No 12 (2010)

The contribution of E.M. Tareev in the development of problem of arterial hypertension (AH), including renal and malignant AH, is presented. The fundamental works of E.M. Tareev devoted to the problem of arterial hypertension are discussed. Many of the concepts of AH stated by E.M. Tareev today are justified not only in the experimental and clinical studies, but they also confirmed by the data obtained during a long-term observation of very large groups of patients.

The article discusses the problem of chronic pancreatitis (CP), the incidence of which is currently increasing. The data for the etiology and pathogenesis of pancreatitis, modern classification, and diagnosis and treatment tactics of CP are presented. The article presents review of the results of numerous studies of the pharmacological treatment of abdominal pain and exocrine pancreatic insufficiency with pancreatic enzyme preparations. To date, all published studies proved that only generation IV medications (Creon and analogues) are most effective in the treatment of pancreatic insufficiency that largely determines the usefulness of Creon for reduction of two major syndromes of CP - exocrine pancreatic insufficiency and abdominal pain syndrome.

Among the variety of neurological symptoms developing as a result of vascular brain lesions, cognitive impairments have a special place, and they significantly affect the quality of life of patients. On the one hand, endothelial dysfunction (ED) is one of the important pathogenetic mechanisms of vascular diseases of the brain; on the other hand- an independent risk factor for development of this pathology. Identification and evaluation of ED in the early stages of vascular cognitive impairment allow developing the correct strategy of therapy, which capable to slowing or regression of the resulting symptoms. Taking into account modern views on the pathogenesis of these disorders, antioxidant medications restoring endothelial function should be considered as important part of complex treatment of cerebrovascular disease.

Amoxicillin/clavulanic acid is accessible in the pharmaceutical market more than 20 years, and currently is one of the most prescribed antibacterial preparations at a wide spectrum of infections in clinical practice. Popularity of this drug is caused by its pharmacokinetic and pharmacodinamic properties. One of modern forms Amoxicillin/clavulanic acid is modified-release film-coated tablets with high concentration of antibiotic and improved pharmacokinetic characteristics.

Hypertensive encephalopathy (HE) is a slow-progressive diffuse focal brain damage due to chronic circulatory disturbance associated with long-term uncontrolled hypertension. The article is dedicated to the pathogenesis of HE, contributing factors; prevention measures are discussed. The role of prevention of brain lesions in arterial hypertension, which should include not only control of blood pressure, but additional treatment aimed to improving the metabolic processes of the brain is emphasized. The potentials for the use Mexidol -antioxidant with neuroprotective effect for this purpose are discussed.

Non-alcoholic steatohepatitis (NASH) is a chronic liver disease developing in patients who do not consume alcohol in hepatotoxic doses, and is characterized by the development macrovesicular steatosis and lobular inflammation of the liver. NASH is considered as a disease of the liver in the metabolic syndrome, the pathogenetic basis of which is the development of insulin resistance. The results of open clinical study of efficacy and safety of herbal medicine Hepabene (milk thistle and fumitory extracts) in the treatment of 43 patients with NASH are presented. It was shown that treatment of NASH with the drug Hepabene due to restoration of hepatocyte function and normalization of bile outflow leads to rapid improvement of general state of patients, reduction of severity of clinical symptoms, laboratory and instrumental parameters. The drug effectively restores motor-evacuatory function of the biliary tract; Hepabene is well tolerated by patients and can be recommended for use in the treatment of patients with NASH, especially with concomitant biliary tract disease.

The article is dedicated to the results of the study which was aimed to development of algorithm of diagnostics and treatment of rheumatoid arthritis at early stages in out-patient polyclinic settings. Besides the standard techniques, the use of quantitative measurement of specific immunological markers and arthrosonography at a stage of diagnostics of disease was suggested. Approaches to treatment contain recommendations about use of nonsteroid anti-inflammatory preparations Diclofenac and Nimesulid, as well as disease modifying anti-rheumatic drugs Methotrexate, Artrofoon and their combinations; efficacy and safety of these drugs were assessed in the present study.

Approved in 2009-2010, RF Government Ordinances and a number of Orders of Health and Human Services agency forms regulatory framework of radically new health care sector - health management. The article describes the reasons for the establishment of this new direction, the principles of activity of health centers from the standpoint of health management. Experts of centers are designed to deal with the assessment, correction, monitoring the level of health of every individual, who appeal not with the already developed disease, but understands the importance of health for his own life and the prospects of his relatives and friends.

The article presents history of development, the procedure and diagnostic value of evaluation of endogenous creatinine clearance by Rehberg-Tareev test used for determining the glomerular filtration rate. Currently, the value of GFR is used not only to detection of violations of kidney's filtration function, but also for the integral estimation of the risk of cardiovascular complications in the general population, especially in patients with relevant risk factors (arterial hypertension, type 2 diabetes mellitus, metabolic syndrome, abdominal obesity).