Saratov JOURNAL of Medical and Scientific Research

comorbidity

Gender peculiarities of cardiovascular pathology in patients with chronic obstructive pulmonary disease

Year: 2019, volume 15 Issue: №1 Pages: 28-33
Heading: Internal Diseases Article type: Original article
Authors: Ryabova A.Yu., Kozlova I.V., Shapovalova T.G., Shashina M.M., Veselov V.V., Zemlyanskaya O.V.
Organization: Saratov State Medical University
Summary:

Purpuse: to research the gender-specific features of cardiovascular disease in the group of patients with chronic obstructive pulmonary disease (COPD). Material and Methods. We conducted a cross-sectional retrospective research of 419 patients hospitalized with exacerbation of COPD to the Pulmonology Department of Saratov Clinical Hospital №8 from 2015 to 2017 By the method of independent target sample, taking into account gender and multimorbidity 169 patients with COPD and cardiovascular disease were included into the research. Results. Relation between the nosological forms and the frequency of occurrence of cardiovascular pathology in the group of patients with COPD is gender- dependent. Gender features of heart remodeling in the group of patients with COPD and cardiovascular pathology are revealed. Women have more therapy adherence. Conclusion. The data that we obtained indicate the characteristics of the formation and course of the cardiovascular pathology in patients with COPD gender-dependent. Research of the features determines the optimal tactics of treatment, improves the prognosis and quality of life of co-morbid patients.

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The role of polymorphism of the genes COL1A1, MMP12, EPHX1 in osteoarthritis and cardiovascular comorbidity

Year: 2018, volume 14 Issue: №3 Pages: 373-379
Heading: Internal Diseases Article type: Original article
Authors: Kabalyk M.A., Nevzorova V.A., Sunyaykin А.В.
Organization: Pacific State Medical University
Summary:

Aim: to analyze polymorphic variants of genes of connective tissue remodeling, biotransformation and their role in the development of cardiovascular comorbidity and osteoarthritis (OA). Material and Methods. The study included 70 patients with OA. As a control group, 30 patients without OA of comparable sex and age were included in the study. All patients were assessed total (absolute) cardiovascular risk according to the SCORE scale. The pain was assessed by visual analog pain scale. The physical dysfunction was assessed on a WOMAC scale. Single-nucleotide polymorphisms of the genes COL1A1 (rs1107946), EPHX1 (rs1051740), MMP12 (rs652438) were studied by PCR-RT. Results. In patients with OA, there is a twofold increase in the frequency of the heterozygous genotype of the GT gene COL1A1. The presence of the T allele of the COL1A1 gene is a risk factor for the development of OA. Patients with OA have a fourfold increase in the frequency of genotype AG of the MMP12 gene. The patients with severe pain significantly present the difference in the distribution of allele frequencies of the polymorphic locus G1997T of the COL1A1 gene from the control sample. The frequencies of heterozygous genotypes COL1A1 and MMP12 differed significantly in patients with different cardiovascular risk. Conclusion. The results partially confirm the integration theory of the pathogenesis of OA, suggest the existence of general mechanisms of connective tissue remodeling.

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Norm and disease. Monomorbidity, comorbidity and methodology for their diagnostics

Year: 2018, volume 14 Issue: №2 Pages: 209-216
Heading: Internal Diseases Article type: Review
Authors: Kats Y.A., Parkhoniuk E.V., Skriptsova S.A.
Organization: Saratov State Medical University
Summary:

The absence of a single classification and generally accepted terminology of comorbidity leads to a different understanding of the issues of diagnosis of comorbidity. Comorbidity is a complex system in which the patient is both an integral object and part of this system, which includes diseases complexes. As it is known, the success of solving diagnostic problems, especially in the presence of comorbidity ultimately determines the consistency and validity of the findings, and, consequently, the effectiveness of the diagnosis as a whole. Previously, we proposed an integrative method which, preserving the system approach and the method of comparison, suggests using the sum of data from genetic, constitutional, immunological, anthropological and other types of examination to obtain the most complete representation not only of the nature of the disease, but, first of all, the patient himself. Proceeding from the foregoing, the present review focuses not only on the features of compiling a "patient diagnosis" in the presence of comorbidity but also on the sequence in which the pathological conditions should be considered and reflected in the main diagnosis in the presence of several active processes.

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Pharmacoeconomic analysis of treatment of rheumatoid arthritis of the early stage and the most frequent comorbide conditions

Year: 2017, volume 13 Issue: №3 Pages: 462-468
Heading: Parmacology Article type: Original article
Authors: Okonenko T.l., Khrutsky А.К., Okonenko L.B., Egorova E.S.
Organization: Yaroslav-the-Wise Novgorod State University
Summary:

Objective: to define the regional structure of comorbid conditions of early rheumatoid arthritis (RA) and the cost of treatment. Material and Methods. Medical records of 100 patients with RA hospitalized in Velikiy Novgorod in 2010 and 2014 were analyzed. Range of drugs, used by doctors in the early stage of RA were considered, and and drugs were systematized. Pharmaceutical and economic analysis of medical records was conducted. Statistical data processing was executed using MS Excel. Results. A wide distribution of comorbid conditions in patients with early state of rheumatoid arthritis was established, the structure of concomitant pathology was determined. All the prescribed drugs and preparations with a frequency of more than 3% are allocated. The average cost for each drug use has been calculated, an ABC-analysis has been performed. Conclusion. Comparison of medical appointments and regulatory lists revealed that the standard is not fully observed. At an early stage of RA a high percentage of patients with comorbid conditions was noted (85.7-93.3%), predominantly cardiovascular, gastrointestinal, thyroid diseases. Cost of treatment of RA at an early stage and the most frequent comorbid status in 2014 has increased in comparison with 2010, the range of drugs in 2014 has decreased by 32%. The results of ABC-analysis of medicinal appointments revealed qualitative and quantitative changes in the major positions of the drugs.

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On the guestion of comorbidity in psoriasis

Year: 2014, volume 10 Issue: №3 Pages: 537-539
Heading: Skin Diseases Article type: Short message
Authors: Bakulev A.L., Shtoda U.М., Utz S.R.
Organization: Saratov State Medical University
Summary:

Goal: analysis of comorbidity in patients with various forms of psoriasis. Material and methods. The study involved 105 patients with various forms of psoriasis. Comorbidities were established on the basis of medical history, clinical findings, laboratory tests and consultation with other specialists. Results. Among the most common comorbidities in psoriasis encountered pathology of the cardiovascular system, gastrointestinal tract, endocrinopathy, metabolic syndrome, psoriatic arthritis and depressive disorders. Conclusion. In most patients, psoriasis is combined with certain comorbid conditions that must be considered when choosing the tactics of treatment

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