[Efficacy of intravenous iloprost (Ilomedin®) in salvage of the only extremity in a patient with thrombangiitis obliterans].

Buerger s disease, or thromboangiitis obliterans, is a severe invalidating systemic vascular disease. The present article deals with a clinical case report concerning treatment of a patient suffering from thromboangiitis obliterans with three limbs amputated (on the background of therapy with alprostadil, Karavanov s mixture, rheopolyglukin, pentoxyphyllin). The course intravenous administration of the stable analogue of prostacyclin - iloprost (IlomedinR) made it possible to save the only extremity.

[Magnesium orotate in treatment of chronic hypertension in pregnant women].

We examined 150 pregnant women with essential hypertension (EHT), EHT and connective tissue dysplasia (CTD), and healthy. Presence of CTD aggravated clinical picture of EHT and was associated with pronounced cardialgic, neurological, asthenic, vertebrogenic, visceral, and other syndromes. The use of antihypertensive, metabolic (magnesium orotate) drugs, sedative and uroseptic phytotherapy, application of other nondrug measures in conditions of multidisciplinary dynamic support of the gestational period facilitated regress of clinical symptoms of EHT and EHT+CTD, favorable course of pregnancy and successful delivery.

[Comorbidity in cardiac pathology: clinical-organizational and epidemiological problems].

Scientific (analytical) approach directs researcher to the study of nosology in isolated native view. The phenomenon under consideration- comorbidity becomes significant and to a substantial degree is able to affect all aspects of the process of medical care. This is shown in this review along such directions as frequency of overt or concealed comorbidity or real state of the problem; magnitude of intracardiac and extracardiac comorbidity; difficulties of diagnostics and treatment arising with comorbidity; problems of validity of statistical (and epidemiological) side of the matter; value of social and organizational aspects of patients care in situations when comorbidity is present.

[Basic and metabolic therapy of hypertensive disease in pregnant women].

This open non-randomized study had the objective to analyse the course of pregnancy and labor as well as their outcomes in 62 women with hypertensive disease (essential hypertention). The patients were allocated to two groups, one (group 1) comprising 32 the other (group 2, control) 30 women. All patients in group 1 underwent pregravid preparation and remained under observation throughout the pregnancy period in specialized cardiological departments. They were given treatment that included intake of antihypertensive drugs (methyldopa, long-acting nifedipin, metoprolol), desaggregant (dipyridamole, pentoxifllin), and metabolically active agent (vitamin E, folic acid, magnesium orotate, actovegin, cocarboxylase, and inosin). Gestosis developed in 25% of the patients in group 1 within 37 weeks and in 56.7% of the women (p < 0.05) in group 2 within 23-37 weeks of pregnancy. Circulatory disturbances in the mother-placenta-fetus system were recorded in 25% and 50% of the women in groups 1 and 2 respectively (p < 0.05), intrauterine fetal hypoxia in 18.8 and 50% (p < 0.05), chronic fetoplacental insufficiency in and fetal growth retardation syndrome in 12.5 and 40% (p < 0.05). In group 2, the perinatal mortality rate was 66.7% and perinatal losses amounted to 100.0% compared with their absence in group 1 (p < 0.05). Premature delivery occurred in 30% of the women in group 2 and was absent in group 1 (p < 0.05). In group 1, 9.4 of the newborn infants had low birth weight compared with 33.3% of the live full-term infants in group 2 (p < 0.05). Conjugated jaundice prevailed among the diseases affecting newborns in group 1 whereas intrauterine infections and posthypoxic encephalopathies were most common in group 2 It is concluded than combined therapy of hypertensive disease in women delayed the development of gestosis and made it possible to maintain pregnancy till normal outcome for both the mother and the child.

[Clinico-organizational and certain deontological aspects (defects) of medical care for patients with severe community-acquired pneumonia].

Objective causes of fatal extramural pneumonia, such as social factors and the severity of the disease, should be considered along with subjective medical errors. Clinical and deontological analysis of lethal cases revealed a number of defects in providing medical care for such patients especially in terms of correction of cardiovascular disorders. Special analysis of 51 medical histories from the ethical viewpoint indicated that 4/5 of the patients had good reasons to set up deontological claims against their doctors.

[The clinicomethodological aspects of the etiology of coronary artery disease].

Having analyzed more than 150 original papers dedicated to the study of cardial pathology risk factors from clinical (specific) and methodological (philosophic) points of view, the authors put forward a hypothesis of the etiology of diseases (by the example of coronary artery disease) as a "critical mass" of these risk factors. Reasoning from it, the authors suggest the ways of using this statement by large quantitative evaluation of clinical data, and application of mathematic modeling to the diagnostics and prognostics of cardial pathology in each particular case.