[The characteristics of application of computer registry in organization of ambulatory polyclinic care of patients with iron-deficiency anemia].

Anemia is a clinical hematological syndrome and also a risk factor for the adverse outcome of many chronic somatic diseases. To assess effectiveness of out-patient polyclinic care for patients with anemia, the computer program "Patient Monitoring System with Anemic Syndrome" was used. The study included 1498 patients (males - 491; females - 1007) aged from 18 to 80 years old, who were under medical observation by general practitioners. The prevalence of anemic syndrome in different age and gender groups varied from 11 to 58%. Statistically significant differences between subgroups of men and women were found in the categories 18-30 years, 31-40 years and 41-50 years. In adult patients of working age, anemic syndrome during routine examination was detected in 37% of cases of seeking outpatient medical care (anemic syndrome in women was three times more common than in men). In patients older than working age, the prevalence of anemic syndrome was lower and averaged 25.7%. In the structure of anemia, 48.4% are hypochromic, 5.4% are hyperchromic, 46.2% are normochromic. The study for serum iron was prescribed in 33.9% of cases of hypochromic anemia, in 22.5% of cases of normochromic anemia and in 11.1% of cases of hyperchromic anemia. Serum iron was detected in every second patient with diseases of the urogenital system, every third patient with neoplasm. Therapy with iron preparations was prescribed in 30.6%, and the administration of vitamin B12 - in 1.4% of cases.

Clinical efficacy of acute respiratory viral infections prevention in patients with chronic heart failure.

AIM: The aim of the study was to evaluate the ARVI prevention effectiveness in patients with chronic heart failure (CHF) using interferon inducer amixin. MATERIALS AND METHODS: Conducted a comprehensive survey, dynamic monitoring and treatment of 60 patients aged from 49 to 70 years (mean age 60.25±4.57 years, 17 men and 43 women) with CHF with preserved ejection fraction of left ventricle (LVEF) (≥50%), II-III functional class (FC) according to the classification of new York Heart Association (NYHA), which developed as a result of coronary heart disease (CHD), hypertensive disease (HD). Of these, 30 patients (group 1) on the background of standard therapy for CHF received for the prevention of ARVI tiloron (Amixin) at a dose of 125 mg once a week for 6 weeks, two courses for 1 year. Group 2 patients received only standard therapy for CHF. RESULTS: A decrease in the frequency of ARVI in patients with CHF treated with Amixin was found, which was accompanied by a decrease in the severity of subclinical inflammation by reducing the production of proinflammatory (IL-1ß) and increasing the production of anti-inflammatory (IL-10) cytokines, reducing neurohumoral activation (reducing levels of aldosterone and Nt-proBNP), increasing the level of α- and γ-interferon. The positive dynamics of biomarkers of systemic inflammation and neurohormonal activation explains the improvement of the clinical course in patients with CHF (increase of tolerance to physical loads, reducing the number of visits to General practitioner and hospital admissions in the hospital during 12 months of observation). CONCLUSION: A promising approach to the prevention of SARS in patients with CHF is course therapy with Amixin (2 times a year before the seasonal rising in the incidence of respiratory viral infections and influenza), which allows to achieve both decreasing in the frequency of SARS per year, and improvement the clinical course of CHF.

[The role of inflammation in the pathogenesis of chronic heart failure]. / Rol' vospaleniia v patogeneze khronicheskoi serdechnoi nedostatochnosti.

The review considers the main points of the concept of progressive chronic heart failure (CHF). The neurohumoral model of CHF pathogenesis could create novel approaches to treating these patients. However, recent studies have shown that the ways of activating the neurohumoral systems in CHF are much more complex. The increased local synthesis of hormones causes the activation of proinflammatory cytokines and proto-oncogenes, which have a number of negative effects. Multiple studies have formulated the immunoinflammatory concept of CHF pathogenesis, according to which the increased concentration of interleukin-6 is a marker of poor prognosis in CHF, and the level of tumor necrosis factor-α directly correlates with the severity of its clinical manifestations and the activity of the neurohumoral background in decompensation. The review gives a classification of cytokines and describes the reasons for their elevated plasma concentration, their possible role in the occurrence and progression of CHF, and their prognostic significance. The pathogenesis of CHF, which includes cytokine aggression, requires further studies of the effect of the inflammatory component on the course of heart failure.