Перегляд за Автор "Trybrat, T."
Зараз показуємо 1 - 7 з 7
Результатів на сторінці
Налаштування сортування
Документ Effect of quercetin on parameters of central hemodynamics and myocardial ischemia in patients with stable coronary heart disease(Higher State Educational Establishment of Ukraine “Ukrainian Medical Stomatological Academy” — Poltava, Ukraine, 2017) Chekalina, N.; Shut`, S.; Trybrat, T.; Burmak, Yu.; Petrov, Ye.; Manusha, Y.; Kazakov, Yu.; Чекаліна, Наталія Ігорівна; Шуть, Світлана Володимирівна; Трибрат, Тетяна Анатоліївна; Бурмак, Юрій Григорович; Петров, Євген Євгенович; Мануша, Юлія Іванівна; Казаков, Юрій МихайловичThe aim: The aim of our research was to study the effect of quercetin on parameters of central hemodynamics and myocardial ischemia in patients with stable coronary heart disease (CHD). Material and methods: The research involved 85 patients with CHD: stable angina pectoris, FC II, and 30 healthy individuals made up the control group. After 1.5 months of stabilizing therapy (β-blockers, statins, aspirin) patients with CHD were randomized into 2 groups — the research group (30 people) and the comparison group (55 people). Quercetin at a dose of 120 mg per os daily was added to standard treatment of the patients of the research group (with CHD), patients of the comparison group continued receiving the same treatment. The day before randomization and 2 months after prescribing differentiation therapy to the patients, echocardiography (echo) and 24 hour Holter ECG monitoring were made. Results: Clinical evaluation of echocardiography revealed that diastolic dysfunction of the left ventricle (LV) had been found in 100% of patients studied: in 97.6% — in the form of violation of relaxation (type I), in 2.4% of patients — in the form of pseudonormalization (type II). The 24 hour Holter ECG monitoring revealed episodes of myocardial ischemia (10.7+2.7 episodes a day), premature atrial contractions (PACs) and premature ventricular contractions (PVCs) in patients with stable CHD. After a two-month term of therapy in patients of both research and comparison groups left ventricular systolic function in terms of ejection fraction (EF) of LV significantly improved (by 4.5% and 3.2% respectively). LV diastolic function improved in both groups in terms of the ratio of the phases of the transmitral flow E/A, also IVRT significance decreased (p<0.05). DT value dropped significantly influenced by quercetin, in the comparison group it didn`t change. According to the 24 hour Holter ECG monitoring, the total time and number of episodes of ST segment depression decreased with dominative results in quercetin group. PVC number was significantly reduced only by influence of therapy with quercetin (р=0.0022). Conclusions: The data have shown cardioprotective properties of quercetin in conditions of CHD.Документ Зв’язок комплаєнсу з індивідуальними особливостями хворих(Вищий державний навчальний заклад України «Українська медична стоматологічна академія», 2017) Трибрат, Тетяна Анатоліївна; Шуть, Світлана Володимирівна; Шепітько, Валентина Володимирівна; Трибрат, Татьяна Анатольевна; Шуть, Светлана Владимировна; Шепитько, Валентина Владимировна; Trybrat, T.; Shut, S.; Shepitko, V.У терапевтичних хворих рівень комплаєнсу асоціюється зі статтю, віком та ураженою системою органів та не залежить від рівня здобутої освіти. Для підвищення комплаєнсу лікареві доцільно надавати значно більше уваги психоемоційному стану хворого, його довірі до тактики лікаря, поясненню можливих наслідків часткової або повної відмови від лікувального плану. Саме тому перспективним напрямом є розробка й впровадження спеціальних програм з урахуванням індивідуальних особливостей пацієнта; У терапевтических больных уровень комплаенса ассоциируется с полом, возрастом и пораженной системой органов и не зависит от уровня полученного образования. Для повышения комплаенса врачу целесообразно предоставлять значительно больше внимания психоэмоциональному состоянию больного, его доверии к тактике врача, объяснению возможных последствий частичного или полного отказа от лечебного плана. Именно поэтому перспективным направлением является разработка и внедрение специальных программ с учетом индивидуальных особенностей пациента; The effectiveness of pharmacotherapy for internal diseases relies very often not only on the proper drug prescription, drugs` dosage, form and quality, but also on the proper execution of doctor`s recommendation by the patient and his desire to cooperate with his family doctor. Exactly for this in medicine there is a term of compliance (English compromise - consent, tolerance) – the patient`s voluntary compliance with the prescribed treatment regimen. According to the WHO, about 50% of patients do not follow the the doctor`s recommendations. The purpose of this article is to determine the influence of additional factors, namely gender, age, level of education of the patient, his marital status and group of disease on compliance. Using the data obtained during the patient survey, four compliance dependence systems were created: compliance/age, compliance/gender, compliance/education level, compliance/infected body system. According to the calculation results of the average values of the compliance for each age category and gender, a certain set of regularities has been identified. First, men of all ages demonstrated a much higher number of compliance units than women that indicates their lower liability to be treated. This fact can be explained by moral and psychological characteristics of upbringing of the men. The next regularity was the connection between the compliance and the patient`s age. Among young people (18-25 years), the compliance with treatment is close to high because most of the patients in this group live with their family, who care about the implementation of medical advice. Next in values test we can see sharp rise upward that indicates a less careful compliance of this age group with treatment. In the age group of 40-55 we can see again a near-to-high result, which can be related to the fact that at this age many people have the first signs of a chronic disease (hypertensive crises, hypo-or hyperglycemic coma, microinsulte, etc.). Man at this age does not want to approach to the status of "elderly" and therefore cares more about his health. Further, as aging, the compliance with treatment becomes lower due to a number of factors, such as: old-fashioned forgetfulness, financial difficulties, critical attitude towards the prescribed medicine, developing resistance to a particular medicine, etc. Based on the data obtained during the survey, the regularities between the level of education and compliance have not been found. The results of the study show that among all therapeutic patients the highest compliance with treatment was observed among the patients with such chronic diseases as cardiovascular, respiratory systems and intestinal tract, which can be related to the relative ease of drugs use (compared with endocrine diseases treatment) and the degree of clinical signs of the disease. Conclusions. Among therapeutic patients the level of compliance is associated with the sex, age and the infected organ system of organs and does not depend on the level of education received. To increase the compliance with the doctor it is reasonable to pay much more attention to the psycho-emotional state of the patient, his confidence and trust in the doctor`s tactician, the explanation of the possible consequences of a partial or complete refusal to follow the treatment plan. That is why the promising direction well as the development and implementation of special therapeutic programs, taking into account the individual characteristics of the patient.Документ Метаболічний синдром і тиреоїдна дисфункція(Вищий державний навчальний заклад України «Українська медична стоматологічна академія», 2015) Трибрат, Тетяна Анатоліївна; Шуть, Світлана Володимирівна; Третякова, Леся Олександрівна; Трибрат, Татьяна Анатольевна; Шуть, Светлана Владимировна; Третьякова, Леся Александровна; Trybrat, T.; Shut′, S.; Tretyakovа, L.Незважаючи на велику кількість існуючих літературних даних і результатів клінічних досліджень , враховуючи високу поширеність патології щитоподібної залози і метаболічного синдрому в популяції, вивчення зв'язку цих захворювань є актуальним з метою поліпшення діагностики та лікування; Несмотря на большое количество существующих литературных данных и результатов клинических исследований в этой области, учитывая высокую распространенность патологии щитовидной железы и метаболического синдрома в популяции, изучение связи этих заболеваний является актуальным с целью улучшения диагностики и лечения; Today metabolic syndrome (MS) is one of the priority issues of medicine and leads to negative social and health consequences. Subclinical thyroid dysfunction (TG) can lead to the formation of metabolic syndrome components. Among the new candidates for the role of metabolic syndrome components —thyroid-stimulating hormone (TSH), a marker of the functional state of thyroid axis. All major components of the metabolic syndrome is closely related to the functional state of the thyroid gland (TG). In active influence on energy balance, lipid and carbohydrate metabolism, weight thyroid hormones influence the cardiovascular system including blood pressure (BP), blood coagulation. Thyroid dysfunction (TD), according to many epidemiological studies, is quite common in the population. According to the Ministry of Health of Ukraine, over the past 5 years, the number of patients with thyroid dysfunction increased 5 times, more than 3, 5 million people in Ukraine are at the dispensary with various thyroid disorders and 70% of Ukraine's population suffers from iodine deficiency. The prevalence of hypothyroidism in the population, according to various researchers, is from 0.1 to 10% and is characterized by a significant increase among older women due to the presence of first regions with iodine deficiency as well, is important genetic predisposition, unfavorable environmental conditions, smoking, increasing the number of consumed drugs. Men rarely hypothyroidism register, its prevalence is only 2% and increases with age prevalence of hypothyroidism is greater than hyperthyroidism, 7-10 times. General worldwide prevalence of hypothyroidism manifest in all population reached 2.3% of cases, whereas subclinical hypothyroidism (CG) in women regardless of age averaged 10% and over 60 increases to 20%. Men rarely hypothyroidism register, its prevalence is only 2% and increases with age CG clinical significance due to the fact that during the first year 5-15% of SG becomes manifest in form of cardiovascular complications in 70-80% of cases. At manifest hypothyroidism the cardiovascular diseases (CVD) have progressed faster. Patients with subclinical hypothyroidism and cardiovascular disease are more likely to exercise than euthyroid. Individuals with subclinical thyroid disease have a higher risk of death. It is known, that the presence thyreopathy in women 45-55 years increases the risk of their metabolic syndrome over the next five years, especially in the presence of progressive obesity in combination with hyperglycemia, bilateral ovariectomy and burdened heredity of obesity, hypertension and diabetes. The total incidence of thyroid pathology in the first five years of menopause is independent of its cause, the maximum in the first year and reduced by fourth-fifth year. In the structure of morbidity leading diffuse endemic goiter (43.2%), especially in the first year, as after natural and after surgical menopause. At menopause duration more than one year thyreopathy iodine deficiency were more common after surgery than after natural menopause. The incidence of hypothyroidism due to autoimmune thyroiditis after surgical menopause maximum in the first year, and then of course —in the first two years. Among the new candidates for the role of metabolic syndrome components - thyroid-stimulating hormone (TSH), thyroid functional status marker. All major axis components of the metabolic syndrome is closely related to the functional state of the thyroid gland (TG). In active influence on energy balance, lipid and carbohydrate metabolism [, weight, thyroid hormones largely determine the cardiovascular system, including blood pressure (BP), blood coagulation in euthyroid conditions. Showing involved of thyroid hormones in the formation of insulin resistance (IR) . Over-production of thyroid hormones, accompanied of sympathetic activity associated with IP, with euthyroid normal insulin secretion. Role of hypothyroidism of MS confirmed IP 75% of women with hypothyroidism compensation. Euthyroid found negative correlation with T4 index HOMA-IR and atherogenic lipids. These data support the role of TSH as one of the components of metabolic syndrome. Thyroid hormones have a direct effect on the contractile function of the myocardium, and through interaction with the sympathetic nervous system changes the peripheral circulation. T3 is "kardiospecific” hormone and promotes left ventricular hypertrophy, coronary vessels spasm, prolonging ischemia by increasing oxygen consumption. So, given the high prevalence of thyroid disease and metabolic syndrome in the population, the study of the relationship of these diseases is urgent to improve diagnosis and treatment.Документ Метаболічний синдром в практиці сімейного лікаря(Вищий державний навчальний заклад України «Українська медична стоматологічна академія», 2015) Трибрат, Тетяна Анатоліївна; Шуть, Світлана Володимирівна; Сакевич, Вікторія Дмитрівна; Трибрат, Татьяна Анатольевна; Шуть, Светлана Владимировна; Сакевич, Виктория Дмитриевна; Trybrat, T.; Shut, S.; Sakevich, V.Актуальною проблемою в усьому світі, зокрема в Україні, залишається рання діагностика метаболічного синдрому. Саме на підвищення настороженості сімейних лікарів, на усвідомлення ними всієї серйозності наслідків і ускладнень МС спрямована освітня робота. Для відображення реальної епідеміологічної ситуації в Україні з поширеності метаболічних захворювань з метою їх профілактики та своєчасної корекції, необхідно запровадити моніторинг метаболічного синдрому; Актуальной проблемой во всем мире, в частности в Украине, остается ранняя диагностика метаболического синдрома. Именно на повышение настороженности семейных врачей, на осознание ими всей серьезности последствий и осложнений МС направлена образовательная работа. Для отображения реальной эпидемиологической ситуации в Украине с распространенности метаболических заболеваний с целью их профилактики и своевременной коррекции, необходимо внедрить мониторинг метаболического синдрома; At the present metabolic syndrome (MS) is one of the most urgent problems of medicine. The prevalence of this disease, which is characterized by a combination of many risk factors for diabetes mellitus (DM) and cardiovascular disease, causes serious concern of the medical community. Today, researchers are studying the features of metabolic syndrome among different groups of population. Modern medicine provides a great opportunity concerning the correction of metabolic disorders if timely detection and efficient MS treatment algorithm are provided. The mentioned problem is worldwide and actual, particularly in Ukraine and the early diagnosis of it is real problem. So the educational work should provide first of all the increasing attention of practitioners, the awareness of the seriousness of the consequences and complications of MS. Metabolic syndrome is a condition of high risk of cardiovascular disease. In addition, the prevalence of metabolic syndrome is increasing year by year, taking the nature of the epidemic, and it occurs on average at every fifth adult in high developed countries . Frequency and terms of MS occurrence is different depending on ethnic, age data and criteria selected for identification, the accumulation of risk factors, stages of ontogeny, the degree of genetic predisposition, state compensation systems, the severity of environmental factors. This is due to neglect the healthy lifestyle, eating rich food contained the digestible carbohydrates, overeating, constant stress and sedentary lifestyle. An effective fight against MS is possible only on condition of deep understanding of the pathogenesis of this condition and development of pathogenetic approaches to drug therapy and prevention. MS develops gradually and long runs without obvious clinical symptoms. The presence of MS can be assumed even when external examination and patient history collection. Abdominal obesity (AO) is recognized by its characteristic redistribution of adipose tissue. Patients with a similar type of obesity often (70%) have the syndrome of obstructive sleep apnea (OSA), about which patients may be unaware. The patient may mark only the presence of snoring. When the patients` history are collected the detailed survey should be done to identify the patients` complaints on daytime sleepiness, the impaired concentration and anxious, choking episodes and / or stop breathing during sleep, loud cracked snoring, nocturia, irritability and personality changes, decreased libido, indentifying the events and / or risk of accidents (fact of dozens of short sleeps during driving). Particular attention should be paid to the fact of occurring complaints or stops of breathing during sleep. If the patient cannot answer this question, you must carefully ask relatives or friends of the patient . Clinic doctor may suspect the respiratory failure during sleep using a simple survey of the patient. The most common scale for evaluation of OSA symptoms is the Epworth Sleepiness Scale . If the patient suffers for AO you should clarify in detail the history of the disease, life, heredity and take the additional measurements. This can be important not only for the diagnosis of MS, prognosis, but also for determining the treatment. Most such patients are the majority of patients with hypertension and coronary heart disease, who refer to family doctors. So it is a family doctor who should refer the patients with cardiovascular disease and obesity research in lipid profile, determination of blood glucose and, if it is necessary to refer the patient to further consultation and treatment of a cardiologist and endocrinologist. It is not difficult to identify the patients with MS, the main thing is to be attentive and indifferent to patients, continuous analysis of their condition and possible complications of existing diseases. Underestimating MS leads to negative consequences. Treatment of MS effects is much more expensive in every respect than the early detection and treatment of metabolic disorders. To reflect the current epidemiological situation in Ukraine with the prevalence of metabolic diseases with the aim of prevention and early treatment should introduce monitoring of metabolic syndrome.Документ Метаболічний синдром і здоровий образ життя(Вищий державний навчальний заклад України «Українська медична стоматологічна академія», 2017) Трибрат, Тетяна Анатоліївна; Шуть, Світлана Володимирівна; Сакевич, Вікторія Дмитрівна; Трибрат, Татьяна Анатольевна; Шуть, Светлана Владимировна; Сакевич, Виктория Дмитриевна; Trybrat, T.; Shut′, S.; Sakevich, V.В статті розглянуто особливості застосування немедикаментозних засобів лікування та профілактики щодо корекції станів, що об’єднуються терміном метаболічний синдром, відповідно до міжнародних рекомендацій та національних уніфікованих клінічних протоколів, де основними заходами є підтримання здорового способу життя ,основаного на раціональному харчуванні, спрямованого на схуднення або підтримання нормальної маси тіла ,відмова від куріння і надмірного вживання алкоголю, а також дозовані фізичні навантаження; В статье рассмотрены особенности применения немедикаментозных средств лечения и профилактики по коррекции состояний, объединяемых термином метаболический синдром, согласно международных рекомендаций и национальных унифицированных клинических протоколов, где основными направлениями являются поддержание здорового образа жизни ,основанного на рациональном питании, направленном на похудение или поддержание нормальной массы тела ,отказ от курения и чрезмерного употребления алкоголя, а также дозированные физические нагрузки; Goal – the analysis of large-scale studies has shown that among the adult population the MS is diagnosed 30% of population depending on characteristics and criteria used for the MS diagnosis (metabolic syndrome) Social importance of the MS problem is associated with the increased educational activity in patients` surroundings, necessity of implementation of the main principles of primary prevention of obesity and diabetes especially among children and young people, promotion of healthy diet principles, the increased role of physical culture and sports. Therapeutic interventions in the treatment of MS patients should be directed to the main elements of the pathogenesis of this syndrome, namely the reduction of body weight, the optimal level of blood pressure (BP), metabolic control, prevention of acute and remote cardiovascular complications. Despite the large number of studies devoted to the problem of obesity treatment, lots of the ways of reducing excess weight, this task remains extremely complicated and requires great effort both the doctor and the patient. Nowadays it is stated that the only thing that really leads to a reduction fat mass is an energy deficit or another words - predominance of energy consumption over its receipt. Therefore, non-pharmacological interventions aimed at the creation of this deficit are of priority importance in the treatment of obesity. Patients should be aware that currently there is no drug that is able completely eliminate the health risks associated with obesity, but at the same time, the change in lifestyle can prevent the progression of metabolic disorders and seriously reduce the risk of complications. The treatment of obesity, as well as treatment of any chronic disease must be continuous – without any break. After reaching the weight loss the efforts of the doctor and patient should be directed to maintain the effect and prevent relapses of disease. Activities aimed at reducing the weight and maintaining the achieved result should include: a balanced diet, explaining to patients about proper way of living with changing eating habits, keeping a food diary and doing exercises. Reduction of body weight by 5-10% over 6-12 months (optimal reduction is considered to be 2-4 kg, but not more than 5 kg per month) is accompanied by a reliable reduction of the risk to health and feasible for most patients. For the compilation of a balanced diet it is necessary to calculate the number of calories allowed to consume per day based on individual energy consumption. And based on the daily calorie norm it is possible make the menu for the day (reducing caloric intake should be achieved the mainly due to reducing fat and partially at the expense of carbohydrates). Staff in primary health care system must take into account the emotional and personal characteristics of the patient at prescribing and making the individual diet programs to prevent the instability of interest of treatment, give practical advice taking into account cultural, religious, ethnic and economic standards. Physical exercising (workout) is an important component of recommendations to change lifestyle. At the stage of body weight reduction doctors add another food to the reduced calorimety diet and allow having a negative energy balance. Under the influence of loads of moderate intensity insulin sensitivity is improving, triglycerides is reducing, HDL cholesterol is increasing, the functional reserves of the cardiovascular and respiratory systems are improving. At the maintenance stage the physical activity becomes even more important being one of the main prognostic factors in maintaining the desired weight. Before the start of physical exercising it is necessary to assess the patient's tolerance to physical loads using veloergometry or treadmill test. It is especially important to carry out a load test if there is coronary heart disease (CHD), when a patient is after the age of 40 and after the age of 30 with risk factors such as IHD, hypertension, DM, smoking and dyslipidemia. To reduce body weight (maximum energy reduction) aerobic exercises are shown, which are continuous rhythmic exercises and involve large muscle groups for quite a long time, increasing the heart rate. The most common varieties of aerobic exercise is the so-called cyclic kinds of sport: walking, swimming, running, skating, skiing, cycling, tennis, basketball, dancing and fitness. Therefore, the main measures of non-pharmacological MS treatment is to maintain a healthy lifestyle based on a diet aimed at weight loss or maintenance of normal body weight, giving up smoking and excessive alcohol consumption, and also dosed exercising with the support of a doctor or nutritionist.Документ Моніторинг основних факторів ризику серцево-судинних захворювань(Вищий державний навчальний заклад України «Українська медична стоматологічна академія», 2013) Трибрат, Тетяна Анатоліївна; Шуть, Світлана Володимирівна; Бондаренко, В'ячеслав Михайлович; Шепітько, Валентина Володимирівна; Сівкова, Наталія Михайлівна; Трибрат, Татьяна Анатольевна; Шуть, Светлана Владимировна; Бондаренко, Вячеслав Михайлович; Шепитько, Валентина Владимировна; Сивкова, Наталья Михайловна; Trybrat, T.; Shut, S.; Bondarenko, V.; Shepitko, V.; Sivkova, N.Нами була вивчена поширеність факторів ризику ССЗ (артеріальна гіпертензія, гіперхолестеринемія, ожиріння, куріння). Надзвичайно висока поширеність основних факторів ризику свідчить про ріст щодо серцево-судинних захворювань та про необхідність продовження більш активного застосування відомих і пошуку нових способів профілактики серцево-судинних захворювань, змінити суспільну свідомість у популяції щодо ставлення до власного здоров’я; Нами была изучена распространенность факторов риска ССЗ (артериальная гипертензия, гиперхолестеринемия, ожирение, курение). Чрезвычайно высокая распространенность основных факторов риска свидетельствует о росте по сердечно-сосудистых заболеваний и о необходимости продолжения более активного применения известных и поиска новых способов профилактики сердечно-сосудистых заболеваний, изменить общественное сознание в популяции по отношению к собственному здоров’ю; The experience of countries achieved a significant reducing mortality from cardiovascular diseases shows the importance of modern methods of diagnosis and treatment, as well as necessity for the active preventive measures among the population. The basis of prevention is monitoring and correction of risk factors. The search`s purpose is examination of expansion of CD risk factors among residents of Poltava region. Search`s object and methods. For the purpose of standardized survey conducted Poltava residents aged 18 to 80 years. The search program provided: a survey through the WHO standard cardiology questionnaire, filling out forms contained medical history and socio-demographic data; registration of the electrocardiogram at rest and 12 standard leads; blood pressure (BP); anthropometry; sampling of fasting venous blood to determine the lipid plasma; survey on smoking and physical activity. Results and their discussion It was found that the situation on control under hypertension is worse with men: they do usually know that the have a high blood pressure, a lower percentage of them are under medical treatment and, so, there is lower efficiency among them. The highest hypertension rate is among the persons with higher education and it does not depend of gender. The process of blood pressure measuring by both the doctor (at the reception) and patient (at home) is worth to be particularly noted. The importance of technically correct measurement of blood pressure are shown in the work of Radwal R., according to this work in 50% of cases the hypertension was wrongly diagnosed in the result of incorrect measurement of blood pressure .Known factors inflated the actual numbers of blood pressure include: wrong choice of cuff, incorrect position of the patient (unfixed back, legs crossed, hand that place below the heart), an abnormal blood pressure measurement techniques (examination without previous rest, imposing cuffs on sleeves, re-pumping, measuring only on one hand) the behavior of the patient before the measurement of pressure (smoking, making coffee). Non-ignoring these factors allow to prevent such problems. Search`s results show the high prevalence of cholesteremia: 35.3% of men and 49.4% women require the prevention interventions, and among them each fifth patient, regardless of gender, has a high value of total cholesterol (≥ 6 mmol 2 / l).Among the analyzed risk factors the most common concerning the men (44.5%) and least common concerning the women (16.3%) is smoking. More than third of men and almost half of women are sedentary. With age, the prevalence of physical inactivity slightly increases but insignificantly. Even at a young age (18-24 years), the level of physical activity of each fourth man and second woman is defined as insufficient. Thus, in our study the problem of overweight were at more than half of the patients, regardless of gender, and the prevalence of obesity among women is by 1.8 times higher than among men. The combination of smoking with alcohol consumption at patients with hypertension increases the body mass index. It is found that significant influence on the developing coronary heart disease at women aged up to 55 has resulted by factors such as smoking with glucose, lipid disorders, gynecological disorders and diseases of the thyroid gland. At atherosclerotic lesions of coronary arteries the determining factor is smoking in combination with glucose and pathological menopause. Conclusions. 1. Extremely high spreading of major risk factors certifies that there is growth of cardiovascular disease and there is necessity to conduct and use all known and finding new ways to prevent cardiovascular disease 2. The public consciousness among population on attitudes to their health should be changed 3. The basis of primary prevention should be the early diagnosis of CD, the correction of high blood pressure, screening tests to identify dyslipidemia, metabolic disorders (obesity, diabetes), healthy lifestyle.Документ Шляхи реабілітації хворих на ішемічну хворобу серця(Вищий державний навчальний заклад України «Українська медична стоматологічна академія», 2018-03-29) Трибрат, Анжеліка Анатоліївна; Трибрат, Тетяна Анатоліївна; Казаков, Юрій Михайлович; Trybrat, A.; Trybrat, T.; Kazakov, Yu.Застосування електрофорезу бішофіту Полтавського показано на амбулаторному так і стаціонарному етапах лікування, а також на санаторно-курортному етапах реабілітації пацієнтів з ішемічною хворобою серця з позитивним впливом на стан пацієнтів.