Vol 10, No 2 (2019)


pages 6-48 views

Secondary prevention for non-communicable diseases at out-patient stage: schools of health for patients at municipal polyclinic

Larina V.N., Kozyrev S.E., Nazimkin K.E., Saino O.V., Safarian S.L., Gasparian L.V.


Background. Currently, chronic noncommunicable diseases (NCD) cause more than 2/3 of all deaths in the world. Despite the continuous improvement of approaches to drug therapy for chronic low risk infections, they can not be completely cured, and mortality tends to increase. In such conditions, the need for preventive measures comes to the fore. One of the approaches of secondary prevention is to educate patients in Health Schools, the goal of which is to reduce the incidence and progression of complications of NCD, reduce morbidity and mortality. Aim. The goal is to assess the attendance of Schools, the gender and sex composition of patients, the structure of educational activities. Methods. Аssessment of the work of the Health Schools through the analysis of patient case report stored in the clinic’s prevention department. The analysis of the cases was carried out taking into account the age, gender, and results of the patient survey. Results. The data obtained indicate a fairly uniform attendance at Health Schools. The School of Health in hypertension was the most visited (20% of the total attendance), the least - the School of Breast Health (less than 10% of the total attendance). Women visited Health Schools more often than men (71.2%). Men were more interested in the school on the general principles of healthy lifestyles and the School on quitting smoking. The main contingent of Health Schools is the elderly. The average age of the patients of the School for type 2 diabetes and healthy joints was about 65 years, and the School for hypertension - about 73 years. Conclusion. Due to patient education, it is possible to increase adherence to treatment prescribed by a doctor, reduce the effect of FR, help patients lead a healthier lifestyle.
CardioSomatics. 2019;10(2):49-55
pages 49-55 views

Myocardial biomechanics, intracardiac hemodynamics and endothelial function in patients before and after various types of pacemakers implantation

Sanakoyeva V.A., Rybachenko M.S., Pukhayeva A.A., Avtandilov A.G.


This review presents 31 sources from 1995 to 2019. Atrioventricular blockades (AVB) 2-3 degrees occupy a special place among the causes of death from cardiovascular disease. The above AVB lead to a significant slowing of the heart rate and predispose to the development and progression of heart failure (HF) and the occurrence of acute hypoxia of the brain and attacks Morgagni-Adams-Stokes. The main method of treatment of hemodynamically significant AB-conduction disorders is electrocardiostimulation (ES), which is the basic method of treatment. A single chamber pacemaker is the most often implanted with using isolated ventricular stimulation in clinical practice in the Russian Federation. Implantation of a dual chamber pacemaker is less frequent. This type of stimulation allows to maintain atrioventricular synchronization constantly. Stimulation of the apex of the right ventricle leads to a decrease in left ventricle (LV) function and structural changes that are a consequence of the occurrence of electric and mechanical dyssynchrony of the myocardium. There is a large number of works devoted to the comparison of different methods of ES leading to the conclusion that a powerful alternative to the stimulation of the apex of the right ventricle can be a dual ventricular stimulation. It is noted that implantation of single-and dual-chamber pacemaker with fixation of the electrode in the region of the right ventricle apex leads to the fact that both modes of stimulation can not cancel the electrical and anatomical remodeling of the myocardium of left atrium and LV. It may be necessary to use a more physiological site of stimulation with using optimal AB-delay to minimize the frequency of ventricular stimulation. Endothelium plays an important and independent role in the development of cardiovascular diseases. The effect of AB conduction impairment on endothelial function (EF) has not been described to date. There were few studies which are discussed the influence of constant pacemaker on endothelial function in patients with AVB 2-3 degrees in recent years. It should be noted that the studies were conducted on a small sample of patients and had a different design.
CardioSomatics. 2019;10(2):56-63
pages 56-63 views

Chronic renal disease in patients with type 2 diabetes mellitus

Khachaturian N.E.


Diabetes mellitus (DM) type 2 (type 2 diabetes) is one of the most common non-infectious diseases worldwide. Chronic hyperglycemia is a leading factor in a development of vascular complications of diabetes which involve various organs, particularly the eyes, kidney, cardiovascular system and nervous system. One of the most common complications of DM is diabetic nephropathy. Presence of chronic renal disease in a patient with DM limits options of glucose-lowering therapy. Dipeptidyl peptidase-4 inhibitors are currently among medications of choice for glucose-lowering therapy in patients with chronic renal disease. All currently available dipeptidyl peptidase-4 inhibitors can be administrated to patients with end-stage kidney disease on dialysis, and a rate of their use is continuously increasing. Given a high risk of hypoglycemic conditions in patients with chronic renal disease, a regular self-monitoring of glycemia is an essential component of a treatment. Glucometer Contour Plus One is one of the most recent devices developed for self-monitoring of blood glucose. Its advantage over all other blood glucose meters is an ability to synchronize with a mobile application Contour™ Diabetes (Contour Diabetes).
CardioSomatics. 2019;10(2):65-70
pages 65-70 views

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