Vol 5, No 3 (2011)

The paper presents the characteristic features of the modern course of infective endocarditis. Unresolved questions of classification of disease
and drug therapy are discussed. Clearly defined indications for surgical treatment of endocarditis.

The aim – definition of distinguished characteristics of the right-sided infective endocarditis (IE) inintravenous drugs abused with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS).

Materials and methods. The study included 10 patients with right-sided IE in conjunction with HIV/AIDS. All patients were male, age – from 28
to 36 years.

Results. Course of the IE in HIV/AIDS among intravenous drugs abused in general corresponds to features specific to IE in intravenous drug users without HIV infection. Distinctive features of IE in these patients are a large burden of lung disease, its disseminated character, more tissue oxygenation disorders and marked pulmonary hypertension and haematological disorders (lymphopenia, anemia), and late diagnosis of IE.

Conclusion. Features of the current right-sided IE in intravenous drugs abused with HIV/AIDS are distinguished . Difficulties in diagnosis of IE in
HIV infection are due to variety of causes of prolonged fever, which should guide doctors to more frequent use of transthoracic echocardiography during prolonged fever in HIV-infected patients.

The aim – assessment of the prevalence of seropositivity to Helicobacter pylori infection and laboratory comparative study of the peripheral
blood in patients depending on the course of coronary heart disease (CHD).

Materials and methods. Observation of 100 patients with coronary artery disease and 40 control patients is presented. Investigation indicators
of clinical blood tests, biochemical blood analysis and determination of immunoglobulin antibody titer against Helicobacter pylori.

Results. In patients with coronary artery disease signs of systemic inflammation associated with the development of acute coronary syndrome are marked with increased antibody titers to infection Helicobacter pylori.

Conclusion. A history of coronary artery disease in patients with Helicobacter pylori-associated gastroduodenal pathology should be considered as a factor that increases the likelihood of unstable coronary desease course. Detected in patients with coronary artery disease signs of systemic inflammation with an increase in titer of antibodies to Helicobacter pylori infection associated with development of acute coronary syndrome.

Aim – to study how anthracyclines influence on cardiovascular system in patients with lymphomas and whether angiotensin-converting enzyme inhibitor Perindopril is cardioprotective in these patients.

Subjects and methods. 26 patients with Hodgkin’s disease and non-Hodgkin’s lymphomas were followed before and after treatment with
doxorubicin. 12 of these patients with arterial hypertension received angiotensin-converting enzyme inhibitor Рerindopril, 10 mg/d, during
treatment with doxorubicin. Cardiological evaluation was performed before and the next day after chemotherapy. Average dose of Doxorubicin was 34,99 ± 13,23 mg/m2.

Results. In patients receiving anthracyclines deceleration time DT increased significantly, a significant reduction in heart rate (HR), cardiac
output (CO) and cardiac index (CI) were observed also (рDT = 0,037, pHR = 0,048, рСО = 0,007, рCI = 0,007). In patients simultaneously
treated with Perindopril these parameters were not statistically different (рDT = 0,92, pHR = 0,22, рCO = 0,35, рCI = 0,39).

Conclusion. Administration of anthracyclines (average dose of Doxorubicin 34,99 ± 13,23 mg/m2) leads to DT of the left ventricle and
reduction in HR, CJ and CI. Simultaneous treatment with Perindopril in patients receiving anthracyclines preserves DF and prevents heart hemodynamics abnormalities.

The main approaches to diagnosis and treatment of pain in the back of the elderly are presented. The main place is given to varieties of mechanical pain. Clinical features of non-traumatic compression of the vertebrae, approaches to the diagnosis ostheoporosis fractures are described. The problem of the differential diagnosis of infectious, neoplastic, metabolic damage of the spine is discussed. The main therapeutic approaches to the therapy of acute mechanical back pain are identified.

Incidence of cardiovascular events among HIV-infected patients in clinical practice has increased recently. Usually strategy of treatment in such patients differs from the conventional and requires close cooperation with experts in HIV infection. Example of successful treatment of the acute pericardial effusion in patient with stage III HIV (World Health Organizationclassification) is presented in this clinical case.

Фибрилляция предсердий (ФП) – наиболее распространенная аритмия, составляющая 1/3 всех госпитализаций по поводу нарушений ритма сердца. В статье рассмотрены основные этиологические факторы, роль электрического и структурного ремоделирования миокарда, способствующие развитию и рецидивированию ФП. Представлена новая классификация ФП согласно длительности возникновения и способа купирования данной аритмии. В рамках последних европейских рекомендаций по диагностике и лечению ФП освещены вопросы кардиоверсии и профилактической антиаритмической терапии. Проанализированы основные стратегии коррекции ФП: контроль ритма и контроль частоты сердечных сокращений, их преимущества и безопасность для пациентов.

In the review the data on the incidence of lung cancer in Russia and the world is presented. Effectiveness of different screening methods used to identify patients with lung cancer, the value of different diagnostic methods is discussed. The data on the current drug therapy of non small-cell lung cancer , built on the basis of doublets of cisplatin and carboplatin used in the first line therapy, as well as on the doublets without cisplatin or carboplatin, generally used in the second line therapy and target therapies which are prescribed separately or in combination with chemotherapy. Indicated the efficiency of certain chemotherapy regimens, data on one-year, sometimes two-year survival, median survival, the major toxicity of combinations, doses, drugs and detailed diagrams of their prescription.

Differential diagnostic search in patients with pulmonary hypertension is always difficult clinical problem. This article describes the clinical case of treating patient with high risk primary pulmonary hypertension.