Vol 7, No 3-4 (2013)

Objective: to assess the rate of silent myocardial ischemia (SMI) and the pattern of cardiac rhythm disturbances in women with rheumatoid
arthritis (RA), their association with traditional risk factors (TRF) for cardiovascular diseases (CVD), with subclinical structural and functional
changes in the heart and vessels, with the activity and severity of rheumatoid inflammation.

Subjects and methods. Two hundred and ninety-one female patients aged less than 60 years with a valid diagnosis of RA and no clinical
signs were examined. A control group consisted of 125 women without rheumatic diseases. In addition to the clinical manifestations, activity,
and severity of RA, the authors assessed major TRFs for CVD, performed Holter ECG monitoring, common carotid artery duplex scanning, transthoracic echocardiographic study, and determined the levels of serum inflammatory markers.

Results. The women with RA differ from the control group in the higher incidence of SMI, supraventricular arrhythmias (SVA) and highgrade
premature ventricular contractions (PVC). The patients with RA and SMI are characterized in terms of age-adjustment by higher disease activity (DAS28), systemic manifestations), cumulative larger-dose glucocorticoids (GC) and a higher percentage of patients receiving disease-modifying anti-rheumatic drugs as compared with those with RA and no SMI with adjustment for age. High disease activity
(DAS28, level of inflammatory markers), IgM rheumatoid arthritis seropositivity, and GC therapy are SVA-associated factors in women with RA; larger left ventricular end-diastolic dimension and serositis are factors associated with high-grade PVC.

Conclusion. The RA women without clinical manifestations of CVD are recorded to have high rates of SMI, SVA, and high-grade PVC, which is primarily due to the activity and severity of rheumatoid inflammation.

Purpose. The study was designed to assess the relationship between the level of plasma concentration of insulin-like growth factor-1 (IGF-1) and indices of the functional state of the liver in patients with non-alcoholic fatty liver disease (NAFLD) and its combination with diabetes mellitus (DM) 2 types depending on the trophological status.

Materials and methods. It were examined 90 patients with non-alcoholic fatty liver disease and its combination with type 2 diabetes mellitus –
with normal body weight and obesity, as well as 20 healthy individuals. The study was carried out using the following methods: clinical, laboratory and instrumental (including liver biopsy).

Results. It was inverse the relationship between the level of IGF-1, and the level of AST, ALT, AST/ALT, total and conjugated bilirubin, alkaline phosphatase in groups of patients with comorbid disorder. There was established the significant decrease of plasma level of IGF-1, and also impairment of liver function indices in all groups in comparison with the controls, and most pronounced changes in patients with comorbid disorders and obesity.

Conclusion. The established relationships suggests that the decrease of IGF-1 may represent the presence of syndromes of cytolysis and cholestasis in patients with NAFLD, type 2 DM and obesity. In order to determination the disorder of the reparative function of the liver is
recommended to determine the level of IGF-1 in patients with combination of NAFLD and type 2 DM. Patients with the level of IGF-1 < 143,9 ± 4,92 ng/ml should refer to the risk of progression of liver function disorders.

The paper shows the basic mechanisms of action of nonsteroidal antinflammatory drugs (NSAID) and their classification. It considers risk
factors for NSAID gastropathy and the possibilities of its treatment, prevention in the context of modern medicine.

Modern internal medicine was typified by the presence of the so-called problem patients whose diagnosis and treatment pose special problems.
G.B. Fedoseev and Yu.D. Ignatov have created the electronic thesaurus “Syndromic diagnosis and basic pharmacotherapy of visceral diseases” to facilitate their diagnosis and choice of personalized therapy.

We present a case of severe systemic lupus erythematosus (SLE) in 24-year-old woman. The specific features of the disease in this case were high disease activity, leucopenia, remitting ulcerative necrotizing skin vasculitis, secondary infectious complications. There was no other organic and haematological disorders typical for SLE, except leucopenia. Adequate treatment with high – dosage glucocorticoids in oral and glucocorticoid pulse-therapy, intravenous antibiotics, intravenous immunoglobulin, vasoactive therapy was successful and lead to decrease of inflammatory process.

Objective – to study the efficacy and safety of Tenoten in the combination therapy of hypertension in early postmenopausal women.

Subjects and methods. The study enrolled 60 early postmenopausal women with grade I–II hypertension. A study group included 30 women who took Tenoten during antihypertensive therapy (AHT); a control group comprised 30 women who received AHT only.

Results. Tenoten could achieve additional improvement of 24-hour blood pressure (BP) monitoring data in the postmenopausal hypertensive women. Tenoten was found to have a positive effect on general health, activity, and mood and to alleviate the symptoms of autonomic dysfunction and anxiety.

Conclusion. Tenoten that is able to alleviate the manifestations of anxiety and autonomic dysfunction, to exert a positive effect on blood
pressure values, and to improves health, mood, and social activity should be used in addition to AGT.

The paper describes clinical experience with metabolic therapy, including neuroprotective drugs and antioxidants, for cerebrovascular diseases.
It gives the results of basic Russian and foreign clinical studies of ethylmethylhydroxypyridoxine succinate and choline alfoscerate and discusses their efficacy and routes of administration.

Objective: to study the efficacy, tolerability, and safety of Artradol in patients with knee osteoarthrosis.

Subjects and methods. The investigation enrolled 35 patients of both sexes, mean age 63,45 ± 6,9 years, with stages II and III gonarthrosis
and walking pain intensity > 40 mm visual analog scale. All the patients were given Artradol (chondroitin sulfate) intramuscularly every other day in a dose of 0,1 g (the first 3 injections), its fourth injection was 0,2 g used for 2 months. Changes in the WOMAC index, up-and-go test, as well as the need to use nonsteroidal anti-inflammatory drugs (NSAIDs), and therapeutic efficiency as viewed by the physician and patient were estimated.

Results. The clinical effect of the drug occurred by the average treatment day of 18. Lower needs for NSAIDs were noted in 97 % of the patients;
NSAIDs were discontinued in 22 (62 %) cases. There was a statistically significant decrease in the total scores of the WOMAC and up-to-go tests on therapy completion. The therapy resulted in considerable improvement in 97,0 % of the patients.

Conclusion. Artradol has high clinical efficacy and safety and a noticeable delayed-acting symptom-modifying effect, which makes it relevant for use in the treatment of gonarthrosis.

The paper outlines basic principles of and new approaches to antibiotic therapy for ENT and upper respiratory tract infections, from point of view of the authors, on the basis of the data available in Russian and foreign literature.

The article deals with the etiology, diagnosis and treatment of acute respiratory infections (ARI). Contemporary possibilities and tactics ethiotropy treatment of antiviral therapy. Given that to date the treatment of ARI is a significant problem associated with both unjustifiably
widespread use of antibiotics , as well as a huge market saturation of pharmaceutical products for the symptomatic treatment of ARI, the
author gives a critical analysis of drugs used for the pharmacotherapy of viral respiratory infections. The results of the literature review and evaluation of the therapeutic efficacy of immune-tolerance of domestic drug Ergoferon in adults and children who become ill with influenza and ARI. Displaying Ergoferon stimulatory effect on production of endogenous IFN-α and IFN-γ, as well as normalization of subpopulations of T-lymphocytes and histamine levels, thereby reducing the time of clinical signs of disease, prevent the onset and exacerbation of typical complications of chronic somatic diseases.

The paper reviews the literature characterizing the incidence of infective endocarditis (IE) in the presence of hypertrophic cardiomyopathy, as well as hemodynamic mechanisms, etiological features, valvular lesion and the course of IE in this pathology, approaches to treatment and prevention, and outcomes of the disease.

Nearly half of patients with chronic heart failure (CHF) have a preserved left ventricular ejection fraction, known as diastolic heart failure. Echocardiography is the primary modality for evaluating left ventricular (LV) systolic and diastolic function in CHF patients. LV developed
pressure (dP/dt) is a classical index of myocardial contractility. At the same time, pulse wave velocity, which has been used as a measure of arterial stiffness, can be used as an index of LV contractile function. The maximal dP/dt of the radial pulse appears to be a good and reproducible criterion of LV systolic performance with high potential as a diagnostic method.