Purpose of the study: to study the effect of the combination of valsartan with sacubitril on myocardial remodeling in patients with coronary heart disease after revascularization. Material and research methods. The study included 320 patients with coronary artery disease who underwent coronary revascularization. On average, the concentration of creatinine was 90.08 ± 1.72 µmol / L. All patients were divided into 2 groups: patients who received valsartan (group B, 160 people), patients who received ARNI - a combination of valsartan and sacubitrile molecules (group C, 160 people). Also, all patients were divided into 2 subgroups depending on the degree of eGFR decrease by the 3rd month of observation: patients with a decrease in eGFR by the 3rd month of observation more than 20% (group 1 - 59 patients) and less than 20% (group 2 - 261 sick). In dynamics, three months later, at the end of the first and second years of follow-up after revascularization, all patients underwent an echocardiographic study (EchoCG). Research results. During the observation process, it was found that against the background of both therapy options, there was a positive dynamics of indicators characterizing myocardial remodeling. he relative dynamics of indicators between the treatment groups was comparable at all stages of observation. In the group of patients with a decrease in eGFR of more than 20% in the first 3 months against the background of standard therapy after revascularization, no significant dynamics of the geometric parameters of the heart was observed at all follow-up periods. In the group of patients who received standard therapy with the addition of sacubitrile, both in group 1 and in group 2, more favorable geometric parameters were achieved, demonstrating a decrease in the severity of pathological remodeling and the formation of CHF. Conclusion. The use of sacubitril in the treatment of patients with coronary artery disease contributes to a more pronounced positive remodeling of the heart chambers - a decrease in the size of the chambers and the LV sphericity index. The effect is more pronounced in patients with a tendency to rapidly develop CKD.
Соблюдение принципов антибактериальной терапии поможет врачам эффективно и безопасно применять антибактериальные препараты, снизить развитие резистентности микробов к антибактериальным препаратам.
Актуальность исследования: Фотодинамическая терапия (ФДТ) - один из новейших методов лечения воспалительных заболеваний, вызванных теми или иными инфекциями или хроническим воспалением, с успехом применяется в ряде европейских стран с 1999 года. Лечение заключается в обработке патогенных зон лазером с предварительным нанесением фотосенсибилизатора. После лазерного воздействия образуется фотокоагуляционная пленка, предохраняющая от повторного проникновения микробов.
Оптимизация подходов в диагностике и терапии коронавирусной инфекции, вызванной COVID- 19. Для осуществления поставленной цели были проанализированы результаты лечения 50 больных с коронавирусной инфекцией, вызванной COVID-19. Все больные были разделены на группы: 1 группа - больные с коронавирусной инфекцией с подтвержденным положительным ПЦР тестом, леченных ивермектином в дозировке 300 мг массы тела (n=12), 2 группа - больные с коронавирусной инфекцией леченные байкалином в дозировке 500 мг (n=14), 3 группа - больные с коронавирусной инфекцией, леченные молнупиравиром 25 мг/кг массы тела, 4 группа - больные с коронавирусной инфекцией леченные новым препаратом на основе G. Lucidum и Алхадая.
The article deals with the study effective and safe use NAID (non-steroidal and anti-inflammatory drugs at patients’ treatment). The rational use NAID will help to guarantee the safety of pharmacotherapy.
В областном противотуберкулезном диспансере Хорезмской области г. Ургенча в детском отделении мы применили метод Арт терапии для лечения больных детей туберкулезом. В данной представленной статье рассматривается арт-терапия как одно из направлений современной психотерапии во взаимосвязи с возможностями ее применения в педиатрической практике. Подробно описаны виды арт-терапии — рисование, музыкотерапия. Также рассмотрены главные механизмы лечебного воздействия, особенности проведения сеансов в зависимости от формы музыкотерапии, рисования. Нами указаны основные сферы применения в педиатрической практике.
Purpose of the study: to study the effect of the combination of valsartan and sacubitril on the indices of central hemodynamics in patients with coronary heart disease (CHD) within 2 years after revascularization. Material and research methods. The study included 320 patients with coronary artery disease who underwent coronary revascularization. All patients were divided into 2 groups: patients who received valsartan (group B, 160 people), patients who received ARNI - a combination of valsartan and sacubitrile molecules (group C, 160 people). At baseline and in dynamics after three months, at the end of the first and second years of follow-up after revascularization in patients with coronary artery disease systolic the blood pressure (SBP, mm Hg), diastolic blood pressure (DBP, mm Hg), heart rate in minute, the concentration of brain natriuretic peptide (BNP) in the blood were determined. Also, during echocardiography, the stroke volume of the heart, indexed to the body surface area (SI, ml / m2), the minute index (MI, ml / m2), the mean pressure in the pulmonary artery (PA, mm Hg) were determined. Research results. In the group of patients taking valsartan (group B), the relative dynamics of BNP concentration was -10.69 ± 0.55% by the 3rd month of observation, -21.24 ± 1.03% by the end of the 1st year, and -34, 39 ± 1.64% by the end of the 2nd year of observation. The inclusion of sacubitril in the therapy scheme contributed to a greater positive effect in reducing the BNP concentration: the relative dynamics of the BNP concentration was -10.30 ± 0.52% by the 3rd month of observation, - 21.91 ± 1.00% by the end of the first year of observation, and -39.28 ± 1.67% (p <0.05 significant difference with group B). By the end of the 1st and 2nd years of observation, the use of a combination of valsartan and sacubitril contributed to a more pronounced decrease in blood pressure (p <0.01), a more pronounced dynamics of MI (p <0.05) and a decrease in pressure in РA (significantly lower baseline indicators, p <0.05 and indicator in group B, p <0.01). Conclusion. The present study revealed a positive effect of revascularization and subsequent therapy of coronary artery disease with the inclusion of sacubitrile on the BNP concentration, blood pressure and mean pressure of pulmonary artery.