Saratov JOURNAL of Medical and Scientific Research

Rebrov A.P.

Saratov State Medical University, Head of Department of Hospital Therapy of Therapeutic Faculty, Professor, Doctor of Medical Science

The history of the hospital therapy department of the medical faculty in Saratov state medical university

Year: 2018, volume 14 Issue: №1 Pages: 109-111
Heading: Scientific schools and memorable dates Article type: Short message
Authors: Yudanova L.S., Rebrov А.Р.
Organization: Saratov State Medical University
Summary:

 The article represents the history of the first Department of Therapy at the University founded in September 1911 and describes the stages of its development.

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Changes in vascular wall stiffness and central aortic pressure in women of early post-menopausal period and the possibilities of correction of the revealed disturbances

Year: 2017, volume 13 Issue: №1 Pages: 034-041
Heading: Internal Diseases Article type: Original article
Authors: Tolstov S.N., Salov I.A., Rebrov A.P.
Organization: Saratov State Medical University
Summary:

Measurement of the central aortic pressure and the augmentation may have additional benefits for characterizing the state of the cardiovascular system than the only stiffness of the vascular wall. The purpose of the study is to assess the changes of indicators of central aortic pressure and arterial stiffness in women of early postmenopausal period, against the background of the prolonged use of menopausal hormone therapy 1 mg E2 / 2mg DRSP. Material and Methods. The study included 162 women in early postmenopause. The subjects were divided into 2 groups: primary — 84 patients, which was appointed menopausal hormone therapy 1 mg E2 / 2mg of DRSP (drug "Angelique", Bayer), control group — 78 women who did not receive menopausal hormone therapy. The duration of observation is 5.2 years. ABPM was performed with the evaluation indicators of arterial stiffness (RWTT, Alx, ASI, AASI, (dP/dt) max.), central aortic pressure, aoPW. Results. Initial aoPW increase was detected in 15 (21.4%) women of the main group and in 19 (24.3%) control group patients (p=0,4). The women in both groups showed an increase to the end of the study aoPW more pronounced in women of control group. Increasing falls detected in 25 (29.7%) women of the main group and in 25 (32%) women of control group (p=0.84). It was noted that in women in both groups a significant decrease of central aortic pressure has been matched. In women of the main group to the end of the study there was a reduction in pulse pressure from 38,4±6,2 to 35,3±4,19mm Hg (p<0,001) and the absence of changes in women drops the control group. It is noted a significant increase of Alxao in patients of control group and no change in women of the main group. ASI revealed a decrease in women of the main group with 132.0 (121.0; 142.0) to 127.0 (115.5; 137.0) to the end of the study, and an increase from 133.0 (111.0; 155.0) to 148.0 (134.2; 171.0) in women in the control group (p<0.01). Decrease of AASI in women of the main group to 0.379 (0.320; 0.463) to 0.264 (0.203; 0.329), (p<0.001)and no change in the control group of women has been detected. Conclusion. The measurement of the central aortic pressure and the augmentation may have additional benefits for characterizing the state of the cardiovascular system. The positive changes in arterial stiffness and reflected waves, determining the value of central aortic pressure, on the background of long-term menopausal hormone therapy combined 1 mg E2 / 2 mg DRSP.

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The teaching continuity of basic and clinical disciplines in the study of internal diseases

Year: 2016, volume 12 Issue: №3 Pages: 415-417
Heading: Pedagogics and Education Article type: Author's opinion
Authors: Ponomareva E.Yu., Rebrov А.Р., Afanasyeva G.A.
Organization: Saratov State Medical University
Summary:

The article discusses the succession of teaching of basic and clinical (therapeutic) disciplines in higher medical school: the urgency and necessity of interdisciplinary cooperation, its form, expected results, existing obstacles and ways to overcome them. The experience cathedral groups in the implementation of the process and prospects of further interdisciplinary cooperation in teaching basic science education and internal medicine.

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Olympiad in Internal medicine: the significance for professional training of students and residents

Year: 2016, volume 12 Issue: №2 Pages: 210-212
Heading: Pedagogics and Education Article type: Short message
Authors: Ponomareva E.Yu., Lobanova O.S., Roshchina A.A., Rebrov A.P.
Organization: Saratov State Medical University
Summary:

The article describes the experience of the organization of Olympiad in Internal medicine at the medical university for senior students and clinical residents. The paper presents the possibility of Olympiad in Internal medicine at the medical university is a modern educational technology that increases interest to the disciplines and motivation to professional development and formation of professional competencies. Such type of Olympiad helps future therapeutics to improve in their specialty and to form a personal reserve for the future work in the medical and research team, promotes continuity between students and postgraduate trainers in higher professional medical education.

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. Chronic kidney disease in patients with chronic back pain taking non-steroidal anti-inflammatory drugs

Year: 2016, volume 12 Issue: №1 Pages: 40-44
Heading: Internal Diseases Article type: Original article
Authors: Gaydukova I.Z., Rebrov А.Р., Lebedinskaya О.А., Polyanskaya O.L., Patrikeeva D.A., Aparkina A.V.
Organization: Saratov State Medical University
Summary:

The aim of the study was to evaluate the incidence of chronic kidney disease (CKD) in patients with chronic back pain and nonsteroidal anti-inflammatory drugs (NSAIDs) intake not less than a year, and to study the interrelation between CKD, peculiarities of pain and its treatment. Material and Methods. 91 patients with axial spondyloarthri-tis — ax-SpA(ankylosing spondylitis and non-radiographic ax-SpA) and 35 patients with degenerative diseases of the spine (DDS) with NSADs intake not less than 1 year were involved in the study. The control group included healthy volunteers who did not took NSAIDs during the last year (n=51). By age, gender, factors of cardiovascular risk, GFR
in patients with ax-SpA, DDS and controls were comparable. The activity of pain was evaluated according to the accepted recommendations. The index of NSAID intake as calculated for the preceding year. Results. GFR in patients with ax-SpAwas 87,0 [77,25; 102,0] ml/min/1,73 m2, 11 (18%) patients showed a reduction in GFR of less than 60 ml/ min/1,73m2. In patients with DDS GFR was 87,5 [65,5; 97,0] ml/min / 1,73 m 2 (p=0,27), decreased GFR of less than 60 ml/min / 1,73 m2 was detected in 3 (15%) patients. The ratio of albumin / creatinine urine in patients with ax-SpA was 35,8 [25,46; 43,4] mg/g, in patients DDS —207,1 [91,66; 244,59] mg/g (p

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Relationship of daily arterial blood pressure monitoring readings and arterial stiffness profile in male patients with chronic obstructive pulmonary disease combined with arterial hypertension

Year: 2013, volume 9 Issue: №2 Pages: 247-252
Heading: Internal Diseases Article type: Original article
Authors: Karoli N.A., Dolishnyaya G.R., Borodkin A.M., Rebrov A.P.
Organization: Saratov State Medical University
Summary:

The aim of the study was to determine correlation between arterial blood pressure daily rhythm and daily profile of arterial stiffness in male patients with chronic obstructive pulmonary disease (COPD) and arterial hypertension. Materials et methods: Prospective investigation comprised 45 male patients with COPD and arterial hypertension. Individuals of 40 years younger and 80 years elder, patients with diabetes, stroke, angina pectoris, or heart infarction, vascular diseases, and exacerbation of chronic disease, bronchial and pulmonary diseases of other etiology were excluded from the analyses. Comparison group included 47 patients with essential arterial hypertension and without chronic respiratory diseases closely similar on general parameters with patients from main clinical series. Twenty-four-hour arterial blood pressure monitoring (ABPM) and daily arterial stiffness monitoring were performed using BPLab® MnSDP-2 apparatus (Petr Telegin, Russian Federation). Results: Patients with COPD combined with arterial hypertension with raised arterial stiffness measures prevail over individuals in essential hypertension group. There is pathological alteration of the ABPM circadian rhythm and raised «Pressure load» values in raised arterial stiffness group. Conclusion: We found ABPM raised parameters in patients with COPD and arterial hypertension. It confirms necessity of ABPM in daily arterial stiffness assessment in patients with COPD.

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Pancreatogenic diabetes mellitus: actual problems of pathogenesis and treatment

Year: 2012, volume 8 Issue: №3 Pages: 862-867
Heading: Endocrinology Article type: Review
Authors: Rebrov А.P., Kunitsyna М.А., Kashkina E.I., Arkhangelskaya Е.Е.
Organization: Saratov State Medical University
Summary:

We have presented the review of literature devoted to the problem of pancreatogenic diabetes mellitus. We have found up that prevalence of pancreatogenic diabetes mellitus needs to be adjusted. In analyzed literature the influence of localization of structural changes of pancreatic tissue on risk of diabetes mellitus development is studied insufficiently. In the result of our literature analysis we have detected that treatment of pancreatogenic diabetes mellitus up to date is not unified and is mostly descriptive, what indicates on necessity of further investigations in order to optimize and increase the efficacy of its treatment.

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Arterial wall rigidity in active and standard therapy of patients with chronic heart failure (three-year investigation)

Year: 2012, volume 8 Issue: №1 Pages: 067-072
Heading: Internal Diseases Article type: Original article
Authors: Rebrov A.P., Kosheleva N.A.
Organization: Saratov State Medical University
Summary:

Aim: to evaluate arterial wall rigidity, clinical condition and prognosis in active and standard therapy of patients with chronic heart failure (CHF). Materials and methods. A total of 211 patients with CHF experienced Q-wave myocardial infarction was enrolled in the study. At admission to the hospital all patients were randomized into two groups. Patients of the first group (n=106) were managed actively after discharge from the hospital, patients of the second group (n=105) were managed conventionally after discharge from the hospital. Patients were observed for three years. Re-sults. Over three year-investigation actively managed patients demonstrated significant (p

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Features of endothelial dysfunction changes at patients with systemic lupus erythematosus on a background of various therapy// Saratov Journal of Medical Scientific Research

Year: 2011, volume 7 Issue: №4 Pages: 822-827
Heading: Internal Diseases Article type: Original article
Authors: Nam I.F., Rebrov А.Р.
Organization: Saratov State Medical University, Saratov Regional Clinical Hospital
Summary:

Aim. To investigated endothelial dysfunction in patients with systemic lupus erythematosus (SLE), depending on different activity, duration of disease and different type of therapy. Methods. We examined 77 patients with SLE during 1 year. We administered puls therapy with high dose glucocorticoids and cyclophosphamide in the 33 patients. 44 patients were given low dose steroids orally or hydroxychloroquine. We investigated the number of circulating endothelial cells in peripheral blood. Vasoactive function was assessed in reactive hyperemia test, antitrombogenic function with short-lived ischemia was examined. Results. Patients with SLE demonstrated endothelial damage, its antitrombogenic and vasodilatation function was reduced especially in high activity of disease. Pulse therapy improved endothelial function after 12-month treatment periods. The activity of the SLE decreased what was associated with reduced endothelial damage. Also vasodilatation function improved, but anticoagulant activity was without changes. Conclusion. It is necessary to administer pulse therapy according to the right indication despite potential danger of steroids and cyclophosphamide on endothelial function. Probably pulse therapy should be used with vasoprotective drugs in order to improve anticoagulant function

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Correlation of predictors of life quality prognosis of patients with coronary heart disease

Year: 2011, volume 7 Issue: №2 Pages: 426-429
Heading: Internal Diseases Article type: Author's opinion
Authors: Osipov D.A., Rozhdestvenskaya T.V., Krom I.L., Rebrov A.P.
Organization: Saratov State Medical University, Saratov Institute of Social Education, Head of Centre of Medical and Social Research
Summary:

The article presents the research results on the role of leading clinical predictors in follow-up prognosis for patients with ischemic heart disease. The inefficiency of socialization in a non-terminal condition is formed by means of insufficiency of somatic, psychological and social resources in patients. Thus clinical predictors have no significant value

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