[Severe disseminated constrictive polyserositis in a patient with rheumatoid arthritis].

Constrictive polyserositis (pleuritis, pericarditis) is a syndrome within the underlying disease (tuberculosis, periodic disease, rheumatoid arthritis, systemic lupus erythematosus, asbestos, silicosis, uremia, some genetic diseases), a complication due to chest surgery or radiation or drug therapy, is occasionally idiopathic (fibrosing mediastinitis). There are frequently great difficulties in making its nosological diagnosis. The paper describes a patient in whom the onset of disease was exudative pleurisy with the signs of constriction, arthralgias; pleural punctures provided serous exudates with 80% lymphocytes. A year later there was ascitis and shin and foot edemas, which concurrent with hepatomegaly and cholestasis was regarded as cryptogenic liver cirrhosis. The signs of constrictive pericarditis were further revealed. The disease was complicated by the development of pulmonary artery thromboembolism (PATE) (which required the use of warfarin) and hemorrhagic vasculitis. Therapy with metipred in combination with isoniazid yielded a slight effect. The diagnoses of tuberculosis, liver cirrhosis, and autoimmune hepatitis, systemic vasculitis were consecutively rejected; the diagnosis of rheumatoid polyarthritis with systemic manifestations was made, by taking into account persistent arthalgias with the minimum signs of arthritis, noticeably increased C-reactive protein, rheumatoid factor, and cyclic citrullinated peptide antibodies (CCPA); plasmapheresis, therapy with metipred and methotrexate, and subtotal pericardectomy were performed. Constrictive polyserositis concurrent with PATE, hemorrhagic vasculitis (probably, drug-induced one), and hepatic lesion has been first described in a CCPA-positive patient with rheumatoid arthritis in the presence of moderate true arthritis (during steroid therapy).

[A comparative evaluation of the electric impulse treatment of atrial fibrillation based on the data from 2 clinics. 2. The late results]. / Sravnitel'naia otsenka élektroimpul'snogo lecheniia mertsatel'noi aritmii na materiale dvukh klinik. Soobshchenie 2. Otdalennye rezul'taty.

Long-term results of electroimpulse treatment for cardiac fibrillation in 1292 patients performed in cardiological clinics of Moscow and Kaunas have been compared. It is shown that more strict selection, longer preparation for the impulse exposure may secure a significant decrease in the number of the fibrillation recurrences both 1 and 6 months after recovery of the normal rhythm.

[Spontaneous restoration of cardiac rhythm in patients with a persistent form of atrial fibrillation]. / Spontannoe vosstanovlenie ritma u bol'nykh s pospoiannoi formoi mertsatel'noi aritmii.

A total of 15 patients with spontaneously arrested sustained atrial fibrillation (its duration 7.0 +/- 1.6 years) were followed up. After termination of atrial fibrillation, all the patients had signs of the sick sinus syndrome (profound sinus bradycardia, pacemaker migration, inferior atrial and atrioventricular rhythms). Thirteen of 15 patients suffered from rheumatic heart disease, nine of them had severe heart failure. Four patients immediately died. An atrial fibrillation relapse occurred in the immediate period in most cases, and rhythm recovery was unaccompanied by the improvement of the patients' condition.

[A method of choosing maintenance anti-arrhythmia therapy after sinus rhythm restoration in patients with a permanent form of atrial fibrillation]. / Metod vybora podderzhivaiushchei antiaritmicheskoi terapii posle vosstanovleniia sinusovogo ritma u bol'nykh s postoiannoi formoi mertsatel'noi aritmii.

The authors suggest a new method of choice of the drug (quinidine or cordarone) for the maintenance antiarrhythmic therapy after sinus rhythm recovery in patients with permanent atrial fibrillation, in patients with rheumatic heart disease and coronary heart disease. The method is based on the formalized prediction of the results of cardioversion and on the distinguishing groups with a good and bad prognosis. In the former group, both drugs can be administered, in the latter group, it is desirable that cordarone may be used.

[A comparison of the efficacy of quinidine and kordaron as agents to stabilize the recovered sinus rhythm in patients with the permanent form of atrial fibrillation]. / Sravnenie éffektivnosti khinidina i kordarona kak sredstv stabilizatsii vosstanovlennogo sinusovogo ritma u bol'nykh s postoiannoi formoi mertsatel'noi aritmii.

The efficacy of chinidine and cordarone as agents preventing the recurrence of the disturbed sinus rhythm was studied and compared on a material of 459 patients with permanent atrial fibrillation eliminated by electropulse therapy. The sinus rhythm was preserved significantly better in a group of patients given cordarone as a preventive agent, which is confirmed with the aid of a multidimensional statistical analysis as well as an analysis of "competing hypotheses".

[The prognosis of the late results of electroimpulse therapy for atrial fibrillation in ischemic heart disease patients]. / Prognozirovanie otdalennykh rezul'tatov élektroimpul'snoi terapii mertsatel'noi aritmii u bol'nykh ishemicheskoi bolezn'iu serdtsa.

The deciding rule has been derived of predicting long-term results of electropulse therapy of permanent atrial fibrillation in patients with coronary heart disease. During checking with the prospective material, the prediction as regards preservation of the sinus rhythm up to 6 months turned out correct in 93% of cases. The deciding rule is based on the commonly available clinical parameters. Work with that rule does not require the use of computers. Prognosis obtained with the aid of the given rule appeared significantly more accurate than that determined by the physician specialized in the field of cardiology.