[The use of plasmapheresis in the combined treatment of patients with unstable stenocardia]. / Primenenie plazmafereza v kompleksnom lechenii bol'nykh nestabil'noi stenokardiei.

Plasmapheresis (PA) was provided to 82 patients with unstable angina pectoris refractory to drug treatment. PA did not influence blood osmolarity, acid-base equilibrium or blood electrolyte level. The patients manifested a slight rise of hematocrit and a decrease of plasma oncotic pressure. PA gave rise to a significant lowering of blood viscosity, a reduction of blood fibrinogen, total protein, cholesterol and triglycerides. Clinically, there was a marked decline of the frequency of angina pectoris of rest and effort attacks. The doses of antianginal drugs could be reduced. PA brought about a significant rise of the count of rosette-forming cells. The increase of drug sensitivity induced by PA sessions correlated with the clinical efficacy of the treatment. Later on the antianginal effect was attained with far lower drug doses.

[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.

[The efficacy of isolated ultrafiltration of the blood in patients with refractory heart failure]. / Ob éffektivnosti izolirovannoi ul'trafil'tratsii krovi u bol'nykh s refrakternoi serdechnoi nedostatochnost'iu.

Application of isolated ultrafiltration (IUF) of blood in 70 out of 100 patients with refractory heart failure (HF) made it possible, acting on some mechanisms of water excretion disorders, to attain the compensation for the HF signs. At the same time the correction of the manifestations of secondary hyperaldosteronism, hypoproteinemia, hyperbilirubinemia, and azotemia was attained only thanks to the presence of the functional reserves of the liver and kidneys. In 35 patients with cachectic HF, IUF failure was determined by marked cardial liver cirrhosis together with depletion of the functional reserves of the cardiovascular system. The lack of sufficient diuresis, hyponatremia, hypoproteinemia, and hyperbilirubinemia may be unfavourable prognostic signs despite the reduction of HF intensity consequent on IUF.

[Hemodialysis in patients with incorrigible arterial hypertension]. / Gemodializ u bol'nykh s nekorrigiruemoi arterial'noi gipertoniei.

Nine patients with renal insufficiency in the terminal stage, 6 with chronic diffuse glomerulonephritis and 3 with chronic pyelonephritis, underwent 402 sessions of programmed hemodialysis. All the patients had persistent high arterial hypertension, which did not yield to conventional medical treatment, complicating hemodialysis extremely, as the procedure produced a critical increase of arterial blood pressure (ABP). The patients were given new hypotensive drugs (minoxidyl, captopril, prazosine), which lowered ABP and permitted a reduction of hypotensive injections during hemodialysis. Three patients were subjected to bilateral nephrectomy, which also considerably facilitated hemodialysis in these patients.