[Possibilities of improving the diagnosis and treatment of obstructive pulmonary diseases in the Northern Administrative District of Moscow].

The quality of the diagnosis and treatment of lung diseases was assessed in the polyclinics of the Northern Administrative District of Moscow by 2 methods: (1) selective examination of 960 case histories of bronchial asthma and chronic obstructive pulmonary diseases and (2) questionnaire survey and spirometry of 2132 patients aged 35 to 75 years who have visited a polyclinic for no respiratory diseases. Random check of the case histories revealed a large number of diagnostic and medical errors suggesting the undertraining of therapists in pulmonology. The performed cycles of educational programs could considerably reduce the number of the errors found on recheck. Questionnaire survey and spirometry could increase the number of diagnosed cases of chronic lung diseases by 10 times.

[Plasma replacement in the treatment of ischemic heart disease]. / Plazmozameshchenie pri lechenii ishemicheskoi bolezni serdtsa.

AIM: To investigate whether plasma replacement (PR) can raise efficiency of drug therapy of ischemic heart disease (IHD). MATERIAL AND METHODS: A 30-60% replacement of circulating plasma for salt or dextran using PF-05 unit has been performed in 324 patients 35-79 years of age with recurrent myocardial infarction and angina pectoris. A total of 520 PR procedures were performed. Biochemical, acid-base, coagulative, viscosity, microcirculatory blood parameters were taken, ECG and stress tests were made. RESULTS: PR resulted in a significant reduction in packed cell volume, total protein, fibrinogen, low density lipoproteins, total cholesterol and led to diminution of blood viscosity, acceleration of capillary blood flow, improvement of O2/CO2. Lowering of fibrinogen levels, number of platelets and their aggregation, enhancement of fibrinolytic blood activity created conditions for moderate controlled hypocoagulation. As shown by stress tests, two weeks after PR 60% of anginal patients of functional class IV can be transferred to class III. CONCLUSION: Because PR is beneficial by many parameters, it lessens the requirement in pharmacological support of patients with complicated IHD.