Hofitol
Chophytol is a choleretic herbal preparation made from field artichoke. The mechanism of its action is due to a set of biologically active substances contained in the leaves of the field artichoke. The combination of cynarin + phenolic acids exhibits a choleretic effect and allows the use of Hofitol as a hepatoprotector. The thiamine, riboflavin, ascorbic acid and inulin contained in artichokes normalize metabolism. In addition, Hofitol has a diuretic effect and promotes the removal of urea from the body. The multicomponent composition of the herbal medicine makes it impossible to conduct pharmacokinetic studies, because The biologically active substances contained in artichoke leaves cannot be traced in the body using traditional markers or biological studies. Available in tablets and solution for oral use. The recommended duration of pharmacotherapy is 2-3 weeks. Repeated courses are possible, the need for which is determined by the doctor on an individual basis. With prolonged use of the drug in submaximal doses, the development of dyspeptic disorders is possible. Hofitol has proven itself in the treatment of patients suffering from various liver pathologies (hepatitis, cirrhosis) and diseases of the biliary tract (cholecystitis, dyskinesias). The plant nature of the drug gives it a number of advantages over synthetic drugs. It causes virtually no clinically significant side effects. The bioflavonoids, biogenic amines, terpenoids, vitamins and minerals included in its composition give the drug a mild hepatoprotective and antioxidant effect. Hophytol is practically non-toxic, which allows it to be included in long-term drug courses in patients of any age without increasing the risk of side effects.
The drug is suitable for use in outpatient settings. Clinical studies have shown the versatility of its pharmacodynamics. In addition to choleretic, antioxidant and hepatoprotective, it has a detoxifying, mild diuretic and hypocholesterolemic effect. Hofitol can be used as part of complex treatment or as monotherapy. An improvement in the general condition of patients is observed, as a rule, already in the second week of treatment: their sleep is normalized, their appetite improves, their mood improves, and the severity of epigastric pain decreases. A month after the start of treatment, the improvement in the condition of 85-90% of patients is supported by both objective indicators and subjective assessments. In 10-15% of patients, clinical symptoms of the disease persist, but they become much less pronounced. The drug can also be used in patients with cholestasis syndrome, because Hophytol, unlike individual hepatoprotectors, does not aggravate their condition. It is important that the normalization of the processes of formation and excretion of bile observed when taking Hofitol helps to improve digestive function in general, because The hepatobiliary system is in close contact with the gastrointestinal tract. Pregnancy and breastfeeding are not direct contraindications to the use of Hofitol, but drug therapy in such cases should be carried out under mandatory medical supervision. The drug should not be used in patients with biliary obstruction, during exacerbation of kidney disease, or in children under 6 years of age. The liquid form of Hofitol contains small amounts of ethanol.
New cholesterol controversy
When do you really need to lower cholesterol and who can live long with high levels? The material about this, prepared by KP, was among the top most read on the newspaper’s website.
Dossier "KP"
Philip Kopylov is a professor at the Department of Preventive and Emergency Cardiology, Director of the Institute of Personalized Medicine at Sechenov University, Doctor of Medical Sciences, researcher, cardiologist.
THE MAIN CHALLENGE FOR DOCTORS
Recently, an international group of cardiologists from Sweden, Italy, France, Japan and other countries made a revolutionary statement: there is no evidence to conclusively support the connection between high levels of “bad” cholesterol and cardiovascular disease. The researchers came to this conclusion after studying data from 1.3 million patients. Their health status was monitored for a total of about 50 years. Even more surprising, according to cardiologists, was that older people with high levels of low-density lipoproteins (the same “bad” cholesterol) live on average longer than others! How is this possible? Does this mean that scrambled eggs, butter and fatty meats have been finally rehabilitated, and doctors need to reconsider their approaches to treating heart patients with statin drugs?
“There may be two people standing in front of us, both of them have high cholesterol, only one needs to be treated, and the second can be left alone,” says Philip Kopylov. - Essentially, this is a solution-explanation of the results of a study on the role of cholesterol, which surprised many. The secret is that monitoring people from different risk groups gives different results. And medications act in different ways: if you give them to a sick person according to medical indications, his condition will improve. But if you feed someone who is healthy or who is not so sick that they really need serious medications, then there will be no improvement. The main task, I would even say a challenge, for modern doctors is to determine those who really need to lower cholesterol and when such patients really need statins. Because other people can live longer without treatment, including those with relatively high levels of “bad” cholesterol.
CHECK YOURSELF
What is your risk of cardiovascular disease?
A person is at low risk if they:
a) no high blood pressure. That is, the pressure is not higher than 130/80 mm Hg. Art. under the age of 65 and not higher than 140/80 after 65 years;
b) no excess weight. That is, the body mass index is not higher than 29 (we talked about how to calculate it in the first part of the publication);
c) no diabetes;
d) no atherosclerosis.
- Under such conditions, the patient usually does not need to be treated even if the level of “bad” cholesterol is elevated. That is, if the level of LDL (low-density lipoprotein) in the blood is up to 4.9 mmol/l, explains Philip Kopylov.
If a person is at high risk of cardiovascular disease, including a high risk of heart attack and stroke, then the cholesterol level should be no more than 2.6 mmol/l. And at a very high risk - a maximum of 1.8 mmol/l . If the indicators are higher, they need to be reduced, including with the help of medications.
into the high and very high risk group (depending on the number of risk factors and the degree of neglect) if:
1) is obese. The most dangerous thing is abdominal, that is, in the abdomen. Measure your waist width: for men the critical mark is 102 cm and more, for women – 88 cm and more;
2) high blood pressure (see point “a” above);
3) there is a diagnosis of diabetes mellitus (as a general rule, it is made when the blood sugar level is above 6.7 mmol/l on an empty stomach);
4) the patient abuses salt - exceeds the norm of 5 mg per day, including salt in all dishes and products;
5) overindulges in alcohol. Let us remind you that, according to the latest data, up to 14 servings of alcohol per week for men and up to 8 servings for women are considered relatively safe for health (how much this will be in different types of drinks - see the “Health” section on kp.ru);
6) male gender - the risk of cardiovascular diseases in men is a priori higher;
7) age - for women over 50 - 55 years old; for men - from 45 years old, and if the above factors are present - then starting from 35 years old.
CHOLESTEROL PLAQUE DIFFERENCES PLAQUE
- If I am not in a high or even medium risk group, does this mean that I can unlimitedly eat foods with animal fats - butter, fatty meat, etc.?
— The question is not easy. When we begin to lean on foods rich in animal fats, with a modern sedentary lifestyle, this often results in obesity. You receive at least one risk factor and move from a more “favorable” group to a less favorable one, with a higher risk. And in general, we must admit: the regulation of the system of production and metabolism of cholesterol in the body still partially remains a mystery to scientists. We don't know everything about her.
— Is it undeniable that cholesterol plaques in blood vessels are harmful and dangerous? Or do you also have doubts?
— In humans, already from adolescence, damage to the internal lining of blood vessels begins. And atherosclerotic plaques develop with age in the vast majority of people (essentially, such plaques are accumulations of cholesterol deposits in places of vascular damage. - Author) . However, the problem is that plaques are not all the same. They can be of two types: stable and unstable. And the most serious challenge in cardiology now is to learn to identify and calculate unstable plaques.
- What is their danger?
- At least half of myocardial infarctions occur due to plaques that do not narrow the lumen in the blood vessels or narrow it less than 50%. Such plaques have a thin covering film and a liquid core, where inflammation constantly occurs. Eventually the tire simply breaks. A blood clot forms at this site and blocks the lumen of the vessel. And everything downstream of the blood begins to die.
TO EXERCISE OR NOT TO EXERCISE?
- It is often said that aerobic exercise - brisk walking, running, swimming, ice skating - is useful for increasing blood circulation. And if the plaques are unstable, then it turns out that increased blood flow can worsen the situation?
— Purely theoretically, yes. However, if these loads are regular and reasonable (see below for the “golden” formula for calculating heart rate. - Author) , then they will have a positive effect. Weight and blood pressure will decrease. Also, as a rule, there is a decrease in cholesterol. That is, risk factors are eliminated, and due to this, competent physical exercise brings undeniable benefits. And if you exercise from time to time, and even try to set an Olympic record in the rare moments of your appearance at the gym, then the threat of rupture of plaques and a heart attack really increases significantly.
ON A NOTE
How to determine safe exercise intensity
Use the “golden formula” for calculating your optimal heart rate: 220 minus your age. the resulting figure by 65% - this is the pulse at a moderate load; multiply by 80% - heart rate during intense physical activity. If it is higher, there is already an excessive load, unfavorable for the blood vessels and heart.
QUESTION: WHO NEEDS STATINS?
— Philip Yuryevich, what about statins? Recently, there has been heated debate; the authors of an international study claim that the benefits of such drugs are very doubtful. To whom and why should they be prescribed from your point of view - as a researcher and cardiologist?
- Let's remember: cholesterol enters our body not only with food, 60 - 70% of it is produced in the liver, even if you are on a lean diet. The effect of statins is, on the one hand, to inhibit the production of cholesterol in the liver. At the same time, a mechanism is launched that turns existing unstable plaques into stable ones. And this actually cuts the risk of heart attacks in half.
— It turns out that if a person’s plaques are stable and do not block the lumen of blood vessels, then there are no indications for taking statins? After all, these drugs have serious side effects - from muscle and joint pain to increased blood sugar. When the task is to protect against a real threat, a fatal heart attack, then such “costs” are the lesser of the evils. Are there any current developments to determine the type of plaque in a particular patient?
— There is an intravascular method, when we insert a special sensor into the vessel and use ultrasound or optical coherence tomography to determine the structure of the plaque.
- Do you need to check every plaque?
- Yes. And the sensor, unfortunately, is expensive. Another approach is computed tomography. We put the patient in a computer scanner and do an X-ray examination with contrast of the heart vessels. The resolution of computed tomographs today makes it possible to determine what kind of plaque it is - stable or unstable.
The third approach is a blood test. Now it is actively developing. Very interesting research work is being carried out on microRNAs, that is, small molecules that are responsible for inflammation and the development of atherosclerosis. Based on their presence, concentration and combination, they are trying to build diagnostic systems to identify unstable plaques.
— Are any of these methods used in Russia?
- So far - on a minimal scale, only in large cardio centers, and then as research work for the most part. In general, the problem of determining the type of plaques is solved in different ways throughout the world. The latest international recommendations propose the introduction of computed tomography with contrast as a method of primary diagnosis.
CONGRATULATIONS!
“Sechenovka” has an anniversary!
In 2021, Sechenov University, First Honey, the legendary “Sechenovka”, as it is often called among the people, turns 260 years old. Over these centuries, they worked, taught, treated, created breakthrough methods for saving people here, and most Russian medical luminaries continue to do so. Among the stars of the university is the founder of the school of military field medicine, Nikolai Pirogov ; famous surgeon, professor Nikolai Sklifosofsky ; the founder of Russian forensic psychiatry Vladimir Serbsky ; founder of the medical examination system Nikolai Semashko ; founder of neurosurgery Nikolai Burdenko; founder of the school of cardiovascular surgery Alexander Bakulev . Now among the professors at Sechenovka are academician Leo Bockeria , the chief transplantologist of the Russian Ministry of Health, academician Sergei Gauthier , one of the leading Russian oncological surgeons, an expert on head and neck tumors, academician Igor Reshetov , and many others.
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Komsomolskaya Pravda" congratulates Sechenov University and wishes new scientific and medical breakthroughs!
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