No 18 (2017)

Pelvic vein incompetence is often associated with typical clinical signs of congestion as well as pelvic pain. This clinical entity is often underestimated and patients suffering from pain related to pelvic varicosities undergo a long and inconclusive diagnostic workup before the exact cause of symptoms is recognized. This article reviews currently available diagnostic, therapeutic and surgical options.

A prospective, randomized study of the efficacy and safety of antianginal therapy using combinations of bisoprolol, ivabradine and trimetazidine or ranolazine at the age 60 to 79 years included 107 patients with coronary artery disease and grade II/III stable effort angina. In case of retention of angina and/or painless myocardial ischemia against the background of use of bisoprolol and ivabradine after randomization, patients were additionally prescribed with trimetazidine (35 mg twice a day, n=54) or ranolazine (500 mg twice a day, n=53). Within 6 months, both methods of treatment were well tolerated, significantly improved the results of the treadmill tesT., the left ventricular systolic and diastolic functions, the structural and functional state of large arteries, and the quality of life of patients. Trimetazidine significantly reduced the duration of painless ST-segment depression according to Holter ECG monitoring. Combinations of low-dose ß-blocker with ivabradine and trimetazidine or ranolazine can be used in the treatment of refractory stable angina in elderly and senile patients.

The evaluation of changes in the musculoskeletal system in patients with axial spondyloarthritis (axSpA) seems to be a relevant task. The article presents the results of study aimed to the determine the occurrence and features of deformations of the vertebral bodies in patients with AxSpA by assessment of spine X-rays and to compare the results with the frequency of decrease in bone mineral density (BMD) assessed by dual energy X-ray absorptiometry (DEXA). According to the results of the study, patients with axSpA showed a high occurrence of changes in the shape of vertebral bodies and a decrease in BMD. Each fifth patient with axSpA has changes in the shape of vertebral bodies with normal BMD. Thus, in order to form a full-fledged characterization of the state of the axial skeleton and adequate correction of the treatment of patients, combined use of the X-ray examination of the spinal column and DEXA is required.

The article presents the results of the evaluation of the effect of dance therapy on motor, cognitive and affective disorders, the quality of life and the daily activity of patients with Parkinson’s disease. It is shown that music classes combined with dances are an effective method of non-pharmacological therapy and rehabilitation of patients with Parkinson’s disease.

Iron refers to irreplaceable trace elements, the regular intake of which is absolutely necessary for the normal functioning of all living organisms in an oxygen environment. The biological role of iron is high and is determined by its participation in oxidation-reduction processes, the reactions of oxygen-dependent free radical oxidation and the antioxidant system, the growth and aging of tissues, the mechanisms of general and tissue resistance, hemopoiesis, the supply of organs and tissues with oxygen, activation and inhibition of a number of enzymes. Many metabolic processes occur with the participation of iron: synthesis of steroids, metabolism of drugs, DNA synthesis, proliferation and differentiation of cells, regulation of genes. Therefore, even the prelatent and latent iron deficiency in the body affects to some extent the processes listed above and affects all levels: genetic, molecular, cellular, tissue, organ, systemic and requires immediate replenishment.

The article presents a review devoted to the relevance of the neurological examination of patients with Parkinson’s disease (PD), as well as the most common causes of error diagnosis of PD, the reasons for hospitalization and mortality in PD.