[Cardiovascular effects of omega-3 polyunsaturated fatty acids: position of omega-3 polyunsaturated fatty acids in Russian and international guidelines. Council of Experts].

This Expert Council focuses on the meta-analysis of studies on the risk of atrial fibrillation (AF) in patients taking omega-3 polyunsaturated fatty acids (PUFA) and of data on the omega-3 PUFA treatment in patients with cardiovascular and kidney diseases.The major statements of the Expert Council: the meta-analysis of AF risk in patients taking omega-3 PUFA showed an increased risk of this arrhythmia. However, it should be taken into account that the risk of complications was low, and there was no significant increase in the risk of AF when omega-3 PUFA was used at a dose of ≤1 g and a standard dose of the only omega-3 PUFA drug registered in the Russian Federation, considering all AF episodes in the ASCEND study.At the present time, according to Russian and international clinical guidelines, the use of omega-3 PUFA can be considered in the following cases: • for patients with chronic heart failure (CHF) with reduced left ventricular ejection fraction as a supplement to the basic therapy (2B class of recommendations according to the 2020 Russian Society of Cardiology guidelines (RSC) and the 2022 AHA / ACC / HFSA guidelines); • for patients with hypertriglyceridemia (>1.5 mmol/l) as a part of combination therapy (IIb class of recommendations and B level of evidence according to the 2021 European guidelines on cardiovascular disease prevention, etc.); • for adult patients with stage 3-4 chronic kidney disease (CKD), long-chain omega-3 PUFA 2 g/day is recommended for reducing the level of triglycerides (2C class of recommendations). Data on the use of omega-3 PUFA for other indications are heterogenous, which can be partially explained by using different form and doses of the drugs.

[The agreed experts' position of the Eurasian Association of Therapists on tactics of management of patients with comorbid pathology infected with SARS-Cov-2].

The agreement of experts of the Eurasian Association of Therapists (EAT) discusses pathogenesis and treatment of COVID-19. Modern data on the characteristics of cardiovascular, kidney, respiratory damage in SARS-infected CoV-2 are presented. The tactics of managing patients initially having cardiovascular diseases, diabetes mellitus, chronic obstructive pulmonary disease, bronchial asthma, chronic kidney disease are discussed in detail. The article presents data on drug interaction of drugs.

[Study evaluating the impact of a combination of inotropic support and heart rate control on prognosis and stabilization rate in patients with decompensated chronic heart failure (LEGION)].

AIM: To evaluate the efficacy of ivabradine and levosimendan in patients with acute circulatory decompensation. SUBJECTS AND METHODS: The study enrolled 41 patients (20 men and 21 women) aged 61 +/- 9 years, admitted for decompensated heart failure (NYHA functional class IV). Ejection fraction averaged 21.6%. In most patients, systolic blood pressure was below 105 mm Hg and heart rate (HR) was 100-115 beats/min. Central hemodynamics was measured using the strip tests. The patients' clinical status was rated applying the scale accepted in Russia. In addition to conventional therapy, Group 1 patients received levosimendan and ivabradine and Group 2 took dopamine after randomization. RESULTS: A significantly more pronounced clinical improvement was noted in Group 1 patients at hours 48 and 72 of determination. There was a significantly more marked HR reduction in Group 1 at 24 and 72 hours of observation. By day 3 of observation, pulmonary wedge pressure was significantly lower in Group 1 than in Group 2. In the same control periods, the increase in coronary perfusion pressure was significantly obvious in Group 1. The drastically increased level of N-terminal fragment of the prohormone brain-type natriuretic peptide was significantly reduced in both groups, but more considerably in Group 1. CONCLUSION: In patients with decompensated heart failure on conventional therapy, the co-administration of levosimendan and ivabradine is more effective than the use of dopamine.

[A case of the successful treatment of the esophageal leukoplakia with rabeprazole]. / Sluchai uspeshnogo lecheniia leikoplakii pishchevoda rabeprazolom.

This clinical endoscopic study is of interest because clinical and endoscopic remission of the disease with a torpid course was achieved in a patient with gastroesophageal reflux disease with a continuously recurrent course complicated with leukoplakia under the condition of regular combination of preparations of the base course PPIs (Pariet) + prokinetic agent (Motilium) + antacid (Magalphil), conduction of continuous treatment during 12 weeks and subsequent supporting therapy (Pariet, 20 mg) during 6 months in the weekend treatment mode, as well as adherence to recommendations for changing the lifestyle.

[Hyperplastic processes of the gastric mucosa in helicobacter infections]. / Giperplasticheskie protsessy slizistoi obolochki zheludka i gelikobakternaia infektsiia.

The investigation of possible H.p. role in the development of stomach mucous changes, promoting to arising of hyperplasiogenic polypus is the purpose of this study. Gastro-duodenal endoscopy with biopsy of stomach mucous from the antral part, body and bottom for H.p. diagnosis and morphological changes was made in 85 patients (at the age of 43-82 years) with hyperplasmiogenic polypus. The H.p. associated chronic gastritis was determined in 47.6% of the patients. H.p. intensity (prevailed weak and moderate--69.2%) correlated with the inflammation activity degree (1st and 2nd--80.3%) and with dystrophic changes (initial and moderate mucous atrophy--74.4%). The obtained data indicate the possible relation to H.p. infection frequency, degree and character of stomach mucous morphological changes. It allows to examine the expedience of the eradiction therapy for the patients with hyperplasiogenic polypus, infected by helicobacterial infection.

[Interrelations of hyperplasia of gastric mucosa and helicobacter infection (based on data from a polyclinic center]. / O vzaimosviazi giperplasticheskikh protsessov v slizistoi obolochke zheludka i khelikobakternoi infektsii (po dannym poliklinicheskogo tsentra).

AIM: To examine a relationship of hyperplastic processes in the gastric mucosa (GM) to Helicobacter infections. MATERIAL AND METHODS: A hundred patients aged 44 to 86 years who had gastric polyps [Group 1, foveolar hyperplasia (n = 21); Group 2, hyperplasiogenic polyps (n = 65), Group 3, adenomas (n = 14)] underwent esophagogastroduodenoscopy with biopsy of the mucosa from the athrum, body, and fundus of the stomach to reveal Helicobacter pylori (Hp) and GM morphological changes. RESULTS: Hp-associated chronic gastritis was detected in 56% of the patients (66.7, 52.3, and 57.1% in Groups 1, 2, and 3, respectively). The rate of Hp seeding correlated with the magnitude of inflammatory and dystrophic changes. As the regulation of epithelial growth and differentiation impairs, the magnitude of GM structural alterations increase. CONCLUSION: The findings indicate that there may be a relationship between the frequency, degree of Hp infection and the pattern of GM morphological changes, which makes it expedient to use eradication therapy in this group of patients.

[Morphology of articular cartilage in osteoarthrosis]. / Morfologii sustavnogo khriashcha pri osteoartroza.

A combined histological, histochemical, histoenzymochemical and morphometric study of 42 articular cartilage samples from patients with different degrees of osteoarthrosis (OA) was made. Ten cartilages without pathology taken at autopsy were used as controls. A characteristic feature in case of cartilage destruction by OA is a progressive loss of glycosaminoglycans (GAG) from the matrix with its defibrination and uzur formation. Decrease in GAG content is associated with partial destruction of chondrocytes and the emergence of cellular clones reflecting reparative regeneration of the cartilage. However, even at the early OA stage the reparation is not adequate, as the GAG content in the matrix at the sites of chondrocyte proliferation remains decreased compared to the control age group.