No 6 (2017)

The lack of a unified concept of the essence of the processes occurring in non-alcoholic fatty liver disease (NAFLD), scarcity of clinical symptoms, and the limited possibilities for timely diagnosis cause the interest of physicians of various specialties in seeking solutions to this problem. The issues related to the evaluation of etiopathogenesis, diagnosis, treatment and prevention of steatosis in patients with NAFLD still remain an urgent task for the world healthcare. Symptoms of mitochondrial dysfunction, such as changes in the lipidogram and lipid peroxidation indices, as well as in the hepatic cell during electron microscopy, arising from steatosis, confirm its role in the development and progression of the disease. This fact should be taken into account when drawing up a diagnosis plan and an algorithm for treating patients with NAFLD.

The present study is devoted to the evaluation of the effect of anticoagulant therapy with apixaban on the parameters of arterial stiffness and endothelial dysfunction (ED) in patients with atrial fibrillation (AF) who have experienced cardioembolic stroke (CES). The study included patients with a persistent or paroxysmal form of non-valvular AF who have experienced stroke and were discharged from Samara ’s vascular centers for follow-up. Patients were divided into 2 groups: 56 patients (Group 1) has received apixaban in a daily dose of 5 mg according to the recommendations. The comparison group (Group 2) included 57patients who did not follow the recommendations for taking anticoagulants. The duration of follow-up was 182.5±5.5 days. All the examinations were carried out during the period of sinus rhythm in patients: volume sphygmography, echocardiography and tissue dopplerography, analysis of ED (von Willebrand factor, tissue plasminogen activator-1 inhibitor, antithrombin III) .The results obtained indicate that arterial stiffness and endothelial function in patients with AF who have experienced CES have a positive tendency to improve against the background of anticoagulant therapy with apixaban.

The article presents the results of the comparative non-interventional clinical study in parallel groups aimed to the evaluation of the efficacy and safety of the drug containing a complex of antibodies to tumor necrosis factor a, moskomarhitectura protein S-100, histamine (cAT) compared to trimebutine in the therapy of irritable bowel syndrome (IBS). The data obtained allow to recommend cAT for widespread use in the treatment of IBS, because it will have a positive effect on the relief of the clinical manifestations of the disease, especially pain syndrome.

Chronic neurogenic retention of urine (CNRU) is a very common and characteristic complication of demyelinating disease of the central nervous system - multiple sclerosis (MS). Comparison of clinical, urodynamic and neuroimaging features of CNRU in MS patients allowed to determine the spinal and cerebral components of the «sphincter» and «detrusor» urinary retention, as well as sensory and motor components. Using the method of comparing clinical, neuroimaging and urodynamic data made it possible to describe the pathogenesis of the development of urinary tract disorders in MS, and the use of method of neuropharmacologic analysis allowed to substantiate the symptomatic therapy of the various forms of CNRU occurring in this disease. The double mechanism of action (central and peripheral) of α1-adrenoblocker for its application in patients with detrusor-sphincter dissynergy (DSD) is described for the first time. The use of mono- and multicomponent symptomatic therapy based on compensation of disturbed reflex connections between the brain and spinal urination centers with the use of α1-adrenoblocker, anticholinesterase agent and GABA agonist in patients with DSD, pseudodissinergia and detrusor hypotony due to MS allowed to compensate the deficiency of impaired functions of lower urinary tract.

Helicobacter pylori (HP) infection is one of the most common human infections, which leads to the development of chronic gastritis, gastric and duodenal ulcers, MALT-lymphoma and gastric adenocarcinoma. Increased HP resistance to previously effective schemes of eradication therapy is a source of serious concern, and requires improvement of therapeutic strategies. The literature review shows that some probiotic strains have an inhibitory effect on the HP, and their use is recommended as an addition to the standard eradication therapy that can reduce side effects and increase its effectiveness.

The article discusses the features of the pathogenesis of mitochondrial dysfunction, which is observed in various pathological conditions accompanied by hypoxia and ischemia. A review of clinical studies and the results of authors’ own experience of use of meldonium as a corrector of secondary mitochondrial dysfunction are presented. Analysis of research confirms that the addition of meldonium to the background therapy is accompanied by a positive clinical effect in cardiovascular and neurological disorders, diabetes mellitus, metabolic syndrome and other diseases with comorbidity.