No 20 (2015)

Один из наиболее сложных вопросов повседневной работы кардиологов - подбор антитромботической терапии для больных с высоким риском развития инсульта и тромботических осложнений. Эта актуальная проблема обсуждалась на симпозиуме «Профилактика инсульта при неклапанной фибрилляции предсердий: эффективность и безопасность», прошедшем в рамках Российского национального конгресса кардиологов.

The rate of progression of fibrosis in different patients varies and depends on many factors, such as race, gender, age of ingress of infection, genotype, presence of concomitant diseases, bad habits, etc. Currently, the most urgent task is the identification of specific genetic factors of progression of fibrosis that will help to determine the prognosis and tactics of management for these patients. The review describes the available literature data on the effect of polymorphisms of thrombophilia and platelet receptors genes on the course and prognosis of chronic liver diseases.

The article presents the historical aspects and the modern idea of applying human normal immunoglobulin preparations. The differences in the content of the instructions for the application of registered products, and the need for standardization and harmonization of the indications for their use are demostrated.

Article provides an overview of foreign and domestic research, in which methods of treatment and prevention of coronary syndromes and vascular disorders were evaluated and developed taking into account the metabolism of cardiomyocytes. The modern look at the pathogenesis of myocardial ischemia in terms of the concept of development of adaptation and disadaptation processes of intracellular energy metabolism significantly expands the therapeutic approaches in clinical practice. In this regard, the role of myocardial cytoprotection as the important component of the treatment of coronary artery disease I pathogenetically substantiated. Taking into account the particularities of the mechanisms of action of 1st and 2nd generation cytoprotectors, their use in combination with background therapy, and one after the other to achieve maximum effect is feasible.

The study was aimed to the evaluation of the adequacy of dual antiplatelet therapy in patients with acute coronary syndrome with ST-segment elevation undergoing coronary artery stenting. The first phase of the study (retrospective) was a pharmaco-epidemiological analysis of dual antiplatelet therapy in all patients. The second phase of the study included survey and monitoring of 150 patients with acute coronary syndrome with ST-segment elevation. At prospective stage of study, patients received clopidogrel over the whole period of hospitalization according to the randomization group. The results of this study allowed to conclude that at outpatient stage of treatment patients prefer clopidogrel generics due to their lower cost; detailed explanation of appropriateness of the use of the combination of antiplatelet drugs increases patients’ adherence to the recommended treatment regimen.

The article presents the results of a prospective clinical study aimed to the evaluation of the efficacy and safety of anti-Helicobacter therapy (AHT) in patients with concomitant chronic hepatitis C, depending on the stage of liver fibrosis. The data obtained allow to conclude that the effectiveness of AHT is not significantly dependent on the stage of liver fibrosis, but the presence of fibrosis significantly determines the risk of side effects on the background of the AHT. The group of highest risk includes patients with liver cirrhosis.

Indications for intravenous administration of iron preparations for the treatment of iron deficiency anemia (IDA) include inefficiency or poor tolerance of oral iron therapy, severe anemia, IDA in the preoperative period, IDA against the background of inflammatory bowel disease associated with impaired absorption; there are also recommendations of combination therapy with erythropoiesis stimulating agents. A number of clinical studies have analyzed the results of intravenous administration of iron preparations in different regimens for the treatment of IDA.

This review of the literature devoted to Isoprinosine (inosine pranobex), which has proven clinical efficacy and a favorable safety profile. The drug reduces the severity and duration of the main clinical symptoms of influenza and acute respiratory viral infections (ARVI), reduces the risk of their complications. Due to the dual mechanism of action (antiviral and immunomodulatory), Isoprinosine allows to reduce the number of drugs appointed in flu and ARVI. It is emphasized that Isoprinosine can be recommended for widespread use in primary health care as the drug of choice for the treatment of not only the flu, but ARVI.