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Biomedical subjects

S B Shustov

Publications and source records attributed to S B Shustov.

At least 19 recordsLinked to original sources

[Diabetes mellitus in elderly: comorbid characteristics of patients with different ontogenetic forms of the disease].

Diabetes in elderly is the interdisciplinary problem of diabetology and gerontology. Unlike adults the specific feature of these patients is comorbidities. On the other hand well known is the influence both age and aging on clinical sings of diabetes. The aim of the study was to investigate prevalence and structure comorbid chronic diseases in elderly patients with different ontogenetic forms of diabetes mellitus type 2 (DM2). We examined 169 elderly women with clinical diagnosis "DM2" (mean age--69.8 yrs., mean BMI--29.5 kg/m2, mean HbA1c--7.03%). The stratification was made by ontogenetic stage of diabetes onset and there were five ontogenetic forms of DM2: menstrual (Ms), early-postmenopausal (EPM), late-postmenopausal (LPM), early-involutional (EI) and late-involutional (LI). Anthropometrical, biochemical and immunochemical assays (HbA1c) were made by standard methods. Gognitive index (CGI) and affective index (AFI) were calculated by SCAG scale as mentalmnestic and affective disturbances accordingly. Comorbid index (CI) was calculated as a sum of concomitant diseases. The most comorbid serious was the early-postmenopausal group (CI--6.04 +/- 0.5), mainly by hypertension (92%) coronary heart disease (80%) and osteoarthritis (80%). The lightest comorbid status was in the late-involutional group (CI--4.5 +/- 0.3), with the minimum of gastroenterological diseases (39.5%), kidney diseases (26.3%), thyroid disorders (23.7%) and exclusively the group had valid negative relationship between age and CI (r = -0.550, p = 0.000). As a whole in the elderly diabetic cohort the magnitude of CI correlated positively with BMI (r = +0.344, p = 0.000), frequency of family diabetes (r = +0.204, p = 0.009), AFI (r = +0.161, p = 0.040), menarche (r = +0.175, p = 0.025) and no significantly with CGI (p > 0.05). Thus early ontogenetic forms of DM2 had more comorbidities, especially those with onset DM2 during first 5 years after menopause. And on the contrary, the latest ontogenetic forms with onset DM2 during 20 years after menopause had minimum concomitant diseases. Also early ontogenetic phase (EPM and El) groups had higher magnitudes of CI, frequency of family diabetes and low frequency of familial longevity than late ontogenetic phase (LPM and LI) groups, which allow us to consider early ontogenetic phase DM2 as a phenomena of accelerated aging.

Age of Onset↗

[Clinical genetic determinants of carbohydrate metabolism disturbances in patients with hypertension and excessive weight].

AIM: To elucidate associations of polymorphic markers of PPAR, PPARG2, IRS1, IRS2 genes with disturbances of carbohydrate metabolism in patients with hypertension and excessive weight. MATERIAL: Patients (n=145, 53 men and 92 women, age 40-75 years) with untreated stage 1 hypertension (systolic BP 140-159 and diastolic BP <100 mm Hg) and excessive weight or obesity (body mass index >27 kg/m(2)) were divided into 2 groups: with (group 1, n=124) and without (group II, n=21) disturbances of carbohydrate metabolism. Group I comprised patients with insulin resistance, abnormal fasting blood glucose or glucose tolerance, type 2 diabetes. Results of oral glucose tolerance test were normal in 25 and abnormal in 99 of these patients. RESULTS: Carriers of Pro allele compared with carriers of Ala allele of PPARG2 gene had higher frequency of insulin resistance. No association was found between insulin resistance and alleles and genotypes of PPAR, IRS1, and IRS2 genes. There was an association between diastolic BP and polymorphic markers Pro12Ala of PPARG2 gene and C24313G of PPARA gene. Carriers of C allele of PPARA gene and Ala allele of PPARG2 gene had higher diastolic BP. No association was found between systolic BP and alleles and genotypes of polymorphic markers of PPARG2 and PPARA genes.

Adult↗

[The light diffusion technique for estimation of the size of urine particles in patients with type 2 diabetes mellitus in the Tamm-Horsfall protein precipitation].

Tamm-Horsfall uroprotein accounts for more than 50% of the urinary proteins in healthy individuals. In abnormalities, it creates a favorable background for detecting smaller-sized uroproteins and for diagnosing pathological processes from the results of native urine tests. In this connection, there is a need for precipitating Tamm-Horsfall glycoprotein while applying laser correlation spectroscopy to analyze the size of urine particles in patients with type 2 diabetes mellitus. Eighty patients with this condition concurrent with different stages of diabetic nephropathy and 23 apparently healthy individuals were examined. The findings suggest that the subfraction urine composition before and after Tamm-Horsfall protein precipitation is different in apparently healthy individuals and patients with type 2 diabetes mellitus concurrent with diabetic nephropathy. This is most likely to be due to the change in the qualitative composition of protein as renal lesion progresses, to the specific features of protein excretion at different stages of a pathological process, and to different concentrations of other low and high molecular-weight proteins.

Adult↗

[Significance of pharmacological blockade of angiotensin II type I receptors for correction of abnormal 24-hour blood pressure profile depending on its variability in patients with arterial hypertension stage II].

AIM: To specify variable 24-h arterial hypertension (AH) stage II profile and to assess significance of pharmacological block of the end of the renin-angiotensin-aldosteron system for correction of the determined disorders. MATERIAL AND METHODS: The study was made of 46 men (mean age 42.8 +/- 3.28 years) with stage II AH and 25 normotensive controls (mean age 39.2 +/- 3.10 years). Depending on the magnitude of mean 24-h AP variability (APV), hypertensive patients were divided into two groups. Variability of systolic and/or diastolic AP (SAPV and DAPV, respectively) was considered high in at least 15.2 and/or 12.3 mm Hg variability, respectively, and normal at less values. RESULTS: AP 24-h profile in men with AH stage II and high APV compared to patients with normal APV is characterized by higher frequency of AP rise and less frequency of its night fall. In patients with high APV the drug eprosartan (teveten) is more effective in correction of hypertension and night fall of AP. CONCLUSION: Eprosartan has an adequate corrective activity in relation to absolute values of SAP and DAP in different hours. The highest hypotensive activity of the drug was seen in persons with initially high circadian AP variability within 24 hours.

Acrylates↗

[Aspects of hemodynamics in thyroid dysfunction].

Quantitative electrocardiography, echocardiography and variation pulsometry were used in examination of 231 patients with thyroid dysfunction of various degree. Changes in the central and pulmonary hemodynamics, clinical course, ECG depended on thyroid and thyrotropic blood activity, sympathetic and parasympathetic components of autonomic nervous system. Thyrotoxicosis patients had hemodynamic disorders of the greater and lesser circulation, hypothyroidism patients had only the former.

Adult↗

[Circadian variability of cardiac arrhythmias in patients with cardiovascular diseases].

A total of 1063 results of Holter monitoring in patients with cardiovascular diseases were analyzed. There were regularities in the circadian rhythm of arrhythmias with their decreased values at night and increased ones in the daytime, and peak in the morning. The profile of rhythm depends on the pattern of arrhythmia and cardiac disease. The main oscillators are as follows: sleep-awakening, activity-rest patterns, circadian variations in the sympathetic tone, severity of disease, diurnal variations in myocardial oxygen demand, blood pressure, cardiosclerosis. Conduction disturbances were increased during sleep and early in the morning. Thus, the main unfavourable period in arrhythmia disturbances are early morning, pre- and postawakening periods.

Adult↗

[Reclid effects on carbohydrate, lipid metabolism, lipid peroxidation and hemodynamics in patients with diabetes mellitus type 2].

Patients with diabetes mellitus type II have disorders in carbohydrate, lipid and other kinds of metabolism. This increases the risk of cardiovascular complications and atherogenesis. Therefore, it is advisable to use drugs preventing an excessive late phase of insulin secretion with resultant reduction of hyperinsulinemia. Reclid, the drug of this group, improves metabolic processes, insulin resistance, lipid metabolism, hemostasis and microcirculation. 3-month reclid therapy of patients with non-insulin-dependent diabetes mellitus produced a good hypoglycemic effect in 85% of the cases. This effect consisted in reduction of basal and postprandial glycemia, levels of glycosylated hemoglobin, 24-h glucosuria. In patients with diabetes mellitus type II reclid diminished the levels of total cholesterol, triglycerides, glycosylated hemoglobin. In patients with left ventricular diastolic dysfunction, reclid improved transmitral blood flow. Thus, reclid provides a good metabolic control in patients with non-insulin-dependent diabetes mellitus. Moreover, it positively affects mechanisms initiating cardiovascular complications in diabetic patients.

Carbohydrates↗

[Standardization of pharmacotherapy of hypertensive disease].

The consumption of the antihypertensive means in Russia and abroad is analyzed, the efficiency and the cost of the recommended circuits of treatment of hypertonic heart disease are investigated and appreciated, taking into account the international researches. The list of medicines, offered as the standard of pharmacotherapy and for supply of military-medical establishments in peace time is made. The offered spectrum of preparations made by a domestic industry permits to ensure effective and inexpensive treatment of blood hypertension according to circuits existing for a today's day.

Drug Therapy↗

[Epithalamin effects on carbohydrate metabolism and cardiovascular system in patients with non-insulin dependent diabetes mellitus].

Epithelamine made in Russia (Samson, St. Petersburg) was tried for effects on carbohydrate metabolism and cardiovascular system in 33 patients with non-insulin-dependent diabetes mellitus (NIDDM). Adjuvant use of epithelamine in combined treatment of NIDDM promoted a stable compensation of carbohydrate metabolism, lowering of glycosylated hemoglobin, immunoreactive insulin. There was also a moderate hypotensive effect and improvement of left ventricular diastolic function.

Antineoplastic Agents↗

Controlled clinical trial on the efficacy and safety of oral sulodexide in patients with peripheral occlusive arterial disease.

One hundred and seven adult outpatients with Leriche stage II peripheral occlusive arterial disease took part in this open, controlled trial. Patients were randomly treated over a six-month period either with sulodexide capsules containing 250 lipoproteinlipase releasing units (LRU, two capsules twice daily for 176 days on average: 56 patients), or with pentoxifylline 400 mg tablets (one tablet three times a day for 180 days on average: 51 patients). The incidences of diabetes, hyperlipoproteinaemias, smoking habit and other risk factors were the same in the two groups. The drugs' efficacies were evaluated by monitoring, at the start of treatment and every month during it, the Winsor Index and the walking distance, both prior to (initial claudication distance-IDC) and after (absolute claudication distance-ACD) the symptom's onset. Compliance with treatment and occurrence of adverse events were constantly monitored; systemic tolerability was evaluated through the use of routine haematological and haematochemical tests. Both treatments brought about a progressive increase in the claudication-free walking distance, statistically significant versus baseline from the second month (ACD, sulodexide group) and third month (ACD and ICD, pentoxifilline and sulodexide groups). At the end of treatment, the absolute increase of ACD was significantly greater in sulodexide-treated patients (p < 0.01) with respect to the pentoxifylline-treated group. In both groups the Doppler test evidenced a good improvement in local arterial haemodynamics. In the sulodexide group, 3.6% of patients developed nausea, dyspepsia and other minor gastrointestinal phenomena. In the pentoxifylline group 17.6% of patients complained of gastroenteric disorders (nausea, vomiting, dyspepsia), or of headache and dizziness. In one patient of this latter group insomnia was also present. Systemic tolerance of both drugs was consistently good.

Administration, Oral↗

Aldosterone content in plasma, erythrocytes and skeletal muscles in Icenko-Cushing's syndrome.

Aldosterone concentration was measured in plasma, erythrocytes and skeletal muscles in 34 patients with Icenko-Cushing's syndrome (ICS). It was established that aldosterone levels in the erythrocytes and whole blood of these patients were elevated, while aldosterone content in the plasma and muscular tissue of the patients was normal. Only in a small group of patients (N = 4) aldosterone levels positively correlated with arterial pressure (BP) and central hemodynamic parameters. Following 10 minutes of headdown tilt (-15 degrees), erythrocyte aldosterone level in the group of healthy controls (N = 12) was markedly elevated, but not in the group of patients with ICS. The results of the study suggest that erythrocytes can be viewed as a mobile aldosterone "depot" and may operate to mediate depressor effects of certain hormones on central hemodynamics.

Aldosterone↗

[Interrelation between hemodynamic parameters and the functional state of components of the endocrine system in patients with pheochromocytoma].

Ten patients with pheochromocytoma were examined before operation, 8 were examined 2-4 weeks after surgical treatment, and 30 in the long-term periods after elimination of hypercatecholaminemia. The patients with pheochromocytoma manifested activation of the renin-aldosterone system and inhibition of PGE2 secretion. In the long-term postoperative period, the level of aldosterone in the blood plasma was increased and that of PGE2 was reduced. In the patients with pheochromocytoma, the interrelation was discovered between the magnitude of arterial blood pressure and secretion of catecholamines, deoxycorticosterone, depressor prostaglandins. At different times after surgical treatment the central hemodynamics was found to be related to the level of mineralocorticoid hormones.

Adrenal Gland Neoplasms↗