Vol 9, No 2 (2015)

Objective: to reveal carbohydrate and lipid metabolic disturbances and their possible importance in examined young men with early arterial hypertension (AH).
Subjects and methods. A total of 130 men aged 40.3 ± 4.3 years were examined. There were 3 patient groups: stage I hypertensive disease with a history of AH (n = 61); primarily diagnosed hypertensive disease without evidence of long-term AH (n = 39); a control group noncardiovascular diseases (n = 30).
Results. The patients with long-term AH were more commonly found to have a compromised history of cardiovascular diseases and type 2 diabetes mellitus, signs of insulin resistance and subclinical atherosclerosis than those with the primarily diagnosed disease and the control group.
Conclusion. Carbohydrate and lipid metabolic disturbances are latent in young men with long-term AH. Both 2and 1-hour oral glucose tolerance tests are recommended for the early diagnosis of glycemic disorders in the above patient cohort. 

Objective: to describe management tactics in patients with back pain syndrome and to give recommendations for the choice of non-drug and drug treatments (with main drug groups) and the duration of a treatment cycle.
Materials and methods. The paper considers the basic mechanisms and causes of back pain syndromes (dorsalgias). It introduces the concept “dorsopathy” that characterizes the appearance of nonvisceral pain syndrome in the extremities and trunk, which is caused by degenerative processes in the vertebral motion segment. The authors provide a description of spondyloarthrosis, one of the main degenerative diseases of the spine, and give current principles of treatment for the major symptoms of the disease.
Results. The main goal of treatment in patients with back pain is to relieve pain syndrome. Selective nonsteroidal anti-inflammatory drugs are the medicaments of choice.
Conclusion. This paper covers current approaches to managing patients with spondyloarthrosis and gives recommendations regarding the treatment of the major disease manifestation – pain syndrome. 

At the present time effectiveness of rehabilitation programs after heart surgery, myocardial infarction, and in some cases for coronary artery disease (CAD) is undeniable. According to the researches, physical exercises, which underlie cardio rehabilitation of patients with CAD, reduce cardiac mortality. In the review accumulated scientific data about modern approaches to cardio rehabilitation is discussed: goals, indications, contraindications, its organization, advantages. Controlled training in patients with CAD, making a complex program of cardio rehabilitation, kinds of control during cardio training are described in details. In this review the second phase of physical rehabilitation after cardiac surgery – a stationary phase, protocols of which are subjective and often contested, is considered. More frequently physical rehabilitation after coronary artery bypass surgery is doing breathing exercises, as there is data that physical exercises, in which tangential force vector in or around the sternum appears, should be avoided for at least 3 months after surgery. On the other hand, avoiding of heaving during the first weeks after surgery leads to more pronounced atrophy of the chest muscles. 

But there is data, according to which, early beginning of an adapted program of cardio rehabilitation (1–2 weeks after surgery) is safely, it accelerates recovery and does not increase problems with the sternum. In this review the following idea is suggested: in order to follow the stages of rehabilitation after cardiac surgery it is necessary to start it on the stationary stage, and control of load rehabilitation programs must be carried out using hemodynamic changes during exercises, energy, SF-36 questionnaire. 

Systemic vasculitides (SV) are a heterogeneous group of acute and chronic diseases, the most important pathomorphological sign of which is inflammation and necrosis of the vascular wall. The basis for the classification of SV is their etiology and pathogenesis, the type of affected vessels and the pattern of inflammation, predominant organ involvements, clinical manifestations, a genetic predisposition, and demographic characteristics. To diagnose vasculitis is a difficult task due to a broad spectrum of its clinical manifestations that depend on the predominant size of affected vessels, the involved organs and systems, and the magnitude of the inflammatory process. There are no specific laboratory tests for most forms of SV; nonspecific inflammatory measures and activated autoimmune reactions are noted to be higher. Screening for SV determines the levels of anti-neutrophil cytoplasmic antibodies (ANCA), cryoglobulins, anti-glomerular basement membrane antibodies, and anti-complement C1q antibodies. However, biopsy with its specimen being pathomorphologically characterized, as well as current noninvasive or minimally invasive diagnostic techniques remain relevant because of a large number of seronegative variants of vasculitis. The ANCA-associated vasculitis management algorithm developed by the British Society of Rheumatology has been presented in 2015. The timely diagnosis and treatment at the onset of SV is the basis for quality of life and survival improvement.