[Stomatological status and quality of life of elderly and senile people].

The stomatological status and the measures of oral health-related quality of life in elderly and senile inhabitants of Novosibirsk were researched. The high prevalence and intensity of the major stomatological diseases, the high need for oral cavity sanation and prosthetics in elderly and senile population were found out.

[Orotic acid as a metabolic agent]. / Orotovaia kislota kak preparat metabolicheskogo deistviia.

The paper reviews clinical and experimental studies into the mechanisms of action of orotic acid (OA). OA has been shown to take an active participation in metabolic processes in the body. As a pyrimidine precursor, it plays a key role in the biosynthesis of nucleic acids and protein, regulates water-salt exchange, by increasing diuresis and reducing the volume of extracellular fluid. OA is also a cellular fixative of magnesium by producing pronounced antiarrhythmic, vasodulator, and cardioprotective effects. OA has ascertained to stimulate erythro- and leukopoiesis. The involvement of OA in metabolic processes explains its cardio- and neuroprotective effects. By enhancing the resistance of myocytes to ischemia, OA favourably affects the clinical course of myocardial infarction and on manifestations of heart failure. OA has been noted to have an angioprotective action and to play an important role in the energy provision of the hypertrophic myocardium, by increasing its contractility. The ability to enhance the functional reserves of the heart adapted to higher exercises accounts for its use in sportive medicine. When there are emergency emotional and vestibular stimuli, OA drugs show an antistressor actions and are effective in treating patients with borderline nervous and mental disorders. Whether OA can be used to treat gastrointestinal diseases is to be clarified.

Valsartan in heart failure patients previously untreated with an ACE inhibitor.

OBJECTIVE: To evaluate the effect on cardiac hemodynamic parameters of valsartan in patients with chronic stable congestive heart failure previously untreated with ACE inhibitors. METHODS: After a 2 to 4 week run-in period, 116 adult outpatients were randomized to receive valsartan 40, 80 or 160 mg twice daily, the ACE inhibitor lisinopril 5/10 mg once daily, or placebo. At baseline and after 28 days of treatment, cardiac hemodynamic parameters were measured. Tolerability was assessed by adverse events and by any changes in systolic or diastolic blood pressure, body weight, heart rate, and routine laboratory parameters. RESULTS: For the 12 hour time point (trough), all doses of valsartan reduced mean pulmonary capillary wedge pressure (statistically significant for valsartan 40 mg and 160 mg), decreased systemic vascular resistance (statistically significant for all three valsartan doses and for lisinopril at peak and trough), and increased cardiac output (statistically significant for all three valsartan doses at peak, and for 80 and 160 mg at trough). There were no clinically relevant effects on any safety parameters. CONCLUSIONS: Valsartan has beneficial effects on cardiac hemodynamics, and is generally well tolerated in patients with congestive heart failure not taking ACE inhibitors.

[The capacity to distinguish short durations of time intervals in children and adults]. / Sposobnost' k razlicheniiu korotkikh dlitel'nostei vremennýkh intervalov u detei i vzroslykh.

Two groups of children (5-6-year-old and 7-8-year-old) were presented with pairs of sound signals of the same or different durations. Sound signal durations in pairs could be 1.0, 1.2, 1.5, and 2.0 sec. The children had to detect the difference between the sounds in a pair. The obtained data were compared to the analogous results shown by the 18-39-year-old subjects. It was found out that the ability to discriminate intervals of short duration substantially improved with age. This phenomenon in presumably connected with perfection of the short-term memory. Independently of the subject's age, the order of presentation of signals in a pair influences the ability to discriminate between their durations.

[Immediate and long-term results of thrombolytic therapy in patients with myocardial infarct: the necessity of differential treatment]. / Blizhaishie i otdalennye rezul'taty tromboliticheckoi terapii u bol'nykh infarktom miokarda: neobkhodimost' differentsirovannogo lecheniia.

Systemic thrombolytic therapy was performed in 273 patients with large myocardial infarction: 82 on streptokinase, 25 on tissue plasminogen activator, and 166 on streptodecase. The signs of recovered coronary blood flow were observed in 68, 84, and 33% of the patients, respectively. The application of tissue plasminogen activator resulted in the maximum reperfusion. The success of thrombolytic therapy was related to the fibrinolytic system of a patient: reperfusion was achieved in 96% of patients having a high blood fibrinolytic activity and only in 31% with a low one. The clinical effect of reperfusion was most profound in patients with Killip's Class III heart failure. The patients with early recovery of coronary blood flow developed twice more frequently, which was evidenced by a 12-month follow-up. Fifty percent of patients with an ejection fraction of below 40% died within the first year of the follow-up. The authors discuss whether one can use a differential therapy, including surgical tools for myocardial revascularization.

[Coronary thrombosis, mechanisms of thrombolysis and the tactics in radiographically guided endovascular treatment of patients with acute myocardial infarction]. / O koronarnom tromboze, mekhanizmakh trombolizisa i taktike rentgenoéndovaskuliarnogo lecheniia bol'nykh ostrym infarktom miokarda.

The radio-angiographic features of coronary blood flow were studied in 119 patients in the first 24 hours of a macrofocal myocardial infarction. In 100 (84%) patients with recognized occlusion of the coronary artery responsible for the infarction the semeiotics of the occluding coronary thrombosis is described, and the characteristics of the residual stenoses after intracoronary thrombolysis were studied. In more than 60% of cases the radiographic features of these stenoses were found to be similar to those of primarily revealed stenoses responsible for infarction of the coronary arteries in degree, form, and the presence of mural thrombus. The mechanism of the formation of these stenoses was of a common character--lysis of the occluding thrombus, which was medicinal in the first case and spontaneous in the second. Medicinal thrombolysis is an analogue of the natural physiological mechanism--spontaneous coronary thrombolysis. It was established that the process of medicinal lysis of the coronary thrombus, a mural thrombus among others, is fully completed by the end of the second day of myocardial infarction. The obtained information makes it possible to formulate some principles of radiologically-guided intravascular treatment of patients with myocardial infarction.

[The possibility of spontaneous lysis of a coronary thrombus in patients with acute myocardial infarct]. / O vozmozhnosti spontannogo lizisa tromba koronarnoi arterii u bol'nykh ostrym infarktom miokarda.

The results of coronary angiography in 108 patients within the first 24 hours of myocardial infarction were compared to autopsy coronary arterial findings in 78 cases of myocardial infarction death within similar periods of time. The rate of occlusion of the coronary artery, responsible for infarction, dropped considerably within 12-24 hours of its onset, as compared to the data obtained within the first 6 hours: from 90.3% to 57.1% as evidenced by coronarography, or from 87.8% to 68.4% as evidenced by postmortem findings. Coronarography conducted within the first day of myocardial infarction demonstrated markedly activated fibrinolysis that coincided with the drop in the incidence of coronary-arterial thrombosis. Fibrinolysis activation is a prerequisite for spontaneous coronary thrombolysis.

Anturan for secondary prophylaxis of myocardial infarction.

273 patients suffering from ischemic heart disease were treated with Anturan for one year at a daily dosage of 800 mg. The number of cardiovascular complications was significantly reduced, compared to the control group.

[Systemic thrombolytic therapy of myocardial infarction]. / Sistemnaia tromboliticheskaia terapiia pri infarkte miokarda.

Systemic thrombolytic therapy was given to 67 patients with large-focal myocardial infarction: immobilized streptokinase (streptodecase) was administered to 37 patients, and native thrombolytic drugs (streptokinase or urokinase), to 30 patients. Systemic thrombolytic therapy initiated within 6 hours of the attack was shown to affect favorably the course of myocardial infarction, as manifested in a significant reduction of the incidence of protracted disease and arrhythmias, and rapid elimination of congestive heart failure. The two regimens being equally effective in clinical terms, immobilized streptokinase was associated with considerably reduced rates of specific side-effects common to thrombolytic therapy.

[Effect of systemic thrombolytic therapy on necrotic focus formation in myocardial infarct patients]. / Vliianie sistemnoi tromboliticheskoi terapii na formirovanie ochaga nekroza u bol'nykh infarktom miokarda.

The formation of the myocardial necrotic focus was assessed by precardial charting at 35 leads and the serial determination of CPK activity and MB fraction in 50 patients receiving the systemic thrombolytic therapy and 52 patients of the control group. Thrombolytic therapy initiated within the first 6 h of the disease was shown to facilitate the limitation of the extent of myocardial infarction through a more rapid stabilization of the necrotic focus. The calculated extent of myocardial infarction in patients treated with thrombolytic drugs was 37.4% less than in the control group. A beneficial clinical effect of thrombolytic therapy was demonstrated.