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Journal articles on the topic 'Polymorbidita'

Author: Grafiati

Published: 4 June 2021

Last updated: 16 February 2022

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1

Voronin, S. V., D. V. Cherkashin, and I. V. Bersheva. "Polymorbidity: definition, classifications, prevalence, estimation methods and practical significance." Bulletin of the Russian Military Medical Academy 20, no. 4 (December 15, 2018): 243–49. http://dx.doi.org/10.17816/brmma12384.

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Based on the analysis of Russian and foreign literary sources, the definition of the concept of polymorbidity is given, its classification, information on prevalence, measurement methods and practical significance are given. It is emphasized that at present in the literature the concepts of polymorbidity, comorbidity, multimorbidity coexist, while there is no universally accepted definition of them. This uncertainty is historically conditioned and is associated with the use of these concepts by various scientific schools. In most modern literary sources, polymorbidity (multimorbidity) refers to a combination of two or more chronic diseases in one patient. At present, a considerable number of different methods of measuring polymorbidity are used, which have their own advantages and disadvantages, and a universal method has not been developed. The most convenient for assessing polymorbidity is currently recognized polymorbidity index Charlson. Due to the lack of unified approaches to the measurement of polymorbidity, as well as taking into account the fact that studies are conducted in different population samples, the published figures for the prevalence of polymorbidity vary considerably. Emphasis is placed on the fact that polymorbidity is a multifaceted problem that has not only clinical but also economic and social importance, which requires a further in-depth study.

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2

Verbovoy, A. F. Verbovoy, I. A. Tsanava Tsanava, N. I. Verbovaya I, and Yu A. Dolgikh Dolgikh. "The polymorbidity and hypothyroidism." Pharmateca 14_2019 (December 25, 2019): 22–28. http://dx.doi.org/10.18565/pharmateca.2019.14.22-28.

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3

Sevostyanova, E. V., Yu A. Nikolaev, I. M. Mitrofanov, and V. Ya Polyakov. "Polymorbidity in hypertensive patients." "Arterial’naya Gipertenziya" ("Arterial Hypertension") 25, no. 2 (July 29, 2019): 200–208. http://dx.doi.org/10.18705/1607-419x-2019-25-2-200-208.

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Background. Hypertension (HTN) is often combined with other diseases, that significantly complicate its course, worsen the prognosis, interfere with the therapeutic and preventive measures. Therefore, assessing the development and structure of polymorbidity (PM) in hypertension is a relevant issue. Objective. To study the structure and degree of PM in hypertensive patients depending on age and gender. Design and methods. We conducted an analysis of 20 560 case histories of patients with HTN and without HTN (men and women), inhabitants of West Siberia-Novosibirsk region, who underwent examination and treatment at the clinic of the Federal Research Center of Fundamental and Translational Medicine in Novosibirsk. All identified diagnoses (nosological forms and classes according to the International Classification of Diseases of the 10th revision, ICD‑10) were considered. Transnosological PM was assessed by the average number of nosologies corresponding to the three-digit ICD‑10 rubric. Results. An increase in the PM index by 16,8 % was found in HTN patients compared to patients without HTN. Among HTN patients, there was an increase in the incidence of comorbid diseases of the circulatory system (in the 16–39 age group in men — by 46 %, in women — by 42,8 %), the endocrine system, eating disorders and metabolism (in the age group 16–39 years for men — by 19,3 %, for women — by 45,2 %), the musculoskeletal system, urinary system (for men) and neoplasms (for women) compared with patients without HTN. Conclusions. We found a high rate of transnosological PM in HTN patients was found and defined its structure.

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4

Voronin, S. V. "Prevalence and features of polymorbidity of servicemen of different age groups according to the results of their medical examination to determine the category of fitness for military service." Bulletin of the Russian Military Medical Academy 22, no. 1 (December 15, 2020): 39–44. http://dx.doi.org/10.17816/brmma25965.

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The prevalence of polymorbidity and its features in military personnel of various age groups was studied. It has been established that polymorbidity during medical examinations of military personnel occurs in all age groups, increasing with age. For each age group of military personnel, its characteristic polymorbidity models are formed. So, in the age group up to 35 years, polymorbidity occurs in one third of the examined and is characterized by both functional disorders of the circulatory system and digestive organs, and the presence of organic pathology of the circulatory system (congenital malformations (developmental defects), mitral and other valve prolapse), digestive organs (chronic gastritis, gastroesophageal reflux disease) and the musculoskeletal system (flat feet, dorsopathies). At the age of 35 to 45 years, polymorbidity occurs in93,5% of those examined and is characterized by the presence of a cardiac and gastroenteric component in all polymorbidity models, in 80% of the models - the musculoskeletal component, in 60% - the metabolic component, in 40% - the endocrine component. Polymorbidity occurs in 97,5% of those examined over the age of 46 years and is characterized by the presence in all models of polymorbidity of the cardiac, cerebrovascular and musculoskeletal component, in 75% of the models - the metabolic component, in 50% - the endocrine component.

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5

Voronin, S. V. "Risk factors for the formation of polymorbidity in military personnel based on the results of their medical examination." Bulletin of the Russian Military Medical Academy 22, no. 3 (December 15, 2020): 61–67. http://dx.doi.org/10.17816/brmma50535.

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Abstract. The risk factors for the formation of polymorbidity in military personnel of different age groups were studied during a medical examination to determine the category of fitness for military service. It was established that the most effective indicators in the form of linear dependences were: the level of trans-systemic polymorbidity and body mass index, waist-to-hip ratio, the cardio-anklevascular index, the thickness of the intima-media complex of the common carotid artery, the level of total cholesterol, and alcohol consumption.In the group of military personnel under the age of 35, positive correlation was found between trans-systemic polymorbidity and body fat, body fat percentage, body mass index, total cholesterol and low density lipoproteins.In the group of military personnel aged 36 to 45 years, positive correlation was found between trans-systemic polymorbidity and body mass index, percentage of body fat, and fat tissue in the body. Given the positive correlation between trans-systemic polymorbidity and indicators characterizing overweight, obesity is one of the leading factors in the formation of polymorbidity under the age of 45 years. It is shown that measures aimed at the prevention of polymorbidityshould basicallyinclude generally accepted measures for cardiovascular prophylaxis and obesity.

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6

Lazebnik, L. B., A. E. Lychkova, and Z. F. Mikhailova. "Polymorbidity in Inflammatory Bowel Diseases." Bulletin of Experimental Biology and Medicine 153, no. 1 (May 2012): 29–31. http://dx.doi.org/10.1007/s10517-012-1635-6.

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7

Sevostyanova, Evgeniya V., Yu A. Nikolaev, I. M. Mitrofanov, V. Ya Polyakov, and N. A. Dolgova. "The role of risk factors of chronic non-communicable diseases in the development of transnosological polymorbidity in a modern therapeutic clinic." Clinical Medicine (Russian Journal) 95, no. 8 (September 26, 2017): 735–41. http://dx.doi.org/10.18821/0023-2149-2017-95-8-735-741.

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Purpose. To study the dependence of the frequency of occurrence and the values of indicators of basic risk factors for chronic non-communicable diseases on the degree of transnosological polymorbidity in patients of a clinic of general therapeutic profile for the period from 2003 to 2013. Material and methods. The analysis of 5019 medical records (2501 men, 2518 women) treated in the clinic of RIECM, Novosibirsk, was carried out. Transnosological polymorbidity was evaluated from the average number of nosologies in accordance with the International Classification of Diseases, 10th revision (ICD-10). The following risk factors were assessed based on clinical and laboratory tests: high blood pressure, increased concentration of total cholesterol, low density lipoprotein cholesterol, triglycerides, glucose, uric acid, decreased concentration of high density lipoprotein cholesterol, obesity. Results. The dependence of the values of indicators and frequency of occurrence of chronic non-communicable diseases risk factors on the degree of polymorbidity, taking into account gender differences, was studied. In both men and women, increased transnosological polymorbidity index was associated with the growth of indicators of main non-communicable risk factors: systolic blood pressure, diastolic blood pressure, glucose, low density lipoprotein cholesterol, uric acid in the blood. In men, a more pronounced increase with growing polymorbidity index was especially noticeable in the body mass index and blood glucose; in women in blood glucose and triglyceride levels. Conclusion. The study demonstrated the important role of risk factors of chronic non-communicable diseases that collectively represent clinical manifestations of metabolic syndrome in the development of polymorbidity in patients of therapeutic profile. These findings indicate the need of differential prevention and treatment of patients with polymorbidity together with mandatory identification and correction of modifiable risk factors of chronic non-communicable diseases.

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8

Trebin, Ernst. "Polymorbidität nach einer Grippeimpfung." Allgemeine Homöopathische Zeitung 260, no. 06 (December 17, 2015): 29–36. http://dx.doi.org/10.1055/s-0041-106166.

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9

Ashcheulova, Tetiana, Tetiana Ambrosova, Oksana Kochubiei, Oleksii Honchar, and Iryna Sytina. "SUBCLINICAL CARDIAC DAMAGE IN CARDIOPULMONARY POLYMORBIDITY." Inter Collegas 6, no. 2 (August 3, 2019): 68–76. http://dx.doi.org/10.35339/ic.6.2.68-76.

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SUBCLINICAL CARDIAC DAMAGE IN CARDIOPULMONARY POLYMORBIDITY. (review). Part 1. Ashcheulova T., Ambrosova T., Kochubiei O., Honchar O., Sytina I. Hypertension and chronic obstructive pulmonary disease are one of the frequent comorbid conditions in internal medicine and are subject to meaningful cooperation among physicians, cardiologists, and pulmonologists. A combination of chronic obstructive pulmonary disease and hypertension presents certain diagnostic and therapeutic challenges. These conditions share common risk factors, similar clinical presentations and some common parts of pathogenesis. The problem of association between chronic obstructive pulmonary disease and hypertension may be currently discusses both as a simple combination of various clinical entities, and as chronic obstructive pulmonary disease resulting in development of factors contributing to hypertension. One way or another, either a simple combination, or a mutually aggravating syndrome, but we state there is a cardiorespiratory continuum where chronic obstructive pulmonary disease acts as a valid component of hypertension development, and vice versa. Thus, it seems to be relevant to study peculiarities of the structural and functional status of the cardiovascular system and microcirculation, systemic remodeling mechanisms, endothelial dysfunction and inflammation in presence of chronic obstructive pulmonary disease -associated hypertension. Problems of additional cardiovascular risk marker development, treatment efficiency assessment remain topical. Use of electrocardiography and echocardiography with dopplerometry has been an important diagnostic principle of subclinical cardiovascular damage in presence of hypertension and chronic obstructive pulmonary disease comorbidity. Non-invasive imaging methods play a central part in diagnostics of subclinical target organ damage. Wide implementation thereof is based on high diagnostic accuracy, common availability, safety and relatively low price. Key words: hypertension, chronic obstructive pulmonary disease, comorbidity, electrocardiography, echocardiography with dopplerometry Резюме. СУБКЛІНІЧНЕ УРАЖЕННЯ СЕРЦЯ ПРИ КАРДІОПУЛЬМОНАЛЬНІЙ ПОЛІМОРБІДНОСТІ (огляд). Частина 1. Ащеулова Т.В., Амбросова Т.М., Кочубєй О.А., Гончарь О.В., Ситіна І.В. Артеріальна гіпертензія і хронічне обструктивне захворювання легень - одне з частих коморбідних станів в клініці внутрішніх хвороб і є предметом конструктивної взаємодії терапевтів, кардіологів, пульмонологів. Поєднання хронічного обструктивного захворювання легень і артеріальної гіпертензії являє певні труднощі для діагностики і лікування. Ці захворювання мають загальні фактори ризику, схожі клінічні прояви і спільність деяких ланок патогенезу. Таким чином, представляється актуальним дослідження особливостей структурно-функціонального стану серцево-судинної системи і мікроциркуляції, вивчення системних механізмів ремоделювання, ендотеліальної дисфункції та запалення при артеріальній гіпертензії в поєднанні з хронічним обструктивним захворюванням легень. Залишаються актуальними питання розробки додаткових маркерів серцево-судинного ризику, оцінки ефективності проведеного лікування. В останні роки важливими принципами діагностики субклінічного ураження серця і судин при коморбідності хронічного обструктивного захворювання легень і артеріальної гіпертензії є використання електрокардіографії та ехокардіографії з доплерометрією. Неінвазивні методи візуалізації відіграють центральну роль в діагностиці субклінічного ураження органів-мішеней. Їх широке застосування обумовлено високою діагностичної точністю, повсюдною поширеністю, безпекою і відносно низькою вартістю. Ключові слова. Артеріальна гіпертензія, хронічне обструктивне захворювання легень, коморбідность, електрокардіографія, ехокардіографія з доплерометрією. Резюме. СУБКЛИНИЧЕСКОЕ ПОРАЖЕНИЕ СЕРДЦА ПРИ КАРДИОПУЛЬМОНАЛЬНОЙ ПОЛИМОРБИДНОСТИ (обзор). Часть 1. Ащеулова Т.В., Амбросова Т.Н., Кочубей О.А., Гончарь А.В., Сытина И.В. Артериальная гипертензия и хроническое обструктивное заболевание легких - одно из частых коморбидных состояний в клинике внутренних болезней и являются предметом конструктивного взаимодействия терапевтов, кардиологов, пульмонологов. Сочетание хронического обструктивного заболевания легких и артериальной гипертензии представляет определенные трудности для диагностики и лечения. Эти заболевания имеют общие факторы риска, схожие клинические проявления и общность некоторых звеньев патогенеза. Таким образом, представляется актуальным исследование особенностей структурно-функционального состояния сердечно-сосудистой системы и микроциркуляции, изучение системных механизмов ремоделирования, эндотелиальной дисфункции и воспаления при артериальной гипертензии в сочетании с хроническим обструктивным заболеванием легких. Остаются актуальными вопросы разработки дополнительных маркеров сердечно-сосудистого риска, оценки эффективности проводимого лечения. В последние годы важными принципами диагностики субклинического поражения сердца и сосудов при коморбидности хронического обструктивного заболевания легких и артериальной гипертензии является использование электрокардиографии и эхокардиографии с допплерометрией. Неинвазивные методы визуализации играют центральную роль в диагностике субклинического поражения органов-мишеней. Их широкое применение обусловлено высокой диагностической точностью, повсеместной распространенностью, безопасностью и относительно низкой стоимостью. Ключевые слова. Артериальная гипертензия, хроническое обструктивное заболевание легких, коморбидность, электрокардиография, эхокардиография с допплерометрией.

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10

Khimion, L., and I. Klymas. "Polymorbidity patient in family physician practice." Health of Society 5, no. 1-2 (June 1, 2016): 66–68. http://dx.doi.org/10.22141/2306-2436.5.1-2.2016.121272.

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11

Tlish, Marina M., Taisiya G. Kuznetsova, Zhanna Yu Naatyzh, and Ruzana M. Tikeeva. "Polymorbidity: a View on Combined Pathology." Kuban Scientific Medical Bulletin 26, no. 5 (November 9, 2019): 125–34. http://dx.doi.org/10.25207/1608-6228-2019-26-5-125-134.

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Aim. To describe clinical cases exhibiting a rare combination of dermatoses in one patient in order to prevent iatrogenic errors.Results. The present article describes clinical cases of patients with polymorbid pathologies, which constitutes one of the current interdisciplinary healthcare problems. The described clinical cases indicate the co-occurrence and overlap of various diseases, which complicates the final diagnosis. Polymorbidity in modern patients turns the diagnostic process into a search for an optimal solution, which frequently requires innovative approaches. A mixed clinical picture leads to iatrogenic errors. A detailed differential diagnostics should be performed when establishing the final clinical diagnosis, which could reduce the frequency of medical-diagnostic and tactical errors. In this connection, a prolonged diagnostic route contributes to the timely detection of interdependent pathologies. The analysis of clinical cases related to managing patients with polymorbid pathologies facilitates the prevention of the progression of each disease, as well as the determination of prognostic aspects.Conclusion. Considering the narrow specialisation of medical institutions, the management of patients with polymorbid pathologies is a challenging problem. The management of such patients requires adherence to a clear clinical diagnostic algorithm and a multidisciplinary approach, which allows diagnostic errors and complications associated with drug therapy to be avoided, thus improving the quality of healthcare services. Polymorbid pathology constitutes an interdisciplinary problem requiring the development of a unified procedure for the management of patients, which should be aimed at the early detection of combined pathology, eliminating polypharmacy, reducing the overall risk of diseases and improving the life quality of patients.

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12

Shirinsky, V. S., and I. V. Shirinsky. "Polymorbidity, ageing of immune system and low-grade systemic inflammation: a challenge for modern medicine." Medical Immunology (Russia) 22, no. 4 (August 7, 2020): 609–24. http://dx.doi.org/10.15789/1563-0625-pao-2042.

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The review article considers the data from literature that concern polymorbidity aspects, its interrelations with ageing of immune system and lo-grade immune ageing, mechanisms of genesis, approaches to its prevention and treatment. Evolution of “comorbidity” and “polymorbidity” terms is traced, an updated definition of polymorbidity is proposed. The world-wide incidence of polymorbidity is increased and now it reaches 23-25% in general population, and up to 98%, in elderly people (> 65 years old). The risk factors of polymorbidity are considered, like as its social burden due to high costs for healthcare, high mortality rates, excessive treatment provided by multidisciplinary specialists. We present evidence for common molecular and cellular mechanisms involved in ageing and polymorbidity, being unified by the term “inflammaging” which represents a low-grade chronic systemic inflammation associated with ageing. The data are presented that concern the “inflammaging” development with involvement of ageing cells from innate and adaptive immunity systems, different pro and anti-inflammatory mediators, lifelong antigenic load. The data are analyzed concerning functional and structural changes in the inborn and adaptive immune system in ageing, role of these changes in “inflammaging” persistence and development of polymorbid conditions. There are complex interactions shown between the bodily senescence and immune ageing, with similar underlying mechanisms in some cases, however, being quite different in other instances. With age, upon existing risk factors, the changed adaptive immunity in most people is not able to full-scale coping with chronic antigenic load, thus increasing the risk of diseases. Moreover, in many elderly people these changes are compensated by steady activation of the innate immunity cells. It is noted that the aging events and development of disease (polymorbidity) cannot be considered distinct entities, since they can interact, being, however, basically different in their nature. In future, one should concentrate our efforts on elucidation of molecular and cellular mechanisms of these interactions, solution of the tasks oriented for development of such interventions that could be able to reduce harmful consequences of ageing and to use useful effects for health maintenance and reaching maximal longevity.

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Nikolaev, Yu A., V. A. Shkurupiy, I. M. Mitrofanov, Vladimir Ya Polyakov, and N. A. Dolgova. "The trans-system polymorbid states and their relationship with social status of patients of therapeutic clinic." Medical Journal of the Russian Federation 22, no. 2 (April 15, 2016): 60–65. http://dx.doi.org/10.18821/0869-2106-2016-22-2-60-65.

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The article presents result of analysis of indicator of polymorbidity in sampling of 9871 patients of therapeutic clinic of the research institute of experimental and clinical medicine (Novosibirsk)during 2003-2011. The study was carried out using archive method with statistical analysis of all nosologic forms, groups and classes of ICD-10 irrespective of particular diagnosis being main or concomitant. The gender differences of indicator trans-systemic polymorbidity during 2003-2011consisted in that in males its increasing was more dynamic than in females. The trans-systemic polymorbidity is correlated with social economic indicators considering as stressors having significant importance for its occurrence and development. These regularities are more specific for males due to direct correlation between trans-systemic polymorbidity and level of payroll salary in contrast with females. Hence, necessity to take into account impact of social economic factors on development of polymorbid pathology for improving system of secondary and tertiary prevention, diagnostic, treatment and rehabilitation of concomitant nosologies in patients. The development of new medical economic standards of treatment of patients with polymorbid pathology to implement principles of personified medicine is required.

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Ternovoy, Nikolay, Oleg Drobotun, and Nikolay Kolotilov. "Polymorbidity and heterogeneity of intact bone tissue in patients with malignant and metastatic bone tumors." Radiation Diagnostics, Radiation Therapy, no. 3 (2019): 33–37. http://dx.doi.org/10.37336/2707-0700-2019-3-3.

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Polymorbidity is the presence of several synchronically occurring diseases (genetically or pathogenetically related or unrelated) in one person at different stages and phases of their development, is accompanied by higher mortality rates, higher disability rates, treatment side effects, increased consumption of the patient’s body resources, lower quality of life. The purpose of the article is to demonstrate the association of polymorbidity and intact bone tissues’ heterogeneity in patients with malignant and metastatic bone tumors. Material and methods. 16 patients with benign bone tumors, 25 – with primary malignant bone tumors and 22 – with metastatic bone tumors were investigated with multispiral tomography scanner: 33 (52.4 %) men and 30 (47.6 %) women aged 25 to 75 years. The control group consisted of 37 patients with suspected tumor lesions of the bones, but the diagnosis was not confirmed. To assess polymorbidity in patients, the CIRS-G system was applied. Conclusion. An increase in polymorbidity level is associated with a decrease in RGD and an increase in the texture heterogeneity of computed tomographic images of the spongy and compact bones (the pattern is reliable, P <0.01) in the series: practically healthy individuals, patients with benign tumors, patients with malignant tumors, patients with metastatic tumors.

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Nurgazizova, A. K. "The origin, development and current concepts of «comorbidity» and «polymorbidity»." Kazan medical journal 95, no. 2 (April 15, 2014): 292–96. http://dx.doi.org/10.17816/kmj2084.

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The article aims to study the current concepts of polymorbidity and comorbidity by a literature review. This article presents the terms used to denote a combination of several diseases for one person, named as «combined», «concomitant», «associated» diseases or conditions, «comorbidity», «polymorbidity», «multimorbidity», «multifactorial disease», «polypathia», «co-disease», «dual diagnosis», «plural diseases». Definitions for currently commonly used terms «comorbidity», «polymorbidity» and «multimorbidity» are given, the historical aspects of their occurrence are discussed. The differences between the concepts of «comorbidity» and «polymorbidity», despite their frequent use as synonyms, are listed. The existing classifications of comorbidity, including definitions of trans-systemic, trans-nosologic and chronological comorbidity, are reviewed. The classification developed by H.C. Kraemer and M. van den Akker (1998), which presents a causal, complicated, iatrogenic, unclear and random comorbidity, is described. The assessment scales for the evaluation of this phenomenon, such as Cumulative Illness Rating Scale, Kaplan-Feinstein index, Cumulative Illness Rating Scale for Geriatrics, Index of Co-Existent Disease, Geriatric Index of Comorbidity, Functional Comorbidity Index, and Total Illness Burden Index, are presented. Detailed description of the comorbidity assessment by Charlson index as the most used and having the least disadvantages, is given. Description of the quantitative evaluation of polymorbidity is given, variation of the number of diseases depending on patient’s age is shown. The list for the most common pathologies that can be combined in a single patient is outlined. Diseases typical for the patients of elderly and senile age are described. The problem of comorbidity becomes more and more important in the areas where social conditions promote the increase of the life expectancy of elderly and senile patients, which requires a common approach to the problems of comorbidity.

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Barna, O. M. "Treatment of Hypertension in Patients with Polymorbidity: Sartans." Medicine of Ukraine, no. 7(193) (August 31, 2015): 20–23. http://dx.doi.org/10.37987/1997-9894.2015.7(193).222619.

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17

Ashcheulova, T., T. Ambrosova, O. Kochubiei, O. Honchar, and I. Sytina. "SUBCLINICAL CARDIAC DAMAGE IN CARDIOPULMONARY POLYMORBIDITY. Part 2." Inter Collegas 6, no. 3 (October 26, 2019): 122–31. http://dx.doi.org/10.35339/ic.6.3.122-131.

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Abstract. SUBCLINICAL CARDIAC DAMAGE IN CARDIOPULMONARY POLYMORBIDITY (Review. Part 2) Ashcheulova T., Ambrosova T., Kochubiei O., Honchar O., Sytina I. Hypertension and chronic obstructive pulmonary disease are frequent comorbid conditions in the internal medicine and are subject to meaningful cooperation among physicians, cardiologists, and pulmonologists. A combination of chronic obstructive pulmonary disease and hypertension presents certain diagnostic and therapeutic challenges. These conditions share common risk factors, similar clinical presentations and some common parts of pathogenesis. A problem of association between chronic obstructive pulmonary disease and hypertension may be currently discusses both as a simple combination of various clinical entities, and as chronic obstructive pulmonary disease resulting in development of factors contributing to hypertension. One way or another, either a simple combination, or a mutually aggravating syndrome, but we state there is a cardiorespiratory continuum where chronic obstructive pulmonary disease acts as a valid component of hypertension development, and vice versa. Thus, it seems to be relevant to study peculiarities of the structural and functional status of the cardiovascular system and microcirculation, systemic remodeling mechanisms, endothelial dysfunction and inflammation in presence of chronic obstructive pulmonary disease-associated hypertension. Problems of additional cardiovascular risk marker development, treatment efficiency assessment remain topical. The use of electrocardiography and echocardiography with dopplerometry has been an important diagnostic principle of subclinical cardiovascular damage in presence of hypertension and chronic obstructive pulmonary disease comorbidity. Non-invasive imaging methods play a central part in diagnosis of subclinical target organ damage. Wide implementation thereof is based on high diagnostic accuracy, common availability, safety and relatively low price. Key words: hypertension, chronic obstructive pulmonary disease, comorbidity, electrocardiography, echocardiography with dopplerometry Резюме. СУБКЛІНІЧНЕ УРАЖЕННЯ СЕРЦЯ ПРИ КАРДІОПУЛЬМОНАЛЬНІЙ ПОЛІМОРБІДНОСТІ (Огляд. Частина 2). Ащеулова Т.В., Амбросова Т.М., Кочубєй О.А., Гончарь О.В., Ситіна І.В. Артеріальна гіпертензія і хронічне обструктивне захворювання легень - одне з частих коморбідних станів в клініці внутрішніх хвороб і є предметом конструктивної взаємодії терапевтів, кардіологів, пульмонологів. Поєднання хронічного обструктивного захворювання легень і артеріальної гіпертензії являє певні труднощі для діагностики і лікування. Ці захворювання мають загальні фактори ризику, схожі клінічні прояви і спільність деяких ланок патогенезу. Таким чином, представляється актуальним дослідження особливостей структурно-функціонального стану серцево-судинної системи і мікроциркуляції, вивчення системних механізмів ремоделювання, ендотеліальної дисфункції та запалення при артеріальній гіпертензії в поєднанні з хронічним обструктивним захворюванням легень. Залишаються актуальними питання розробки додаткових маркерів серцево-судинного ризику, оцінки ефективності проведеного лікування. В останні роки важливими принципами діагностики субклінічного ураження серця і судин при коморбідності хронічного обструктивного захворювання легень і артеріальної гіпертензії є використання електрокардіографії та ехокардіографії з доплерометрією. Неінвазивні методи візуалізації відіграють центральну роль в діагностиці субклінічного ураження органів-мішеней. Їх широке застосування обумовлено високою діагностичної точністю, повсюдною поширеністю, безпекою і відносно низькою вартістю. Ключові слова. Артеріальна гіпертензія, хронічне обструктивне захворювання легень, коморбідность, електрокардіографія, ехокардіографія з доплерометрією. Резюме. СУБКЛИНИЧЕСКОЕ ПОРАЖЕНИЕ СЕРДЦА ПРИ КАРДИОПУЛЬМОНАЛЬНОЙ ПОЛИМОРБИДНОСТИ (Обзор. Часть 2). Ащеулова Т.В., Амбросова Т.Н., Кочубей О.А., Гончарь А.В., Сытина И.В. Артериальная гипертензия и хроническое обструктивное заболевание легких - одно из частых коморбидных состояний в клинике внутренних болезней и являются предметом конструктивного взаимодействия терапевтов, кардиологов, пульмонологов. Сочетание хронического обструктивного заболевания легких и артериальной гипертензии представляет определенные трудности для диагностики и лечения. Эти заболевания имеют общие факторы риска, схожие клинические проявления и общность некоторых звеньев патогенеза. Таким образом, представляется актуальным исследование особенностей структурно-функционального состояния сердечно-сосудистой системы и микроциркуляции, изучение системных механизмов ремоделирования, эндотелиальной дисфункции и воспаления при артериальной гипертензии в сочетании с хроническим обструктивным заболеванием легких. Остаются актуальными вопросы разработки дополнительных маркеров сердечно-сосудистого риска, оценки эффективности проводимого лечения. В последние годы важными принципами диагностики субклинического поражения сердца и сосудов при коморбидности хронического обструктивного заболевания легких и артериальной гипертензии является использование электрокардиографии и эхокардиографии с допплерометрией. Неинвазивные методы визуализации играют центральную роль в диагностике субклинического поражения органов-мишеней. Их широкое применение обусловлено высокой диагностической точностью, повсеместной распространенностью, безопасностью и относительно низкой стоимостью. Ключевые слова. Артериальная гипертензия, хроническое обструктивное заболевание легких, коморбидность, электрокардиография, эхокардиография с допплерометрией.

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Nadeev, A. P., and G. S. Karpovich. "Extragenital diseases, comorbidities, and polymorbidity in maternal death." Arkhiv patologii 81, no. 4 (2019): 11. http://dx.doi.org/10.17116/patol20198103111.

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Nadeev, A. P., and G. S. Karpovich. "Extragenital diseases, comorbidities, and polymorbidity in maternal death." Arkhiv patologii 81, no. 4 (2019): 11. http://dx.doi.org/10.17116/patol20198104111.

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Ostroumova, O. D., A. I. Kochetkov, T. M. Ostroumova, and M. V. Klepikova. "Potential of nicergoline in polymorbidity and cognitive impairment (clinical case)." Medical alphabet 1, no. 19 (November 2, 2020): 11–18. http://dx.doi.org/10.33667/2078-5631-2020-19-11-18.

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In real clinical practice, the problem of polymorbidity and, in particular, its cardiometabolic phenotype, is now widespread. One of the its variants is a combination of arterial hypertension with diabetes mellitus, overweight, cognitive impairment, and peripheral atherosclerotic arterial disease. The clinical significance of such polymorbidity portrait, on the one hand, lies in its frequent occurrence, and, on the other hand, in the cardiovascular risk amplification in the settings of simultaneous coexistence of diseases initially characterized by an extremely unfavorable prognosis for the patient. The article presents a clinical case of a patient with a such polymorbidity variant and considers the nicergoline potential in the complex correction of mutually associated comorbidities. The nicergoline ability to improve cognitive functioning, to have a beneficial effect on peripheral circulation, which is reflected in an increase in the distance of painless walking, and also to realize some antihypertensive effect has been demonstrated. No less important is the fact that the high therapeutic efficacy of nicergoline was combined with an optimal safety profile, which consists in good tolerability of therapy and the absence of adverse drug reactions.

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Chevallereau, Gaelle, Mathilde Legeay, Guillaume T. Duval, Spyridon N. Karras, Bruno Fantino, and Cedric Annweiler. "Profiling older community-dwellers with hypovitaminosis D: A classification tree analysis." International Journal for Vitamin and Nutrition Research 90, no. 3-4 (June 2020): 195–99. http://dx.doi.org/10.1024/0300-9831/a000591.

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Abstract. Despite the high prevalence of hypovitaminosis D in older adults, universal vitamin D supplementation is not recommended due to potential risk of intoxication. Our aim here was to determine the clinical profiles of older community-dwellers with hypovitaminosis D. The perspective is to build novel strategies to screen for and supplement those with hypovitaminosis D. A classification tree (CHAID analysis) was performed on multiple datasets standardizedly collected from 1991 older French community-dwelling volunteers ≥ 65 years in 2009–2012. Hypovitaminosis D was defined as serum 25-hydroxyvitamin D ≤ 50 nmol/L. CHAID analysis retained 5 clinical profiles of older community-dwellers with different risks of hypovitaminosis D up to 87.3%, based on various combinations of the following characteristics: polymorbidity, obesity, sadness and gait disorders. For instance, the probability of hypovitaminosis D was 1.42-fold higher [95CI: 1.27–1.59] for those with polymorbidity and gait disorders compared to those with no polymorbidity, no obesity and no sadness. In conclusion, these easily-recordable measures may be used in clinical routine to identify older community-dwellers for whom vitamin D supplementation should be initiated.

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Лаптева, Е. С., А. Л. Арьев, М. Р. Цуцунава, Г. Т. Арьева, and Д. С. Дьячкова-Герцева. "COMORBIDITY/POLYMORBIDITY PROBLEMS OF TERMINOLOGY AND APPLICATION OF INDEX INDICATORS (REVIEW)." Успехи геронтологии, no. 3 (August 2, 2021): 336–44. http://dx.doi.org/10.34922/ae.2021.34.3.001.

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В обзоре представлен анализ литературы по спорным вопросам использования терминов полиморбидность, мультиморбидность, коморбидность. Отмечается нарастающая публикационная активность по теме коморбидности/мультиморбидности. Основная дискуссия ведется в нескольких направлениях: какой термин надо использовать коморбидность, мультиморбидность или полиморбидность; использовать или не использовать индексовые показатели коморбидности; если использовать, то конкретно для каких целей; какая эффективность этих показателей. Делается вывод, что многие вопросы до настоящего времени не решены и необходимы дальнейшие исследования по данной проблеме. Настало время определиться с терминологией и конкретизировать, ГДЕ и КОГДА нужны индексовые показатели коморбидности/ полиморбидности. The review presents a literature analysis on controversial issues of the use of the terms polymorbidity, multimorbidity, comorbidity. Increasing publication activity on the topic of comorbidity/multimorbidity is noted. The main discussion is conducted in several areas: what term should be used comorbidity, multimorbidity or polymorbidity; use or not use index indicators of comorbidity; if used, specifically for what purpose; what is the effectiveness of these indicators. It is concluded, that many issues have not yet been resolved and further research is needed on this issue. It is time to define terminology and specify WHERE and WHEN comorbidity/polymorbidity indexes are needed.

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Egorov, I. V. "Difficult patient: overlap-syndrome, paraneoplastic syndrome or random polymorbidity?" Doctor.Ru 19, no. 11 (2020): 46–51. http://dx.doi.org/10.31550/1727-2378-2020-19-11-46-51.

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Objective: to describe a clinical case of CRST syndrome in combination with an oncological disease. Materials and methods. Patient S., 64 years old, complained of dizziness, stiffness in the hands, numbness of fingers, loss of appetite. After a thorough questioning and examination, systemic scleroderma was suspected and an additional examination was prescribed, which included routine clinical and biochemical tests, a "thyroid panel", rheumatological parameters, tumor markers, chest x-ray, ultrasound of the abdominal cavity, thyroid ultrasound, electrocardiography, echo gastroscopy. Results: Based on the examination data, the diagnosis was made of adenocarcinoma of the antrum of the stomach, as well as limited scleroderma (CREST syndrome) in combination with chronic autoimmune thyroiditis (СAIT). The course of the disease almost completely fits into the CREST syndrome, but there was no confirmation of esophageal dysfunction or esophagitis (in this case, the term CRST syndrome is sometimes used). The rest of the limited version of scleroderma was beyond doubt. Cases when CAIT accompanied systemic lupus erythematosus, systemic scleroderma, Sjogren's syndrome, mixed connective tissue diseases, etc., have not only been described, but also studied for overlap conditions - overlap syndromes. Conclusion. The pathogenetic mechanisms of the association of various autoimmune diseases are not completely clear; it is assumed that the key role in the formation of polyautoimmunity is played by defects of the immune system associated with polymorphism of various genes, in combination with environmental factors and hormonal disorders. And the detection of an oncological process does not look random: because of autoimmunity, an aberrant immune response, or the use of immunomodulatory drugs, many of the rheumatic diseases seem to increase the risk of neoplasia Key words: gastric adenocarcinoma, CREST-syndrome, limited scleroderma, chronic autoimmune thyroiditis, overlap-syndrome, rare disease, etiology, diagnostic research, paraneoplastic syndrome, methodology of diagnosis.

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Obrubov, S. A., N. V. Khamnagdaeva, A. N. Kazimirskiy, J. M. Salmasi, L. Y. Semenova, and G. V. Poryadin. "Initial pathogenetic mechanism of acquired myopia in children with polymorbidity." Modern technologies in ophtalmology, no. 4 (December 7, 2020): 218–19. http://dx.doi.org/10.25276/2312-4911-2020-4-218-219.

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Besimo, C. "Polymorbidität und Polypharmakotherapie im Alter - Eine interdisziplinäre Herausforderung." ZWR - Das Deutsche Zahnärzteblatt 116, no. 6 (June 2007): 286–91. http://dx.doi.org/10.1055/s-2007-984580.

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Asfandiyarova, Nailya S., Olga V. Dashkevich, Natalya V. Doroshina, and Ekaterina I. Suchkova. "Type 2 diabetes mellitus and multiple chronic diseases." Diabetes mellitus 21, no. 6 (February 18, 2019): 455–61. http://dx.doi.org/10.14341/dm9605.

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Background: Recently, there has been an increase in the number of patients with multiple chronic diseases (MCD), particularly due to obesity and ageing. The role of type 2 diabetes mellitus (T2DM) in the development of MCD, however, is still unclear. Aims: This study aimed to determine the incidence of T2DM in the structure of polymorbidity considering sex and age-related characteristics. Materials and methods: Patients with MCD (n = 2,254; 769 men/1,485 women; aged, 1899 years) were examined. The incidence of type 2 diabetes among patients with MCD considering age and sex was determined. Results: Type 2 DM was detected in 407 patients with MCD (18.1%; male:female, 1:2.53). The polymorbidity index in male patients with type 2 diabetes was 1.52.0 times higher than that in male patients without diabetes. The rate of polymorbidity index increase was similar in both groups; however, its high initial value in patients with diabetes at a young age determined the burden of the comorbidity at a later age. In type 2 diabetes, hypertension was the predominant comorbidity at 1859 years of age (p0.05), whereas other cardiovascular diseases and liver and kidney diseases were predominant at 4574 years of age (p0.001) and hemiplegia at 4589 years of age (p0.05). Between 60 and 74 years, oncological diseases were found to be more common in patients without diabetes (p0.001). Obesity, regardless of the presence of diabetes, was associated with a greater disease burden (p0.05). Sex-related difference considering MCD in patients with type 2 DM was only observed for the higher incidence of myocardial infarction (p0.001) and peptic ulcer disease in males (p0.01). Females were more likely to have obesity, liver steatosis at a young age, or osteoarthritis than males in the general group (p0.05); no differences were noted with respect to other diseases. Conclusions: In this study, type 2 diabetes was present in 18.1% of patients with MCD; moreover, a high initial polymorbidity index in patients with T2DM at young age was associated with a higher incidence of chronic diseases later in life than that in patients without diabetes. Based on these results, type 2 diabetes, along with ageing and obesity, can be considered as a risk factor in the development of MCD.

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Abramova, V. N., T. A. Slyusar, and C. L. Medvedeva. "Anxiety-depressive and asthenic disorders in patients older than 75 years with chronic brain ischemia." Medical alphabet 4, no. 39 (January 18, 2020): 40–43. http://dx.doi.org/10.33667/2078-5631-2019-4-39(414)-40-43.

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Purpose of the study. To study the prevalence and severity of depression, anxiety and asthenia in patients older than 75 years with chronic brain ischemia (CBI) and their relationship with somatic burden.Materials and methods. 121 patients aged 75 to 95 years with CBI of two and three stage were examined (57 patients with ischemic stroke in anamnesis, 64 without stroke). We used the Beck’s questionnaire to determine the level of depression, State-Trait Anxiety Inventory (STAI) one for detecting anxiety, Multidimensional Fatigue Inventory (MFI-20) one for assessing the severity of asthenia. The level of burden of somatic pathology was calculate by the polymorbidity index.Results. A characteristic feature of patients older than 75 years with CBI is the high prevalence and severity of emotional disturbances (anxiety and depression), as well as asthenic syndrome, high values of the polymorbidity index, which is advisable to take into account when planning CBI therapy.

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Zyryanov, Sergey Kensarinovitch, and Olga Igorevna Butranova. "Anti–cholinergic burden in the population of elderly: importance in surgery." Hirurg (Surgeon), no. 1 (January 1, 2021): 70–78. http://dx.doi.org/10.33920/med-15-2101-08.

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An increase in the population of elderly and senile patients leads to a change in approaches to patient management in the practice of doctors of various profiles. Polymorbidity and, as a result, polypharmacy, highly specific for this population, underlies the widespread occurrence of adverse drug

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Yamshchikova, Anastasia V., A. N. Fleishman, and M. O. Gidayatova. "CO-MORBID CONDITIONS IN THE VIBRATION DISEASE PATIENTS." Hygiene and sanitation 98, no. 7 (October 28, 2019): 718–22. http://dx.doi.org/10.18821/0016-9900-2019-98-7-718-722.

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Introduction. Occupation vibration is the main etiological factor of the vibration disease. Vibration disease disrupts the activity of different systems of the body (nervous, vascular, musculoskeletal, endocrine systems, etc.) which predisposes to the development of co-morbid conditions. Aim of the study. Based on the studying the prevalence and the structure of co-morbid pathology in vibration disease patients to identify the dependence of a polymorbidity on the duration of work experience and severity of vibration pathology, determine a prognosis of “10-year survival” according to the Charlson co-morbidity index. Material and methods. A retrospective analysis of 175 clinical charts of 83 patients of the clinic of the Research Institute for Complex Problems of Hygiene and Occupational Diseases for the period from 2013 to 2018 was carried out. All patients (40-60 years old men) were exposed to vibration in the course of the occupational activity for more than 10 years. Results. Co-morbid conditions in vibration disease were found in 90% of the patients. There most frequent were hypercholesterolemia (52%), dorsopathy (29%), arterial hypertension (27%), sensorineural hearing loss (24%), etc. The results confirm the previously described data on the predominance of co-morbid cardiovascular and metabolic disorders in vibration disease, which are interrelated by pathogenetic mechanisms. The Charlson co-morbidity index in the study group was 2.6 ± 1.04. Average statistical association of the polymorbidity prevalence (φ = 0.21) with the severity of the vibration disease was revealed. Conclusions. The vast majority of the vibration disease patients have co-morbid pathology. More severe damage in vibration pathology is associated with polymorbidity. This relationship is probably due to the mutual worsening of the course of associated diseases.

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Ostroumova, O. D., I. A. Alyautdinova, S. N. Litvinova, A. V. Arablinskij, and A. A. Kirichenko. "Optimization of Pharmacotherapy Within the Framework of a Patient-oriented Approach in the Treatment of Hypertension in Multimorbidity Patients (Clinical Case and Literature Review)." Rational Pharmacotherapy in Cardiology 17, no. 1 (March 3, 2021): 124–32. http://dx.doi.org/10.20996/1819-6446-2020-11-07.

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Arterial hypertension (AH) remains one of the main causes of disability and death worldwide, including in Russia. At the same time, the risks of coronary and cerebrovascular events increase in the presence of additional risk factors. The most common modifiable risk factors are metabolic disorders, including pre-diabetes, dyslipidemia, peripheral arterial atherosclerosis, and obesity, which also imposes certain features on the choice of optimal pharmacotherapy. Currently, the terminology of comorbid conditions continues to be discussed depending on their pathogenesis and the presence or absence of dominance of one disease over others, i.e. polymorbidity, comorbidity and multimorbidity. At the same time, “associative polymorbidity” is distinguished with a certain set of diseases that often occur in conjunction with each other with individual susceptibility of the body. One of the most common phenotypes of polymorbidity occurring in all age groups in both sexes is cardiometabolic, which is based on the formation of insulin resistance, sympathetic overactivity and chronic inflammation. This article provides a clinical example of the use of a fixed combination of angiotensin II receptor blocker telmisartan and calcium channel blocker amlodipine with the addition of an I1-imidazoline receptor agonist moxonidine in real clinical practice in a polymorbid cardiometabolic patient with target organ damage (left ventricular hypertrophy and microalbuminuria). High antihypertensive (favorable effect on 24-hour blood pressure, especially in the early morning) and organoprotective effectiveness of this combination, its possibilities in correcting additional risk factors (reduced heart rate, body weight and a positive effect on metabolic parameters), due to a synergistic effect on the central pathogenetic mechanisms of hypertension and obesity – insulin resistance and sympathetic overactivity.

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Gantsgorn, E. V., and A. N. Alekseev. "Case Report: «Difficult Patient» and the Problem of Polymorbidity and Polypragmasy." Medicina 6, no. 4 (2018): 99–108. http://dx.doi.org/10.29234/2308-9113-2018-6-4-99-108.

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Yeryomenko, G. V., T. S. Ospanova, T. V. Bezditko, and V. I. Blazhko. "ASTHMA AND DIABETES MELLITUS 2 TYPE – POLYMORBIDITY OF THE XXI CENTURY." Asthma and allergy 2019, no. 1 (2019): 27–30. http://dx.doi.org/10.31655/2307-3373-2019-1-27-30.

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Makhov, Valery M., L. V. Romasenko, A. S. Panfyorov, Yu A. Doronina, and A. A. Balakhonov. "The Polymorbidity of Diverticular Disease of the Colon – Factor Determining Therapy." Effective Pharmacotherapy 15, no. 18 (May 28, 2019): 24–28. http://dx.doi.org/10.33978/2307-3586-2019-15-18-24-28.

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Leskina, L. M., N. P. Golovkova, and N. I. Kotova. "The value of experience and age of workers in the diagnosis of chronic disease for the prevention of occupational health disorders." Russian Journal of Occupational Health and Industrial Ecology, no. 9 (March 19, 2020): 679. http://dx.doi.org/10.31089/1026-9428-2019-59-9-679-680.

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The hygienic assessment of working conditions of workers of the main professions engaged in management of the mechanized vehicles at mining combine is given. The index of polymorbidity of chronic diseases was established. The experience and age at which workers are diagnosed with chronic General somatic disease for the first time are determined.

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Sevostyanova, E. V., Yu A. Nikolaev, I. M. Mitrofanov, and V. Ya Polyakov. "Risk factors for cardiovascular disease in patients with non-alcoholic fatty liver disease with polymorbidity." Cardiovascular Therapy and Prevention 18, no. 5 (November 1, 2019): 74–79. http://dx.doi.org/10.15829/1728-8800-2019-5-74-79.

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Aim. To study the associations of the frequency and values of parameters of the main risk factors (RF) of cardiovascular diseases (CVD) and the degree of transnosological polymorbidity (PM) in patients with nonalcoholic fatty liver disease (NAFLD).Material and methods. The analysis of 3667 medical records (men, women) treated in the clinic of Research Institute of Experimental and Clinical Medicine (Novosibirsk) was carried out. Index of polymorbidity was evaluated by the number of nosological forms in accordance with the International Classification of Diseases, 10th revision (ICD-10). The following risk factors were assessed according to clinical and laboratory tests: arterial hypertension, dyslipidemia, hyperglycemia, obesity.Results. Both among men and women with increasing index of PM there was identified growth of the parameters that determine the main RF: systolic BP, diastolic BP, obesity (both in men and women), atherogenicity index (in women), glucose concentration in the blood serum (in women). Frequency of AH occurrence in persons with a high degree of PM among men was 49%, and among women — 69% higher, compared with persons with a low degree of PM. Among men, there was an increase in the incidence of AH (by 9%) and obesity (by 9%) in individuals with a high degree of PM, compared with individuals with an average degree of PM. Among women, there was an increase in the incidence of AH (by 15%), obesity (by 9%), hyperglycemia (by 11%) in persons with a high degree of PM, compared with individuals with an average degree of PM.Conclusion. There was established the role of risk factors for cardiovascular diseases, arterial hypertension mainly, in the development of polymorbidity in patients with NAFLD. The findings indicate the need for personified prevention and treatment of such patients with mandatory identification and correction of modifiable CVD RF.

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Uspenskaya, Ol'ga, Elena Shevchenko, Elena Ivanchenko, Tatyana Potemina, Olga Novozhilova, Taisiya Morozova, and Matia Skotareva. "FEATURES OF THE DENTAL STATUS OF POLYMORBIDE PATIENTS WITH A CARDIOMETABOLIC PHENOTYPE." Actual problems in dentistry 15, no. 4 (February 12, 2020): 66–71. http://dx.doi.org/10.18481/2077-7566-2019-15-4-66-71.

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Subject. The article discusses topical issues of polymorbidity of dental patients, particularly features of the dental status of patients with a cardiometabolic phenotype. The study of the oral cavity in the presence of multiple somatic pathology involves an interdisciplinary approach and requires dentists to develop additional professional knowledge. The polymorbidity of the cardiometabolic phenotype often leads to the appearance and development of organic and functional disorders of the hard tissues of the teeth and oral mucosa. This feature should be taken into account both by dentists and other medical specialists when observing and treating patients of this category. The aim of the study is to establish a relationship between qualitative disorders of the structure, function of organs and tissues of the oral cavity and the presence of cardiometabolic pathology. Methods. The study involved 60 patients hospitalized in the cardiology and neurological departments of Clinical Hospital No. 38 of Nizhny Novgorod, aged from 18 to 85 years. Case histories were studied where the selection criteria were: blood pressure, high density lipoproteins (HDL), and glucose concentration in the blood. To determine the dental status of patients used DMF, PMA and Green—Vermillon indexes. Results. In the course of the study, it was found that in 97 % of patients with metabolic syndrome, the DMF index exceeds the norm (DMF> 10); 50 % of patients showed moderate gingivitis, and in 27 % of patients - severe; 6% of patients show good oral hygiene; in 83 % of patients the level of hygiene is much lower: in 33 % of patients the level of hygiene is average, in 50 % the level is poor and in 9 % it is very poor. Conclusions. The results obtained indicate that dental morbidity has a pronounced polymorbidity.

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Storozhuk, N. V., T. M. Platonova, B. G. Storozhuk, E. V. Lugovskoy, L. A. Storozhuk, and T. V. Dovgalyuk. "Influence of some comorbid and polymorbid states on the indicators of hemostasis in patients with ischemic heart disease and percutaneous angioplasty." Reports of Vinnytsia National Medical University 23, no. 1 (March 1, 2019): 134–37. http://dx.doi.org/10.31393/reports-vnmedical-2019-23(1)-23.

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Identification of markers of possible thrombotic complications in patients with ischemic heart disease and percutaneous angioplasty with comorbid conditions on the background is significant for preventive medical interventions, depending on the degree of thrombotic risk. The hemostasis markers (sF, fibrinogen, D-dimer and C-protein) of 91 patients (77 men and 14 women) with ischemic heart disease and percutaneous angioplasty, of whom 32 patients had a stent retrombosis in anamnesis, were measured in different groups of comorbidity and polymorbidity. The purpose of the paper is to investigate changes in hemostasis in some comorbid conditions in patients with ischemic heart disease and percutaneous angioplasty, as well as to identify possible markers of thrombinemia. The results of the study suggest that the presence of comorbidity and polymorbidity in the investigated patients acts as a prognostic weighting factor in the development of thrombotic complications. A comprehensive study of hemostasis markers, among which sF is the most informative one, objectively characterizes disorders in the hemostasis system, while diabetes mellitus and restenosis in the anamnesis being the most dangerous comorbid conditions during the development of thrombotic complications.

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Nikolaev, Yu A., E. V. Sevostyanova, I. M. Mitrofanov, V. Ya Polyakov, and N. A. Dolgova. "Features of polymorbidity in cardiac and gastroenterologic patients from a therapeutic clinic." Terapevticheskii arkhiv 88, no. 1 (2016): 40. http://dx.doi.org/10.17116/terarkh201688140-45.

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van Bussel, B., E. Pijpers, I. Ferreira, P. Castermans, and A. N. Kruseman. "Polymorbidity in diabetes in older people: consequences for care and vocational training." Postgraduate Medical Journal 83, no. 986 (December 1, 2007): 763–67. http://dx.doi.org/10.1136/pgmj.2007.062356.

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40

Partsernyak, A. S., M. A. Aflitonov, Y. Sh Khalimov, E. B. Kireeva, A. N. Mironenko, and S. A. Partsernyak. "THE ACTIVITY OF APOPTOSIS AND PREMATURE AGING IN YOUNGAND MIDDLE-AGED MAN WITH POLYMORBID CARDIOVASCULAR DISEASEAND NON-PSYCHOTIC MENTAL DISORDERS." HERALD of North-Western State Medical University named after I.I. Mechnikov 9, no. 1 (March 15, 2017): 48–53. http://dx.doi.org/10.17816/mechnikov20179148-53.

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Objective: To study the activity of apoptosis and premature aging in individuals of middle age with polymorbidity cardiovascular disease and non-psychotic mental disorders.Design and methods: The study included 78 men with MCVP and 20 healthy men. used in the study: complex psychological test methods and laboratory-instrumental evaluation of the cardiovascular system. definition p53 protein was performed by ELISA using kits BMS eBioscience BMS256 (BenderMedSys- tems, uSA). Results: n the group of patients with polymorbidity cardiovascular disease (PTS) of the p53 protein level was 4,89 uI / ml in the control group, p53 0,93 uI / ml. In all groups celebrated the acceler- ated pace of aging by an average of 10 years, compared with the control group. In the second phase of the study, patients were divided into three groups, depending on the planned treatment scheme. In the group of patients treated with standard therapy of p53 protein level was 3,51 uI / ml, from the group comprising in addition to standard therapy, psychotherapy - 2,34 uI / ml, in the third group, where the methodology of psycho-physiological and psychological visual and auditory correction - 1 8 uI / ml. After a course of treatment in all groups showed slowing premature aging . The first and second groups , a transition of V in class IV , the third group III to V of the functional class of aging . during the correlation analysis it was found a strong correlation between p53 protein and BV (r + 0,69; p < 0.05).Conclusions: Patients with polymorbidity cardiovascular disease marked increase in titer of apop- tosis protein p53 , accelerating premature aging 7-10 years. A direct correlation between p53 protein and biological age (r + 0,69; p < 0.05). Against the background of complex treatment with standard therapy with psycho-physiological and psychological visual and auditory correction decreased prema- ture aging, as compared with the groups that used the standard therapy for 8-10 years.

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Kamchatnov, P. R., B. A. Abusueva, S. B. Khanmurzaeva, and N. B. Khanmurzaeva. "Choosing of therapy for a patient with dorsalgia." Terapevticheskii arkhiv 92, no. 9 (October 14, 2020): 102–7. http://dx.doi.org/10.26442/00403660.2020.09.000836.

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Dorsalgia is one of the most common skeletal muscle syndromes. Dorsalgia often develops in patients of older age groups with polymorbidity that requires the appointment of a large number of medications. In these conditions, the choice of effective and safe therapy is a difficult problem. Discusses management of a patient suffering dorsalgia with comorbidities, the risks of complications of therapy, possible safety treatment, in particular, through the use of combination therapy.

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Oganov, R. G., and O. M. Drapkina. "POLYMORBIDITY: SPECIFICS OF CO-DEVELOPMENT AND CONCOMITANCE OF SEVERAL DISEASES IN ONE PATIENT." Cardiovascular Therapy and Prevention 15, no. 4 (September 16, 2016): 4–9. http://dx.doi.org/10.15829/1728-8800-2016-4-4-9.

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Tarlovskaya, E. I. "Comorbidity and polymorbidity – a modern interpretation and urgent tasks facing the therapeutic community." Kardiologiia 17, S9 (2018): 29–38. http://dx.doi.org/10.18087/cardio.2562.

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Chan, Randolph C. H., Huso Yi, and Queenie K. Y. Siu. "Polymorbidity of developmental disabilities: Additive effects on child psychosocial functioning and parental distress." Research in Developmental Disabilities 99 (April 2020): 103579. http://dx.doi.org/10.1016/j.ridd.2020.103579.

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Ettinger, Ol’ga A., Gennadiy E. Gendlin, Elena A. Stepanova, Irina I. Ganieva, Svetlana V. Borisovskaya, Il’ya G. Fedorov, and Igor’ G. Nikitin. "Amyloid cardiomyopathy in the elderly: clinical options, difficulties in diagnosis and treatment." Medical Journal of the Russian Federation 26, no. 1 (June 25, 2020): 45–66. http://dx.doi.org/10.18821/0869-2106-2020-26-1-45-66.

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This article analyzes the frequency and features of cardiac amyloidosis in the elderly. The morphology and pathogenesis of amyloid cardiomyopathy are presented. The features of the clinical picture of the heart and aortic lesions in systemic and local variants of amyloidosis are analyzed. Polymorbidity in older people, which complicates the diagnosis of cardiac amyloidosis and leads to a delay in treatment, is reviewed. The diagnostic methods of various types of cardiac amyloidosis are evaluated. Modern trends in the treatment of amyloidosis are presented.

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Grigoryeva, N. Yu, M. V. Maiorova, M. E. Korolyova, and M. O. Samolyuk. "Comorbidity and polymorbidity of the patient with chronic obstructive pulmonary disease and cardiovascular diseases." Terapevticheskii arkhiv 91, no. 1 (January 15, 2019): 43–47. http://dx.doi.org/10.26442/00403660.2019.01.000027.

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Aim: the study of comorbid status and characteristics of clinical course of ischemic heart disease (IHD) in patients with chronic obstructive pulmonary disease (COPD). Materials and methods. We conducted a retrospective analysis of case histories of 958 IHD patients aged 32 to 93 years (mean age of 60.8±10.2 years), including men - 525 (54.8%), women - 433 (45.2%) who were treated in the cardiology Department of city clinical hospital №5 of Nizhny Novgorod. Related COPD was diagnosed in 251 patients (26.3%). We compared two groups patients: with IHD and COPD, and the second - persons suffering from only IHD (without COPD). Results. Myocardial infarction was transferred by 62.2% of patients in Group 1, which is 16.3% more than in Group 2 (p

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Gorokhovskaya, G. N., Yu A. Vasyuk, A. I. Martynov, E. Yu Maychuk, V. L. Yun, I. V. Truten, and M. M. Petina. "Modern opportunities of nitropreparations in patients with ischemic heart disease: from angina to polymorbidity." Consilium Medicum 20, no. 12 (2018): 61–68. http://dx.doi.org/10.26442/20751753.2018.12.180063.

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Lobmann, Ralf. "The influence of polymorbidity, revascularization, and wound therapy on the healing of arterial ulceration." Vascular Health and Risk Management Volume 4 (June 2008): 683–89. http://dx.doi.org/10.2147/vhrm.s2186.

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Biteeva, I., H. Schreder, J. Sindern, and I. Rudolph. "PIN45 POLYMORBIDITY, THERAPY AND COSTS OF AMBULATORY CARE FOR HEPATITIS C PATIENTS IN GERMANY." Value in Health 13, no. 3 (May 2010): A194. http://dx.doi.org/10.1016/s1098-3015(10)72951-x.

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Luzny, Jan, Jana Bellova, and Emanuel Donek. "DOES GERONTOPSYCHIATRY BELONG TO MEDICINE? CROSS-SECTIONAL STUDY MONITORING POLYMORBIDITY IN HOSPITALIZED GERONTOPSYCHIATRIC PATIENTS." Biomedical Papers 154, no. 1 (March 1, 2010): 89–92. http://dx.doi.org/10.5507/bp.2010.015.

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