Vol 20, No 3 (2009)

The main line of treatment for acute coronary syndrome with ST-segment elevation is to restore blood flow along infarct-related artery by thrombolytic therapy or percutaneous coronary intervention (PCI) as soon as possible. The choice of a reperfusion technique is determined by the capacities of a specific health care facility or a possibility of referring a patient to an institution that is able to perform PCI. The time of the onset of reperfusion can be reduced by prehospital thrombolysis. Due to the complexity of performing emergency PCI in our country, this strategy may become saving to an enormous number of patients.

Atrial fibrillation (AF) is the most common cardiac arrhythmia. In many patients with both paroxysmal and persistent AF, it is a cause of serious complications due to hemodynamic disorders, requires preventive therapy to reduce a risk for thromboembolic events, including stroke, of which this arrhythmia is a pathogenetic factor. A number of randomized studies have provided evidence that the risk of thromboembolic events, stroke in particular, can be reduced by anticoagulant and antiaggregatory therapy. This investigation has studied the frequency of prescribing warfarin and aspirin to patients of different ages and anticoagulant therapy adherence in persons aged over 75 years.

The paper describes the major links of the pathogenesis of different morphological types of endometrial hyperplasia, adenomyosis, and uterine myoma. It considers the options of pathogenetic therapy for diseases of this group and the factors influencing treatment policy, as well as the appropriateness of the most extensively used pharmacologicals as part of combined therapy for proliferative diseases of the uterus

The paper considers the basic pathogenetic mechanisms of development of the metabolic syndrome and its association with non-alcoholic adipose hepatosis. It presents the current classifications of the metabolic syndrome and non-alcoholic adipose hepatosis. The leading role in the pathogenesis of these conditions is played by the insulin resistance phenomenon. The present-day recommendations are given on the treatment of the above pathology. The data of the study aiming at examining the liver in patients with the metabolic syndrome and the evaluation of the impact of metformin therapy on this cohort of patients are shown.

The paper reports the results of complex therapy in patients with dorsopathy accompanied by pain and myotonic syndrome. It elevates the clinical efficacy of the Russian multivitamin complex Benfolipen that contains benfotiamine, of treatment for acute coronary syndrome with a fat-soluble analogue of thiamine.

The anti-inflammatory effect of Pepsan-R that is new to the Russian Federation, used as monotherapy in 50 patients with 0-first degree gastroesophageal reflux disease (GERD), was evaluated. The drug contains 2 active ingredients: guaiazulene and dimeticone. The mechanism of its action is to suppress mast cell degranulation and to generate a protective layer on the gastroesophageal mucosa. The efficacy of the agent was clinically shown in 100% of the patients (10% of them needed larger doses of the drug). Four-week positive changes were morphoendoscopically seen in 50% of the patients. No side effects were recorded

The development of Helicobacter pylori resistance to antibiotic therapy, the high proportion of reinfection and relapses, and side effects after eradication therapy require new approaches to treating peptic ulcer. To restore of psychovegetative balance and neurohormonal regulation, a complex of therapy for peptic ulcer was added by Grandaxin having an autonomic modulator effect, which potentiated the effect of the traditional therapy.

The VIBE retrospective observational cohort study demonstrated that that risks for extravertebral and femoral neck fractures tended to reduce in patients given oral bisphosphonates for a year. This study confirmed that ibandronate was as effective as other bisphosphonates, such as alendronate and residronate. The risk of vertebral fractures turned out to be much less in compliant patients who received ibandronate in a dose of 150 mg once monthly than those who took other bisphosphonates weekly

Since erectile dysfunction is frequently accompanied by hypogonadism, this study has been undertaken to define indications for combined therapy with phosphodiesterase type V inhibitors in combination with androgens. Androgen monotherapy have turned out to be effective in 67.6% of patients. It is advisable to use combined therapy to patients with severe and moderate erectile dysfunction, diabetes mellitus and/or coronary heart disease shortly after these conditions are diagnosed. However, there is an earlier occurrence of benefits from therapy with phosphodiesterase type V inhibitors if androgens have been previously used.

The dry eye syndrome is one of the cardinal causes of keratopathy in endocrine ophthalmopathy (EOP). Timely treatment and prevention of corneal and/or conjunctival xeronosus, as well as pathogenetic therapy for orbitopathy prevent severe corneal damage in EOP.