[Differentiated types of chronic agoraphobia]. / Tipologicheskaia differentsiatsiia khronicheskoi agorafobii.

The study included 60 patients aged 18-65 years with anxious-phobic disorder (APD)--agoraphobia with and without panic disorders. Diagnosis of the disease was performed according to ICD-10. It was established that dynamics and outcome of APD with stable agoraphobia depend on some comorbid psychic disorders (neurotic, nonpsychotic affective, personality disorders, slow-progredient schizophrenia). Influence of such disorders on APD depends on level of realization of the comorbid correlations: symptomatic (nondelirious hypochondria) and intersyndromal ones (affective and personal disorders as well as slow-progredient schizophrenia). Typology of APD with stable agoraphobia is proposed, that is determined by comorbid correlations with the phenomena of nondelirious (overvaluable or neurotic) hypochondria. Agoraphobia, comorbid with the phenomena of overvaluable hypochondria, is characterized by isolated phobic avoidance (1-2 situations), lack of the signs of progredience of psychopathologic disorders and relatively favourable outcome (lack of the cases of invalidism, decrease of a professional status in 8% of the patients). Agoraphobia, comorbid with the phenomena of neurotic hypochondria, is characterized by total phobic avoidance, syndromal comorbidity with polymorphic and generalized somatophormic disorders, depressive disorders syndromally completed, slow-progredient schizophrenia and less favourable outcome (avoidance behaviour of severe degrees was found in 57% of the patients, including 18% of patients disabled due to mental disease).

[Chronic anxiety and phobic disorders with persistent agoraphobia: clinical and follow-up study]. / Khronicheskie trevozhno-fobicheskie rasstroistva s iavleniiami stoikoi agorafobii (kliniko-katamnesticheskoe issledovanie).

There were studied 2 groups of the patients with a diagnosis of agoraphobia (according to ICD = 10). The first group included 34 patients which didn't use a specialized psychiatric service; the second one included 25 patients which needed an active therapy under conditions of psychiatric hospital. Dynamics of a disease was investigated by the method of retrospective (3 years) and following prospective (3 years) evaluation. The first group was characterized by relatively favourable outcome of chronic anxious-phobic disorders (APD) with the phenomena of a stable agoraphobia (5.8% of patients with a decrease of social adaptation): a limited agoraphobic avoidance (2 cases in the average), a rare and only psychogenic exacerbation (23 cases). Comorbid disorders were presented as minor depression (53%), somatophormic disorders (single isolated cardialgias and the conversive disorders--28%), personal disorders of hyperthimic (53%) and hysteric (35.5%) type. The second group was characterised by relatively worse outcome of chronic APD with the phenomena of a stable agoraphobia (32.0% of the patients with a decrease of social adaptation), that was associated with more generalized avoidance behaviour (more than 2 cases), with a gradual increase of both the severity of panic attacks and agoraphobia in limits of either periodic long-term aggravations (46%) or a continuous progredient course (29%). As compared with the 1-st group the second group was also characterised by significantly higher average number in a month of the panic attacks (4.9 + 1.1 vs 2.4 + 0.4; p < 0.01) and hospitalization (2.5 + 0.6 vs 0.2 + 0.2 + 0.1; p < 0.05) during all period of prospective observation. More severe comorbid disorders were revealed: slow-progredient schizophrenia (20% vs 0% in the first group; p < 0.01), a major depressive disorder (28% vs 3%; p < 0.01), dysthymic disorder (32% vs 3%; p < 0.05); personal disorders were presented mostly by the deviations of schizoid type (59%).

[Therapy of cardio-neurotic diseases in general practice: clinical experience with atarax]. / Terapiia kardionevroticheskikh rasstroist v obshcheterapevticheskoi praktike: opyt primeneniia ataraksa.

An open study of efficiency and safety of atarax (hydroxisine) enrolled 55 outpatients (23 males and 32 females, mean age 45.91 +/- 1.91) with generalized anxious and somatoform disorders running as cardioneurosis as well as nosogenic reactions (maladaptation), manifestations of cardiovascular pathology (acute myocardial infarction, angina of effort functional class II-III, postinfarction cardiosclerosis, essential hypertension in 5, 13, 2 and 5 patients, respectively). The patients received atarax for 28 days (daily dose 50 mg). The course was completed in 54 patients. In 47 of them, the overall score value by Hamilton Anxiety Scale dropped by 10 scores, the reduction being more obvious in patients with somatic anxiety. Hydroxysine is well tolerated and safe both in patients with somatic pathology and those with cardiovascular disorders.

[Bleeding as a complication of resuscitation in a case of thromboembolism of the pulmonary artery]. / Krovotechenie kak oslozhnenie reanimatsi pri tromboémbolii legochnoi arterii.

Massive blood shed (1700 ml) from the punction wound in the left ventricle was observed in a patient on 65,000 U heparin. Comatose condition was accompanied by a pronounced lactacidemia of liquor (10 mmol/l) developed due to adrenaline administration with an extremely high glucose level (33 mmol/l--in blood; 11 mmol/l--in liquor). High efficacy of hyperbaric oxygenation in hypoxemic coma has been established.