Vol 5, No 1 (2011)

Objective: to assess the nature and degree of the impact of metabolic syndrome (MS) and obstructive sleep apnoea syndrome (OSAS) severity on myocardial structural and functional changes.

Subjects and methods. The study covered 80 patients of both sexes, whose mean age was 49.62 ± 9.87 years. The patients were divided into 3 groups according to the severity of OSAS. All the patients underwent general clinical examination with anthropometric measurements, as well as cardiorespiratory monitoring and biochemical studies.

Results. The mean body mass index in the examinees was 34.52 ± 4.91 kg/m2. In severe apnoea, there was a significant increase in abdominal adipose tissue redistribution (p = 0.005), an elevation in systolic and diastolic blood pressures and uric acid levels, progression of impaired lipid profile and insulin resistance (p < 0.05). More significant hypertrophy of the left ventricle and its reduced systolic function were recorded in severe OSAS (р < 0.05). The frequency of type 1 diastolic dysfunction was lower in the mild apnoea group (30% of the patients) than that in the severe apnoea group (67 %) (p = 0.01).

Conclusion. The found myocardial structural and functional changes are due to the degree of OSAS and to the impact of MS components. Due to inadequately effective antihypertensive and hypolipidemic therapy performed in patients with MS, it is necessary to diagnose OSAS and to define the degree of its severity for its correction.

The treatment of chronic heart failure (CHF) in patients over 60 years of age may be a challenge to a general practitioner. The physiological features of the elderly and significant comorbidity frequently have a considerable impact on the effects of drugs and the magnitude of side effects. Reduced sinus node automatism, significant atherosclerosis of the aorta and great vessels, and renal dysfunction - all should be borne in mind when choosing a drug and its dosage regimen. The paper considers non-drug treatment modalities, as well as the specific features of use of some groups of drugs and therapy for concomitant diseases in elderly patients with CHF.

Objective: to evaluate the basic and pleiotropic effects of atorvastatin in patients with rheumatoid arthritis (RA) and dyslipidemia (DLP).

Subjects and methods. The blood lipid profile was studied in 204 patients with RA. According to the found lipid disturbances, the patients
were randomized into 2 groups. A study group comprised 30 patients receiving generic atorvastatin 10 mg/day as part of combination therapy.
A comparison group included 20 RA patients matched for clinical characteristics and baseline lipid levels, who took no statins. Blood lipid
parameters and the markers of inflammation, vascular wall damage, and artery rigidity were examined over time.

Results. DLP was found in 58.3 % of the patients with RA. The use of atorvastatin in combination therapy resulted in not only a decrease in atherogenic cholesterol fractions, but also in a considerable reduction in the level of the markers of systemic inflammation and endothelial damage, and in disease activity. Six-month atorvastatin therapy showed a positive impact on the elastic properties of vessels in RA patients.

Conclusion. In RA patients with DLP, atorvastatin exerted a beneficial effect not only on the blood lipid profile, but also on the magnitude of inflammation and the elastic properties of vessels, and disease activity.

Lung cancer (LC) annually afflicts 63–65 thousand people in Russia and 1.04 million worldwide, which amounts to 12.8% of all notified cases of neoplasms. In LC patients, infectious complications are characterized by a severe course; destruction foci, decay cavities, and abscess may form.
All give rise to difficulties in making a diagnosis and in choosing a treatment policy. Infections caused by P. aeruginosa, A. baumanii, bacteria of the family Enterobacteriacae, S. aureus, and Enterococcus spp present the greatest problem in inpatients with LC. The early diagnosis of infectious
complications and the use of adequate schemes of antibiotic prevention and therapy promote a reduction in mortality from infection in this category
of patients and expand the possibilities of their specific antitumor treatment.

Obstructive sleep apnoea syndrome (OSAS) is observed in the population with a frequency of 5–15 %. The importance of OSAS is due to its close relationship with cardiovascular diseases. OSAS increases a risk for sudden cardiac death and is an independent predictor of chronic heart failure in males. OSAS is shown to be associated with the preclinical forms of atherosclerosis and left ventricular dysfunction.