[Extracorporeal circulation methods in the treatment of nonspecific aortic arteritis]. / Lechenie bol'nykh nespetsificheskim aortoarteriitom s pomoshch'iu metodov ékstrakorporal'nogo krovoobrashcheniia.

AIM: Development of a protocol of multiple-modality treatment of patients with nonspecific aortoarteritis (NAA) making use of plasmapheresis and specific plasma adsorption of proteinases. MATERIALS AND METHODS: Six patients with NAA aged 15 to 58 years were examined using ultrasonic dopplerography, magnetic imaging, and angiography of the large vessels. Red cell sedimentation rate was assessed, cathepsin G activity, antitryptic activity, and content of C-reactive protein in the blood measured. Drug therapy was supplemented by repeated sessions of plasmapheresis and specific plasma adsorption on immotin. RESULTS: After sessions of plasmapheresis (n = 17) and plasma adsorption (n = 13), increased cathepsin G activity dropped by at least 30% (in 3 patients it normalized), the content of C-reactive protein decreased in the presence of normal antitryptic activity (in patients with decreased activity it normalized and in those with increased values a tendency to normalization was observed). Red cell sedimentation rate decreased, particularly so 1 and 2 months after treatment; the patients felt better. CONCLUSION: Multiple-modality treatment of NAA patients making use of plasmapheresis and plasma adsorption decreases the activity of the inflammatory process.

[A trial of long-term lovastatin treatment in patients with a heterozygous form of hereditary hypercholesterolemia]. / Opyt dlitel'nogo lecheniia lovastatinom bol'nykh s geterozigotnoi formoi nasledstvennoi giperkholesterinemii.

Patients with heterozygous family hypercholesterolemia (HFH) were divided into two groups. Group 1 patients received lovastatin in a daily dose 40-60-80 mg under control of lipids and peripheral blood biochemistry. In 17 patients lovastatin was given as monotherapy, in 15 patients it was combined with plasmapheresis. No hypolipidemic therapy was given to ten patients of group 2. The treatment and follow-up lasted for 4.1 +/- 1.9 years, on the average. A marked hypolipidemic effect was seen in the comorbid therapy. 43% of the patients became resistant to lovastatin, the resistance developed more frequently in monotherapy. The blood fibrinogen fell by 40%, spontaneous and induced platelet aggregation returned to normal, being somewhat higher in subjects resistant to lovastatin therapy. The study shows that hypolipidemic therapy has reduced the risk of IHD fatal complications and progression of non-coronary atherosclerosis in patients of group 1.

[Hemosorption in the treatment of patients with ischemic heart disease and drug-resistant stenocardia]. / Gemosorbtsiia v lechenii bo'lnykh ishemicheskoi bolez'niu serdtsa s refrakternoi k medikamentoznoi terapii stenokardiei.

A course of hemosorption combined with chemotherapy resulted in much less frequent attacks of angina pectoris and in compensation of cardiac insufficiency in 27 coronary heart disease patients resistant to chemotherapy. There was an increase in the drugs efficacy. Sensitivity of the lymphocytes to chemotherapeutic agents administered rose as shown by rosette test due to specific unlocking of the receptors. The underlying mechanism of hemosorption-related compensation of cardiac insufficiency implies correction of secondary hyperaldosteronism and a decrease in the level of ADH leading to enhanced diuresis, natriuresis, inhibited kaliuresis and to normal values of blood electrolytes.

[Effectiveness of low-volume hemofiltration in treating severe arterial hypertension with initial manifestations of renal failure]. / Effektivnost' nizkoob''emnoi gemofil'tratsii v lechenii tiazheloi arterial'noi gipertonii s nachal'nymi proiavleniiami pochechnoi nedostatochnosti.

High efficiency of low-volume hemofiltration, replacing 7 to 8 litres of the filtrate, is demonstrated. It has been used as part of combined treatment in 10 patients with severe arterial hypertension in combination with early signs of chronic renal failure. Low-volume hemofiltration brings down arterial blood pressure and allows reduced doses of hypotensive drugs; moreover, it improves basically eye-ground appearance in cases of malignant arterial hypertension as well as renal nitrogen excretion. Possible mechanisms of the hypotensive effect of low-volume hemofiltration, in addition to volume reduction, may be the control of secondary hyperaldosteronism and increased diuresis and natriuresis.

[Use of bicarbonate dialysis in patients with terminal renal failure]. / Primenenie bikarbonatnogo dializa u bol'nykh s terminal'noi pochechnoi nedostatochnost'iu.

Six patients with terminal renal failure were subjected to a comparative assessment of the effects of acetate and bicarbonate dialyses on acid-base and gas composition of the blood as well as on the tolerance to the procedures conducted. It is shown that the cross-over of the patients to bicarbonate dialysis made it possible to appreciably reduce the number of side effects. The rate of hypotonia and muscular convulsions reduced by 50%, headache by 30%, nausea and vomiting practically disappeared. The use of the bicarbonate-containing dialysing solution prevented hypoxemia while acidosis correction was more adequate.