[Experience with clinical administration of new drug Thrombovasim® in vascular surgery].

Recent years have witnessed an increased worldwide interest in medical use of unique naturally occurring enzymes - subtilisins possessing pronounced fibrinolytic and anti-inflammatory properties. The article deals with experience in clinical administration in vascular surgery of new therapeutic agent Thrombovasim® containing pegylated subtilisin as an active substance. Thrombovasim® has a favourable profile of safety, good tolerance and causes no severe haemorrhagic complications.

[Assessment of risk factors of atrial fibrillation in patients with metabolic syndrome].

The aim of the work was to identify risk factors of atrial fibrillation (AF) in 151 patients with metabolic syndrome (MS, IDF 2005); 88 of them presented with the recurrent form of AE 63 had no arrhythmia. Practically all patients suffered from arterial hypertension. The groups were comparable in terms of age, concomitant disorders, AH duration, arterial pressure, and severity of chronic heart failure.

[Cardiac resynchronization therapy in patients with narrow QRS].

Conduction delay affecting 30-50% of patients with NYHA class III-IV heart failure (HF) mainly results from left bundle branch block and leads to deterioration of cardiac contractility through intra- and interventricular dyssynchrony. Cardiac resynchronization therapy (CRT) has class I recommendation for the treatment of patients with severe systolic HF who have left ventricular ejection fraction less or equal to 35%, QRS duration greater than or equal to 120 ms. Nevertheless some studies have shown that systolic asynchrony is present in 27-43% of HF patients with narrow QRS complexes (defined as <120 ms).

[Metabolic syndrome and chronic persistent atrial fibrillation].

The aim of the study was to elucidate specific features of chronic recurrent atrial fibrillation (AF) in patients with metabolic syndrome (MS) and disturbed carbohydrate metabolism compared with AF patients without MS. It enrolled 145 patients aged 44-83 years: 117 with abdominal obesity (BMI >30 kg/m2, waist circumference >80 and 94 cm in women and men respectively) including 30 without metabolic disturbances; 35 with impaired glucose tolerance (IGT), 52 with type 2 DM, and 28 controls without MS. Parameters measured included frequency and severity of AF, carbohydrate and lipid metabolism, albuminurea, C-reactive peptide level, quality of AH control, results of echocardiography and 24 hour ECG monitoring (sinus rhythm), and insulin resistance index (HOMA IRindex).

[Capabilities of hypoglycemic therapy in women with decompensated type 2 diabetes mellitus].

Aim: to comparatively evaluated the efficiency of various sugar-lowering therapy (SLT) options in patients with decompensated type 2 diabetes mellitus (T2DM).

Subjects And Methods: One hundred and eighty-two women who were over 55 years of age with a more than 3-5-year history of T2DM and more than one-year decompensation, abdominal obesity (AO), arterial hypertension, and concomitant treatment-matched were randomized into 4 groups: (1) metformin (n=46); (2) a combination of metformin and gliclaside MB (n=47); (3) metformin and insulin (n=44); and (4) insulin (n=45). A follow-up was 12 months.

[Dynamics of structural-functional parameters of cardiovascular system during use of complex therapy of women with type 2 diabetes mellitus].

Aim of the work was to study dynamics of parameters of cardiovascular system in women during use of various sugar lowering drugs in complex multifactorial therapy of type 2 diabetes mellitus (DM). We included in this 12 months study 182 women older than 55 years with type 2 DM, abdominal obesity and artrerial hypertension (AH). All women received angiotensin converting enzyme inhibitors and statins.

[Cardiovascular disorders and possibilities of their therapy in patients with type 2 diabetes mellitus and diabetic nephropathy].

The aim of the study was to assess specific cardiovascular lesions in patients with type 2 diabetes mellitus and diabetic nephropathy (DN) and search for the methods of their correction. It included 182 overweight or obese (abdominal type) women above 55 yr with arterial hypertension (AH) divided into groups with normal or low (less than 30 ml/day) albuminuria (n = 87), albuminuria (30-300 mg/day, n = 59), proteinuria (above 30 mg/day, n = 21), and stage I-IIa chronic renal insufficiency (CRI, n = 15). It was shown that structural geometric changes in the left ventricle (LV) with the prevalence of myocardial concentric hypertrophy and diastolic dysfunction (DD), enhanced myocardial hardness, and preserved systolic function undergo progression with increasing severity of DN and decreasing glomerular filtration rate combined with poorly controlled DM2, abnormal lipid profile, long history of AH in the absence of adequate AP control, signs of vascular atherosclerosis (thickening of intima and media in carotid arteries), and large number of macrovascular complications.

[Nibentan in arresting acute atrial fibrillation: risk or benefit?].

Aim: To study efficacy and safety of using a domestic anti-arrhythmic drug nibentan for arresting acute atrial fibrillation.

Material And Methods: A total of 210 patients received nibentan in a dose 0.125 mg/kg dissolved in 20.

[Combination of prehospital systemic thrombolytic therapy with endovascular procedures in the treatment of patients with acute myocardial infarction].

Since July 2002 we have been conducting a study of efficacy of prehospital thrombolytic therapy combined with subsequent endovascular procedures in the treatment of patients with acute myocardial infarction. Fifty nine patients received prehospital fibrinolysis with tissue-type plasminogen activator (TPA, n=28) or streptokinase (n=31) within 6 hours after onset of symptoms. TPA infusion compared with that of streptokinase was associated with smaller ischemic myocardial damage and lower frequency of side effects (3.

[Electromechanical heterogeneity of the myocardium].

Herein we discuss modem data showing that ventricle's working myocardium is highly heterogeneous. Significant transmural differences in electrophysiological and biomechanical properties of cardiomyocytes are reviewed. The reviewed evidence of myocardial heterogeneity constitutes the basis for modem assessment of segmental kinetics of different regions in intact heart.

[Stent thrombosis in patients with myocardial infarction].

The problem of stent thrombosis in patients with myocardial infarction is reviewed with consideration of possible mechanisms and causes of in-stent thrombus formation during first 30 days after the procedure. Roles of the patient factor, factor of the stented vessel, stent in self, stent deployment technique, and management after stenting are discussed.

[Intensive care of children with DIC syndrome based on the use of low molecular weight heparins].

The first section of this paper presents data on low-molecular-weight heparins: pharmacokinetics and pharmacodynamics, advantages in comparison with common heparin. The second section presents the results of fraxiparin and clivarin use in 43 children aged 9 months to 14 years with acute/subacute DIC syndrome of infectious origin. Therapeutic and maintenance doses, the mode of injection of low-molecular-weight heparins, and methods for laboratory monitoring of their efficiency and safety are presented.

[Effects of cerebrolysin on the oxidant homeostasis, the content of microelements and electrolytes in children with minimal brain dysfunction].

In 36 children of 3-8 years old with minimal cerebral dysfunction there were evaluated both concentrations of malonic dialdehyde in blood plasma, erythrocytes and platelets as well as the content of 25 elements (K, Mg, Ca, Na, P, Se, Zn, Co, Cr, Cu, Fe, Mn, Mo, Si, Li, Ni, V, Pb, Sn, Cd, Al, As, Be, Bi, Ti) in hairs. These indices were estimated both before and after course of cerebrolysin therapy (the a dose 2-5 ml intramuscularly during 1 month). There was observed positive influence of the drug on the clinical manifestations of the disease, oxidant and elements homeostasis.

[Brain stem auditory evoked potentials in spinocerebellar degeneration].

A study was made of brainstem auditory evoked potentials (BAEP) in 66 patients from 56 families with different forms of spinocerebellar degenerations (SCD). 27 patients with olivopontocerebellar degeneration (OPCD), 13 patients suffering from Friedreich's disease (FD), 10 patients with Pierre Marie's familial ataxia (PMFA), 6 patients with late onset cerebellar atrophy (LOCA), and 10 patients with other forms of SCD were examined. The changes in BAEP turned out extremely diverse which can be regarded as a manifestation of marked phenotypic pleomorphism common to SCD.

[Role and physiologic importance of thrombinemia in healthy newborns].

The sensitive orthophenanthroline test was used to reveal paracoagulation in 27 normal newborns, thrombinemia reaching the highest level at the moment of birth and in the period of heavy depression of blood coagulation (on the fifth day of life) was detected. It has been suggested that the physiological role of thrombinemia is in the leveling of hypocoagulation shifts and providing of the local hemostasis. To escape thrombotic complications, drug correction of the hypocoagulation physiological level (activity of prothrombin complex factors is 30-60%) is not recommended.

[The sick sinus syndrome and lipid peroxidation: its possible role in the pathogenesis of the disease].

As many as 196 persons were examined. Of these, 106 were with a normal sinus rhythm and 90 had sick-sinus syndrome (SSS). Measurements were made of the level of malonic dialdehyde and the total antioxidant blood activity, the lipoprotein spectrum.

[Mild forms of multi-infarct dementia: effectiveness of cerebrolysin].

The randomized double-blind placebo-controlled study of the effectiveness of cerebrolysin in a mild form of multi-infarct dementia was carried out. Sixty patients were divided in two equal groups differing significantly at the beginning of the study by none of the compared parameters. They received for 28 days daily drop intravenous doses of cerebrolysin (15 ml of the drug in 200 ml of a 0.

[Lateralization of secondary lesions of the brain stem in stroke by the method of short-latency auditory evoked potentials].

Twenty-seven patients with acute cerebral circulation disorders (ACCD) in large hemispheres and 4 patients with ACCD in the cerebellum were examined by means of short-latent acoustic evoked potentials (SAEP). The signs of the secondary stem syndrome were recorded in the neurological status of all the patients. Computer-aided tomography discovered displacement of the median structures of varying degree and deformation of cisternal spaces of the stem.

[A method for correcting dislocation in hemorrhages into the cerebral hemispheres].

Hypertension consequent upon increasing brain edema, and intercerebral pressure gradient which is the cause of transverse dislocation diminish with the use of a method which provides for hydrodynamic equilibrium. The method consists in connecting the ventricle of the intact cerebral hemisphere to a balloon located in the cavity of the removed hematoma according to the principle of communicating vessels. The craniospinal pressure gradient is removed by additional catheterization of the spinal subarachnoid space and its connection to the ventricle and balloon according to the same principle.

[Use of electromagnetic feedback in the rehabilitation of children with injuries of the elbow joint].

The paper is devoted to the non-drug functional treatment of children with elbow joint damages by the use of portable self-contained device, based on the principle of electromagnetic feedback. It is demonstrated that sending of artificial feedback signals (light, sound) at the moment of arbitrary contraction of the muscles being trained during 8-10 treatment procedures ensures restoration of muscular-articular sense, strength, endurance of weakened muscle groups, normalizes volume of motion in the elbow joint.

[Intracranial hypertension in the acute stage of a stroke (spinal fluid dynamic and computer-tomographic studies)].

The given study aimed to answer the question about the realization in clinical practice of the possibility of the timely identification of the degree of intracranial hypertension in patients with cerebral stroke under continuous monitoring of the intracranial volume/pressure ratios by means of examination of CSF changes and CT of the head. On the basis of an analysis of the interrelationship between the severity of neurologic deficit, findings of CT of the head and the results of examination of the cerebral hemodynamics the authors evaluated the informativeness of the main parameters of monitoring the intracranial volume/pressure ratios in the acute stage of cerebral stroke. It has been found that only prolonged registration of the mean and pulse pressure of the CSF in combination with "testing the reserve of the intracranial volume" may ensure the timely detection of disorders of the homeostasis of the craniospinal reservoir and the selection of the most effective means of their correction.