No 5 (2011)

This article is dedicated to modern methods of pharmacological correction of neurohumoral systems activity in various stages of myocardial infarction. It is emphasized that following of current guidelines is not always effective in prophylaxis of the left ventricle remodeling. Possibilities of new drug groups usage for this aim are discussing.

Therapy of somatostatin analogues plays an important role in the treatment of acromegaly and is used as an additional treatment after neurosurgical intervention or as a primary therapy. Prolonged form of octreotide (Swiss, Sandostatin® LAR) is the most studied and widely used as somatostatin analog. The initial dose of Sandostatin® LAR is typically 20 mg, however, according to many studies, it was noted that after the first 3 months of treatment does not always achieved remission of acromegaly and to better control the disease should increase the dose of the drug in most patients. This review focuses on the use of Sandostatin® LAR at high (30 mg per month or more) doses in patients with active acromegaly. The use of Sandostatin® LAR at high (30 mg per month or more) doses, increases the efficiency of achieving biochemical control of active acromegaly, without compromising the safety profile of this drug.

The article is dedicated to the gastroenterological disorders occurring in diabetic autonomic neuropathy (DAN) in patients with diabetes mellitus. Mechanisms of development, clinical manifestations, diagnosis and approaches to the treatment of most common forms of the gastrointestinal diseases against the background of DAN are considered.

Chronic pelvic pain is one of the leading women's health issues. Myofascial pain syndrome (MFS), affecting the pelvic floor muscles, occupies an important place among different reasons. The article is dedicated to the problems of pathogenesis and diagnosis of MFS of this localization. Modern approaches to the treatment of MFS are presented; the drugs of choice are non-steroidal anti-inflammatory drugs (in particular, lornoxicam) and muscle relaxants. In severe MFS, use of antidepressants is of great importance.

The review is dedicated to the major infectious and noninfectious causes of sore throat; most common characteristics of inflammatory diseases accompanied by sore throat (pharyngitis, tonsillitis) are considered. Data for the diagnosis and differential diagnosis of these diseases, criteria for choice of antibiotics and modern approaches to the treatment using "topical" dosage forms are presented.

This article is devoted to the analysis of current antiacne drugs affecting various parts of the pathogenesis of acne. In connection with the need for long-term administration, the clinical efficacy and side effects of drugs for external application are discussed. Particular attention is given to the most common side effects of antiacne drugs for external application - phototoxic reactions induced by ultraviolet rays of different spectrum. It is emphasized that only azelaic acid is most effective antiacne drug that does not cause development of photodermatosis and can be actively used at any time of year, regardless of insolation. The data for efficacy and safety of azelaic acid according to results of domestic and foreign clinical studies are presented.

Treatment effectiveness was evaluated by the pain expression on visual-analog scale (VAS), the algofunctional Lesquene index (AFIL), the WOMAC scale index, and a pain intensity at palpation. A concentration of C-reactive protein (CRP) in a high-sensitive immune-turbidimetric test was determined. After one month of therapy the pain of joints evaluated with VAS has decreased by 24,7 % (p < 0,0001), at palpation - by 58,8 % (p < 0,0001), the functions of the joint improved by 29,3 % (p < 0,0001) evaluated with AFIL, and by 22,4 % (p < 0,0001) evaluated with general WOMAC index. The CRP concentration decreased by 54,4 % (р = 0,004). The AFIL decrease by 30 % and more was observed in 17 (65,4 %) cases and in 12 (46,2 %) patients the total WOMAC index decreased by 30 % and more. A common estimate of Neurodiclovit effect was good in 18 (69,2 %) and satisfactory in 8 (30,8 %) patients. In patients suffering from knee osteoarthritis with metabolic syndrome Neurodiclovit administration for four weeks in the on demand regime was well tolerated in 87 % patients and showed good analgetic and anti-inflammatory effect.

The authors have studied clinical efficacy of felodip (Felodip, TEVA) in patients with hypertension and analyzed factors influencing adherence to therapy in real-world outpatient practice. The study enrolled 5474 patients with arterial hypertension from 84 clinics in Moscow. According the results of Moriski - Green test on the first visit, patients were divided into 2 groups - first group with low adherence to treatment (LAT), and the second - with a high adherence to treatment. All patients received felodipine during 8 weeks. Among patients completed the study, over 98% of patients have reached the target blood pressure levels or decreased it by more than 20 and 10 mm Hg (systolic and diastolic, respectively). Improvement of quality of life, more pronounced in the LAT group, was observed. Male gender, older age is associated with lower adherence to therapy. By contrast, presence of home tonometer, coronary heart disease and diabetes mellitus are associated with higher adherence. The including of drug in reimbursement drug list is not independent and crucial factor for improvement of treatment compliance.

The increasing number of aorto-coronary bypass grafts surgeries demands to develop new options and methods of treating this category of patients. According to up to date concepts patients after CABG are exposed to different risk factors and needed to be treated using modern approaches to reduce the progression of coronary artery disease and its complications. New drugs such as ω-3 unsaturated fatty acids are known to improve the outcomes after performed CABG surgery. This article analyses the place of Omacor in the complex treatment of these patients before CABG. According to performed study the therapy of omacor 2 g daily during 14 days before surgery was associated with reduction of intimal hyperplasia of venous conduits. In addition, the number of smooth muscle cells and proliferation index were also significantly reduced according to performed immunochemistry investigation. Based on this study, antiproliferative activity of Omacor may improve the viability of venous conduits in long terms.