All articles - Cardiovascular System and Cardiology
Number of articles: 413
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Today, hypertension is considered by many authors within the framework of the manifestation of the metabolic syndrome. It has been established that in persons with hypertension in 60% of cases, various variants of MS are found. In addition, hypertension is a factor that reduces the quality of life of patients, especially those with comorbid pathology. Adipose tissue is an endocrine organ in which a large number of biologically active substances are produced: leptin, adiponectin, insulin antagonists, angiotensinogen, angiotensin I and II, angiotensin-converting enzyme, renin, etc. Hence, antihypertensive drugs used for the treatment of patients with MS or T2DM must meet the following requirements: effectively reduce blood pressure throughout the day, not adversely affect carbohydrate, lipid, and purine metabolism, have an organoprotective effect, and reduce the risk of cardiovascular complications. In recent years, scientists around the world have again returned to forgotten statins. And they discovered, in addition to the lipid-lowering effect, which affects the level of cholesterol and low-density lipoproteins, their pleiotropic effect. The pleiotropic effect of statins is the antifibrotic action of drugs. This is especially true for rosuvastatin. Currently, scientists from China and Russia have proven their effectiveness in the outcome of severe viral pneumonia caused by Сovid-19 or SARS-Cov-2 in obese patients with diabetes mellitus who took statins before pneumonia. -
FUNDAMENTALS OF RADIATION DIAGNOSTICS OF THE HEART AND LARGE VESSELS IN CHILDREN (REVIEW)Radiation diagnostics of the heart and large vessels in children are part of the general clinical examination of the patient. Its purpose is to establish a diagnosis of the disease, as well as determine the nature of hemodynamic disorders. The examination plan (algorithm) of children should be drawn up in such a way as to avoid excessive exposure. X-ray endovascular interventions include many other manipulations: scabbard, scabbard closure of uninhabited arterial duct Batalov and defect in the septum of the heart, scabbard embolectomy, scabbard removal of foreign bodies from the heart. This technique is used in chemotherapy to dissolve blood clots in the lumen of the vasodilatation thrombolysis. New endovascular manipulations are, first of all, the introduction of a special filter transcatheter method in the hollow and femoral veins to prevent thromboembolism of the branches of the pulmonary artery in varicose veins of the limbs, such as thrombophlebitis. Secondly, the introduction of a "memory" vessel into the endoprosthesis vessel and the use of a flexible light probe for laser destruction of atheromatous plaques and clots.
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PROSPECTS OF MODERN RESEARCH AND SUCCESS IN THE TREATMENT OF BRONCHIAL ASTHMA (REVIEW)In this article, the authors show the achievements of studies by genetic and pathogenetic methods in the treatment of bronchial asthma (BA) disease to date. However, despite the fact that there are several proposals and methods from researchers in the treatment of AD, the development and standardization of treatment for exacerbation of this disease with systemic glucocorticoids is still relevant. Literary data indicate that until now, the methods of treatment that are based on the sensitivity of lymphocytes to glucocorticosteroids (GCS) in AD have not been sufficiently studied. Therefore, the following studies may allow forming new approaches to the treatment of bronchial asthma with glucocorticosteroids.
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CHRONIC HEART FAILURE WITH PRESERVED AND INTERMEDIATE LEFT VENTRICULAR EJECTION FRACTION, WAYS OF ITS CORRECTION (REVIEW)Current HF therapy is mainly focused on an objective assessment of LVEF, which has been shown to be a predictor of poor outcomes even in the absence of symptomatic HF. Historically, patients with HF were divided into 2 groups depending on their LVEF: LVlEF and LViEF. This distinction was important in the treatment of HF because of the different demographic characteristics, etiology, and comorbidities between the two groups. Complex drug regimens, often present in heart failure with preserved ejection fraction, can exacerbate HF and increase the risk of adverse drug exposure and harm. One of the most important is the identification and correction of all factors and diseases that contribute to the onset and development of diastolic dysfunction, the emergence and progression of LVsEF and LViEF. These mainly include hypertension and LVH, coronary artery disease, constrictive lesions of the myocardium/pericardium, diabetes mellitus, obesity, and so on. categories of patients.
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MODERN VISUALIZATION METHODS IN DIAGNOSTICS OF MORPHO-FUNCTIONAL CHANGES OF THE MYOCARDIUM AND CORONARY ARTERIES (REVIEW)The most important task of health care is early detection and diagnosis, management, improvement of the system of cardiological and cardiac surgery care, increasing its efficiency and availability, especially in patients with suspected coronary artery disease. Despite the constant improvement of technologies for the diagnosis and treatment of CVD, coronary heart disease (CHD) remains the main cause of premature death and disability worldwide. At the present stage of the development of medicine, an important role in the early and timely diagnosis of diseases is played by methods of medical imaging, characterized by a minimum of adverse effects and contraindications, which make it possible to assess the degree of damage to the human body and its organs, and help in determining the tactics of treatment and the final result, the expected improvement in the prognosis of the disease. Early and timely diagnosis of CVD, in particular IHD, plays an important role in reducing the percentage of disability and mortality, in developing treatment tactics with further determination of indications for myocardial revascularization methods.
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CHARACTERISTIC OF SEVERE FORMS OF BRONCHIAL ASTHMA IN CHILDREN OF THE ANDIJAN REGIONTo study the characteristics of severe bronchial asthma, 140 children were examined. A survey, clinical, allergological and functional examinations were carried out. Studies have shown that in boys, asthma becomes severe earlier. Polyvalent sensitization to epidermal allergens and the presence of bronchial asthma in the mother of the child, severe asphyxia at birth are risk factors for severe asthma in children.
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DIFFERENTIAL DIAGNOSTICS OF NON-SPECIFIC INTERSTITIAL PNEUMONIAA retrospective analysis of case histories of 82 patients with nonspecific interstitial pneumonia, 24 patients with idiopathic pulmonary fibrosis, 8 with exogenous allergic alveolitis, 12 with systemic scleroderma and 6 with drug pneumonia was carried out in hospital treatment in the pulmonology department of the Samarkand city medical hospital in 2010-2019 years. It has been established that in the differential diagnosis of nonspecific interstitial pneumonia and other lung diseases, particular attention should be paid to the anamnesis, clinical presentation and CT signs.
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OUR EXPERIENCE IN TREATMENT OF PATIENTS WITH THERMO-INHALATION TRAUMAAccording to the literature, a combination of skin burns with respiratory tract lesions occurs in 30% of patients with flame burns and there is a clear tendency to its growth. An analysis was made of 205 patients with thermo-inhalation lesions who were treated from 2009 to 2019. Studies have shown that all patients with severe burn injury flame have shown emergency fibrobronchoscopy at the earliest possible date. Timely objective assessment of the severity of TIT and the possibility of developing tracheobronchial and pulmonary complications is an important component in the diagnosis and treatment of patients with thermal injury, and helps to predict the course of burn disease and prescribe adequate intensive care.
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THE CASES OF COMBINATION WITH ALLERGIC DISEASES AMONG A FAMILY WITH FAMILY-BRONCHIAL ASTHMAA retrospective analysis of the medical history was carried out in 49 families of patients with bronchial asthma who were hospitalized in the Department of Pulmonology and Allergology SamGMO in 2010-2012. The state of concomitant allergic diseases among individuals from families of patients with familial bronchial asthma was studied on the basis of anamnesis, clinical data, general laboratory tests, instrumental examination methods among 346 relatives of the first and fourth generations of the family. At the same time, it was noted that concomitant allergic diseases are risk factors for AD in healthy people in the family, and it is necessary to conduct primary and secondary prevention in a time.
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THE RISK FACTORS FOR CARDIOVASCULAR COMPLICATIONS IN PATIENTS WITH TYPE 2 DIABETES MELLITUSPurpose: to study the influence of risk factors on the development of cardiovascular complications in patients with diabetes mellitus and to evaluate the effectiveness of treatment depending on the effect of certain factors. Materials and methods. Westudied 23 patients with type 2 diabetes mellitus with chronic cardiovascular complications, who were prescribed long-term therapy for diabetes and cardiovascular complications. Patients were offered questionnaires with questions about the prescribed treatment, the actual treatment received and the reasons for the violation of the recommendations. Compared indicators of glycemia, blood pressure, weight in compliant and non-compliant patients. On the basis of the obtained objective and subjective facts, the factors influencing the development of cardiovascular complications in patients with type 2 diabetes mellitus were studied. The results of the study revealed that the most important factors affecting the development of cardiovascular complication s in patients with diabetes mellitus and the effectiveness of their treatment are as follows: fluctuations in glycemia, prandial glycemia, episodes of hypoglycemia, weight gain and increased blood pressure, as well as the patient's lack of information in assessing his glycemia, blood pressure and weight. Conclusions: despite the fact that the earliar protocols for the treatment of cardiovascular complications in patients with diabetes mellitus, based on evidence-basedmedicine, despite the fact that diabetes schools are organized, the effectiveness of treatment remains at a low level. It is necessary to take in to account the above factors affecting the therapy of diabetic cardiovascular complications, eliminate the mandraise the patient's awareness of type 2 diabetes.
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TO THE QUESTION OF THE COURSE OF PULMONARY TUBERCULOSIS WITH DISEASES OF THE CARDIOVASCULAR SYSTEMWith pulmonary tuberculosis, even in the early stages of the development of a specific process, changes in the cardiovascular system are noted. The high sensitivity of the vascular system to tuberculous intoxication has long been established. With the combination of active tuberculosis process with cardiovascular pathologies, great difficulties arise in connection with the need for a comprehensive antibacterial therapy for tuberculosis and the simultaneous treatment of concomitant diseases, including vascular pathology. The purpose of this article is to study the features of the course of cardiovascular lesions in patients with pulmonary tuberculosis during various periods of the disease. Of particular interest is the study of changes in the right and left parts of the heart in those cases when signs of hypertension are not detected on the basis of clinical, radiological and electrocardiographic studies. With the combination of active tuberculous process with cardiovascular pathology, great difficulties arise in connection with the need for complex antibacterial therapy for tuberculosis and the simultaneous treatment of concomitant diseases, including vascular pathology.
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FEATURES OF CLINICAL AND INSTRUMENTAL INDICATORS IN PATIENTS WITH MYOCARDIAL INFARCTION WITHOUT A WAVE AND WITH A WAVE QThe subject of our study was, first of all, a retrospective analysis of the course of the hospital period of IM without the Q wave. The patients were divided into 2 groups: Group 1 - 21 patients with IM without Q wave and Group 2 - 23 patients with IM without Q wave. The study results showed that patients with IB without Q wave should be included in the special control group for further personal approach. Patients with IM and wave Q had higher complication rate, so they had such complications as early postinfarction angina - 10 (43,7%) cases, rhythm and conduction disorders - 12 (52,1%) and 6 (26%). Therefore, along with high risk of repeated IM development and high probability of death, deterioration of basic clinical and laboratory instrumental parameters in the group of patients with IM without a wave Q was observed in 1/2, whereas the initial values of patients with IM without a wave Q did not deteriorate significantly.
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IMBALANCE OF THE NEURAL AND ENDOCRINE SYSTEMS IN RHEUMATOID ARTHRITISWith rheumatoid arthritis (RA), along with the main manifestations, there are a variety of neurological, neurotic and endocrine symptoms caused by immune effects. In addition, the chronic course of RA and the disability of patients leads to a violation of their usual way of life, a change in the circle of vital interests and the formation of neurotic disorders. Neurotic disorders are accompanied by a violation of the plasticity of the nervous system - its ability to regulate all structural and functional organizations and adaptation processes, which in turn leads to profound changes in immunological homeostasis, hormonal balance and all types of metabolism. In this regard, the frequency and severity of neurotic disorders (ND), as well as changes in adrenocorticotropic hormone (ACTH) and cortisol, were studied in 168 patients with rheumatoid arthritis. In 73.3% of patients with RA, ND were detected: in 16.2% - mild, in 31.4% - moderate and in 25.7% - severe. In patients with RA, instability of the functional activity of the system in the form of a decrease in the content of ACTH and cortisol was also noted. Weighting of neurotic symptoms leads to a decrease in the content of both hormones.
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ASSESSMENT OF DANGERS FOR CHILDREN AND ADOLESCENTS WHO ARE HOUSEHOLD CONTACT OF TUBERCULOSIS INFECTIONIn article is evaluated danger household contact of tuberculous infection in development of the disease of children and adolescents in Samarkand state antituberculosis dispensary. Often in family tuberculosis was ill the mother, in most cases noted contact with the mother. In general, children and adolescents are infected as result of contact with disseminated form tuberculosis patients. The risk of the development tuberculosis of children, increased if the source of infections was earlier in prison zone. The negative social factors are considered as the prognostic factor to epidemic tension. The danger of the disease tuberculosis increases of children and adolescents from household centre tuberculosis, in which mother or two members of families (the close relatives) seek with tuberculosis. The children have a high danger of the development of the disease and particularly need for observation and undertaking preventive sanitary action.
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АSSESMENT OF PRIMARY CARE PHYSICIAN ABOUT TOTAL CARDIOVASCULAR RISKIn practical medicine, the assessment of total cardiovascular risk (CVR) plays an important role in identifying a high-risk group among “asymptomatic” patients, that is, individuals without clinical manifestations of atherosclerosis. Currently, the most famous are the American Framingham Total Coronary Risk Scale, as well as the European SCORE (Systematic Coronary Risk Evaluation) scale, which predicts the 10-year fatal risk of all CVDs for European countries with low and high risk. The survey involved 66 doctors from various regions of Uzbekistan. In the course of questioning the participants, a high level of awareness of doctors was determined regarding the assessment of total CVR using the European SCORE scale. Only 10% of respondents do not use it in their practical work or are not familiar with it.
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SIGNIFICANCE OF SYSTOLIC AND DIASTOLIC DYSFUNCTION IN CIRRHOSIS OF THE LIVERIn clinical and instrumental examination of 98 patients with cirrhosis of the liver by means of Echo-CG in M-regimen, in 85% of cases damage to the heart was revealed. The basis of damage to the heart was presented by hypertrophy of the left ventricle and myocardial dystrophy that resulted in disturbance of contractive function, diastolic and systolic dysfunction. Damage to the heart in its turn contributed to the development of chronic cardiac insufficiency and increase of portal hypotension degree.
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ASSESSMENT OF SIGNS OF DIASTOLIC DYSFUNCTION OF THE RIGHT VENTRICLE IN PATIENTS WITH ARTERIAL HYPERTENSIONHypertension (HT) is currently one of the most pressing medical problems. This is largely due to the fact that arterial hypertension, which largely determines high cardiovascular morbidity, disability and mortality, is also characterized by a wide prevalence. In this regard, 71 HT patients were examined by us. All examined were subjected to a comprehensive examination in order to exclude symptomatic AH and other diseases. The diagnosis of HT was made on the basis of the criteria proposed by the WHO expert committee. The study included patients with stage II-III hypertension - 31 women (43.66%) and 40 men (56.3%) (aged 25 to 63 years). With the addition of cardiac insufficiency in patients at various stages of hypertension, a more severe pancreatic DD develops, in some cases a restrictive character.
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