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Biomedical subjects

A I Kirienko

Publications and source records attributed to A I Kirienko.

At least 19 recordsLinked to original sources
PubMed2006

[Risk factors of chronic venous insufficiency of the lower extremities and possibilities of its medication in therapeutic practice].

AIM: To verify incidence of risk factors of chronic venous insufficiency (CVI) of the lower limbs and efficacy of outpatient treatment. MATERIALS AND METHODS: A total of 4388 patients were examined by questioning and examination of the lower limbs. 1209 patients with CVI stages C1, C2 and C3 were included in the study. They received recommendations to use elastic compression, topic modalities, physiotherapy. Patients of the study group were given, in addition, detralex for 8 weeks. RESULTS: Characteristic symptoms of CVI were seen in 68% males and 84% females but only 17.5 and 20%, respectively, had complaints. The risk was highest in history of CVI in the patient's mother, sitting or standing job, hard physical labour, obesity and constipation, two or more labours in women. The effect was achieved in the detralex group. CONCLUSION: Many outpatients had symptoms of chronic venous insufficiency but had no complaints. Detralex therapy proved highly effective in outpatient practice.

Adolescent↗
PubMed2006

[C677T mutation in methylentetrahydrofolatereductase gene in patients with venous thromboses from the central region of Russia correlates with a high risk of pulmonary artery thromboembolism].

AIM: To investigate genetic factors of risk (RF) to develop venous thrombosis and pulmonary artery thromboembolism (PATE) in population of central Russia. MATERIAL AND METHODS: We studied polymorphism of the genes of coagulation factor II (G20210A), factor V (G1691A) and methylentetrahydrofolatereductase (MTHFR) with polymerase chain reaction and restriction analysis of DNA amplified sites. We estimated prevalence of the mutations in healthy population and in patients with flebothrombosis as well as effects of the mutations on a PATE rate in patients with thrombosis. We examined 97 patients with documented flebothrombosis. PATE was detected in 54 of them. The control group consisted of 56 healthy volunteers matched by age and gender. RESULTS: G1691A mutation in the gene of coagulation factor V (Leiden mutation of factor V--LMFV) in healthy population occurred in 3.6%, in patients with flebothromboses--in 19.6% (OR = 6.58; 95% CI from 1.47 to 29.42; p = 0.006). Heterozygous mutation G20210A in prothrombine gene was detected in 8 (8.2%) patients (p = 0.027), while this mutation was registered in none controls. Polymorphism of MTHFR gene (C677T) was seen both in the control and patients (60.7 and 52.6%, respectively). LMFV occurrence in patients with flebothrombosis and PATE is less than in patients with flebothrombosis without TEPA (16.7 and 23%, respectively). The PATE risk is significantly higher in carriers of mutant allele 677CT and 677TT of MTHFR compared to patients free of this mutation (OR = 3.11; CI 95% from 1.35 to 7.15; p = 0.006). Homozygous inheritance of this mutation in males combined with PATE in 100% cases. Of 8 carriers of heterozygous mutation G20210A in prothrombin gene PATE was detected in 5 carriers. CONCLUSION: LMFV and mutation G20210A in prothrombin gene are genetic risk factors of venous thrombosis. LMFV is not a PATE risk factor. Mutation C677T in MTHFR gene has no influence on the risk of venous thromboses but makes PATE much more probable. This suggests that it may be a genetic risk factor of PATE in this disease.

Adolescent↗
PubMed2006

[Effectiveness of compressive hosiery < > for therapy of chronic venous insufficiency].

Total 40 patients with III grade chronic venous insufficiency underwent conservative treatment with compressive hosiery < >. Patients were divided into 2 groups: the first group used compressive stockings, the second--tights. To objectivize the assessment, all patients underwent volumetry, radionuclide phlebography and regional blood volume measurements. It was shown that in the first group pain syndrome was coped in 73% of patients, edematous--in 60%. According to volumetry data, mean calf volume has reduced by 183+/-41 ml, phlebography has revealed an improvement of muscular-venous pump capacity in 11 patients; in 9 patients it remained unchanged. Blood filling in the affected limb decreased in 16 patients from 10.7% to 8.2% and from 7.5% to 5.3% for thigh and calf, respectively. In the second group an improvement of venous return parameters was more pronounced. Compressive tights relieved pain in lower extremities in 95%, decreased led edema--in 90% of patients. There was significant reduction in calf volume--by 259+/-31 ml to the end of treatment course. Radionuclide phlebography has shown significant improvement of muscular-venous pump evacuatory function and reduction of blood filling in all patients of the second group. In conclusion, results of the study evidenced the effectiveness of compressive hosiery for treatment of chronic venous insufficiency.

Adult↗
PubMed2006

[Semisynthetic Diosmin (Phlebodia 600) for therapy of lower limb chronic venous insufficiency].

The study was held to assess clinical effectiveness of coaggregated semisynthetic Diosmin (Phlebodia 600) for patients with II-III CEAP classes of chronic venous insufficiency (CVI), caused by lower limb variceal diseases. In 30 cases Phlebodia 600 demonstrated positive effect on CVI symptoms, edematous and convulsive syndromes. The authors conclude that Phlebodia 600 is highly effective and safe for patients with CVI.

Administration, Oral↗
PubMed2005

[Antiphospholipid syndrome in the structure of hematogenic thrombophilia in young and middle-aged patients with venous thrombosis].

AIM: To specify detectability and clinical presentation of antiphospholipid syndrome (APS) in young and middle aged patients with phlebothromboses (PT). MATERIAL AND METHODS: Enzyme immunoassays for lupus anticoagulant, PCR determination of G1691A mutation in the gene of coagulation factor V, mutation G20210A in prothrombin gene, mutation C677T in methylenetetrahydrofolate reductase (MTHFR) gene were made in 97 patients (57 males and 40 females) with venous thrombosis as well as estimation of external and internal coagulation, antithrombin III activity, protein C activity, plasma fibrinogen, stimulated platelet aggregation, blood and plasma viscosity. RESULTS: APS was detected in 20.6% young and middle-aged patients with venous thrombosis, in 18.5% of them--primary APS. In APS patients acquired risk factors of thrombosis occurred significantly less frequently than in patients with venous thrombosis free of APS (30 and 70%, respectively). Recurrent pulmonary artery thromboembolism (TEPA) prevailed in APS patients. In patients with combined hemostatic disturbances (APS+mutation) TEPA was diagnosed more frequently than in APS patients and in the absence of markers of genetic thrombophilia. Plasma viscosity is most important diagnostically among rheological indices.

Adolescent↗
PubMed2005

Radionuclide assessment of the treatment by compression of patients with chronic venous insufficiency.

A study was made of the efficacy of the compression medical tricot in the treatment of chronic venous insufficiency (CVI). To evaluate the treatment by compression, the authors, in addition to the clinical examination, used radionuclide techniques such as examination of the regional blood volumes and phleboscintigraphy. The results of the given work have shown that the compression products under test are effective agents for the treatment of CVI by compression which improves venous return and the patients' quality of life. The data obtained point out that in addition to the lowering of blood filling, the medical tricot influences the interstitial element of the edematous syndrome, leading to the elimination of the latter one. The use of elastic bandages creates the known difficulties (the necessity of the patient training in bandaging, complexity of creating an adequate bandage, quick depreciation). In view of this fact the use of the compression tricot which possesses the fixed grade of compression for a concrete form and stage of CVI is preferable in the therapy of chronic venous diseases.

Adult↗
PubMed2004

Evaluation of the efficacy of heparins of varying molecular mass and duration of their use in the treatment of patients with acute venous thrombosis.

This paper analyses the results of examination and treatment of 90 patients with acute thrombosis in the inferior vena cava system. To verify the diagnosis, use was made of contrast phlebography (retrograde iliocavography), ultrasound angioscanning, and perfusion scanning of the lungs, The treatment was carried out using heparins of varying molecular mass given for a short and longer time together with indirect anticoagulants. It has been demonstrated that the use of low-molecular heparin does not produce any noticeable changes in the hemostatic system, which can be revealed by standard coagulation tests. In the authors opinion, a differentiated approach is required to the choice of the regimes of heparin therapy. The indications for the use of heparins have been worked out. Early administration of vitamin K raises the efficacy of anticoagulant therapy and shortens the time of heparin therapy. The use of low-molecular heparin allows to minimize the incidence of thromboembolic and hemorrhagic events without an increase in the total expenses for treatment.

Acute Disease↗
PubMed2004

Chronic diseases of lower extremity veins in industrial workers of Moscow (results of the epidemiological survey).

This paper describes the results of the study into the prevalence of chronic venous diseases among industrial workers of Moscow. It has been established that chronic venous diseases are fairly prevalent among industrial workers. They affect the people of both sexes (67.5% of women and 50.4% of men), varying age and occupation. With age their incidence rises. The most significant risk factors of the onset of chronic venous diseases include hereditary predisposition, pregnancy and birth, overweight, and intake of hormonal contraceptives. The study has demonstrated that in most cases, such patients are not rendered medical assistance.

Adult↗
PubMed2004

Endovasal laser obliteration of the greater saphenous vein in patients with varicosis.

This paper describes the first results of endovasal laser obliteration of the greater sephenous vein in two patient groups (n=40) math varicosis. In 15 cases (control group), laser obliteration was employed during routine operation as an alternative to phlebectomy according to Babcock following crossectomy. In 25 patients (the main group), operation was performed without ligation of the saphenofemoral anastomosis. After puncture and catheterization according to Seldinger the greater saphenous vein was exposed to thermal action over the length from the osteal valve to the upper third of the leg. The follow up of the patients amounted to 12 months. The results obtained in the main patient group seem most interesting. Stable elimination of truncal varicosis could be attained in more than 90% of cases, which was associated with quick medicosocial rehabilitation, the minimal number of complications and an excellent cosmetic effect.

Adult↗
PubMed2003

[The problem of postoperative venous thromboembolic complications in general surgery].

The paper reviews occurrence, diagnostic tools venous thromboembolic complications. Cost effectiveness of preventive measures for venous thrombosis and pulmonary embolism in general surgery is analysed. The study included 45 patients who underwent elective (21) and urgent (24) abdominal and pelvic interventions. Each patient was examined with ultrasonic with color Doppler imaging before and 8-10 days after surgery. Deep venous thrombosis of lower limbs was diagnosed in 11.1%, most of cases being asymptomatic. Ultrasonic angioscanning appeared to be an acute and reliable diagnostic tool for this pathology. Various approaches to the management of patients at thrombotic risk are reviewed. Cost effectiveness analysis of anticoagulation prevention for postoperative venous thromboembolic complications must address the problem: is prevention outcome worth those extra efforts? Surveillance of 500 patients at high thrombotic risk has shown that preventive use of low weight heparin (Clexane) is economically beneficial then conventional Heparin, the more in the absence of special preventive strategy. Targeted prevention in patients with different risk of postoperative venous thromboembolic complications can yield more then 3-fold reduction in occurrence of these complications.

Adult↗
PubMed1999

[Polymorphism of GPIIIA platelet glycoprotein gene PIA1/A2 compared to plasma hemostasis in myocardial infarction patients].

AIM: To investigate gene PIA1/A2 polymorphism and some parameters of plasma hemostasis in postmyocardial infarction (PMI) patients with chronic cardiac failure (CCF). MATERIALS AND METHODS: A total of 58 PMI patients with CCF, pulmonary artery thromboembolism (PATE), phlebothrombosis (PT) were examined. The age of the patients ranged from 24 to 84 years. Polymorphism of platelet glycoprotein GPIIIa gene was assessed according to the standard PCR-RFLP. RESULTS: Occurrence of genotypes PIA1/A2, PIA1/A2 was 70.8 and 29.2%, respectively; of allele PIA1 and PIA2 84.5 and 15.5%, respectively. In PMI patients genotype PIA1/A1 occurred in 71.7% of cases, genotype PIA1/A2--in 28.3%. Incidence of alleles was: 84.0% (PIA1), 16.0% (PIA2). PATE patients had genotype PIA1/A1, PT patients had distribution of the genotypes 50.0% and 50.0%, respectively. In patients who had suffered MI at the age under 45 years prevalence of the genotypes was 63.2% PIA1A1, 36.8% PIA1A2, of alleles 83.6% PIA1, 16.4% PIA2. In patients with a history of MI at the age over 50 the incidence of the genotypes and alleles was, respectively, 75.0% PIA1A1, 25.0% PIA1A2, 87.7% PIA1, 12.3% PIA2. Patients with genotype PIA1/A2 had a significantly higher fibrinogen than PIA1A1. Concentration of soluble fibrin monomeric complex was higher in patients with genotype PIA1/A2 reflecting activation of intravascular clotting. AT-III decrease by 5.4% indicated lower anticoagulant activity in patients with genotype PIA1A2. CONCLUSION: In patients with MI at the age under 45 years gene PIA1A2 and allel PIA2 occurred more frequently than in patients who had MI at older age. Allele PIA2 was associated with the risk of MI onset at young age. It is suggested that patients with genotype PIA1/A2 are at higher risk of thrombotic conditions, of coronary artery thrombosis in particular, than patients with genotype PIA1/A1.

Adult↗