[A comparison analysis of the use of intravenous ß-interferon-1a 30 mcg and subcutaneous ß-interferon-1a 44 mcg in routine clinical practice of treatment in patients with multiple sclerosis]. / Sravnitel'nyi analiz rezul'tatov primeneniya v povsednevnoi klinicheskoi praktike dlya lecheniya rasseyannogo skleroza preparatov ß-interferon-1a 30 mkg dlya vnutrimyshechnogo vvedeniya i ß-interferon-1a 44 mkg dlya podkozhnykh in''ektsii.

OBJECTIVE: to compare the results of treatment of multiple sclerosis (MS) with genfaxon, cinnovex and rebif. MATERIAL AND METHODS: The drugs were used in the treatment of 80 patients of the Moscow West administrative okrug during 2014-2015. Thirty patients were treated with genfaxon, 20 with cinnoVex and 30 with the original drug rebif. RESULTS AND CONCLUSION: Twenty-five percent of patients treated with cinnoVex were withdrawn from the study due to the non-efficacy (mean frequency of relapses was the same before and after treatment). A significant decrease of relapses was noted in patients treated with genfaxon. The high frequency of side-effects was the major problem in the treatment withgenfaxon. Due to this reason, some patients stopped treatment.A significant decrease of relapses was noted in patients treated with rebif though aversive effects were frequent during the first year of treatment. The effects of biosimilars found in this study are in line with earlier reports. Therefore, the increase of the quality of interferon-beta-1a biosimilars used for MS treatment is needed.

[Preventive and cessation therapy of mental disorders in patients with the acute coronary syndrome].

An open prospective trial of 93 inpatients divided into two main groups (61 patients) - with mental disorders (31) and without mental disorders (30) and a comparison group (32 patients) was carried out. All patients survived the acute coronary syndrome (myocardial infarction, unstable angina). The efficacy and safety of both preventive and cessation therapy with pantogam active in mean doses 1.8 and 1.2 g /daily, respectively, was demonstrated in respect of heterogeneous depressive, anxiety and somatoform disorders of the neurotic level.

[Disorders of intrarenal hemodynamics in glomerulopathies]. / Narusheniia vnutripochechnoi gemodinamiki pri glomerulopatiiakh.

The intrarenal hemodynamics was examined in 101 patients with chronic glomerulonephritis (CGN) and 111 patients with type I diabetes mellitus. Intrarenal hypertension was diagnosed from renal functional reserve (RFR) depletion. In CGN intrarenal hypertension was revealed in all clinical and morphological variants of nephritis: in 40% of patients with a nephrotic variant, in 25% with a latent variant and in 83% of patients with nephritis concurrent with the severe urinary syndrome. In focal segmental glomerulonephritis and fibroplastic nephritis, the depleted RFR was encountered 4 times more frequently than the preserved one. There was a association between RFR and arterial hypertension, albuminemia, blood creatinine. In diabetes mellitus intraglomerular hypertension was diagnosed in 34% of patients without renal damage (those having normal albuminuria), in 79% at the preclinical stage of diabetic nephropathy (in microalbuminuria) and in 93% at its clinical stage. Intrarenal hemodynamic disorders in diabetes mellitus are primary and provoked by hormonal metabolic disorders. The morphological signs of renal hyperperfusion failure develop at the preclinical stage of diabetic nephropathy.

[The clinical significance of renal functional reserve]. / Klinicheskoe znachenie pochechnogo funktsional'nogo rezerva.

Patients at risk to develop intraglomerular hypertension were denoted among those with chronic glomerulonephritis (CGN) basing on the relationships between various clinico-laboratory findings, clinical syndromes and markers of intraglomerular hypertension (low or absent renal functional reserve). The risk groups include CGN patients with urinary syndrome and arterial hypertension with nephrotic disease and serum creatinine over 1.4 mg/%, with renal damage typical for focal-segmental glomerulosclerosis or fibroplastic glomerulonephritis. Patients with nonimmune progression via a rise of intraglomerular pressure should be given drugs reducing intraglomerular hypertension.

[The antiproteinuric action of angiotensin-converting enzyme inhibitors in chronic glomerulonephritis and diabetic nephropathy]. / Antiproteinuricheskoe deistvie ingibitorov angiotenzinprevrashchaiushchego fermenta pri khronicheskom glomerulonefrite i diabeticheskoi nefropatii.

Antiproteinuria effects of angiotensin-converting enzyme (ACE) inhibitors was studied in 23 patients with chronic nephritis (CN) and 32 patients with diabetic nephropathy (DN). CN patients received Capoten, DN patients were given enalapril. The drugs were also examined for the action on systemic arterial pressure, renal function and intrarenal hemodynamics. Significantly decreased urinary excretion of protein occurred in DN patients on the treatment month 1, in CN subjects on month 3. In both groups ACE inhibitors produced marked hypotensive effect, did not affect renal function, noticeably improved intraglomerular hemodynamics. Hypotensive and antiproteinuria activity of the drugs were unrelated. The mechanism of antiproteinuria action of ACE inhibitors works via normalization of intrarenal hemodynamics. Systemic arterial hypertension seems to be an additional factor aggravating disturbances of intrarenal circulation and provoking proteinuria.

[Acute pharmacological block of the renin-angiotensin system and the recovery of intrarenal hemodynamics in patients with chronic glomerulonephritis]. / Ostraia farmakologicheskaia blokada renin-angiotenzinovoi sistemy i vosstanovlenie vnutripochechnoi gemodinamiki u bol'nykh khronicheskim glomerulonefritom.

A test with capoten, inhibitor of angiotensin-converting enzyme, was employed to assess intrarenal hemodynamics (renal functional reserve-RFR) in 17 patients with morphologically confirmed chronic glomerulonephritis (CGN) in intact renal function without hypertension. Capoten induced three types of changes: RFR increased (9 cases, 7 patients recovered RFR), RFR without changes (5 cases), RFR decreased (3 cases, 2 patients lost RFR). It is stated that indications to inhibitors of angiotensin-II-converting enzyme in CGN should be based on the initial intrarenal hemodynamics and its changes in response to acute capoten test. Capoten is to be administered in initially reduced or absent RFR and is not to the used in normal RFR without hypertension and functioning kidneys. RFR recovery in the acute capoten test allows long-term treatment with inhibitors of angiotensin-converting enzyme.

[Hyperfiltration as a factor in the progression of chronic kidney diseases]. / Giperfil'tratsiia kak faktor progressirovaniia khronicheskikh zabolevanii pochek.

As many as 34 patients with nephrotic syndrome (NS) and 42 patients suffering from type I diabetes mellitus without clinical manifestations of renal damage were examined for clinical and morphological signs of hyperperfusion renal damage (hyperfiltration, microalbuminuria, specific morphological alterations). The lack of renal functional reserves was regarded as a criterion for the status of hyperfiltration (oral protein administration, intravenous injection of small doses of dopamine). The risk of the progression of renal failure by the hemodynamic type in NS amounted to 65%. In the mechanism of the development of hyperfiltration in NS, the role of systemic hypertension, renal failure, a reduction of the ultrafiltration coefficient is discussed. Hypooncia does not make any material contribution to the development of hyperfiltration in NS. The clinical and morphological signs of hyperfusion renal injury were revealed in 50% of patients suffering from type I diabetes mellitus without the clinical signs of renal injury.

[The effect of a protein loading test on the fibrinolytic system in patients with chronic glomerulonephritis and amyloidosis]. / Vliianie belkovoi nagruzochnoi proby na fibrinoliticheskuiu sistemu u bol'nykh khronicheskim glomerulonefritom i amiloidozom.

Investigation of the reserves of the fibrinolytic system with the aid of protein stimulation was carried out in 10 patients with chronic glomerulonephritis and in 10 patients suffering from amyloidosis. All the patients manifested proteinuria exceeding 3.5 g/day and other symptoms of nephrotic syndrome of varying intensity. Renal function was preserved in all the patients. The reserves of the fibrinolytic system were measured by analyzing blood plasma and urine before and after beef protein stimulation. The data revealed reciprocal responses of activator activity in blood plasma and urine in patients suffering from chronic glomerulonephritis and amyloidosis. In patients with amyloidosis, the test revealed complete depletion of activator activity in urine while its considerable reserves were preserved in blood plasma of the systemic channel.

[The renal systems regulating water-electrolyte balance in the nephrotic syndrome]. / Pochechnye sistemy reguliatsii vodno-élektrolitnogo balansa pri nefroticheskom sindrome.

A study was made of the role of renal factors regulating water and sodium balance in the body in chronic nephritis of the nephrotic type. 120 patients with the nephrotic syndrome were examined at different phases of its formation, namely at the phase of edema increase, stabilization phase, and at the phase of edema reduction. The rate of glomerular filtration and its relation to sodium excretion were defined. A significant decrease of glomerular filtration was identified at the phase of edema increase as was its rise at the phase of edema stabilization. A study was made of the activity of the hormonal systems regulating sodium reabsorption in the canaliculi, namely of aldosterone, the renin-angiotensin system, and renal prostaglandins. To specify the role of the hormonal systems, investigations were performed under the conditions of blocking aldosterone synthesis with heparin and blocking of prostaglandin synthesis with indomethacin. It has been revealed that inhibition of glomerular filtration is the crucial factor in sodium retention at the phase of edema increase. Enhancement of sodium reabsorption in the canaliculi is related to excess production of aldosterone and inadequate production of renal prostaglandins. Activation of the renin-angiotensin system does not play any material role in the formation of the nephrotic syndrome.

[The renal functional reserve in the nephrotic syndrome]. / Funktsional'nyi rezerv pochek pri nefroticheskom sindrome.

Functional reserves of the kidneys (FRK) were examined in 29 patients with the nephrotic syndrome and in 14 healthy subjects. FRK were determined as the degree of the increase of endogenous creatinine clearance after stimulation with beef protein (0.7 g per kg bw) or dopamine (3 micrograms/min per kg bw). It was revealed that in 2/3 of the patients, FRK were lowered or lacking. The lack of FRK was seen in all the morphological varieties of renal lesions, with the frequency being greater in the severe clinical forms of the nephrotic syndrome, in lasting nephropathy, in association with arterial hypertension or renal failure. It has been noted that FRK may recover after successful treatment of the nephrotic syndrome, attesting to a favourable regimen of organ functioning and suggesting deceleration of the tempo of renal disease progress.