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Biomedical subjects

N A Tomilina

Publications and source records attributed to N A Tomilina.

At least 19 recordsLinked to original sources
PubMed2006

[The peculiarities of bone exchange disorder and its regulation in men after long terms following orthotopic heart transplantation and cadaveric kidney transplantation].

The study found bone exchange disorder manifested by accelerated bone resorption, retarded bone formation, and the loss of the bone mineral density (BMD) of the axial and peripheral skeleton in 19 men (39 observations) 66 +/- 44 months following orthotopic heart transplantation (OTHT) and in 92 men 45 +/- 28 months after cadaveric kidney transplantation. An accelerated bone resorption, more pronounced in cadaveric kidney (CK) recipients, is associated with hyperparathyroidism (HPT) and renal dysfunction, while bone formation retardation is associated with a decrease in insulin-like growth factor-1 level. An increase in osteoprotegerin level is of compensatory character. The prominence of HPT depends on the degree of renal dysfunction; in CK recipients it also depends on the degree of the reduction in the levels of biologically active testosterone and estradiol. Reduction in BMD of the peripheral skeleton after OTHT are associated with the degree of renal dysfunction and a decrease in free testosterone index; after CK transplantation it is associated with HPT, the cumulative dose of glucocorticoids, reduction in the levels of biologically active testosterone and estradiol, as well as sex-hormone binding globulin (SHBG); reduction in spine BMD is only associated with SHBG.

Adult↗
PubMed2006

[Coronary artery disease after renal transplantation: epidemiology, risk factors, and surgical approaches to treatment].

Coronary artery disease (CAD) is the main cause of death in renal transplant recipients. The aim of the present study was to determine the frequency and risk factors of post-transplantation CAD and its influence on the long-term results of surgery, as well as to evaluate the efficiency of myocardial revascularization in patients with severe CAD. Analysis of the observation of 479 renal recipients (332 men and 147 women) aged 38.69 +/- 11.2 was performed. The mean follow-up period was 64.56 +/- 37.44 months. Sixty-eight patients had diabetes mellitus. CAD was diagnosed in 14.8% (71 out of 479) renal recipients; in 12.7% of patients it developed de novo and was revealed 32.4 +/- 18.6 months after the surgery. Ten-year survival of renal recipients with CAD was only 39%, while in the group of non-CAD patients it was 75% (p < 0.0001). Age more than 45, male gender, diabetes mellitus, hypercholesterolemia, infections, pre-existing left ventricular myocardial hypertrophy, and renal transplant dysfunction were defined as significant risk factors of CAD de novo. Multi-factor Cox model found only age more than 45 (p < 0.009), male gender (p < 0.00001), and hyperlipidemia (p < 0.0058) to be independent risk factors of CAD. Myocardial revascularization was performed in 29 patients with coronary lesions: 27 patients underwent percutaneous transluminal coronary angioplasty with stenting and 2 patients underwent coronary artery bypass grafting (5 and 52 months after renal transplantation). However, angioplasty had to be repeated in 6 out of 27 (22%) patients within 3 to 6 months. The average follow-up duration was 23 months (2 to 74 months) after revascularization. Prolonged effect (more than 12 months) was achieved in 17 out of 29 (58.6%) patients. None of the patients developed myocardial infarction after revascularization. Two patients died 28 and 35 months after angioplasty due to extracardial complications (hepatic cirrhosis and an oncological disease); one patient died 78 months after repeated revascularization from progressive cardiac insufficiency while receiving dialysis due to a relapse of renal transplant insufficiency. Thus, CAD develops in 14.8% of renal transplant recipients; in 12.7 of patients it develops de novo. There are conventional and nonconventional post-transplantation CAD risk factors, which include renal transplant dysfunction and post-transplantation infections. Association with myocardial hypertrophy, observed in a significant number of patients, is a feature of post-transplantation CAD. Coronary revascularization, angioplasty with stenting in particular, may be considered to be an effective method of CAD treatment in renal transplant recipients.

Adolescent↗
PubMed2004

[A renoprotective effect of enalapril in chronic transplantation nephropathy].

AIM: To study safety and efficacy of ACE inhibitor enalapril in chronic transplantation nephropathy (CTN) as well as nephroprotective efficacy of this drug in various clinical variants of CTN. MATERIAL AND METHODS: A retrospective study covered 220 recipients with CRF. The patients were divided into the study group (n = 103) and the control group (n = 117). The study group was given ACE inhibitor enalapril the efficacy of which was assessed by arterial pressure (systolic, diastolic, mean) dynamics, 24 h proteinuria and the rate of CTN progression. This rate was suggested by probability of plasm creatinin doubling (Kaplan-Meier technique). RESULTS: Enalapril significantly inhibited CTN progression running with minimal or marked proteinuria, had a pronounced hypotensive effect, promoted stabilization of minimal proteinuria (in CTN with minimal proteinuria) or reduction of protein excretion (in a proteinuric variant of CTN). CONCLUSION: Use of enalapril in CTN in a daily dose 10 mg maximum is safe and can be used for inhibition of CTN progression.

Adolescent↗
PubMed1990

[Half-body irradiation in the combined therapy of disseminated lymphomas].

Half-body irradiation at a single dose of 400-800 cGy was delivered to patients with disseminated fast-growing types of lymphomas and large aggregates of tumors and vital dysfunction of the body (the compression syndrome). Active detoxification therapy including heparinization, hemodilution with enforced diuresis and hemosorption was performed to prevent the syndrome of acute tumor lysis and postradiation complications. This treatment modality resulted in the elimination of clinical manifestations of the compression syndrome, normalization of the body homeostasis, a considerable reduction of the volume of tumor aggregates on a short-term basis, entering the patients into a curable state; the 5-year follow-up results were evaluated.

Adult↗
PubMed1988

[Functional status of the cardiovascular system in Hodgkin's disease and the effect of radiotherapy].

The main indices of cardiohemodynamics, phase structure of the cardiac cycle and ECG were studied in 34 patients with Hodgkin's disease aged 16 to 43: before the initiation of therapy, after a course of radiotherapy and in long term after therapy. The patients were characterized by tachycardia increasing with a degree of a process, ECG signs of myocardiodystrophy, a tendency to the formation of the phase syndrome of hypodynamia, slight pulmonary hypertension, a decrease in AP and peripheral vascular resistance. After a course of radiotherapy according to a radical program functional indices of the cardiovascular system in most of the patients returned to normal. However signs of radiation pericarditis with a favorable clinical course developed in some patients. Long after therapy positive changes in the cardiovascular system were noted among patients with IIA stage, negative shifts were noted in patients with III-IV stage.

Adolescent↗
PubMed1985

[Further study of the indications for combination cytostatic-anticoagulant-antiaggregation-corticosteroid therapy of chronic glomerulonephritis].

One hundred and twenty-five patients with different morphoclinical variants of chronic glomerulonephritis (CGN) were examined for the efficacy of cytostatic-anticoagulant-antiaggregation (CAA) therapy. The treatment appeared successful in 47 (37%) of patients. The efficacy largely depended on the degree and intensity of the disease clinical manifestations as well as on a dramatic increase in the permeability of the glomerular filter for medium- and high-molecular serum proteins and on superimposition of sclerotic transformation of renal glomeruli. The use of CAA therapy was most successful in GN whatever superimposition of fibroplastic transformation. The treatment was abortive in prolonged (more than 12 months) persistence of pronounced proteinuria combined with hematuria and/or arterial hypertension, in the nephrotic-hypertonic pattern of GN irrespective of the disease stage, in disease patterns manifesting themselves chiefly by hematuria and negligible proteinuria.

Adolescent↗