internal Diseases Article type: Original article
Authors: Furman N.V., Puchinyan N.F., Dolotovskaya P.V., Dovgalevsky la.P., Panina A.V.
Organization: Saratov Institute of Cardiology, Russia

Purpose of the study: to evaluate the prognostic value of brain natriuretic peptide (BNP) as a predictor of cardiovascular events in patients with acute coronary syndrome (ACS) within one year after hospitalization. Material and Methods. The study included 201 patients, including 150 men and 51 women, who were treated in the emergency department of cardiology with ACS including 96 patients without symptoms of CHF and/or AHF. Results. All patients were divided into groups depending on the presence signs of heart failure of CHF and/or AHF at the time of admission: patients with no signs of heart failure were divided into 2 groups: those with BNP levels >101 pg/mL (group 1; n=37) and <100 pg/mL (group 2; n=59); the third group consisted of patients with symptomatic HF (n=105). In patients without clinical signs of CHF and/or AHF with elevated level of the BNP at the time of hospitalization was observed significantly increased risk of unstable angina during the year compared to patients with normal levels (OR 2.83 [95% Cl: 1.1—7.24], p=0.04). In patients without clinical signs of CHF and/or AHF with elevated BNP levels at the time of hospitalization compared to patients with AHF and/or CHF, had no statistically significant differences in the long-term prognosis. Conclusion. Patients with ACS in the absence of CHF and/or AHF but with elevated levels of BNP at admission should be attributed to the group of high risk for cardiovascular complications. Increasing the level of BNP in ACS patients at admission has an adverse value for long-term outcome and can be used as an additional risk marker.

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Prognosis of development of unfavorable phenomena of chemotherapy in patients with for the first time revealed tuberculosis of lungs

Year: 2015, volume 11 Issue: №4 Pages: 576-582
Heading: Phthisiology Article type: Original article
Authors: Danilov A.N., Morozova T.l., Doktorova N.P.
Organization: Saratov State Medical University, Saratov Research Institute of Rural Hygiene

Aim: development of criteria and a method of prognosing of emergence of adverse side effects to the first mode of chemotherapy at patients with for the first time revealed tuberculosis. Materials and Methods: The analysis of the collateral reactions (CR) on tubercular preparations has been carried out at 214 patients receiving treatment at the first mode of chemotherapy. During the treatment an indicator of quality of life by a technique the DIGNITY (health, activity, mood), a condition of intersystem interaction of respiratory and cardiovascular systems of an organism (Hildebrant's coefficient), a vegetative index of Kerdo were estimated at patients. Results. Ufavorable effects on PTP develop at every third patient (33,6%). The CR different types depends on the age and availability of the accompanying pathology. Allergic reactions develop at patients with existence of endocrine pathology (27,8%) authentically more often, toxic — at patients with defeats of nervous system (56,3%). Extent of change of an index of Kerdo of 59,4±2,4%, Hildebrant's coefficient 48,9± 1,6% in the first 4 weeks of treatment of the patient corresponds to emergence of CR in the first 3 months of chemotherapy. Conclusion. Dynamics of coefficient of Hildebrant, Kerdo's index and an indicator of treatment, SAN at the initial stages, are considerably associated with the risk of development of side effects of chemotherapy and were a basis of the developed computer system expert for prognosing the development of these complications. The predictive value of system is 76,3% of sensitivity at 84,7% of specificity.

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Course prognosis of cervical osteochondrosis

Year: 2012, volume 8 Issue: №2 Pages: 527-533
Heading: Neurology Article type: Original article
Authors: Skulovitch S.Z., Chekhonatsky A.A., Kolesov V.N., Chekhonatsky I.A.
Organization: Saratov State Medical University

Today we can state that in spite of a considerable number of cervical osteochondrosis studies, there is a lack of research devoted to analysis of its course. There is no correlation between initial expert evaluations of cervical osteo-chondrosis cases and further course of pathological process. Goal of the research is to develop system of course prognosis of cervical osteochondrosis taking into account environmental infuence, heredity, living conditions, psychological profle of patient’s personality. Materials and methods. Dynamics of degenerative-dystrophic changes progressing of cervical vertebrae in 236 patients was analyzed. Results. Received data demonstrated that probability of stage I changing to stage II, III and IV depended on patients’ sex, age and type of labour activity, frequent supercooling and stress. Probability of fast progression of cervical osteochondrosis (5-year cycle of stage I changing to stage III and IV) was to a great extent associated with heredity, urban living, presence of endocrine system diseases, syndrome of nonspecifc dysplasia of connective tissue and low indices of quality of life. Conclusion. Proposed system allows making prognosis of morphologic changes in spinal cord, and is based on radiation methods of verifcation without taking into consideration dynamics of neurological symptomatology.

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Fundamental Basis of Medical Aid Organization and Management in the Region

Year: 2012, volume 8 Issue: №2 Pages: 255-258
Heading: Internal Diseases Article type: Author's opinion
Authors: Denisova Т.Р., Danilov A.N., Malinova L.I., Shuldyakov V.A., Malinov I.A., Shuvalov S.S., Gorjainov V.V.
Organization: Saratov National Research University n.a. N. G. Chernyshevsky, Saratov State Medical University, Saratov Regional Clinical Hospital

The article presents computations on informational and analytical basis of public health database, that help to perform accurate monitoring, and detection of public health system state, as well as prognosis of further dynamics of public health system parameters for scientifically proved health care organization and decisions in management.

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Perioperative complications in patients with high anaesthetic and operating risk (review, part II)

Year: 2012, volume 8 Issue: №1 Pages: 051-057
Heading: Anaesthesiology and Reanimatology Article type: Review
Authors: Sadchikov D.V., Prigorodov M.V., Vartanjan T.S.
Organization: Saratov State Medical University

The article presents the literature review on perioperative complications that have been systematized. The prognosis of perioperative complications has been proved

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Prognosis and diagnostics for placental insufficiency according to markers of endothe-lial dysfunction, deciduation, apoptosis and cellular proliferation

Year: 2011, volume 7 Issue: №1 Pages: 052-059
Heading: Obstetrics and Gynecology Article type: Original article
Authors: Lipatov I.S., Tezikov Yu.V.
Organization: Samara State Medical University

Objective. The research goal is to estimate prognostic and diagnostic possibilities of markers of endothelial dysfunction, deciduation, apoptosis and cellular proliferation concerning realization of placental insufficiency. Material. 154 women of high risk group of severe placental insufficiency development have been examined in dynamics of the second and third trimesters of pregnancy. 30 healthy pregnant women have made the control group. Research methods are clinical, immunological, instrumental. Results. It is established that prognosis and early diagnostics for severe placental insufficiency can be carried out with application of monitoring of the maintenance of endothelial dysfunction markers, placental fibers of a mother placenta membrane, apoptosis and cellular proliferation in blood. In the second trimester of pregnancy prognostically significant criteria have included an increase of an index of cytotoxicity of antien-dothelial antibodies, the general IgE, lymphocytes, expressing Fas/APO-1/CD 95-receptor, TNFb and decrease of FGP. Conclusion. Therefore the forms of realization and severity level of placental insufficiency have been caused by the beginning and degree of damages in adaptation of endothelial systems, activation of the immunopathological reactions in the placenta manifested by trophoblastoma programmed cellular destruction of lymphocytes

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New approach to surgery in obliterating atherosclerosis of lower limb arteries

Year: 2010, volume 6 Issue: №4 Pages: 850-856
Heading: Surgery Article type: Original article
Authors: Kazantsev A.M., Korymasov E.A.
Organization: Samara State Medical University

Complex examination of 296 patients with obliterating atherosclerosis of lower extremities was carried out. Prog-nostically significant clinical, hemodynamic, hemostatic, immunological characteristics, markers of endothelial dysfunction and changes in lipid profile in patients were studied. Pathogenetic system of disease prognosis was worked out as a result of multifactor analysis where the index of course of disease was accounted. When the index was lower than + 13, obliterating atherosclerosis was not considered as progressive. Progressive atherosclerosis was determined with the index over the point +13

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Important issues of alcoholic liver disease prognosis

Year: 2010, volume 6 Issue: №1 Pages: 094-100
Heading: Internal Diseases Article type: Review
Authors: S.P. Sernov, V.B. Lifshitz, Yu.I. Skvortsov, V.G. Subbotina, A.G. Martynova, L.S. Sulkovskaya, V.I. Shulgin, L.A. Suchilina
Organization: Saratov State Medical University, Saratov Psychiatric Hospital

Alcoholic liver disease prognosis has not been thoroughly developed yet. The possibility of morphologic prognosis has been limited due to disadvantages of liver biopsy. Insignificant amount of studies is devoted to laboratory methods. prognosis value of serum markers of liver fibrosis at the last cirrhotic stages is widely considered in the medical literature. at the same time the results of treatment are determined by making a diagnosis

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