[Treatment of cardiac insufficiency in patients with chronic obstructive lung disease].

Course and systematic long-term noliprel therapy of chronic obstructive lung disease (COLD) complicated by chronic pulmonary heart permitted to arrest or significantly slow down further progress of heart remodeling, impairment of systolic and diastolic function of right and left chamber and to decrease pressure in the pulmonary artery. These changes correlated with an improved clinical picture of the disease, increased tolerance to physical exercise, and reduced frequency of progressive right ventricular insufficiency. The integral indicator of clinical symptoms fell down from 12.54 +/- 0.27 to 9.26 +/- 0.22 by the 12th month of therapy. This finding confirms beneficial effect of noliprel on clinical manifestations of heart failure and substantial improvement of structural and functional parameters of the right heart.

[Clinicofunctional condition and quality of life in patients with chronic obstructive pulmonary disease before and after outpatient treatment with fenspiride].

AIM: To study effects of long-term administration of fenspiride in combination with broncholytic drugs on dynamics of clinical symptoms, external respiration function and quality of life in patients with chronic obstructive pulmonary disease (COPD). MATERIAL AND METHODS: A comparative randomized trial of fenspiride used for 6 months in combination with broncholytic drugs enrolled 68 COPD patients. A clinical status, external respiration function were examined. Quality of life was evaluated with WHO questionnaire WHOQOL-100. RESULTS: Addition of fenspiride to combined treatment of COPD attenuates COPD symptoms, normalizes blood biochemistry, improves external respiration function, raises exercise tolerance. Quality of life improved by physical and mental state scales. CONCLUSION: Fenspiride addition to COPD treatment improves efficacy of the standard treatment and is recommended for treatment of COPD of stage I and II in combination with broncholytic drugs.

[Hartil effects on structural-functional condition of the heart in patients with chronic cor pulmonale].

AIM: To study effects of long-term administration of ACE inhibitor ramipril (hartil) on renin-angiotensin-aldosteron system (RAAS), dynamics of clinical symptoms of the disease and structural-functional indices of the right and left ventricle (RV, LI) in patients with chronic obstructive pulmonary disease (COPD) with decompensated chronic cor pulmonale (CCP). MATERIAL AND METHODS: X-ray examination, echocardiography (echo-CG), investigation of external respiration function were made in 45 patients with non-exacerbated COPD with CCP. The study group consisted of 25 COPD patients with CCP. They received ramipril (hartil) in a dose 2.5-5 mg. The control group of 20 patients did not receive ACE inhibitors. RESULTS: As shown by echo-CG, administration of hartil in decompensated CCP significantly improved diastolic LV and RV functions, reduced systolic and diastolic sizes of both ventricles and atria. To treatment month 12 the changes enhanced with improvement of the systolic function. Patients with decompensated CCP who had no long-term correction of RAAS exhibited deterioration of RV systolic and diastolic function, the size of their right atrium and ventricle enlarged, blood pressure in the pulmonary artery rose. CONCLUSION: Long-term administration of ACE inhibitor hartil in COPD patients with CCP in personally adjusted doses in outpatient conditions is effective and results in positive structural-functional changes of the right heart.

[Efficacy of different schemes of anti-helicobacter therapy in duodenal ulcer]. / Effectivnost' razlichnykh skhem antikhelikobakternoi terapii pri iazvennoi bolezni dvenadtsatiperstnoi kishki.

AIM: To study clinical efficacy and antihelicobacter activity of combined treatment of duodenal ulcer (DU) with famotidin (qamatel), metronidasol (trichopol) and jozamycin (walpraphen). MATERIAL AND METHODS: A total of 96 patients with uncomplicated DU have been treated (mean age 42.5 +/- 1.5 years). The examination included standard tests, endoscopy, pH-metry (on the treatment days 1, 15 and 28), biopsies and prints from the antral stomach and its body. The sections were stained by Gimse for morphological assessment of duodenal mucosa and detection of Helicobacter pylori (HP). Gastric acid-producing function was examined with intragastric pH-metry. The patients were divided into 3 groups: group 1 received monotherapy with famotidin (20 mg twice a day); group 2 received combined treatment with famotidin (40 mg/day), metronidasol (500 mg twice a day), josamycin (300 mg in 3 doses) for a week with following intake of famotidin alone (40 mg/day) for 3 weeks; group 3 received the same treatment plus clarythromycin. Group 1 patients benefited from the treatment but elimination of pain and dyspeptic syndromes was longer than in groups 2 and 3 (p < 0.05). Ulcer healing to treatment day 28 was observed in 71.8, 90.0 and 88.2%, respectively. Side effects occurred in 0, 10 and 16.7% cases, respectively. CONCLUSION: 1-week schemes of combined treatment with famotidin, metronidasol, josamycin or clarythromycin are highly effective in DU and their side effect rates are not very high.

[Experience in the use of immunomodulator likopid in ulcer disease]. / Opyt primeneniia immunomoduliatora likopida pri iazvennoi bolezni.

We studied the effect of immunomodulator likopid on leukocytic immunity and duodenal ulcer (DU) course in 92 DU patients (70 males, 22 females; mean age 32 +/- 1.2 years) having positive tests for Helicobacter pylori. The diameter of ulcer defects in the duodenal bulb ranged from 0.2 to 1.3 cm, mean size of ulcer was 0.8 +/- 0.1 cm. We measured lymphocyte population with rosette formation test, T-lymphocyte subpopulation by determination of sensitivity to teophylline, humoral immunity--with Manchini. The addition of likopid to present-day antiulcer therapy with antisecretory and antihelicobacter drugs shortens ulcer healing by 3-4 days, raised H. pylori eradication to 100%. In the course of the treatment lymphocyte and monocytes count increased, neutrophil count reduced. The course treatment normalized cellular immunity: count of T-lymphocytes rose to 1.27 x 10(9) +/- 0.01 to 1.78 x 10(9) +/- 0.04 g/l (p < 0.05), T-suppressors--from 11.36 +/- 0.56 to 14.05 +/- 0.52% (p < 0.05), count of B-lymphocytes fell from 32.44 +/- 0.31 to 28.7 +/- 0.28%. A positive trend in the number of T-lymphocytes was accompanied with normalization of T-helpers/T-suppressors which increased from 2.51 +/- 0.21 to 3.52 +/- 0.18 (p < 0.01). CIC tended to lowering from 118.1 +/- 0.43 to 110.6 +/- 0.27 U (p < 0.05). Complement concentration in the serum rose from 30.1 +/- 0.3 to 32.6 +/- 0.2 (p < 0.001). This improved DU course. Thus, inclusion of likopid improves immune status of the patients, free radical oxidation of lipids and, consequently shortens ulcer healing.

[Clinical efficacy of combined anti-Helicobacter treatment of patients with duodenal ulcer]. / Klinicheskaia effektivnost' kombinirovannogo antikhelikobakternogo lecheniia bol'nykh iazvennoi bolezn'iu dvenadtsatiperstnoi kishki.

84 patients with duodenal ulcer and positive by Helicobacter pylori (HP) were divided into two groups. Group 1 consisted of 42 patients who received omeprasol, metranidasol and clarithromycin. Group 2 of 42 patients received rovamycin instead of clarythromycin. The results of the study show that anti-HP regimen with rovamycin is superior to clarythromycin by main criteria (percent of healed ulcers, HP eradication, time to remission, recurrence rate, side effects rate). Thus, three-component therapy of patients with recurrent duodenal ulcer maintains intragastric acidity optimal for fast healing of ulcer defect.

[Efficiency of ramipril treatment in patients with chronic obstructive bronchitis complicated by chronic cor pulmonale]. / Effektivnost' lecheniia ramiprilom bol'nykh khronicheskim obstruktivnym bronkhitom, oslozhnennym khronicheskim legochnym serdtsem.

The supplementation of the angiotensin-converting enzyme inhibitor ramipril to combined therapy in patients with chronic obstructive bronchitis complicated by chronic cor pulmonale resulted in positive central, pulmonary, and peripheral hemodynamic changes, improved peripheral tissue oxygenation, by exerting beneficial effects on the course of the disease.