Terapevt Arkh
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A present review is devoted to the current state of the problem of blood pressure variability (BPV) in hemodialysis patients. The BPV classification and clinical significance of BPV metrics are discussed. The results of cohort and randomized studies on the high BPV influence on outcomes in hemodialysis patients, as well as on the possibilities of antihypertensive drugs in the treatment of high BPV in dialysis patients, are presented.
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Rebamipide is a mucoprotective drug which was developed in Japan in 1990. The therapeutic effect of rebamipide based on the induction of cyclooxygenase-2 and increasing level of prostaglandins, inhibition of oxygen free radicals production, epidermal growth factor stimulation, vascular endothelial growth factor, nitric oxide, and decreasing of lipid peroxidation and neutrophils migration. The combination of proton pump inhibitors and rebamipide is more effective in relieving of gastroesophageal reflux disease symptoms and reducing recurrence rate of disease. Using rebamipide in the treatment of gastroesophageal reflux disease is justified because this drug has a unique mechanism of action, which eliminating the main stages of pathogenesis of the disease.
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Improvement and development of technologies for laboratory and instrumental examination of patients in recent years have greatly facilitated the diagnosis of ischemic myocardial damage. However, a decrease in the rating of cardiovascular diseases is not expected in the short term. This is due to an increase in the life expectancy of the population, general aging of the population and improving diagnostic capabilities and the provision of medical care. ⋯ Full restoration of organs is possible only if the patient is successfully evacuated to the hospital and there are specialists of the appropriate level of experiebce, X-ray surgical equipment with suitable supplies or pharmacological agents, usefull for quickly restoration the patency of the great vessels and normal blood flow. A large number of studies appear on the phenomenon of preconditioning at the present stage of development of fundamental medical science. The purpose of this article is to reveal the possibilities of using molecular markers of the phenomenon of preconditioning in the framework of the early detection of hypoxic conditions, the assessment of their diagnostic use in the clinic and the prevention of hypoxia-associated diseases.
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The article gives a critical assessment of the so-called obesity paradox. Methodological errors that occur in the organization of studies that studied the obesity paradox and the formation of comparison groups are highlighted. ⋯ The organization of prospective studies or more careful consideration of all currently known risk factors for cardiovascular diseases (CVD) will significantly improve the results of the study of the effect of overweight and obesity on mortality in patients with CVD. Thus, despite the biological possibility of the existence of a positive effect of adipose tissue in CVD, the presence of a large number of errors identified in the analysis of the work of researchers obesity paradox require to reconsider the existence of this phenomenon, it should be taken into account the possibility that the obesity paradox may be a consequence of improper design studies to investigate this phenomenon.
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New methods and treatment plans for patients with chronic coronary artery disease after endovascular interventions are currently introduced into clinical practice. It allows reducing hospital stay down to 24 hour, with discharge the next morning. This approach is called overnight stay. Using a similar strategy increases the availability of various types of endovascular interventions, shorter waiting lists, and cut the cost of treatment due to a reduced hospital stay.