[The stages of history of national clinic of internal diseases: The Soviet medicine (stage 4)].

The publication continues the topic of previous article and develops the theme of periodization of clinical internal medicine in Russia for last 200 years. The discussion covers the fourth stage - the Soviet period of internal medicine in 1920s - 1950s that resulted in crisis. The authors, using historical examples, illustrate the need to take into account historical and social processes in studying the development of medicine.

[200 years of history of National clinic of internal diseases: issues of periodization (stages 1-3)].

The main development of the clinical internal medicine in Russia took place over the past 200 years. To understand the pattern of this process, we explored its possible subdivision into phases (periods). This article presents the first part of the proposed periodization describing the characteristics and time frame of the first three stages (from the beginning of the 19th century to the late 1910s).

[The specific features of left cardiac cavity remodeling in patients with chronic obstructive pulmonary disease and chronic cor pulmonale].

AIM: To study left ventricular structural and functional changes in patients with chronic obstructive pulmonary disease (COPD) and chronic cor pulmonale (CCP) at different stages of a cardiac remodeling process. SUBJECTS AND METHODS: Echocardiography was used to examine 98 patients with COPD complicated by the development of CCP in a number of cases. The significant signs of CCP were absent in 19 patients; the signs of compensated and decompensated CCP in 41 and 38 patients, respectively. RESULTS: In the patients with COPD, the formation of CCP during remodeling of the heart involves its left cavities whose changes lie in the occurrence of left ventricular (LV) diastolic dysfunction, mainly of the restrictive type, in ventricular spherization, higher myocardial systolic tension, in tendencies towards increases in LV mass index, left atrial sizes, and in the indices reflecting LV systolic dysfunction. The LV diastolic dysfunction correlates with the degree of right ventricular hypertrophy and dilatation and the presence of complete right bundle-branch block. CONCLUSION: Progressive worsening of diagnostic filling of the left ventricle and its systolic function is an additional factor aggravating hemodynamic disorders in patients with COPD and CCP, which should be kept in mind on choosing an appropriate therapy for patients with CCP.