[Autopsy study in the analysis of cardiovascular mortality].

The frequency of using autopsy to verify the cardiovascular causes of death was studied in typical regions of Russia. One thousand and sixty deaths from circulatory system diseases were analyzed among a representative sample of 285,736 subjects. Death occurred outside health care facilities in 88% of the analyzed cases; nevertheless, autopsy was made only in 28.3%. Moreover, autopsy was carried out in all cases of less than 40-year-old males and less than 50-year-old females who had died from suspected cardiovascular diseases. The proportion of notified cardiovascular mortality increased in the structure of overall mortality and the rate of autopsy-verified diagnosis decreased with advanced age. To obtain valid information on cardiovascular mortality rates is limited due to low autopsy rates primarily in cases of death outside health care facilities, particularly among elderly and senile persons, despite the fact that it is these fatal cases that constitute the bulk of registered cardiovascular mortality.

[Selenium provision in heart failure of different aetiology].

Determination of selenium status of patients with chronic heart failure of various etiologies showed reduced provision of selenium compared with the control group. Statistically significant increased serum levels of selenium have occurred on average 35,9% after the correction. Intake of sea cabbage jam led to a significant increase in the level of selenium in serum only at patients with deficiency of this trace constituent.

[The topical issues of the terminology, classification, and statistics of acute forms of ischemic heart disease].

The paper discusses the problems in the formation of statistical information on acute forms of coronary heart disease (IHD) in Russia and possible ways of their solution. Among other problems, there is the detection and notification of cases of sudden coronary death as an independent nosological entity that belongs to the acute forms of IHD. The terminology and classification of the acute forms of IHD, which affect the formation of statistical data, are considered. The consequences of underestimates of the role of a postmortem study, as the most important postmortem diagnostic method, in modern practical health care are discussed. The paper is largely debatable and intended for a wide circle of readers in order to attract their attention to the detection and notification of the acute forms of IHD in clinical practice, especially in cases of death from acute IHD in the prehospital stage.

[Detectability of acute forms of coronary heart disease in real clinical practice].

The study was designed to evaluate the frequency of inapparent and/or unrecorded cases of acute coronary heart disease (CHD) and its influence on overall estimates of CHD mortality and morbidity. A specially developed algorithm was used to identify unrecorded cases in official medical documentation concerning 285,736 subjects. Their fraction was found to be 20.78 and 24.48% among men and women respectively. 89.43% of them died from acute CHD. Addition of the newly identified cases to official statistics increased overall CHD morbidity rates by 26.24 and 32.41% for men and women and mortality rates by 2.13 and 2.28 times respectively. These data indicate that acute CHD is poorly diagnosed in routine clinical practice and the real CHD mortality rate is grossly underestimated.

[Administration of monoclonal antibodies to B-lymphocytes (rituximab) in rheumatoid arthritis in Russia].

AIM: To assess efficacy and tolerance to anti-B-cell drug rituximab in therapy of rheumatoid arthritis (RA) by the data of RF register of this drug. MATERIAL AND METHODS: Rituximab was studied in 42 patients with high RA activity. 37 patients received rituximab according to a conventional scheme: 2 intravenous 1000 mg infusions with a 2-week interval. The rest patients received 2 intravenous 500 mg infusions. The response was evaluated by DAS28 index. RESULTS: Rituximab administration resulted in almost complete elimination of B-cells from peripheral blood. This produced a significant positive effect manifesting with reduction in the number of inflamed and painful joints. This trend was evident to observation week 8 reaching maximum to week 24. Clinical response correlated with decline of inflammation as shown by ESR and CRP. According to DAS28 index, good and satisfactory results were registered in 8 weeks in 62% patients, in 16 weeks--in 86%, in 24 weeks--in 100%. Rituximab tolerance was good. CONCLUSION: Effective treatment with rituximab for rheumatoid arthritis opened a new perspective in antirheumatic biological therapy and demonstrated an important role of B-cells in the disease development. This drug is recommended for wide use in the treatment of severe rheumatoid arthritis resistant to prior therapy including TNF-alpha blockers.

[Assessment of safety and antihypertensive efficacy of a cardioselective beta-blocker nebivolol in patients with hypertension and concomitant chronic obstructive bronchitis]. / Otsenka bezopasnosti primeneniia i antigipertenzivnaia éffektivnost' beta1-kardioselektivnogo adrenoblokatora nebivolola u bol'nykh s arterial'noi gipertenziei v sochetanii s khronicheskim obstruktivnym bronkhitom.

Safety, tolerability and antihypertensive efficacy of a cardioselective beta-blocker nebivolol was studied in 30 patients with mild and moderate hypertension and concomitant stage I chronic obstructive bronchitis. Nebivolol (5 mg/day) was given for 1 month; in 5 patients complementary hydrochlorothiazide (12.5 mg/day) was required for sufficient antihypertensive effect. Nebivolol was well tolerated (only 1 patient complained of head ache), did not cause worsening of bronchitis and spirometric parameters, exerted no cardiodepressive action, and did not induce apparent disturbances of metabolism.

[Experience in the combined treatment of different clinical forms of chronic bronchitis with new phytotherapeutic mixtures]. / Opyt kombinirovannogo lecheniia razlichnykh klinicheskikh form khronicheskogo bronkhita novymi fitoterapevticheskimi smesiami.

As many as 68 patients suffering from chronic bronchitis (CB) were subjected to combined treatment by new mixtures of medicinal herbs given per os and by inhalation. Administration of the first (antiseptic) or the second (broncholytic) mixture was determined by the clinical variant of CB. In 81% of cases, the method produced a beneficial effect, contributing to the shortening of the times of the patients' treatment in the hospital. The long-term results were also positive, allowing the simultaneous use of the phytotherapeutic mixtures per os and by inhalation in the treatment of CB patients.

[Arthrotec treatment of rheumatoid arthritis]. / Opyt lecheniia artrotekom bol'nykh revmatoidnym artritom.

AIM: To try arthrotek, a combined drug, in patients with rheumatoid arthritis (RA). MATERIALS AND METHODS: 10 RA women aged 30 to 60 years with endoscopically verified minimal affection of gastroduodenal mucosa (not more than 25 hemorrhages and/or 5 erosions) received arthrotek (1 tablet 3 times a day for 3 months). The efficacy was judged by changes in the joints and gastroduodenal lesions. RESULTS: The 3-month treatment produced positive changes in the main auricular and gastroduodenal symptoms. Side effects (head ache, diarrhea, sleepiness) disappeared after reducing the day dose to 2 tablets. CONCLUSION: Arthrotek proved highly effective against RA. It is also a good gastroprotector promoting healing of gastroduodenal erosions.

[Long-term effects of structum administration (according to data from multicenter trial)]. / Otdalennye rezul'taty primeneniia struktuma (po materialam mnogotsentrovogo issledovaniia).

AIM: To evaluate duration of a clinical response to the drug structum in patients with osteoarthrosis (OA) of the knee and hip joints as well as structum effects on OA course and that of concomitant diseases. MATERIAL AND METHODS: The duration of a clinical response to structum after the end of the treatment and its effect on OA and concominant diseases course were studied for 12 months in 9 centers participating in the study of the drug efficacy and tolerance in patients with gon- and coxarthrosis in an open multicenter randomized controlled 6-month trial. Out of 555 patients with OA of the knee and hip joints enrolled in the first study, the examination covered 373 patients: 159 patients of the test group treated for 6 months with structum and 214 controls. By basic clinical parameters the groups were similar. Clinical examination was made after structum treatment and 12 months later and included assessment of the number of exacerbations, hospitalizations, outpatient consultations, days of temporary disability for OA, pain in the joints while walking and at rest by the visual scale, Leken's functional index, x-ray pictures of the joints, administration of nonsteroidal anti-inflammatory drugs (NSAID), exacerbations of concomitant diseases (gastrointestinal diseases, arterial hypertension, ischemic heart disease). RESULTS: An overall functional Leken's index in patients with gon- and coxarthrosis given structum 12 months after the treatment did not reach the initial values as well as pain and daily need in NSAID. Structum effect in patients with knee joint OA persisted for 4.6 months, in hip joint OA--4.1 months; in patients with stage I-II the effect lasted longer than in stage III (5.2 and 4.6 months vs 4.17 and 3.24 months, respectively. Even short-term therapy with structum reduced the number of further exacerbations, hospitalizations and visits to their doctor. 12 months after structum therapy the effect persisted in 40% patients. Frequency of exacerbations of the concomitant diseases was less than in patients on continuous NSAID. CONCLUSION: Structum is a highly effective drug against OA as it acts long, reduces frequency of exacerbations, hospitalizations, visits to the doctor, duration of disability, NSAID requirement and improves the course of some concomitant diseases.

[Results of the multicenter clinical trial of structum preparation in Russia]. / Itogi mnogotsentrovogo klinicheskogo issledovaniia preparata struktuma v Rossii.

AIM: To study clinical effectiveness and tolerance of structum in patients with osteoarthrosis (OA) of the knee joints (KJ) and hip joints (HJ) in a multicenter open randomised trial. MATERIAL AND METHODS: A 6-month trial of effectiveness and tolerance of structum has been performed in 9 medical centers and included outpatients (males and females) with KJ OA or HJ OA satisfying the OA diagnostic criteria of the American Rheumatology College, having x-ray stage I-III according to Kellgren-Lawrence with manifest pain, a total functional Leken index from 4 to 11, regular intake of non-steroid antiinflammatory drugs (NAID) for 30 days in the last 3 months. Consent was obtained from each patient. 192 patients received structum, 363 matched patients served control. Structum was given per os for 3 weeks in a dose of 1.5 g/day then in a dose 1.0 g/day up to 6 months. The patients continued on NAID. The patients' examination was performed in the beginning of the study, at its months 3 and 6. RESULTS: Leken index in HJ and KJ OA significantly fell after 3 months of structum treatment. Up to month 6 it fell still further (p < 0.05). After 6 months of treatment pain syndrome relieved both at rest and movement, pain at rest disappeared fully in 57% of NJ OA patients and 46% of HJ OA patients, for movement pain it was 17 and 13%, respectively. During the treatment NAID intake was less required in both groups (p < 0.05) while 55% of patients in both groups could discontinue NAID after 6 months of the treatment. Tolerance of the drug was rather good, side effects were mild. CONCLUSION: Structum (chondroitin sulphate) is an effective drug for treatment of KJ and HJ OA: it relieves pain, preserves and improves articular function, allows to reduce or discontinue NAID, is well tolerated.

[Lysosomal cation proteins of neutrophils in acute pneumonia and chronic bronchitis]. / Lizosomal'nye kationnye belki neitrofilov krovi pri ostroi pnevmonii i kronicheskom bronkhite.

A decrease in the content of lysosomal cation proteins in 75 patients with acute pneumonia and chronic bronchitis and the recovery of their level in pneumonia patients after treatment allows the assessment of non-specific reactivity of the organism. The reliable difference in the level of cation proteins in ordinary and purulent chronic bronchitis enables one to use this test for the differentiation of the character of inflammation.

[Use of new mixtures of medicinal plants in the treatment of chronic bronchitis]. / Ispol'zovanie novykh smesei lekarstvennykh trav v terapii khronicheskogo bronkhita.

Three new prescriptions of drug plants were included into combined hospital treatment of 156 patients with chronic bronchitis. Each of the three mixtures was to treat a certain clinical form of chronic bronchitis being composed of plants with specific mechanism of action. The mixture was taken a tablespoonful 8-10 times a day. Pronounced and moderate effect of the therapy was achieved in 95.6% of those treated. This justifies the use of the mixtures as an adjuvant therapy in basic treatment of chronic bronchitis.

[Use of phthivazide in the treatment of patients with acute pneumonia and chronic bronchitis]. / Ispol'zovanie ftivazida v lechenii bol'nykh ostroi pnevmoniei i khronicheskim bronkhitom.

The treatment scheme of 540 patients with acute pneumonia and chronic bronchitis involved a 0.5 g ftivazid three times a day for 15-20 days. Compared with control groups of patients on the standard therapy, the drug presents a more advantageous treatment. Adequate efficacy and tolerance of the drug ftivazid make it appropriate for use in acute pneumonia and chronic bronchitis.