Terapevt Arkh
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Obesity is an independent predictor of cardiovascular diseases (CVD), including heart failure (HF). Nevertheless, numerous studies have shown that patients with CVD who are overweight and slightly obese have a better short-term and moderate prognosis than thinner patients with CVD. ⋯ Understanding the obesity paradox is important in patients with HF, given the high prevalence of obesity in patients with HF. The article presents an overview of clinical studies devoted to the study of obesity as a risk factor for HF, the pathogenesis of HF in obesity, and highlights the issues of the obesity paradox and the treatment of obesity in this category of patients.
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The vector concept in the analysis of the electrical signals of the heart began to be used at the dawn of the development of electrocardiology. For several decades, vectorcardiography has developed in parallel with electrocardiography; reached its peak in the 60s, and after a period of cooling experienced a resurgence since the early 90s, when it became possible to mathematically synthesize vectorcardiograms (VCG) from digital electrocardiograms in 12 leads. ⋯ The article describes the main milestones in the development of the VCG, the history of international cooperation in this area, the contribution of domestic scientists to this field of science. Modern promising areas of research related to the vector concept of the analysis of the electrical signals of the heart are briefly reflected.
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Are presented the key aspects of the management of patients with acute decompensation of heart failure leading to improved clinical outcomes. Are described the existing problems and possible solutions.
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The article is devoted to debatable aspects of Helicobacter pylori eradication therapy. The eradication cancer-preventive effects are considered. ⋯ The perspectives of populational, individualized and personalized strategies for H. pylori eradication therapy assessment are given. Recommendations for individualized H. pylori eradication strategy implementation in practical healthcare are proposed.
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In recent years, the harmonization of domestic and foreign clinical recommendations for the treatment of cystitis has been achieved. Nitrofurans and fosfomycin trometamol are recommended as first line therapy antibiotics, and oral 3rd generation of cephalosporins are recommended as alternative antibiotics; fluoroquinolones are excluded from the recommended medications due to an unfavorable safety profile. The main rationale for inclusion of antibiotics in the recommendations as a first line therapy of cystitis is the level of resistance of uropathogens to antibiotics, primarily Escherichia coli. ⋯ In the latest WHO document of 2021, experts divided antibiotics into three groups (ACCESS, WATCH, RESERVE) according to the priority of choice. The ACCESS group of drugs for the treatment of cystitis includes nitrofurantoin and furazidine as agents with minimal collateral effect, while fosfomycin trometamol and cephalosporins are listed in the WATCH group. Thus, from the standpoint of ecological safety, WHO experts recommend prescribing nitrofurans in the treatment of cystitis in the first line of therapy.