[Contemporary therapy of chronic obstructive pulmonary disease and its new directions].

Chronic obstructive pulmonary disease (COPD) gives rise to substantial structural changes in the respiratory tract and lungs with the development of chronic inflammation and bronchiolitis, as well as pulmonary parenchymatous destruction and the formation of emphysema. The listed changes substantiate the development of new treatment techniques, which will help correct structural changes in the respiratory tract and will slow down or even reverse progressive worsening of the respiratory function. In the future, the development of blood and/or saliva infection of inflammation biomarkers (e.g. endogenic protease inhibitors, antioxidants, cytokines etc.) will make it possible to find valuable diagnostic signs of forthcoming exacerbation, as well as to evaluate the effectiveness of new therapeutic techniques in clinical studies. COPD, or chronic bronchitis, airway obstruction, and emphysema, should be considered among pathological processes which result in smoking-induced chronic system inflammatory syndrome including cardiovascular diseases, metabolic disorder, and cancer. Possibly, treatment with new preparations, directed towards treating the patient as a whole rather than separate COPD symptoms, will be developed in the future.

[Cardiac syndrome X].

Cardial syndrome X (CSX) is a rare condition. Patients who suffer from it complain of exhausting chest pain attacks and other symtoms whose causes are unknown. Such patients are usually treated at conventional cardiological hospitals without any clearly proven therapeutic effect. Various therapeutic programs have been proposed to treat CSX. The population of CSX patients is heterogenous, which demonstrates a multifactorial nature of the syndrome and explains why it is necessary to apply a strictly individual approach in each case, using both pharmaceuticals and psychosocial factors. In spite of good long-term prognosis, the quality of patients' life is low.

[Contemporary diagnostics of pulmonary arterial embolism].

Nowadays, computed tomography along with pulmonary angiography (CTPA) is a recognized method of assumed pulmonary embolism (PE) diagnostics; however, even in experienced centers, CTPA sensitivity varies between 58 and 95%. Computed tomography with contrast venography and femoral scanning aimed at the diagnostics of profound venous thromboembolism, is a useful addition to CTPA. Besides these methods, some other well-known diagnostic techniques may be used in complex PE diagnostics: ventilation-perfusion pulmonary scanning, the evaluation of PE probability by clinical manifestations (P. Wells method), and digital subtraction angiography.

[Clinical application of omega-3-fatty acids (cod-liver oil)].

A range of prospective studies have proven high efficacy of omega3-polyunsaturated fatty acids (omega3-FA, cod-liver oil (CLO)) in secondary prophylaxis of atherosclerosis and its complications. Monotherapy with CLO or its combination with statines in natients with hypertriglyceridemia substantially lowers triglyceride level. Due to their anti-inflammatory properties, including the capability of prostaglandin production reduction, clinical application of omega3-FA is indicated in high risk of preterm delivery, and in patients with rheumatoid arthritis. In the latter CLO application allows reduction of the dose of nonsteroidal anti-inflammatory drugs, and improves chief clinical symptoms (reduces pain and morning joint stiffness.)

[Features of cardiologic diseases prevalence among individuals engaged into geology].

The authors studied influence of work and living conditions on geologists' health state. A cohort under study demonstrated paradoxical epidemiologic situation with high mortality risk of arterial hypertension, whereas prevalence of this disease among specialists working on expeditionary shifted mode is nearly equal to that among general population. Unfavorable situation concerning cardiovascular diseases could be caused by high prevalence of cardiovascular risks and some occupational hazards. The situation is deteriorated by insufficient medical observation and psychologic traits of the specialists working on expeditionary shifted mode.

[Cardiological pathology in geological professionals]. / Kardiologicheskaia patologiia u spetsialistov geologicheskoi otrasli.

The staff of the Medical Center "MEDGEO" have surveyed the working conditions and everyday life determined by the specific features of their watch-and-expeditionary work for their impact on the health status of geological workers. Since 1975, more than 13,000 specialists of the industry and members of their families have been examined in different climatic and geographical regions of the country, including 5,689 persons directly in their working places. More than 3,000 specialists have been studied in the clinical setting by using comprehensive diagnostic techniques. The authors' findings indicate that in the study cohort, there is a paradoxical epidemiological situation with a high risk of death due to arterial hypertension whereas the prevalence of this disease in the watch-and-expeditionary workers do not differ from that in the country's population. According to the authors' data, the reasons for the poor situation associated with circulatory diseases are associated with both the high spread of total risk factors for cardiovascular diseases and the adverse impact of some occupational conditions. The situation is also aggravated by inadequate medical control and by the psychological peculiarities of specialists working in the watch-and-expeditionary manner.

[Stem cells: general characteristics and perspectives of their clinical use]. / Stvolovye kletki: obshchaia kharakteristika i perspektivy primeneniia v klinicheskoi praktike.

Culturing of embryonic and adult stem cells (SC) is characterized. Animal experiments on models of human pathology (diabetes mellitus, acute myocardial unfarction, cerebral stroke, Parkinson's disease, etc.) have shown that use of SC is associated with good effects on the diseases. Pilot results of SC treatment of acute myocardial infarction, parkinsonism, hemoblastoses, systemic lupus erythematosus, rheumatoid arthritis and others are reviewed.

[Pharmacological capacities of the prevention of colorectal cancer]. / Farmakologicheskie vozmozhnosti profilaktiki kolorektal'nogo raka.

The paper discusses the results of researches and clinical cases of the use of some drugs and diet in the prevention of colorectal cancer (CRC). Particular emphasis is laid on the efficacy and mechanism of antitumor action of aspirin and nonsteroidal antiinflammatory drugs, folic acid, calcium, ursodeoxycholic acid, epidermal growth factor receptor inhibitors, alpha-difluoromethylornitine, selenium. The paper underlines the importance of dietary addition of products containing the high levels of dietary fibers (available in vegetables, fruits, wheat bran, porridges, etc.) and nonhydrogenated unsaturated fats and omega3-fatty acids. To keep to the general routine involving high physical activity, obesity prevention is of great value in the prophylaxis of CRC.

[Acute respiratory distress syndrome]. / Ostryi respiratornyi distress-sindrom.

Current literature on acute respiratory distress-syndrome (ARDS) is reviewed with characteristics of the terms "acute pulmonary lesion" and "ARDS". Clinical and x-ray classifications of ARDS are presented. Etiology and pathogenesis, epidemiology, clinical manifestations and principles of current treatment are discussed. Use of mechanical ventilation of the lungs in ARDS patients is physiologically validated. Much attention is payed to application of natural and artificial surfactants.

[Statins in clinical practice]. / Primenenie statinov v klinicheskoi praktike.

The review covers principles of treatment with statins, their pharmacokinetics, characterizes six most usable in clinical practice statins and one novel drug--rozuvastatin from a "superstatins" group. Statins proved effective in primary and secondary prophylaxis of coronary atherosclerosis, secondary prevention of ischemic stroke and diseases of peripheral arteries with intermittent claudication, prevention of Alzheimer's disease. Statins are indicated in dyslipidemia in diabetes mellitus type 2, nephrotic syndrome and renal insufficiency. Further studies are needed on statins' effects on hypercholesterolemia, their antiinflammatory and immunomodulating properties, the ability to enhance revascularization of ischemic tissue and stimulate proliferation of osteoblasts in osteoporosis.

[Features of mental state, mental and physical work capacity and hemodynamic parameters in healthy persons and patients with arterial hypertension working in conditions of psychoemotional stress]. / Osobennosti psikhicheskogo statusa, umstvennoi, fizicheskoi rabotosposobnosti i pokazatelei gemodinamiki u zdorovykh i bol'nykh arterial'noi gipertoniei, rabotaiushchikhv v usloviiakh nervno-émotsional'nogo napriazheniia.

The study covered features of psychologic state, mental, physical performance and hemodynamic parameters in healthy individuals and patients having high blood pressure, both facing psychoemotional strain at work. The patients suffering from hypertension of I B-II A stages developed inadequate psychic adaptation, asthenic and hypochondriac signs, worse mental and physical performance, lower cognitive functions of memory and attention.