Vol 24, No 9 (2013)

The paper considers current approaches to choosing an antihypertensive drug to prevent renal lesion and to improve prognosis, which are relied on evidence-based information and experts’ opinion laid down in the new variant of the European clinical guidelines.

The paper deals with pneumatic hammer disease (PHD), one of the most common occupational diseases in Russia, which is accompanied by peripheral vascular and sensory disorders. It describes historical stages for studying the disease, the specific features of the clinical status and diagnosis of PHD due to exposure to local and systemic vibrations, as well as therapeutic and diagnostic measures.

The paper considers the current manifestations of an epidemic process in acute enteric infections - long-term and intraannual changes, the regional distribution and structure of morbidity.

Examinations of 175 patients with vertebrobasilar insufficiency established specific changes in the rate of skin sympathetic reactions in the segmental paravertebral areas of the cervical spine in relation to the pattern of injury of vertebromotor segments.

Much importance is attached to the inadequacy of inhibitory cortico-limbic and limbico-reticular influences and to total gamma aminobutyric acid (GABA) deficiency in the development of muscular tonic syndrome in acute and chronic pains. Baclosan (baclofen) is a GABA receptor agonist used as a central myorelaxant. Its clinical application is to treat pain and abnormalities associated with increased muscle tone and spasticity.

The paper gives the results of randomized controlled trials of the hypolipidemic efficiency and safety of therapy with rosuvastatin, its efficacy in the primary and secondary prevention of cardiovascular diseases and those of Russian trials evaluating the therapeutic equivalence of Mertenil (Gedeon Richter, Hungary) to original rosuvastatin.

Nicorandil has a number of advantages over nitrates in treating stable angina pectoris. Thus, enhanced exercise tolerance is accompanied by a significant improvement in the indicators of brain blood supply, better erectile function and quality of life, lower admission rates, and better tolerance. The findings are important in choosing drug therapy policy in this category of patients.

The paper describes the Russian and international experiences with the high selective β-adrenoblocker bisoprolol in patients with cardiovascular diseases and demonstrates its major (anti-ischemic, antihypertensive, anti-arrhythmic, etc.) effects in the context of evidence-based medicine.

Neuroleptic cardiomyopathy is a dangerous consequence of the adverse cardiotoxic effect of antipsychotic drugs. The paper identifies and substantiates the clinical and morphological criteria that may be a valid basis for verifying neuroleptic cardiomyopathy.

Postinfarction left ventricular remodeling was evaluated in patients who had experienced Q-wave myocardial infarction (MI). The patients were aged less than 40 years (Group 1) and 40 to 50 years (Group 2). In acute MI, there was a preponderance of eccentric hypertrophy (EH), in Group 1 in particular; the second most frequent conditions were normal geometry (NG) in Group 1 and concentric hypertrophy (CH) in Group 2. During 5-year follow-up, the rate of EH increased in the groups (in Group 2, in particular) with a respective decline of NG and CH cases. The number of patients with concentric remodeling substantially unchanged in the groups.

According to the World Health Organization data, migraine ranks third (14.4%) in its population-based prevalence in the world. The International Classification of Headache, 3rd Edition (2013), provides a useful guide to its diagnosis and differential diagnosis. Current diagnostic techniques, such as magnetic resonance imaging, yield additional information that is useful for the diagnosis of headache.

The paper gives data on informatization in primary health care in foreign countries. Information technologies (IT), such as electronic medical records, an electronic prescription, a clinical decision support system, electronic communication channels, telemedicine, an electronic appointment system, and patient informatization technologies, are most relevant to primary health care in foreign countries. The major barriers to the introduction of informatization into public health care are motivation, the level of training in medical personnel and the patient perception of innovations. The introduction of IT into a therapeutic and diagnostic process enhances the competitiveness of a therapeutic-and-prophylactic institution.