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RISS 인기검색어
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- 저자 : ( Mikhail Voevoda ) (검색결과 3 건)
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( Irina Urvantseva ),( Konstantin Nikolaev ),( Mikhail Voevoda ),( Alevtina Nikolaeva ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: SYNTAX score (SS) is an effective angiographic predictor of clinical outcomes in patients with multivessel coronary artery disease undergoing percutaneous coronary intervention, but the associations between high SS and short-term outcome in patients treated with primary percutaneous coronary intervention (PCI) for acute ST-segment elevation myocardial infarction (STEMI) have not been studied. The aim of this study was to evaluate associations of the severity of coronary artery disease according to SYNTAX score with short-term outcome and clinical characteristics in patients treated with PCI for acute STEMI. Methods: A total of 330 patients (274 male и 56 females, mean age 53.6±8.9 years) with acute STEMI who underwent primary PCI were stratifi ed into the 3 groups. For SS the following distribution was used: low (=22, N = 216), medium (23-32, N = 66), high score (>32, N = 48). All in-hospital clinical outcomes were estimated in these patients. Results: During the short-term observation in hospital cardiovascular mortality was higher in groups of high and medium SS in compared with group of low SS (18.8%, 12.1% and 1.4%, respectively, p<0.01). Besides that the no-refl ow phenomenon, stent thrombosis, pulmonary edema, pleural effusion, acute left ventricular aneurysm, recurrent myocardial infarction and bleeding were signifi cantly more frequent among the patients in high SS group (p<0.05). Multivariate binary logistic regression analyses demonstrated that SS is an independent determinant for pleural effusion (95 % confi dence interval (CI), 1.019-1.082; p=0.002), no-refl ow phenomenon (95 % CI, 1.008- 1.089; p=0.018), pulmonary edema (95 % CI, 1.027-1.090; p<0.001) and acute left ventricular aneurysm (95 % CI, 1.015-1.092; p=0.006). Conclusions: The SS is useful index to predict the risk of short-term adverse clinical events during hospitalization in patients with acute STEMI undergoing PCI.
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( Alla Ovsyannikova ),( Oksana Rymar ),( Vladimir Maximov ),( Mikhail Voevoda ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: The aim of research was to determine the incidence of arterial hypertension in patients with debut of diabetes mellitus before 25 years of age. Methods: We examined 70 people in Siberia who had debut of diabetes mellitus up to 25 years: 5 patients had been confi rmed MODY 2, 33 patients had type 1 diabetes, 32 patients - type 2. We have done clinical examination, measurement of blood pressure, blood sampling for biochemical and hormone (TSH, C-peptide) analyzes. Arterial hypertension was diagnosed when blood pressure (BP) is above then 139/89 mm Hg for people older 18 years and above 95 percentile of the distribution BP for patients younger than 18 years. Results: The median of age of the patients at moment of examination was 23,0 [16,0:35,5] years for patients with type 1, with type 2- 29,5 [17,7:37,0] years (p1- 2<0,001), with MODY 2 -13,0 [6,5:30,5] years (p2-mody=0,022). The median of duration of diabetes mellitus was 9,0 [3,5:19,5] years at type 1: 2,0 [1,0:5,0] years at type 2: 3,0[1,0:4,0] years at MODY 2 (p1-2 = 0,02, p1- MODY = 0,04). 5 patients (15%) with type 1 diabetes had hypertension 1 and 2 degrees. 6 patients (19%) with type 2 diabetes also have high blood pressure. Patients with MODY 2 had not arterial hypertension. Overweight was present in 2 patients (6%) with type 1 diabetes and in 5 (16%) - with type 2 diabetes. Conclusions: 1. Young patients with diabetes have high incidence of hypertension which requires good monitoring pressure in these patients from the time of diagnosis of diabetes. 2. Overweight in young patients with diabetes is rarer than hypertension. It is indicate the need for controlling the pressure in the persons not only with the overweight but with normal weight too.
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( Alla Ovsyannikova ),( Oksana Rymar ),( Vladimir Maximov ),( Mikhail Voevoda ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: The aim was to investigate the clinical, laboratory and genetic determinants of diabetes mellitus in patients with debut of disease before 25 years of age and family history of diabetes in Siberia. Methods: We examined 70 people with debut of diabetes before 25 years of age with family history of diabetes: 5 patients who we verified MODY 2 (after molecular genetic testing), 33 diagnosed with type 1 diabetes at 32 - 2 type. All patients had a clinical examination, blood sampling for biochemical, hormone and molecular genetic (research glucokinase gene) analyzes. Results: Missense mutations in the glucokinase gene were localized in exons 1,4 and 7. The “classical” symptoms of debut were in 94% of patients with 1 type of diabetes. Asymptomatic debut of “diabetes no type 1” was in 60% of patients. Allergic reactions dominated among the comorbidities in patients with diabetes. Pathologies of the gastrointestinal tract (diabetes mellitus type 1 -27%, 2 type -12 %, MODY 2-20%), thyroid (18 %, 28 % and 40 % respectively), hypertension (18 % with type 1, 28 % - type 2) were in these patients. Peripheral diabetic neuropathy and diabetic retinopathy prevailed among the complications. Statistical differences were found in glucose, glycated hemoglobin, C-peptide, C-reactive protein among laboratory parameters in patients with diabetes mellitus type 1 and type 2. Conclusions: 1. We discovered a new one missense mutation and three previously described mutations in the glucokinase gene. 2. Young patients with type 1 diabetes had “classic” symptoms. Patients with “diabetes not type 1” had not clinical symptoms (60%) and had normal body weight (84 %). 3. Allergic reactions and diseases of the thyroid gland dominated in all types of diabetes mellitus in patients of the young age.
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