Significance of L-carnitine in internal medicine.

The review presents the results of a number of experimental and clinical studies proving the prospects of using L-carnitine in the clinic of internal diseases. Due to the antioxidant and antihypoxant properties, the additional use of L-carnitine in addition to the main etiopathogenetic therapy is prescribed by cardiologists, nephrologists, neurologists, gerontologists. Experimental studies we conducted earlier showed no effect of L-carnitine on the activity of the P450 CYP 3A4 system, which reduces the likelihood of drug-drug interaction at the level of metabolism of drugs metabolized by P450 3A4.

[Essential questions of training of dentists for accreditation].

The paper presents sociological study aimed to analyze the conditions and methodological rationale for the basic directions of optimization of accreditation procedure for dentists. The study included 129 graduates of dental faculties of educational institutions of Sechenov First Moscow State Medical University. The material was collected by questionnaire survey and interviewing.

[Influence of the Potassium Channels Activator Nicorandil to the Quality of Life in Patients With Ishemic Heart Disease and Stable Angina Pectoris].

The aim of the study to assess the influence of medicamentous therapy to the quality of life of ischemic heart disease patients with stable angina pectoris by activator potassium channels nicorandil in comparison with traditional therapy by isosorbide dinitrate. The study included 84 ischemic heart disease patients. Authors consider quality of life as an estimated category of state of the subject in an illness situation.

[The clinical immunologic characteristic and laboratory diagnostic of bronchial asthma under pecilomycosis.].

The actuality of the problem is is conditioned by detection of infection of patients' blood with fungi genus paecilomyces in the form of carriage or activation of pecilomycosis infection with clinical manifestation of allergic diseases and bronchial asthma. The purpose of study is to analyze clinical and immunologic characteristics of bronchial asthma under pecilomycosis and to develop new approaches to its laboratory diagnostic in conditions of the primary health care unit. The complex examination of patients that included collection of allergy anamnesis, physical examination, application of laboratory, cytology, immunology and microbiology analysis was carried out.

[Pathogenesis of myocarditis in patients with bronchial asthma and pecilomycosis].

We studied the influence of activation ofpecilomycotic infection in blood on the morphofunctional state of myocardium based on the clinical and pathomorphological data. The study included 23 patients with bronchial asthma (BA) concomitant with pecilomycosis after acute viral respiratory infection; protocols of autopsies and pathological sections of the heart muscle of the patients who died from asphixy and acute cardiac insufficiency were analyzed. Histological sections showed up vascular dystonia of the microcirculation bed, arteriole spasms, wall destruction in small and medium-size vessels and the adjacent muscular tissue, stromal oedema, valvular swelling, andperiwall endocarditis.

[ACTUAL QUESTIONS OF TEACHING PALLIATIVE CARE IN A SYSTEM OF FURTHER PROFESSIONAL EDUCATION.].

In response to the introduction ofpalliative care as a new kind of medical care in Russian Federation (Federal law No.323 from 21.11.

[ACCREDITATION OF THE HEALTH PROFESSIONAL AS A LAUNCH PAD FOR CONTINUING MEDICAL EDUCATION.].

The rapid development of medical science and health care practice, the need to improve the quality of health care, the ongoing modernization of education was the basis for scientfic rationale and implementation of the system of continuous medical education, which will be gradually expanded to cover individuals who have undergone 2016 accredited specialist.

[HIGH FREQUENCY OF CYP2C19 ULTRARAPID METABOLIZERS IN RUSSIAN PATIENTS WITH PEPTIC ULCER].

Introduction: The main enzyme responsible for metabolism of proton pump inhibitors (PPI) is cytochrome P-4502C19 (CYP2C19). Among all CYP2C19 polymorphisms ulrarapid CYP2C19*17 allele plays an important role in clinical practice as in CYP2C19*17 allele carriers acid suppression achieved with PPI including eradication regimens may be insufficient.

The Aim Of The Study: To find the frequency of CYP2C19 ultrarapid metabolizers in Russian patients with peptic ulcer

Methods: We retrospectively reviewed the results of pharmacogenetic tests of 971 Russian patients with endoscopically and histologically proven ulcers, 428 male (44%) and 543 female (56%).

EFFECT OF CYP2C19 GENETIC POLYMORPHISMS ON THE EFFICACY OF PROTON PUMP INHIBITOR-BASED TRIPLE ERADICATION THERAPY IN SLAVIC PATIENTS WITH PEPTIC ULCERS: A META-ANALYSIS.

Introduction: Several meta-analyzes reported the effect of CYP2C19 genetic polymorphisms on the efficacy of proton pump inhibitor-based triple therapy for Helicobacter pylori eradication. Most of the studies which were included in these meta-analyzes were held on Asian population. Thus, there is lack of information about the effect of CYP2C19 genetic polymorphisms on the efficacy of proton pump inhibitor-based triple eradication therapy in Slavic patients with peptic ulcers.

[Preclinical investigation of pharmaceuticals impact against cytochrome P450 activity and prognosis of substrate affinity as means for providing substrate therapy safety].

Tricyclic antidepressants, not influencing the P450 3A4 activity, are safe in combination with drugs of other groups used in the treatment of comorbid patients. Azaphen is is one of the agents most widely used in the clinical practice. The in vitro electrochemical analysis showed that pipofezin (azaphen) was not a substrate, inductor, and/or inhibitor of cytochrome P450 CYP3A4 isoenzymes.

[Role of an educational-and-methodological complex in the optimization of teaching at the stage of additional professional education of physicians in the specialty "anesthesiology and reanimatology"].

An educational-and-methodological complex (EMC) in the specialty 'Anesthesiology and Reanimatology", which promotes manageability, flexibility, and dynamism of an educational process, is of great importance in solving the problem in the systematization of knowledge and its best learning by physicians at a stage of additional professional education (APE). EMC is a set of educational-and-methodological materials required to organize and hold an educational process for the advanced training of anesthesiologists and resuscitation specialists at the stage of APE. EMC includes a syllabus for training in the area "Anesthesiology and Reanimatology" by the appropriate training pattern (certification cycles, topical advanced training cycles); a work program for training in the specialty "Anesthesiology and Reanimatology"; a work curriculums for training in allied specialties (surgery, traumatology and orthopedics, obstetrics and gynecology, and pediatrics); work programs on basic disciplines (pharmacology, normal and pathological physiology, normal anatomy, chemistry and biology); working programs on the area "Public health care and health care service", guidelines for the teacher; educational-and-methodological materials for the student; and quiz programs.

[Innovation structure of postgraduate medical education in the specialty of anesthesiology as a constituent of the continuing professional development concept in the light of the Bologna Declaration provisions].

To implement the basic provisions of the Bologna Declaration for postgraduate professional education of anesthesiologists-resuscitators, to upgrade the quality of training specialists, it is important that, by preserving the existing forms of an educational process, to introduce into continuing professional development the following innovation educational technologies, by taking into account the existing forms and technologies of the Russian higher medical school: to realize the continuing professional development (CPD) concept; a credit accumulation system as a generalizing function during CPD; distance and multimedia learning; and a modular organization of a learning and educational process.

[Main points of a modular approach to developing educational programs for the postgraduate training of physicians in the area of anesthesiology and reanimatology].

The uniquely shaped and contained structure of a modular approach to organizing an academic process, which comprises a conceptual rationale for the conversion of an educational process in accordance with a modular design, is detailed in the paper. All learning modules have the similar structure consisting of the following sections: background, general and specific objectives, contents, methods of teaching and assessment, the place and conditions of training. The authors provide evidence for the use of a module as a form of organization of individual educational programs, curricula, and academic plans of subject-matter during postgraduate training of physicians.

[Conceptual and methodological rationales for the use of innovational and traditional educational technologies for the postgraduate training of physicians in the area of anesthesiology and reanimatology].

Background: Implementation of an innovational educational space program by the I. M. Sechenov Moscow Medical Academy envisages for the specialty "Anesthesiology and Reanimatology "first of all the development of a new-generation state educational standard, that considers the underlying principles of the Bologna Declaration, its introduction into educational process practice, and the maintenance of the high competence of a physician throughout his/her professional activity.

[Potentialitis of phosphodiesterase inhibitors in management of patients with chronic heart failure complicating cardiac ischemia].

In spite of the advances in understanding the pathogenesis and approaches to the treatment of chronic heart failure, it remains one of the main causes of the patients invalidism and death, that makes the cardiologists all over the world develop new drugs for the treatment of the disease. The aim of the study was to show possible long-term use of enoximone, a new agent from the group of phosphodiesterase inhibitors, in doses of 75-150 mg a day in traditional combined pharmacotherapy of the patients with chronic heart failure. Thirty eight patients with chronic heart failure III-IV FC (NYHA) and 30% left ventrical efflux function were observed.

[On the use of statins in patients with chronic cardiac insufficiency].

Today, the necessity to use hypolipidemic agents belonging to the group of statins as means of primary and secondary prevention of coronary artery disease (CAD) and its complications is not doubted. The results of numerous large studies conducted in many different countries during the last 10 to 15 years confirm this statement. The appropriateness of statin application to patients with chronic cardiac insufficiency (CCI) is still under discussion, because there are no sufficient data on whether hypolipidemic therapy is able to improve the prognosis in this category of patients.

[Role of a credit system in the development of continuous postgraduate training of physicians within the framework of the innovation educational space formation program of the I. M. Sechenov Moscow Medical Academy].

Russia 's joining the European higher educational space and an increase in the international competitive capacity of the European higher educational system envisage first of all that the European credit test system (ECTS) should be accepted and introduced into all national higher educational schools, which ensures both credit test and cumulative functions and guarantees the academic recognition of the education abroad. The issues of modernization of approaches to reforming the continuous postgraduate training of physicians, by using the credit test system, as well as new forms and technologies for an educational process in accordance with the European educational system principles are under discussion. The novelty of the proposed development is that the credit test system is first applied to the continuous postgraduate training of physicians within the framework of the Russian higher medical educational system.

[Endothelial dysfunction in patients with chronic heart failure, and possibilities of its correction with isosorbide-5-mononitrates].

Vascular endothelial dysfunction has been proven to play an important role in the development and progression of chronic heart failure (CHF). The influence of isosorbide-5-mononitrate monocinque on endothelial function in patients with NYHA II class chronic heart failure complicating the course of coronary artery disease (CAD) with II--III class stable exertional stenocardia was studied. Disturbances in endothelium-dependent vasodilation in a form of a lowered endothelial response to an increase in shift tension during reactive hyperthermia test were noted in patients with CHF complicating CAD.

[Efficacy and Safety of a Domestic Non-selective b-adrenoblocker Possibilities of the Use of Proxodolol in the Treatment of Patients With Chronic Heart Failure.].

Novel (made in Russia) nonselective b-blocker with a1-blocking properties proxodolol was given to 30 patients with ischemic heart disease, NYHA class II-III chronic heart failure (CHF) and left ventricular ejection fraction (LVEF) <40%. Methods of control included clinical examination, registration of hemodynamic and morphofunctional parameters of the heart. Proxodolol caused clinical improvement which appeared as reduction of signs of CHF and betterment of myocardial contractile function with 14% increase of LVEF according to data of echocardiography.

[Antihypertensive efficacy, tolerance and safety of lisinopril (sinopril) and captopril (capoten) in patients with mild and moderate arterial hypertension].

Aim: To compare effectiveness, tolerance and safety of two inhibitors of angiotensin-converting enzyme--sinopril (lisinopril) and capoten (captopril)--in outpatient treatment of patients with mild and moderate hypertension.

Materials And Methods: The patients were randomly assigned to sinopril or capoten groups. Sinopril was given in daily dose 10-40 mg, capoten--in daily dose 25-100 mg for 8 weeks.

[Functional activity of platelet guanylate cyclase and cardiac hemodynamics in patients with chronic heart failure and relevant changes after treatment with isosorbide-5-mononitrate].

Aim: To study effects of long-term administration of isosorbide-5-mononitrate (monochinquare retard-MR) on functional activity of soluble guanylate cyclase (GC), cardiohemodynamics and exercise tolerance in patients with coronary heart disease (CHD) complicated by chronic cardiac failure (CCF).

Materials And Methods: The trial included 20 males aged 58 to 77 years with CHD, effort angina (NYHA class II-III), CCF (NYHA class I-II). Endothelial function was assessed before the treatment and 12 weeks after it by indirect measurement of production of endothelial relaxing factor (NO)--by activation of platelet soluble GC in the presence of its activators: L-arginine, disulphide, sodium nitroprusside and protoporfirine IX.

[Comparative efficacy, safety, cardio-hemodynamic effects of isosorbide dinitrate (ID) aerosol and sublingual tablets of nitroglycerin].

Aim: To study efficacy, safety, cardiohemodynamic effects of ID aerosol--isoket--for relief of anginal attacks and their prevention in long-term treatment.

Materials And Methods: 15 patients with ischemic heart disease suffering from stable angina class II-III. Isoket was tried for efficacy, tolerance, hemodynamic parameters, morphofunctional status of the heart, exercise tolerance.