Vol 23, No 3 (2012)

Therapy resistant asthma (TRA) is most difficult to treat and its course is least predictable. TRA remains least studied notwithstanding the fact that its many mechanisms have been detected. To this point there has been no clear definition of TRA and this terminology has not been widely used so far. This paper gives the results of an investigation, which could identify the phenotype of TRA, by taking into account its pathogenetic and clinical heterogeneity, reveal the predictors of the disease, and elaborate unique criteria to make its diagnosis.

The absence of specific clinical symptoms of functional disorders of the biliary tract makes it difficult to diagnose liver and biliary tract diseases. All treatment options for sphincter of Oddi dysfunction are divided into invasive and noninvasive ones. Duspatalin is widely used to relieve smooth muscle spasm of the sphincter of Oddi.

Beta-blockers (BB) are known to be effectively reduce mortality and the risk of myocardial infarction, stroke, and other cardiovascular events in patients with coronary heart disease (CHD), chronic heart failure, arterial hypertension (AH), and arrhythmias. However, the use of nonselective and secondary generation relatively selectivite BB can be complicated by psoriasis exacerbation or psoriasiform erythema developement, an adverse reaction generally related to the undesirable β 2-adrenoreceptor blockade. One hundred and two hypertensive patients with severe exacerbated psoriasis and CHD were enrolled in the trial aimed to asses efficacy and safety of highly selective b1-blockerbisoprolol (Bidop, Gedeon Richter). The study results showed that bisoprolol while significantly reduced number of anginal attacks and lowered blood pressure, did not affect the psoriasis course and symptom improvement.

The timely detection and correction of cognitive impairments in patients with metabolic syndrome let us affect effectivelyall underlying disorders. Therapy with pyribedil (Pronoran) is successfully used to correctmoderate cognitive impairments in patients with metabolic disturbances.

Russian National Research Medical University, Moscow The efficiency of using the fixed combination perindopril and amlodipine (Prestance, Servier, France) wasconsideredin patients with arterial hypertension (AH). Fifteen patients (mean age 55.13±11.1 years) with Stage II AH, grades ll-lll, andamoderate-to-high-risk for cardiovascular events, including those concurrent with coronary heart disease, were examined. Biochemical blood tests, Korotkoff office blood pressure (BP) measurements, and 24-hour BP monitoring were performed before and during treatment. Prestance was given once daily; the follow-up was 4 weeks. The use of Prestance resulted in a significant reduction in systolic and diastolic BP (SBP and DBP), a morning rise of SBP, and the rate of morning increase in DBP and unchanged both daytime and nocturnal heart rate. In addition, metabolic neutrality and no side effects of the fixed combination perindopril and amlodipine (Prestance, Servier, France) wereshown.

The paper considers the problem of chronic constipation and its new promising control methods, the etiopathogenetic aspects of development of this pathology and current therapeutic procedures. It gives the main groups of laxatives with the evaluation of their therapeutic capacities and the assessment of a potential risk for adverse reactions. The perspectives of a novel laxative containing lactulose and paraffin are assessed.

The paper gives the data of a preliminary study of prostate secretion microbiocenosis in a group of patients with chronic abacterial prostatitis. Prostate secretion was studied by real-time polymerase chain reaction, which allowed the microorganisms undetected by standard cultural studies to be identified. The microorganisms identified are representatives of a class of anaerobes.

Sanguiritrin as enteric-coated tablets is effective as a systemic resorptive anti-infective agent against dysbacteriosis in the presence of various acute and chronic diseases of infectious etiology.

Orthostatic hypotension occurs in 29% of elderly and senile patients with arterial hypertension; it is associated with comorbidity. Perindopril (ifrequired, in combination with indapamide) is an optimal antihypertensive treatment in the above patients.

The current approach to treating type 2 diabetes mellitus (T2DM) is not only to eliminate the manifestations of carbohydrate metabolic decompensation, but also to prevent the complications of the disease. The analysis has revealed that the major criterion of carbohydrate metabolic compensation (HbAlc) is inadequately used (15.9%) in a district therapeutic-and-prophylactic institution and no disease compensation is seen in most patients, the microvascular and macrovascular complications of T2DM are inadequately prevented.

Smoking cessation by patients with asthma before pregnancy improves not only the course of the disease during gestation, but also the health status of children with hereditary predisposition to asthma.

The paper shows the possibilities of using urea breath tests to diagnose Helicobacter pylori infection and to monitor its therapy. The test is based on the determination ofurea cleavage products (carbon dioxide or ammonia) by urease of the bacterium Helicobacter pylori in expired air.