This research was aimed to study the possibilities of multislice computed (MSCT) tomography to diagnose status of coronary arteries at the patients with ischemic heart diseases. Material and methods. The research includes the results of complex study of 70 patients, which were send to the cardiology department for the verification of ischemic heart disease, as well as for examination and correction of provided therapy at this category. All patients had been provided traditional invasive coronary angiography and MSCT of coronary arteries. Results. At the 29 (76,3%) patients of 1 group stenosis of coronary arteries were not revealed, in 6 (15,8%) patients were revealed insignificant hemodynamic stenosis. In 3 (7,9%) patients revealed significant hemodynamic stenosis and in 1 (2,6%) critical stenosis (narrowing coronary artery lumen КА > 90 %). By data of MSCT and coronary angiography was revealed strong correlative relationship in diagnosis of stenosis. These factors argue about high comparability of both methods. The greatest correlation relationship was revealed for trunk of left coronary artery, right descending artery and circumflex artery and was 9,2; 0,84 and 0,81 accordingly. Analogical indexes were less for the right coronary artery and was 0,71. Though, large part of the patients in main group was not needed in intracoronary intervention and surgical revascularization. Conclusion. MSCT can use as noninvasive alternative method of coronary angiography in patients with high risk of ischemic heart disease. Comparative analysis of MSCT of coronary arteries and invasive coronary angiography revealed that MSCT has sensitivity of 91%, specificity of 89%.

İşin məqsədi. İşin məqsədi COVİD-19 diaqnozu PCR (polimerazalı zəncirvari reaksiya) testi ilə təsdiq olunmuş xəstələrdə ağciyərlərdə baş verən dəyişikliklərin diaqnostikasında və dinamikasının izlənilməsində döş qəfəsi rentgenoqrafiya və komputer tomoqrafiya müayinələrinin imkanlarının öyrənilməsi olmuşdur.Material və metodlar. Tədqiqat Azərbaycan Tibb Universitetinin Tədris-Cərrahiyyə Klinikasında aparılmışdır. Tədqiqata 124 xəstənin döş qəfəsinin rentgenoqrafiya və 60 xəstənin komputer tomoqrafiya müayinələrinin nəticələri daxil edilmişdir. Hər iki müayinənin aparıldığı 30 xəstədə nəticələr müqayisəli dəyərləndirilmişdir.Nəticələr. Döş qəfəsi rentgenoqrafiya müayinələrində daha çox aşkar etdiyimiz əlamətə buzlu şüşə görüntüsü aid edilmişdir ki, bu da 74(60%) nəfərdə aşkar edilmişdir. Bundan bir qədər az 24(19%) xəstədə isə konsolidasiya sahələri vizuallaşmışdır. 26 xəstədə (21%) xəstədə rentgenoloji dəyərləndirilən dəyişiklik aşkar edilməmişdir. Zədələnmələr daha çox periferik ağciyər sahələrində (68%) və aşağı paylarda izlənilmiş (72%) və daha çox hallarda (56%) bilateral xarakter daşımışlar. 3(2%) xəstədə plevral effuziya aşkar edilmişdir. Komputer tomoqrafiya müayinəsində də, həmçinin daha çox aşkar etdiyimiz əlamətə buzlu şüşə görüntüsü aid edilmişdir ki, bu da 48 (80%) xəstədə aşkar edilmişdir. Bundan başqa, 21(35%) xəstədə isə konsolidasiya sahələri aşkar edilmişdir ki, bu da görüntülərdə buzlu şüşə görüntüsü ilə birlikdə vizuallaşmışdır. Digər səciyyəvi əlamətlərdən 25(42%) xəstədə plevral fibrotik bandlar, 9(15%) xəstədə düyünşəkilli buzlu şüşə görüntüsü və 12(20%) xəstədə vaskulyar genişlənmələr aşkar edilmişdir. 4(7%) xəstədə plevral effuziya izlənilmişdir. 12(20%) xəstədə komputer tomoqrafiya müayinəsində dəyişiklik aşkar edilməmişdir. Zədələnmələr daha çox periferik ağciyər sahələrində (86%) və aşağı arxa seqmentlərdə izlənilmiş (80%) və daha çox hallarda (60%) bilateral xarakter daşımışlar.Yekun. COVID-19 pnevmoniyasının diaqnostikasında və menecmentində radioloji müayinələrdə izlənilən əlamətlər yüksək informativliyə malikdir.Bu vacib məqamlar COVİD- 19 pnevmoniyası ilə məşğul olan bütün mütəxəssislər üçün əhəmiyyətlidir.

The novel coronavirus infection (COVID-19) pandemic, caused by the highly contagious severe acute respiratory syndrome coronavirus (SARS-CoV-2), is still at its peak, causing thousands of deaths every week. Since the beginning of the coronavirus (just a few months ago), our understanding of the disease has grown rapidly. While there are several large randomized drug trials currently underway, current survival from severe COVID-19 is entirely dependent on providing the best supportive care possible. To determine the benefits of NIV in ARF in patients with COVID-19. The study included 25 patients admitted to the intensive care unit of the AMU surgical clinic during the period from April 1 to August 1, 2020. Our experience with NIV has shown that the majority of patients undergoing NIV tolerate this procedure relatively well at the initial stage. However, in a number of patients during the first minutes or hours of NIV, there is no improvement in their condition (clinical parameters and gas exchange) or the procedure is poorly tolerated; the proportion of such patients is usually about 15–35%. Non-invasive ventilation of the lungs was carried out with an oral-nasal mask using an ELISA ventilator. The parameters were set and adjusted according to the general state and according to blood gas data 4 times a day: RR <35, pH> 7.30, neurological dysfunction according to the Kelly scale> 3-5, modified with a scale for determining the participation of auxiliary respiratory muscles <3 points. With hypercapnia, the following parameters were set: Ps – 12, PEEP – 6 cm water column, FiO2 -30-40%, and with hypoxemia – Ps – 12, PEEP – 5 cm water column, FiO2 -50-60 %. The median treatment period with NIV was 12 days. The average daily treatment time with NIV on the first day was 16.5 hours, on the second day – 17.2 hours and on the third day 15.7 hours. The patient was discharged on the 18th day with improvement.

BackgroundPatients with active rheumatoid arthritis (RA) are frequently diagnosed with an atherogenic lipid profile and supra-aortic vessel ultrasound signs of atheromatous plaques, which have been linked to the inflammatory activity of RA. Recent experimental and clinical evidences suggest that the beneficial effects of statins are pleiotropic and have been proposed to have anti-inflammatory and immunomodulatory effects, inhibiting proinflammatory cytokines (IL-1β, 6, 8, TNF-α), adhesion molecules (sICAM 1, E-, P-selectin), osteoprotegerin, which are implicated in RA pathogenesis. However, the beneficial role of statin therapy in clinical improvement and their benefit-risk profile are still debatable.ObjectivesTo evaluate the effect of medium-term rosuvastatin therapy on lipid profile, endothelial dysfunction and RA activity in patients with rheumatoid arthritis (RA) in comparison with conventional disease modifying antirheumatic drugs (DMARD) therapy.MethodsThe study included 82 patients in the Specialized Course Out-patient Therapy Department of the 1st Clinic of Tashkent Medical Academy of age group between 44 and 65 years (mean 52±8.4), predominantly female gender (n=57, 69.5%), with early RA (mean disease duration 9.2±2.4 months), and divided into 2 groups. Group 1 (n=40) received methotrexate (MTX; 7.5 mg/week; plus prednisolone (10 mg/day). Group 2 (n=42) received MTX and prednisolone with the same previous doses plus rosuvastatin (40 mg/day). Lipid profile assessment comprised triglycerides, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C). Disease activity was assessed by the disease activity score of 28 joints (DAS28), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and visual analog scale (VAS). Disease activity, lipid profile and intima-media thickness (IMT) of common carotid arteries were measured before and after 85 days (6 months) of treatment.Results4 patients receiving rosuvastatin were excluded due to abnormal liver function test parameters (De Ritis ratio <0.9), further assessment was thus performed on 78 (Group 2, n=38) early RA patients. Overall ESR (Group 1: 24.4±7.26; Group 2: 37.4±12.3) and CRP (Group 1: 5.56±0.58; Group 2: 3.71±1.23) declined significantly during the treatment. The mean DAS28, unconditionally considered as the most important index of clinical disease activity in RA, was found to be lower (p<0.05) in the adjunct statin-treated group (Group 2: 3.68±0.77) than that of the conventional DMARD treated group (Group 1: 4.45±1.08). Statin significantly reduced LDL-C (3.9±1.2 mmol/l to 3.3±0.8 mmol/l; p=0.08) and increased HDL-C (1.3±0.6 mmol/l to 2.0±0.4 mmol/l; p=0.06) after 6 months of treatment. However, rosuvastatin therapy showed no significant improvement in VAS score (6.7±1.5 to 6.9±0.6; p=0.41) and IMT (1.04±0.09 to 1.08±0.07; p=0.05).ConclusionsStatins ameliorate RA activity, reduce potential cardiovascular risk in the context of atherosclerosis and mediate clinically apparent anti-inflammator...

AIM. To assess coronary calcification nature in patients with rheumatoid arthritis using digital radiography.METHODS. Chest and distal upper extremities X-ray examination results of the 60 patients with rheumatoid arthritis were retrospectively analyzed. The patients mean age was 54.3±7.8 years, mean disease duration - 8.34±0.3 years. The correlation closeness assessment of qualitative features in the observed group was performed by Pearson correlation coefficient.RESULTS. When performing distal upper extremities X-ray examination, in 9 (15.0±4.6%) patients stage I, in 16 (26.7±5.7%) - II, in 21 (35.0±6.2 %) - III, in 14 (23.3±5.5%) patients - stage IV rheumatoid arthritis was found. In 19 (31.7±6.0%) patients coronary calcifications were visualized in the anterior interventricular branch of the left coronary artery, in 14 (23.3±5.5%) patients - in the circumflex branch of the left coronary artery, in 10 (16.7±4.8%) - in the right coronary artery, in 10 (16.7±4.8%) patients - the main trunk of the left coronary artery. In 7 (11.7±4.1%) patients aortic arch calcifications were found. It was found that the coronary calcifications incidence was higher in more prolonged disease course. Correlation relationship between coronary calcifications and rheumatoid arthritis stage was determined: in 7 (77.8±4.1%) patients with stage I, 14 (87.5±4.8%) patients with stage II and in all patients with stage III and IV coronary and aortic calcifications of various nature were identified. The coronary calcification incidence and prevalence had a direct correlation with the patient’s age: in most cases (66.7±10.3%) patients aged 55-60 years had multivessel calcification (≥3).CONCLUSION. There is a close correlation relationship between coronary calcifications and rheumatoid arthritis stages; coronary calcification incidence and prevalence in patients with rheumatoid arthritis depends on age, as well as the disease duration and stage, which is particularly important in the treatment strategy determination.