[Survival of patients with infectious endocarditis in various treatment methods]. / Vyzhivaemost' bol'nykh infektsionnym éndokarditom pri razlichnykh metodakh lecheniia.

The aim of the study was to compare survival of patients with infectious endocarditis (IE) by abuse of intravenous narcotic substances in conservative and combined treatment in acute IE phase. A total of 195 IE patients were examined. 121 of them was treated conservatively, 74 patients received a combined treatment including surgical one. A long-term prognosis was studied by the Kaplan-Meier method. Among drug addicts with IE, the number of survivors in the observation period in early operation in the active IE phase was significantly higher than in the conservative therapy. Long-term survival of drug addicts with IE in combined treatment was also higher: 1-2- and 3-year survival was 85.8, 76.3 and 61.0% against 64.8, 49.0 and 34.2% in conservative treatment, respectively. In non-addicts the differences were weaker: long-term survival in combined treatment was higher than in conservative one only in 5-year survival (74.1 and 41.6%, respectively).

[Right ventricular myocardial infarction in a patient with infectious endocarditis]. / Infarkt miokarda pravogo i levogo zheludochka serdtsa u bol'nogo infektsionnym éndokarditom.

A case of right and left ventricular myocardial infarction in infectious endocarditis of the aortic valve in an injected drug abuser is reported. The infarction was diagnosed only in autopsy. Diagnostic difficulties are discussed. The literature on the problem is listed.

[Infectious endocarditis of the left heart atrium in injection drug addicts]. / Infektsionnyi éndokardit klapanov levykh kamer serdtsa u in"ektsionnykh narkomanov.

AIM: To study etiology, clinical picture, course and prognosis of left heart infection endocarditis (LHIE) in drug addicts. MATERIAL AND METHODS: 61 drug addicts entered the study. 14 of them had lesions of the left heart valves (group 1), 11--of the right and left heart valves (group 2), 36--of the tricuspid valve (group 3), 39 control patients with LHIE had no addiction. Mean age in group 1 was 25.9 +/- 8.8 years, in group 4--48.3 +/- 12.6 years, p < 0.001. RESULTS: Females prevailed in group 3, males--in group 4. Splenomegaly was more frequent in the addicts. Lung lesions (abscesses and infarction) prevailed in groups 2 and 3. Cardiac failure was found more frequently in groups 1 and 4, edema--in group 3, brain affections--in groups 1 and 4. Renal damage was encountered with equal frequency in the addicts and non-addicts. The addicts had, largely, infarctions, non-addicts--glomerulonephritis. Viral hepatitis C was associated with drug addiction. Blood seedings were on the whole positive in 54%, in drug addicts--in 69%. St. aureus predominated (44%). In group 3 it was detected in 72%. It was higher than in groups 4 and 1 (p < 0.001, p < 0.01, respectively). Lethality in group 1 (57%) was higher than in group 3 (22%, p < 0.05) and group 2 (18%, p < 0.01). The leading cause of death in group 1 was cerebral thromboembolism with development of meningoencephalitis. Other causes--progressive cardiac and renal failure.

[Role of vasodilator agents in the complex treatment of circulatory insufficiency in patients with ischemic heart disease]. / Rol' vazodilatatorov v kompleksnoi terapii nedostatochnosti krovoobrashcheniia u bol'nykh ishemicheskoi bolezn'iu serdtsa.

The paper is concerned with the results of therapy of CHD patients with circulatory insufficiency using cardiac glycosides combined with a nitrate of prolonged action (sustak) and an arterial dilator apressin. Since the patients were advanced in years, sustak was given at average doses of 6.4 mg every 8 h and apressin at a daily dose of 75 mg. Additional treatment with vasodilators resulted in positive hemodynamic shifts in the patients with stage IIA and IIB circulatory insufficiency. The highest hemodynamic effect in therapy of marked circulatory insufficiency was observed in the patients with a low initial cardiac output and a high peripheral vascular resistance after multimodality therapy (cardiac glycosides, sustak and apressin). Changes in hemodynamics should be taken into account during therapy with vasodilators and control over their efficacy should be exercised.