Oral medical dissolution of gallstones in patients with gallstone disease

Being the main treatment for cholelithiasis, laparoscopic cholecystectomy does not always solve the problem. It often entails postcholecystectomy syndrome (PCS). Oral medication to dissolve gallstones with bile acids is alternative therapy for some patients. However, lack of efficacy and limited medical indications make it necessary to apply combination treatment tactics. This study was conducted to investigate the dissolution of gallstones during the combined effects of ursodeoxycholic acid (UDCA) and rosuvastatin as well as to assess the results of eradication therapy in the presence of H. pylory as a measure to prevent cholelithiasis in the course of treatment.

[Optimal rehabilitation of patients with coronary heart disease in outpatient setting].

The problem of invalid rehabilitation in Russia is an important state task and dictates necessity of design of an effective state program of primary prevention of cardiovascular diseases. Common global practice of medico-social model is based on complex detailed medico-social aid. Rehabilitation of postmyocardial infarction patients consists of three phases (stages): hospital posthospital (readaptation) and postreconvalescent (supportive). The program includes physical, psychological and pharmacological rehabilitation. Departments of readaptation and medico-social rehabilitation provide effective conduction of all kinds of rehabilitation. The Moscow North-East Regional Administration has a rich experience in organization of departments of readaptation and medico-social rehabilitation. The departments practice an individual approach to the patients and work in a close contact with bureaus of medico-social commission of experts. Management of patients by cardiologist, rehabilitation specialist and outpatient clinic's physicians provides uninterrupted staged rehabilitation, timely correction of pharmacotherapy, early patient referral to invasive investigations and treatment of coronary heart disease. A course of rehabilitative measures lasts 2 months. Setting up departments of medico-social rehabilitation in outpatient clinics provides more effective use of money assigned by the state for social support of invalids.

[Role of a local therapeutic service in the timely identification, treatment, and rehabilitation of patients with coronary heart disease].

Local polyclinic therapists' long experience in timely identifying, treating and rehabilitating patients with coronary heart disease (CHD) is analyzed. A local therapist's attention is given to diferent course types--the clinical manifestations of CHD. The principles of continuity in the work of a therapist and a hospital: possibilities of extrahospital treatment are denoted; indications for hospitalization are specified. Rehabilitative measures include psychotherapy sessions in addition to drug, dietary, and exercise therapies. Continuity in the work of a therapeutic unit and a sociomedical expert commission contributes to the elaboration of clearer criteria for determining the degree of working capacity loss.