[Phasing and continuity of the treatment of thyroid eye disease in patients with Graves' disease].

 According to modern concepts, thyroid eye disease (TED) is an independent progressive autoimmune disease of the organ of vision, closely associated with the autoimmune pathology of the thyroid gland (TG), (ICD code - H06.2, proptosis in case of impaired thyroid function E05.0). TED treatment is a long step-by-step process, including immunosuppressive therapy, radiation therapy of the orbits and surgical treatment.TED is a multidisciplinary problem. A patient with thyrotoxicosis clinic and TED symptoms will be taken to an endocrinological clinic for normalization of thyroid hormones and treatment of thyrotoxicosis complications. At the same time, under the supervision of an ophthalmologist, TED diagnostics and treatment will be carried out. Teamwork is of utmost importance because the effectiveness of TED treatment will depend on the speed of achieving a stable euthyroid state, the accuracy of determining the TED activity and severity, and the presence of complications requiring surgical treatment.There are two main phases in the TED development. In the first phase of active inflammation, an increase in the symptoms of TED occurs, then a plateau phase follows, when the symptoms of activity persist but do not progress, then the symptoms regress and the process becomes inactive, while visual disturbances and cosmetic defects may persist. Determining the TED activity is very important from a clinical point of view, because the choice of treatment and tactics of patient management depend on the inflammation activity.We describe a clinical case of phasing treatment of TED complicated by optic neuropathy and movement disorders in a patient with Graves' disease, resistant to immunosuppressive therapy with glucocorticoids and requiring deep lateral bony orbital decompression.

[Detection of arrhythmias in patients with ischemic heart disease using different methods of prolonged ECG recording on a magnetic tape]. / Raspoznavanie aritmii u bol'nykh ishemicheskoi bolezn'iu serdtsa s pomoshch'iu razlichnykh metodov dlitel'noi registratsii EKG na magnitnuiu lentu.

Prolonged ECG recording on magnetic tape was performed in 327 coronary patients. In 187 out of them, continuous 24-hour ECG recording (Holter's monitoring) was performed and in 178 subjects, intermittent recording (for 14 s every 15 min) was conducted over 24 hours. In 38 patients, both methods were used. Various heart rhythm irregularities were determined by these methods in 92.1 and 86.8% of the patients, respectively, with the nature and frequency of arrhythmias in both groups displaying basically the similar pattern. The employment of both methods made it possible to detect in a considerable proportion of patients cardiac rhythm disturbances which had not been elucidated in the previous clinical and ECG examinations. The method of Holter's monitoring proved to be more informative in comparison with intermittent ECG recording, i.e. it was effective in determining the precise number and duration of arrhythmia episodes occurring over the period of 24 hours.

[Anti-arrhythmic effectiveness of ethmozine, cordaron and rhythmodan in treating ischemic heart disease]. / Antiaritmicheskaia éffektivnost' étmozina, kordakona i ritmodana pri lechenii bol'nykh ishemicheskoi bolezn'iu serdtsa.

The authors observed 127 patients with different disorders of the cardiac rhythm treated with ethmozine, cordarone and rhythmodan. To assess the efficacy of the therapy circadian ECG was recorded on a magnetic tape with a portable cardiomonitor, exercise tests (bicycle ergometry, treadmill and walking under ECG control) were conducted. Good effect was seen after a course of treatment in patients with ventricular and atrial extrasystolae, paroxysms of supraventricular, ventricular tachycardia and auricular fibrillation. Cordarone was found effective in the Wolff-Parkinson - White syndrome and paroxysms of supraventricular tachycardia.