No 6 (2009)

The article is devoted to the review of current treatment regimens of Helicobacter pylori infection and place them clarithromycin. Current recommendations of international consensus Maastricht II-III are presented. We discussed the possible ways to solve the main problems associated with increasing antibiotic resistance of H. pylori. The basic reasons for its development are stated. Particular attention is paid to the prospects of new regimens, in particular the eradication treatment regimen with clarithromycin administration, and to the quality of antibacterial drugs.

The paper presents the review data for the Meksidol pharmacological effects and pharmacokinetics. We considered the neuroprotective, anti-ischemic, nootropic, antistress, anxiolytic, anticonvulsant, anti-alcohol, antiatherogenic, and geroprotective effects of Meksidol. Special attention is given to the Meksidol effects in the treatment of neurodegeneration diseases, especially acute and chronic cerebral circulation disorders. The data for multicomponent mechanism of Meksidol action with important antioxidant and membranotropic effects, the ability to modulation of the receptors and membrane-bound enzymes enzymes function, and restoration of neuromediator balance are presented.

The article is dedicated to the problem of psychopathological disorders in the internal medicine and their impact on the course of somatic, in particular cardiovascular diseases. General practitioners often are faced with depression and anxiety disorders. Given the fact that currently depression is considered as an independent factor of cardiovascular disease, and depression and anxiety more frequently occurs in patients with coronary heart disease than an average of population, timeliness of diagnosis and treatment of these disorders are critical issue for internists.

Acute low back pain (LBP) - a common pathological condition associated with a high incidence of temporary disability. LBP - a benign condition requiring a detailed instrumental assessment only in the presence of symptoms, suggested the secondary nature of pain. An important task is pain relief in patients with LBP. NSAIDs, including meloxicam (Movalis) can be used for this reason. The data for drug efficacy in various pain syndromes are presented. We have observed good tolerability and low risk of gastrointestinal complications. Given the current data we discuss the problem of low risk of atherothrombotic complications in Movalis administration.

The article is dedicated to the problem of drugs administration out of the instructions for use (off-label-use). It is emphasized that the off-label-use of drugs applies not only for indications but also for others formal parameters, such as dosage form, dosage, mode of administration, etc. We discuss the practice of off-label-use in foreign countries, particularly in Germany. In Russia, there is no normative document giving guidance for action if off-label-use of drug required. Today, however, the legal practice of off-label-use may occur as individual therapy for health reasons when performing the necessary requirements for scientific substantiation of the potential benefit to the patient, decision-making by council of physicians, adequate informing the patient (or his representative) and patient voluntary informed consent.

We consider the current realities of medical science and practice, their positive and negative aspects. The significance of clinical guidelines focused on the quality and cost of remedial actions are discussed. It is emphasized that the introduction of these standards can not prevent many diagnostic errors, whether due to inappropriate modern theoretical training of physicians, leading to the subjective, erroneous interpretation of the results of patients assessment. The paper discusses importance of clinical-anatomical conferences with current imaging method of autopsy data in quality supply of doctors medical education, including postgraduate education.

The article is dedicated to the problem of lipid metabolism disturbances and its role in the pathogenesis of metabolic syndrome (MS) and its complications. We review the numerous international studies have shown the importance of dyslipidemia in the development and progression of cardiovascular disease, evaluating lipid-lowering and pleiotropic properties of statins and fibrates. Data for own comparative analysis of case histories of 66 patients with MS treated with lipid-lowering therapy by micronized fenofibrate (Tricor) and atorvastatin are presented. According to the analysis results, fenofibrate can be recommended for use in patients with low HDL cholesterol level, high triglyceride level, and normal or moderate elevated low density lipoprotein cholesterol level. It is submitted that fibrates have a wide range of favorable nonlipid effects, among which anti-inflammatory, antioxidant, anticoagulant properties, the effect on the functional state of the endothelium of the vasculature, which may play a key role in decrease of risk of cardiovascular complications of metabolic syndrome.

In a study including 52 patients assessed the Berlition ® 300 (Berlin-Chemie AG/Menarini Group company, Germany) efficacy in the treatment of chronic liver diseases. The results of treatment confirm the positive effect of the drug Berlition ® on the functional state of the liver in patients with chronic lesions of different etiology, which was seen as significant improvement in clinical condition, the normalization of the functional "hepatic indices, decrease of cholesterol and glucose levels, significant improvement of quality of life in patients. Only one patient had moderate changes in some biochemical parameters after treatment.