Terapevt Arkh
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In Russia, diabetes mellitus afflicts 8 million people, 90% of them had type 2 diabetes mellitus (T2DM) and this figure is growing steadily. At the same time there is a rise in the incidence of macrovascular events (unstable angina pectoris, myocardial infarction). ⋯ To prevent chronic complications of DM is likely to be the most urgent task of not only modern diabetology, but also medical science as a whole. In this connection, of great value are the results of a few large international randomized controlled studies, the main objective of which was to evaluate the impact of the rate of blood glucose control on the incidence and outcomes of cardiovascular diseases in patients with T2DM
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The paper considers the pathogenesis, clinical picture, and diagnosis of acute intoxications with alcohol and substitutes, and its prehospital medical care. It details an emergency team's tactics in patients with the above conditions.
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The paper deals with the topical problem of modern gastroenterology and coloproctology--the influence of genetic factors on the development and course of Crohn's disease (CD). It presents the data of foreign authors and the results of Russia 's first study evaluating the effect of the major polymorphic variants of the NOD2/CARD15 gene predisposing to CD on the risk, course, and other features of CD.
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The paper deals with the analysis of studies of the role of the bone morphogenetic proteins fibroblast growth factor 23 (FGF-23) and Klothno in the development of vascular wall calcification in chronic renal disease (CRD). FGF-23 is shown to be an important phosphaturic hormone that inhibits hypercalcemic and hyperphosphatemic effects of elevated serum vitamin D concentrations. ⋯ Most authors regard FGF-23 as a potential uremic toxin in patients with end-stage CRD. There are data that support the renoprotective value of the morphogenetic protein Klotho whose expression in CRD is decreased.
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Rheumatoid arthritis (RA) is a chronic autoimmune disease that is characterized by a systemic inflammatory and destructive joint lesion that is manifested by the involvement of various organs and systems into the pathological process. Whether the variants of the course and outcomes of RA may be predicted early is the most important inadequately studied problem. HLA-DRB1* genotypes affect disease severity; however, different alleles encoding the identical amino acid sequence have a varying association with the disease and their combinations can differently increase the risk of RA. ⋯ A number of studies have demonstrated that if a patient has concurrently antibodies to cyclic citrullinated peptide (CCP) and rheumatoid factor, as well as HLA-DRB1 alleles, the likelihood of rapid X-ray progression is 10 times greater than that in a patient without these markers. The paper considers the course of early RA depending on the combined determination of immunological and immunogenetic markers (SE and CCP antibodies). Each of them makes a substantial contribution to the development of a destructive process in early RA, which necessitates the assessment of a combination of the factors.