Saratov JOURNAL of Medical and Scientific Research

Saratov Institute of Cardiology, Russia

Clinical audit of medical care quality by computer informational analytical system in patients with hypertension followed in Saratov polyclinic

Year: 2009, volume 5 Issue: №4 Pages: 548-554
Heading: Internal Diseases Article type: Original article
Authors: О.М. Posnenkova, V.I. Gridnev, A.R. Kiselev, V.A. Shvartz
Organization: Saratov Institute of Cardiology, Russia
Summary:

The research goal is to point out potentiality of clinical audit of care quality carried out by IAS "Register AH" in hypertensive patients followed in Saratov polyclinic.
Data of medical cards of 205 hypertensive patients (average age 52,8±9,1 years) followed in Saratov polyclinic have been analyzed with the help of IAS "Register AH" indicators set. Implementation of clinical recommendations on diagnosis, treatment and following-up of hypertensive patients from 2007 till 2008 has been assessed.
There was no correspondence between statements of recommendations of diagnostic measures for clinical status, treatment and following-up of hypertensive patients. Clinical aim of treatment to support the principal blood pressure has not been achieved in 85% of patients. The main cause has consisted in the patient's clinical status without taking into account the treatment and dynamic follow-up.
Clinical audit has allowed the complex evaluation of medical care process in hypertensive patients followed in the studied polyclinic and allowed to reveal a cause of inappropriate results of care. The use of IAS "Register AH" systematizes medical data contained in ambulatory cards, automatizes the process of obtaining indicators results. It increases the reliability assessments

AttachmentSize
200904_548_554.pdf412.79 KB

Investigation Of Arterial Blood Pressure Level And Metabolic Indices In Patients With Arterial Hypertension At Pharmacotherapy With Antihypertensive Medicines Of Various Chemical Structure

Year: 2009, volume 5 Issue: №4 Pages: 500-505
Heading: Clinical Pharmacology Article type: Original article
Authors: T.V. Kurkina, A.A. Svistunov, S.I. Bogoslovskaya, V.A. Klochkov, E.V. Luchinina, G.Kh. Glybochko
Organization: Saratov Institute of Cardiology, Russia, Saratov State Medical University
Summary:

The research goal is to carry on the comparative analysis of medicines of various chemical structure, Telmisar-tan and Bisoprolol, and to reveal their effect on the arterial blood pressure level and the indices of various metabolic processes in patients with arterial hypertension. 60 out-patients with arterial hypertension (stage II risk III) both males and females aged 33-55 have been under study taking Telmisartan and Bisoprolol for 3 months. While treating the patients the arterial blood pressure level control and biochemical investigations for determination the indices of metabolic processes have been carried out. The investigated medications have provided the decrease of systolic and diastolic arterial pressure parameters, the increase of concentration of total and ionized calcium, chlorine ions, urea and total bilirubin in blood plasma. Therapy with Telmisartan has shown more significant increase of potassium level in erythro-cytes, decrease of levels of natrium, glucose, glycolized hemoglobin and triglycerides and increased contents of alani-naminotransferase and aspartataminotransferase. The course of therapy with Bisoprolol has restored the normal level of magnesium in blood plasma, has not have any influence on carbohydrate and lipid metabolism, increased the level of alaninaminotransferase and significantly increased the contents of total and ionized calcium, urea and creatinine. 3-months therapy with Telmisartan and Bisoprolol has proved the decrease of systolic and diastolic arterial pressure in patients with arterial hypertension. The medications under study have had active and variable effects on metabolic indices

AttachmentSize
200904_500_505.pdf333.79 KB

Clinical Effectiveness Of Dynamic Out-Patient Control Technology Over Hypertensive Patients Based On Computer System And Mobile Phone Connection

Year: 2009, volume 5 Issue: №3 Pages: 358-362
Heading: Internal Diseases Article type: Original article
Authors: V.A. Shvartz, V.I. Gridnev, A.R. Kiselev, O.M. Posnenkova
Organization: Saratov Institute of Cardiology, Russia
Summary:

A new follow-up technology of dynamic out-patient control based on system of mobile monitoring of patients with arterial hypertension (SMMAH) has been created in Saratov Scientific Research Institute of Cardiology. SMMAH is based on exchange of information between patient and doctor with the help of Internet and standard short mobile messages. The aim of the present work is to study the effectiveness of SMMAH for follow-up control of hypertensive patients for the period of 12 months. 79 patients with hypertension aged 49±11 were included in the investigation. Control period lasted 12 months. Control visits were made in the 1st, 6th and 12th months. The number of patients became out of control, its causes, percentage of patients who achieved and maintained target blood pressure (BP) were analyzed after each visit. Data were presented as M (95% confidence interval). As a result in 1 month period of investigation 88,6% of patients regularly used mobile messages, 11% of patients were out of control. In 6 months period 68,4% of participants were under control, 31,6% of patients dropped out. In 12 months period — 67% and 33% of patients accordingly. Target BP was maintained in 87% (77%-96%) of patients in 1 month period, in 78% (66%-90%) of patients in 6 months period and in 68% of patients (53%-84%) in 12 months period. High clinical effectiveness of SMMAH has been proved during the study: 67% of patients have followed prescribed therapy after the investigation period and 68% of them have maintained target BP level.

AttachmentSize
200903_358_362.pdf318.42 KB

INFLUENCE OF SEASON PATTERN ON PREVALENCE AND SEVERITY OF ACUTE MYOCARDIAL INFARCTION, FUNCTION OF HEMOSTASIS IN PATIENTS WITH ISCHEMIC HEART DESEASE OF CLIMATE AREA OF MIDDLE VOLGA REGION

Year: 2007, volume 3 Issue: №3 Pages: 68-72
Heading: Internal Diseases Article type: Original article
Authors: O.K. Rybak, A.N. Burlaka, N.P. Ivannikova, A.P. Burlaka
Organization: Saratov Institute of Cardiology, Russia, Saratov State Medical University
Summary:

The aim of this study is to evaluate season pattern, severity and outcome of acute myocardial infarction in dependence of yearly patterns of function of hemostasis in middle Volga Region. Season pattern of prevalence myocardial infarction with winter peak was discovered, be accompanied of increase platelet aggregation, deterioration of blood viscosity, fibrinolysis depression. Most serious clinical course of summer myocardial infarction was observed with prosperity of hemostasis.

AttachmentSize
200703_068.pdf147.27 KB

DAILY PATTERN OF ACUTE MYOCARDIAL INFARCTION IN ELDERLY AND SENILE PATIENTS OF MIDDLE VOLGA REGION

Year: 2007, volume 3 Issue: №1 Pages: 71-73
Heading: Internal Diseases Article type: Original article
Authors: O.K. Rybak, A.N. Burlaka, N.P. Ivannicova, M.E. Rakovsky, A.P. Burlaka
Organization: Saratov Institute of Cardiology, Russia
Summary:

The aim of this study is to evaluate daily patterns of acute myocardial infarction in elderly and senile patients of climate area of middle Volga Region. Daily recurrence of acute myocardial infarction was discovered in dependence of sex and age, hours of "high risk" and "prosperity" were determined.

THE DYNAMICS OF 0,1 HZ-COMPONENT OF HEART RATE VARIABILITY AT PATIENTS WITH ARTERIAL HYPERTENSION AT TREATMENT BY FOSINOPRIL AND ATENOLOL

Year: 2008, volume 4 Issue: №1 Pages: 84-87
Heading: Internal Diseases Article type: Original article
Authors: O.V. Shevchenko, A.R. Kiselev, V.I. Gridnev, O.M. Posnenkova, A.N. Strunina, A.A. Svistunov
Organization: Saratov Institute of Cardiology, Russia, Saratov State Medical University
Summary:

Aim: to study dynamics of the 0,1Hz-componentofthe heart rate variability(HRV) spectrum in patients with arterial hypertension taking fosinopril and atenolol. 49 patients with hypertension were enrolled (age - 46+/-7 years). Fosinopril and atenolol were administered consequently. The power of 0,1 Hz-component of the HRV spectrum was assessed during a passive orthostatic test. Results: In patients taking fosinopril and atenolol comparable decrease of blood pressure was observed. Atenolol caused reliable decrease of a heart rate during orthostatic test. The power dynamics of 0,1Hz-componentwas comparable in patients taking fosinopril and atenolol. Conclusion: fosinopril and atenolol influenced similar on 0,1-Hz mechanisms of vegetative heart control system.

AttachmentSize
2008_01_084_087.pdf183.65 KB