International Medical Journal最新文献

{"title":"USE OF COMBINED NUCLEOTIDE DRUG IN TREATMENT OF OPHTHALMIC MANIFESTATIONS OF SJOGREN’S DISEASE","authors":"D. Miroshnik","doi":"10.37436/2308-5274-2020-1-13","DOIUrl":"https://doi.org/10.37436/2308-5274-2020-1-13","url":null,"abstract":"Ophthalmic lesions in Sjogren's disease are among the most pronounced, they significantly complicate the patient's life. Along with Sjogren's disease, there is the so−called Sjogren's syndrome, which is a similar lesion of the salivary and lacrimal glands, which develops in 5−25 % of the patients with systemic connective tissue diseases and in 50−75 % with chronic autoimmune diseases. The main sign of damage to the lacrimal glands is the development of dry keratoconjunctivitis, which in severe cases can lead to complications in the form of corneal ulcers, up to the threat of perforation. The study of the effectiveness of various drugs in the treatment of symptomatic therapy showed that the problem of achieving a lasting effect of correction of ophthalmic manifestations has not been currently solved. In order to study the effectiveness of the drug \"Encad−Biolik®\" (Kharkiv, Ukraine) to stimulate the reparative processes of the cornea as part of the complex therapy of Sjogren's disease were examined 15 patients (30 eyes) who received the drug \"Encad−Biolik®\" in the form of intramuscular injections and bath phonophoresis. The duration of treatment was 8.0 days, the time of complete epithelialization of the cornea made 7.4 days. In the eyes of two patients who had corneal ulcers, the process was stopped, resulting in a slight cloud−like turbidity. The results of the study demonstrate that the use of the drug \"Encad−Biolik®\" in the patients with Sjogren's disease was not accompanied by side effects and reduced the duration of corneal epithelialization, duration of treatment, and improved structural results in corneal healing.\u0000\u0000Key words: Sjogren's disease, \"Encad−Biolik®\", cornea, epithelialization.","PeriodicalId":54933,"journal":{"name":"International Medical Journal","volume":"1 1","pages":"61-63"},"PeriodicalIF":0.0,"publicationDate":"2020-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45169055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"INFLUENCE OF GENOTYPIC VARIABILITY OF M. TUBERCULOSIS ON THE COURSE OF TUBERCULOSIS WITH MULTIPLE DRUG RESISTANCE","authors":"V. Krutko, L. Nikolaieva, T. V. Maistat, O. Oparin, A. Rohozhyn","doi":"10.37436/2308-5274-2020-1-15","DOIUrl":"https://doi.org/10.37436/2308-5274-2020-1-15","url":null,"abstract":"Tuberculosis is infectious and socially dependent disease, being now one of the most pressing issues in practical health care. As well the usual types of tuberculosis infection, chemoresistant tuberculosis is spreading rapidly in the world. The WHO estimates that about 500,000 people on the planet are infected with M. tuberculosis, which is resistant to standard anti−tuberculosis drugs. The probability of successful treatment decreases with emergence of new genotypes of M. tuberculosis with total resistance. In the modern epidemiology of tuberculosis, it is important to identify genotypes on certain signs, allowing to address issues such as their origin, identification of the infection source, possible routes and factors of transmission, as well as to reveal cases and spread of resistance to anti−tuberculosis drugs. To evaluate the therapy efficiency of multidrug−resistant tuberculosis patients with revealed genotypic variability during treatment, 10 patients with chemoresistant pulmonary tuberculosis having M. tuberculosis genotypic variability were treated. In these patients, the clinical, laboratory and radiological dynamics of disease in intensive phase of treatment were studied. Analysis of treatment results for patients with chemoresistant tuberculosis with genotypic variability of M. tuberculosis was evaluated by the intoxication syndrome dynamics of, the timing of closure of the decay cavities and cessation of bacterial excretion. The study found that the genotypic variability of M. tuberculosis is characterized by the change of less virulent genotypes of M. tuberculosis to more virulent. Signs of intoxication have been shown to change from less virulent M. tuberculosis genotypes to M. tuberculosis Beijing genotypes. Genotypic variability of mycobacteria in hospital suggests that hospitalization in tuberculosis facilities is a risk of exogenous tuberculosis superinfection. Studying the influence of genotypic variability of M. tuberculosis on the course of multidrug−resistant tuberculosis requires more extensive research, being a very relevant and promising area in phthisiology.\u0000\u0000Key words: Mycobacterium tuberculosis, genotypic variability, VNTR−genotyping, treatment.","PeriodicalId":54933,"journal":{"name":"International Medical Journal","volume":"1 1","pages":"68-71"},"PeriodicalIF":0.0,"publicationDate":"2020-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46759831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DEGENERATIVE DISC DISEASE IN YOUNG PEOPLE. MEDICAL IMAGING TECHNIQUES","authors":"R. Abdullaiev, K. Ibragimova, I. Mamedov, R. Abdullaiev","doi":"10.37436/2308-5274-2020-1-10","DOIUrl":"https://doi.org/10.37436/2308-5274-2020-1-10","url":null,"abstract":"Degenerative changes of intervertebral discs is a very complicated process as a result of interaction of many factors: genetic, environmental, physical activity. Abnormalities in the vertebrae structure create the preconditions for the overload of the vertebral motor segment, which contributes to the spread of degenerative lesions and increases the risk of spinal injuries. Degenerative disc disease is one of the most common causes of back pain. The process of degeneration begins at a young age and in adulthood it often becomes widespread with a predominance of one or another localization. Methods of medical imaging occupy an important place in diagnosis of musculoskeletal pathologies. Radiography assesses the changes only in bone structures, but does not allow the visualization of soft tissues, which include not only the ligaments of the vertebral motor segment, but also the intervertebral discs. Magnetic resonance imaging is the most effective method for diagnosing degenerative changes in intervertebral discs. Possibilities of ultrasound examination in the diagnosis of early stage degenerative disc disease have not been studied enough. There were examined 147 patients aged 18−27 years with clinical and neurological signs of degenerative disease of cervical and lumbar spinal discs. Ultrasonic semiotics showed changes within the pulpal nucleus as an increased echogenicity and displacement back towards the fibrous ring, fibrous ring thinning, which indicated the disc protrusion. In patients with pain in neck and lower back, fragmentary imaging of the fibrous ring and prolapse of the disc contents into the lumen of spinal canal, indicating the development of hernias was found. The presence of herniated discs of cervical and lumbar spine in all cases coincided with the results of magnetic resonance imaging, and protrusion did in 91,4 % of cases. Thus, among medical imaging the ultrasonography is the most accessible and informative method for diagnosing degenerative changes in intervertebral discs of cervical and lumbar spine.\u0000\u0000Key words: degenerative disc disease, ultrasonography, cervical and lumbar intervertebral discs.","PeriodicalId":54933,"journal":{"name":"International Medical Journal","volume":" ","pages":"48-52"},"PeriodicalIF":0.0,"publicationDate":"2020-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45929891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CYCLIN-EPENDENT KINASES 4/6 INHIBITORS IN COMBINATION WITH AROMATASE INHIBITORS IN TREATMENT OF METASTATIC BREAST CANCER (clinical observation)","authors":"M. Sadchikova, L. V. Syniavina, N. M. Otchenash","doi":"10.37436/2308-5274-2020-1-8","DOIUrl":"https://doi.org/10.37436/2308-5274-2020-1-8","url":null,"abstract":"It is known that a complete recovery in patients with generalized tumor is impossible, but the use of effective treatment regimens can significantly inhibit the development of the disease. The main goal of treatment of metastatic breast cancer is to increase overall survival, time to disease progression, improvethe quality of life, to prevent serious complications. In recent years, the standard of first−line hormone therapy in postmenopausal patients has been the use of aromatase inhibitors. Recently, a new class of drugs has emerged that can increase the effectiveness of hormone therapy, which significantly strengthens the position of this method in metastatic breast cancer. A clinical trial of PALOMA−2 and its findings are presented: the palbociclib + letrozole protocol as first−line therapy in postmenopausal patients with estrogen−positive Her2 new negative advanced breast cancer improves the objective response rate and clinical efficacy compared to letrozole monotherapy. The overall incidence of adverse responses was higher in patients treated with palbociclib + letrozole compared with placebo + letrozole. This clinical case demonstrates the possibility of long−term effective disease control in metastatic breast cancer. Literature data and personal experience show high efficacy of the combined protocol of hormone therapy and inhibitors of cyclin−dependent kinases 4/6. The use of such protocols is advisable in patients with multiple bone metastases, while achieving an effective reduction of pain. The use of such regimens is possible in patients with a low ECOG score who cannot tolerate chemotherapy with more severe toxicity.\u0000\u0000Key words: metastatic breast cancer, aromatase inhibitors, palbociclib.","PeriodicalId":54933,"journal":{"name":"International Medical Journal","volume":"1 1","pages":"39-41"},"PeriodicalIF":0.0,"publicationDate":"2020-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46656428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FEATURES OF HEMOSTASIS SYSTEM IN WOMEN WITH THROMBOPHILIA AS ONE OF CAUSAL FACTORS FOR UNSUCCESSFUL ATTEMPTS IN EXTRACORPOREAL FERTILIZATION","authors":"T. L. Viesich, D. Tarawneh","doi":"10.37436/2308-5274-2020-1-6","DOIUrl":"https://doi.org/10.37436/2308-5274-2020-1-6","url":null,"abstract":"Excessive activation of blood coagulation, imbalance in coagulation potential, presence of endotheliopathies, local hemorrhages and microthrombi in the area of blastocyst invasion may be common in the mechanism of implantation losses in thrombophilia. One of the ways to optimize the results of extracorporeal fertilization is the prevention of thrombotic complications. Despite the achievements of modern morphology, some issues concerning the pathogenesis of infertility and habitual miscarriage remain poorly understood. To assess the system of hemostasis in women with thrombophilia as one of the causative factors of unsuccessful attempts in extracorporeal fertilization, a study of 63 patients was conducted, which included hormonal, genetic studies, HLA−typing, ultrasonography, hysterosalpingography, determination of infectious profile and was performed depending on clinical situation. The study of the hemostasis system included the determination of total coagulation potential, analysis of primary hemostasis, fibrinolytic system, the state of intravascular hemocoagulation and antiplasmin potential of blood. The state of intravascular hemocoagulation was assessed by the concentration in blood plasma of pathological hemocoagulants, i.e. soluble complexes of fibrin monomers and fibrinogen−fibrin degradation products. The results of the study showed that in women with a thrombophilia history and unsuccessful attempts in extracorporeal fertilization, there is a pathological activation of the hemostasis system, which plays a significant role in the pathogenesis of unsuccessful fertilization attempts. In thrombophilia, a subclinical form of chronic disseminated intravascular coagulation develops, the leading link in the development of which is the activation of platelet−vascular hemostasis with subsequent involvement into the process of coagulation potential due to a decrease in the anticoagulant blood system.\u0000\u0000Key words: thrombophilia, hemostasis system, extracorporeal fertilization, infertility.","PeriodicalId":54933,"journal":{"name":"International Medical Journal","volume":"1 1","pages":"29-32"},"PeriodicalIF":0.0,"publicationDate":"2020-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44470980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CHOICE OF SURGERY TACTICS IN PATIENTS WITH HIGH RISK OF ANASTOMOTIC LEAK DEVELOPMENT","authors":"M. Tymchenko","doi":"10.37436/2308-5274-2020-1-5","DOIUrl":"https://doi.org/10.37436/2308-5274-2020-1-5","url":null,"abstract":"Intestinal resection is one of the most common surgeries performed on urgent indications, the most difficult is the decision in favor of the formation of primary anastomosis in the case of primary infection of abdominal cavity, multiple defects of the intestinal wall, as well as the general serious condition of a patient. In order to improve the methods of diagnosis and prevention of post−surgery complications, as well as personification of surgical tactics of treatment in the patients undergoing anastomotic surgeries in intestine, the results of treatment of 96 patients were analyzed. The level of serum cryoglobulins was determined by the method of A. E. Kalovidoris with modifications. The results of surgical treatment were evaluated according to the classification of D. Dindo et al. (2004). The use of cryoglobulin levels before surgery can significantly affect surgical tactics: at a low degree it is possible to perform resection of a segment of small intestine with the formation of primary small intestinal anastomoses; at average − it is possible to perform small−intestinal anastomoses with unloading intestinal stoma or with the location of the anastomosis extraperitoneally (if possible) and decompression of the anastomosis with an incubation probe; at high − it is expedient to supplement performance of an anastomosis with a variant of an enterostomy or \"delayed\" anastomoses, at a severe general condition of patients it is expedient to form final small intestinal stoma. Determining the level of cryoglobulinemia as a marker of the prognosis of failure of the sutures of intestinal anastomoses and the use of differentiated surgical tactics depending on the level of this index contributes to a significant improvement in direct results of surgical treatment of the patients undergoing resection of small intestine segments. The proposed tactics virtually eliminate the implementation of multi−stage surgical interventions and helps to reduce the duration of treatment of patients, reduce the level of post−surgery complications and mortality.\u0000\u0000Key words: cryoglobulinemia, surgical treatment, small intestine, anastomoses.","PeriodicalId":54933,"journal":{"name":"International Medical Journal","volume":"1 1","pages":"25-28"},"PeriodicalIF":0.0,"publicationDate":"2020-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41621647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FEATURES OF PSYCHO-EMOTIONAL DISORDERS IN YOUNG PATIENTS SUFFERING FROM CHRONIC RADICULOPATHIES OF VERTEBROGENIC GENESIS","authors":"N. Kufterina","doi":"10.37436/2308-5274-2020-1-11","DOIUrl":"https://doi.org/10.37436/2308-5274-2020-1-11","url":null,"abstract":"According to current notions, the development of neuropathic pain includes the mechanisms of peripheral and central sensitization, the emergence of a generator of pathologically enhanced excitation, pathological illogical system, on the basis of which a specific clinical form of pain is formed. The neuropathic nature of pain is observed in 30−40 % of the patients suffering from back pain. In order to study the psycho−emotional disorders in relation to the duration of chronic pain in young people suffering from the vertebrogenic lumbosacral radiculopathy, 97 people were examined. To estimate pain syndrome a visual−analog scale and DN4 questionnaire was used, for reactive and personal anxiety level we involved the Spielberger − Khanin test, the Beck's inventory was applied for the depression level, MFI−20 for objectification of asthenic manifestations was utilized. Complaints of the patients were divided into specific (nociceptive and neuropathic pain syndrome) and nonspecific. Non−specific complaints in the examined patients included disorders of the emotional sphere, which had the following structure: asthenic, anxiety, depressive and their combinations, as well as the presence of somatoform symptoms, which was confirmed by neuropsychological testing. In the analysis of the dependence of frequency and severity of emotional disorders on the duration of chronic pain, the patterns were found to increase the frequency of all emotional dysfunctions, reduce the severity of anxiety and increase depression with the same severity of asthenic ones. According to the results of this study, the following conclusions were made: the severity of anxiety disorders decreases with increasing duration of the disease, and the depressive disorders increase. The severity of asthenic syndrome did not differ significantly in this category of patients with any duration of chronic pain.\u0000\u0000Key words: chronic vertebrogenic lumbosacral radiculopathies, asthenic, anxious, depressive disorders, young patients.","PeriodicalId":54933,"journal":{"name":"International Medical Journal","volume":"1 1","pages":"52-55"},"PeriodicalIF":0.0,"publicationDate":"2020-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46855199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MICRORNA-122 AS A BIOLOGICAL MARKER OF CHRONIC VIRAL HEPATITIS C","authors":"O. Shevchenko-Makarenko, L. Shostakovych-Koretska, V. Dosenko, T. Drevytska","doi":"10.37436/2308-5274-2020-1-16","DOIUrl":"https://doi.org/10.37436/2308-5274-2020-1-16","url":null,"abstract":"New epigenetic markers are being studied in various countries around the world to diagnose, predict, and treat the patients with chronic viral hepatitis C. Epigenetics is currently studying the hereditary changes in gene expression or phenotype that are not related to the changes in DNA sequence. One field of epigenetics is the expression of RNA that does not encode a protein, namely miRNA, which is a molecule 18−22 nucleotides in length that plays a crucial role in regulating gene expression. Circulating miRNAs are a new genetic material that can be isolated from a patient's blood. The expression level of a particular miRNA has different biological and clinical effects. By means of its determination in various miRNAs it is possible to predict development of diseases. In order to study the baseline expression of miRNA−122 in patients with chronic viral hepatitis C with the first HCV genotype, 74 patients were examined. Diagnosis and monitoring of the patients was performed according to the local protocols and bioethical standards. The level of miRNA−122 expression in patients with chronic viral hepatitis C with the first HCV genotype was established by reverse transcription. Studies show that the level of miRNA−122 expression in the patients with HCV and healthy individuals showed significant variability. The obtained data indicate that the expression level of miRNA−122 in patients is 29 times higher than in healthy individuals at p = 0.0001 (U; Z). This can be an additional biomarker as an index of the presence of chronic viral hepatitis C and can be further used in practice. Therefore, the high level of miRNA−122 expression in subjects (≥ 8.771 rel. units (Log10 miR−122 ≥ 0.939 rel. units)) may be the basis for further screening of patients for HCV infection. The prospects of using this index, which will allow to personalize the diagnosis and treatment tactics for patients, that, in turn, will contribute to the implementation of the WHO global strategy for the elimination of viral hepatitis.\u0000\u0000Key words: chronic viral hepatitis C, miRNA−122, elimination of viral hepatitis, biological marker.","PeriodicalId":54933,"journal":{"name":"International Medical Journal","volume":"1 1","pages":"72-75"},"PeriodicalIF":0.0,"publicationDate":"2020-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44819308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ANALYSIS OF CLINICAL AND ANAMNESTIC PARAMETERS IN CHILDREN WITH EPILEPSY OF DIFFERENT AGE GROUPS","authors":"T. Litovchenko, O. Sukhonosova, A. I. Ekzarhova, V. Olenych","doi":"10.37436/2308-5274-2020-1-9","DOIUrl":"https://doi.org/10.37436/2308-5274-2020-1-9","url":null,"abstract":"According to epidemiological studies, it has been determined that from 0,5 to 1,0 % of children have epilepsy. As well it is considered as one of the most common chronic neurological diseases of childhood. Epilepsy is a multi−etiological disease, the clinical course of which is characterized by spontaneous uncontrolled functional disorders arising from hypersynchronous electrical discharges in the cerebral cortex. This study was aimed to investigate the features of clinical manifestations and anamnestic data in children of different ages, suffering from different epilepsy forms. We examined 1,017 patients aged from 3 months to 17 years. All patients were assessed for somatic and neurological status, electroencephalography, magnetic resonance imaging of the brain, if necessary the laboratory tests and consulting other specialists were performed. The analysis of findings shows that the most common is symptomatic epilepsy compared to idiopathic and cryptogenic. The prevalence of idiopathic epilepsy increases in early school age and enhances as much as possible in adolescence. In patients with cryptogenic epilepsy, forms with focal onset, generalized and unclassified seizures were identified. Cryptogenic epilepsy was mostly diagnosed in children under 10 years, likely indicating a disruption of physiological connections and morphofunctional immaturity. The symptomatic epilepsy according to the localization of focal disorders was divided into: temporal, frontal, parietal, occipital and multifocal. The major symptoms of epilepsy are observed in primary school and adolescence. In preschool age, the most common is frontal localization of the focus, parietal ; in primary school − temporal, occipital and parietal, in early − multifocal. Etiological factors of symptomatic epilepsy include the CNS congenital malformations, CNS perinatal lesions, traumatic brain injury, neuroinfections etc. Thus, due to the findings we determined the etiological and trigger factors that led to the development of pathological conditions, including epilepsy.\u0000\u0000Key words: children, epilepsy, clinic, medical history, etiologic and trigger factors.","PeriodicalId":54933,"journal":{"name":"International Medical Journal","volume":"1 1","pages":"42-47"},"PeriodicalIF":0.0,"publicationDate":"2020-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49220615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DYNAMICS OF FUNCTIONAL STATE OF KIDNEYS IN PATIENTS WITH RESISTANT HYPERTENSION AND CHRONIC KIDNEY DISEASE ACCORDING TO LONG-TERM FOLLOW-UP","authors":"O. Matova, K. Serbeniuk, L. V. Bezrodna, V. Bezrodnyi, V. Radchenko","doi":"10.37436/2308-5274-2020-4-1","DOIUrl":"https://doi.org/10.37436/2308-5274-2020-4-1","url":null,"abstract":"Resistant hypertension and chronic kidney disease are closely related from a pathogenetic and clinical point of view. To study the dynamics of functional state of kidneys and as well as to identify the predictors of its improvement, 117 patients with resistant hypertension were examined. Dynamic follow−up of patients included monitoring of antihypertensive therapy, blood pressure, biochemical and humoral parameters during 3, 6 and 36 months of treatment. The findings have shown that a significant long−term improvement in blood pressure control in the patients with chronic kidney disease improves their function and also has a nephroprotective effect in patients without any signs of renal damage. The established prognostic value of the higher initial creatinine content for the improvement of renal function in patients with resistant hypertension is stipulated with a positive effect of antihypertensive therapy on the glomerular filtration rate dynamics. The close association between improved renal function and lower baseline levels of interleukin 6 as well as an active renin in the blood may indicate a role for systemic inflammation and renin−angiotensin−aldosterone system activity in the renal dysfunction development. Prolonged improvement in blood pressure control in the patients with resistant hypertension without diabetes is associated with a stable level of urinary albumin excretion, whereas in patients with diabetes, an albuminuria increases over time. The study concluded that independent predictors of improved renal function in patients with resistant hypertension are higher baseline creatinine and lower glomerular filtration rate, lower concentrations of interleukin 6, active renin and plasma potassium.\u0000\u0000Key words: resistant arterial hypertension, chronic kidney disease, functional state of kidneys, antihypertensive therapy.","PeriodicalId":54933,"journal":{"name":"International Medical Journal","volume":"14 1","pages":"5-11"},"PeriodicalIF":0.0,"publicationDate":"2020-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70056589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}