Saratov JOURNAL of Medical and Scientific Research

Lipatova Т.Е.

Saratov State Medical University n. a. V. I. Razumovsky, Head of Department of Therapy with Courses of Cardiology, Functional Diagnostics and Geriatrics, Assistant Professor, DSc

Protracted course of myocardial infarction in a senior patient against the background of acute calculous cholecystitis (clinical case)

Year: 2019, volume 15 Issue: №3 Pages: 817-821
Heading: Cardiology Article type: Case report
Authors: Romanova N.A., Lipatova Т.Е., Parshina S.S., Haibekova T.V..
Organization: Saratov State Medical University
Summary:

The article describes the clinical case of protracted course of myocardial infarction in a senior patient against the background of acute calculous cholecystitis, discusses medical examinations and treatment; attention is drawn to the need for a particularly careful assessment of temporal dynamics of the ST segment and T wave of electrocardiograms in polymorbid patients to confirm the protracted course of myocardial infarction.

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Platelet functional pools under pharmacological suppression of aggregation in ST segment elevation myocardial infarction

Year: 2019, volume 15 Issue: №3 Pages: 779-783
Heading: Cardiology Article type: Original article
Authors: Malinova L.I., Dolotovskaya P.V., Furman N.V., Puchinyan N.F., Lipatova Т.Е.
Organization: Saratov State Medical University
Summary:

The purpose of the study is to investigate clinical significance of peripheral pool platelets functional heterogeneity, assessed with combination of collagen and ADP, under pharmacological suppression of platelet aggregation in acute coronary syndrome. Material and Methods. The study involved 374 patients with acute coronary syndrome (ACS). Functional activity of platelets (FAT) was studied on the first, the 7th and 30th days after ACS manifestation in the whole blood by impedance and luminescent aggregometry. The functional heterogeneity of platelets was studied using our own method with an estimate of AAk (functional subpopulation of platelets aggregation (cluster II)), ASk (the functional subpopulation of platelets secretion (cluster II)) and ДА (a parameter of platelets functional heterogeneity). The follow-up period was 24 months after ACS manifestation. Results. In the study sample ADP- and collagen-induced platelet aggregation remained almost constant during the whole observation period. It was established that in patients treated with double antiplatelet therapy parameters of functional platelet heterogeneity statistically significantly decreased by the seventh day of observation: ЛАк 2(0; 3)vs 1 (0; 2) Ohm, p=0,049; AS 0.26 (0.15; 0.47) vs 0.19 (0; 0.26) nmol, p=0.07. The excess of ЛАР measured on the second day after ACS manifestation, a threshold of 2 Ohms, was associated with a significant increase in the 30-day risk of rethrombotic events (HR 1.8; Cl 1.2; 3.1). Conclusion. The dynamics of platelet functional heterogeneity was revealed in patients with acute coronary syndrome treated with double antiplatelet therapy. A high degree of platelet functional heterogeneity in patients with acute coronary syndrome was associated with a significant increase in the 30-day risk of rethrombotic events.

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Clinical and diagnostic significance of arterial stiffness in the early post-stroke period

Year: 2019, volume 15 Issue: №3 Pages: 769-773
Heading: Cardiology Article type: Original article
Authors: Mayorova S.V., Lipatova Т.Е., Haibekova T.V.
Organization: Saratov State Medical University
Summary:

The purpose of the study is the analysis of neurological functions' restoration in patients with hypertension in the early post-stroke period after ischemic stroke, depending on the parameters of vascular wall rigidity. Materials and Methods. The study included 50 patients with hypertension in the acute phase of ischemic stroke. Clinical, laboratory and instrumental studies were carried out on patients. Vascular wall rigidity was defined using the ankle-brachial index and stiffness index, as well as deficit neurological functions — using the NIHSS, MRS scales. Results. It is shown that high levels vascular wall rigidity is associated with marked shortage of neurological function in hypertensive patients in the early post-stroke period. Conclusion. Accounting indicators of vascular stiffness allow more accurate assessment of prognosis and help to develop personalized treatment strategy in patients with hypertension in the early post-stroke period after ischemic stroke.

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Frailty and arterial hypertension (lecture)

Year: 2019, volume 15 Issue: №3 Pages: 757-763
Heading: Cardiology Article type: Lecture
Authors: Lipatova Т.Е., Tyultyaeva L.A., Denisova Т.Р., Shulpina N.Yu.
Organization: Saratov Regional Hospital for Veterans of Wars, Saratov State Medical University
Summary:

The lecture analyses reference data on the problem of combination of senile asthenia and hypertension in elderly and senile patients. It discusses modern views on the possibilities and problems of diagnosis and treatment of patients with a combination of senile asthenia and hypertension.

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Cardiovascular risk factors and arterial stiffness in patients with ulcerative colitis

Year: 2019, volume 15 Issue: №3 Pages: 753-757
Heading: Cardiology Article type: Original article
Authors: Lipatova Т.Е., Mihailova Е.А., Dudaeva N.G.
Organization: Saratov State Medical University
Summary:

Purpose: to assess cardiovascular risk factors and arterial stiffness in patients with ulcerative colitis (UC) without clinical manifestations of cardiovascular diseases. Material and Methods. 76 patients with remission of UC, 40 patients with irritable bowel syndrome and 25 healthy volunteers of comparable age and gender were examined. The 10-year risk of fatal cardiovascular events (SCORE) was calculated. Daily monitoring of arterial stiffness, endothelium function together with its vasodilative, vasoconstrictive and adhesive functions were evaluated in all examinees. Results. Traditional cardiovascular risk factors such as hypercholesterolemia, obesity or hypertension were not typical for patients with UC. Risk SCORE was low in the majority of UC patients. Patients with UC were characterized by the increase of intima-media complex thickness, C-reactive protein level, and by the decrease of HDL cholesterol. UC patients demonstrated the increase of arterial rigidity and endothelial dysfunction which reflected in statistically significant decrease of endothelium-dependent vasodilation to 11.48%, and increase of plasma levels of endothelin-1, vascular adhesion molecules VCAM-1 and ICAM-1. Conclusion. UC patients need multidisciplinary approach to study their arterial rigidity and markers of endothelial dysfunction.

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Features of dental prosthetics at patients with chronic periodontitis and coronary heart disease

Year: 2019, volume 15 Issue: №2 Pages: 251-256
Heading: Stomatology Article type: Original article
Authors: Lepilin A.V., Eremin A.V., Lipatova T.E.
Organization: I.M. Sechenov First Moscow State Medical University, Saratov State Medical University
Summary:

Objective: at patients with chronic generalized periodontitis in combination with chronic ischemic heart disease to study the change of cytokines, biomarkers of osteoproliferation and osteoresorption in comparison with the character- istics of endothelial functions and the determine rational approaches to prosthetics. Material and Methods. 90 patients with periodontitis and coronary heart disease, who use metal, metal-ceramic and removable partial dentures using thermoplastic resin were survey. We studied of cytokines, markers of bone metabolism in the oral fuid, evaluated va-sodilating, vasoconstrictor and adhesive endothelial function. Results. The coronary heart disease in combination with chronic periodontitis is characterized by the endothelial dysfunction, which associated with the activity of periodontitis. Biochemical manifestations of periodontitis, bone resorption and endothelial dysfunction are more pronounced by the use patients metal dentures compared to metal-ceramic and removable partial dentures using thermoplastic resin. Conclusion. The use of patients at periodontitis and coronary heart disease metal dentures, in contrast to patients using metal-ceramic and removable partial dentures using thermoplastic resin, is accompanied the increase of biochemical markers of infammation and bone resorption in the oral fuid and the endothelial dysfunction.

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Features of dental prosthetics at patients with chronic periodontitis and coronary heart disease

Year: 2019, volume 15 Issue: №2 Pages: 251-256
Heading: Stomatology Article type: Original article
Authors: Lepilin A.V., Eremin A.V., Lipatova T.E.
Organization: I.M. Sechenov First Moscow State Medical University, Saratov State Medical University
Summary:

Objective: at patients with chronic generalized periodontitis in combination with chronic ischemic heart disease to study the change of cytokines, biomarkers of osteoproliferation and osteoresorption in comparison with the character- istics of endothelial functions and the determine rational approaches to prosthetics. Material and Methods. 90 patients with periodontitis and coronary heart disease, who use metal, metal-ceramic and removable partial dentures using thermoplastic resin were survey. We studied of cytokines, markers of bone metabolism in the oral fuid, evaluated va-sodilating, vasoconstrictor and adhesive endothelial function. Results. The coronary heart disease in combination with chronic periodontitis is characterized by the endothelial dysfunction, which associated with the activity of periodontitis. Biochemical manifestations of periodontitis, bone resorption and endothelial dysfunction are more pronounced by the use patients metal dentures compared to metal-ceramic and removable partial dentures using thermoplastic resin. Conclusion. The use of patients at periodontitis and coronary heart disease metal dentures, in contrast to patients using metal-ceramic and removable partial dentures using thermoplastic resin, is accompanied the increase of biochemical markers of infammation and bone resorption in the oral fuid and the endothelial dysfunction.

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Periodontal disease at cardiovascular pathology

Year: 2019, volume 15 Issue: №2 Pages: 246-251
Heading: Stomatology Article type: Review
Authors: Eremin A.V., Lepilin A.V., Lipatova T.E.
Organization: First Moscow State Medical University n.a. I.M. Sechenov, Saratov State Medical University
Summary:

The purpose of the systematic literature review was to characterize existing problem of the relationship between cardiovascular diseases and periodontal diseases on the basis of information analysis of the Russian and English original studies and metanalyses published in open access bibliographical databases such as eLibrary and PubMed the past ten years as a methodological basis for future clinical and experimental studies

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Dynamics of prevalence of diseases of the digestive system among the population of different age groups in conditions of social stress

Year: 2018, volume 14 Issue: №2 Pages: 345-348
Heading: Gerontology and geriatrics Article type: Original article
Authors: Tyultyaeva LA, Denisova TP, Lipatova TE, Kovalev EP.
Organization: Saratov State Medical University n.a. V.I. Razumovsky Research Institute of Cardiology
Summary:

Objective: to analyze the prevalence of digestive diseases during social stress among the population of different age groups (young, mature, elderly / old). Material and Methods. We studied data from the official statistical reports of the health Committee of the city of Saratov and the logs of incoming and departures / deaths of patients in the surgical and gastroenterology clinics of the city for 1990-2006. Social stress was considered as a factor in the breeding population system from the equilibrium state. Linear regression analysis, odds ratio, and analysis of the speed characteristics of the dynamics of the studied parameters in time were applied. The number of time moments when the sign of the rate of change in the prevalence of the studied parameters changed to the opposite was estimated. Results. The change in the sign of the rate of prevalence of acute pathology of the digestive system was most often observed during the period of maximum severity of social stress, which emphasizes the importance of the social component in the emergence and development of digestive pathology. The increase in the prevalence of diseases of the digestive system in all age groups was revealed. The increase in the prevalence of individual nosological forms, as well as the greatest number of times when the sign of the rate of prevalence of the pathology changed to the opposite, were most often registered among the population of young and elderly / senile age. The population of the mature age was characterized by greater stability of the studied parameters, that is, higher resistance to social stress. Conclusion. The prevalence of diseases of the digestive system during the period of social stress varied among the population of different age groups asynchronously: the most significant changes in the studied parameters were observed among the population of two extreme age groups: young and elderly / old people. These groups of people need closer attention of the doctor than patients of mature age, because they have a higher risk of developing diseases of the digestive system.

Keywords: age
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A method of improving clinical work with patients with peptic ulcer of stomach and duodenum

Year: 2018, volume 14 Issue: №2 Pages: 334-337
Heading: Gerontology and geriatrics Article type: Original article
Authors: Lipatova T.E., Tyultyaeva L.A., Nazarov M.M., Semenov S.V.
Organization: Saratov Regional Hospital for Veterans of Wars
Summary:

Objective: identification of risk groups for development of complications of ulcerous disease of stomach and duodenum.Material and Methods. We used data from the official statistical reports of the health Committee of the city of Saratov and the logs of incoming and departures/deaths of patients in the surgical and gastroenterology clinics of the city (1976-2006). The parameters of the prevalence of gastric ulcer and duodenal ulcer and its complications in the population of different age groups are analyzed. Linear regression analysis, odds ratio, and analysis of the speed characteristics of the dynamics of the studied parameters in time (mean, minimum, maximum speed, range of the dynamics of the studied parameters, the number of changes in the sign of the speed of change in the prevalence of the studied parameters) were applied. Results. It was found that the probability of complications of the disease is higher among those age groups, which are characterized by a frequent change in the sign of the rate of change in the prevalence of the pathology. The necessity of age accounting in stratification of the risk of complications of gastric ulcer and duodenal ulcer and the multiplicity of medical observation of persons of different ages with this pathology, taking into account the analytical parameters of the disease. Conclusion. The scheme of determining the multiplicity of dispensary examinations of patients with gastric ulcer and duodenal ulcer is proposed.

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