No 18-19 (2010)

The article is dedicated to the problem of neurocognitive disorders (VAND) in HIV infection that are making major contributions to clinical disease. It is noted that the incidence of VAND reaches 80% and varies depending on the severity of neurological disorders. The risk factors for VAND are presented; role of HIV replication in cerebrospinal fluid (CSF) is discussed. Control of virus replication in the CSF may play an important role both in prevention of VAND and the recovery of drug-resistant mutant viruses. Therefore, in recent years the ability of different antiretroviral drugs to penetrate the blood-brain barrier into the CNS has particular significance. It is emphasized that client-centered approach and optimized antiretroviral therapy with account of penetration of the blood-brain barrier may provide effective treatment of symptoms of CNS involvement and improvement of clinical outcomes.

Anticoagulant are one of the most commonly used drugs in various fields of clinical medicine. These include tools that affect hemostasis and are used to prevent or treat arterial or venous thrombosis and tromboèmbolism. The knowledge of their properties and the skills of their therapeutic application are necessary to achieve the maximum benefits and limit the frequency of bleeding complications. This overview focuses on the practical use of some new anticoagulants, including oral medicines which have been recently introduced into clinical practice as well as those which are in various stages of clinical trials.

The article describes the tactics of management of patients with chronic obstructive pulmonary disease (COPD). The data for the etiology, pathogenesis, and principles of diagnosis, treatment and prevention of this disease are presented. Supportive treatment of COPD involves the use of bronchodilators (sympathomimetics, cholinolytics, theophyllines), which should be preferably administered by inhalation. Patients with proven clinical or spirometric response to steroids should receive inhalation glucocorticoids. For prevention of COPD exacerbation, use of freeze-dried lysates of most common causative agents of respiratory tract infections, as well as N-acetylcysteine, is most effective. Targeted and systematic therapy provides a reduction in the risk of exacerbation and progression of COPD, relief of symptoms, increase in exercise tolerance, which generally lead to improvement of quality of life of patients.

The article presents the results of use of combined drug Novigan for the treatment of 15 women with different forms of cystitis. Against the background of 5-day use of Novigan, evident improvement was observed equal to that of the use of several drugs from different groups. Findings suggest the short-term use of Novigan in the treatment of patients with different forms of cystitis as effective and safe.

Peyronie's disease is condition that is accompanied by formation of dense fibrous plaque of tunica albuginea of the penis, which causes its deformation during erection. Prevalence of Peyronie's disease in Europe is more than 9 %, in Russia - 8 % according to referrals and up to 25 % according to autopsies. The disease often leads to sexual problems in relatively young men. The article is dedicated to the main methods of conservative and surgical treatment of Peyronie's disease, own experience of the authorsis presented.

The article presents the results of evaluation of frequency of occurrence and characteristics of arterial hypertension (AH) in 230 patients with chronic obstructive pulmonary disease (COPD). 60 men with essential arterial hypertension, matched by age to the examined patients with COPD were included in comparison group. The results of the analysis indicate a higher detection rate of arterial hypertension, as well as a higher average systolic and diastolic blood pressure (BP) in different age groups in patients with COPD compared with the general population, suggesting the COPD as a risk factor for arterial hypertension. In contrast to the patients with essential arterial hypertension, family history is not typical for patients with COPD and AH, and the incidence of overweight and obesity is lower than in the general population. Pathological types of diurnal blood pressure curve are dominated in patients with COPD and characterized primarily by the insufficient degree of nocturnal BP reduction, which is apparently due to the fact that during sleep such patients have periods of hypoxemia and hypercapnia, leading to activation of neurohumoral activation. It should be noted that COPD patients without arterial hypertension have a tendency to a lack of nocturnal decrease in blood pressure. Apparently, this indicates that obstructive pulmonary disease may interfere with the normal circadian rhythm of blood pressure.

Comparison of dynamics of concentration of various short-acting erythropoesis stimulating agents (ESA) used for correction of anemia in patients with terminal chronic renal insufficiency (tCRI) is presented. The study enrolled 50 tCRI patients which were treated by hemodialysis during 6 months to 5 years. The study has shown the similar bioavailability of various short-acting ESA - Eprex, Eralfon and Recormon, which were used in combination with iron preparations for correction of anemia in CRI patients. It suggests equal efficiency of intravenous administration of these agents in patients with tCRI.

Developing legislative regulation of turnover of confidential information in the Russian Federation has a direct relation to the sphere of medical practice. Enacted in recent years legislation clearly regulates the activities of health workers, working with personal data of patients. The article presents the analysis of domestic legislation and recommendations for compliance with the requirements of protection of confidential information, imposed on the staff of health care facilities.