[A study of the efficacy and safety of lornoxicam in patients with acute sciatica]. / Issledovanie effektivnosti i bezopasnosti vosproizvedennogo preparata lornoksikam u patsientov s ostroi lyumboishialgiei.

OBJECTIVE: To compare the efficacy, safety and tolerability of lornoxicam and xefocam used as the reference drug in patients with acute nonspecific pain in lower back caused by acute sciatica. MATERIAL AND METHODS: A simple blind clinical study was conducted with 108 patients (men and women, aged 20-55 years) with complaints of pain in the lower back and an established diagnosis of vertebrogenic radiculopathy L4, L5, S1. Patients were randomized into 2 treatment groups by randomization method of envelopes in the ratio of 1:1 (54 patients per group). The first group received lornoxicam in a dose of 16 mg/day for 2 days, the second group was treated with xefocam (the lyophilisate for preparation of solution for intravenous and intramuscular injection) according to a similar scheme. RESULTS AND CONCLUSION: The results demonstrate the comparable efficacy of lornoxicam and the reference drug. The analysis of the safety profile reveals no significant differences between treatment groups.

[Atrial fibrillation registered for the first time: characteristics of clinical course, treatment, prognosis].

To study the clinical presentation of the first episode of atrial fibrillation (AF), treatment tactics and its compliance with current recommendations, features of the further clinical course and prognosis in patients with AF we performed a retrospective study on data of Polyclinic No 1 of the General Management Department of the President of RF . We analyzed data from 58 patients (36 men, 22 women) from January 2009 to September 2011 inclusive. The first episode of AF was recorded in the age from 48 to 90 years (in 39.7% of patients - aged 80 to 90 years old), mostly had paroxysmal character (84.5%), in 82.1% of cases was accompanied by marked clinical symptoms: sense of disruption of the heart (50%), feeling short of breath (28.6%), weakness (17.9%). In 87% of cases clinical symptomatology required calls for medical emergencies. In 42.9% of cases uncontrolled hypertension was possible predisposing factor for developing AF. Paroxysmal AF moved to constant in 38.8% of patients during the period from 1 year to 18 years. Due to the high risk of thromboembolic complications (2 to 5 on a scale of CHADS2), after the detection AF warfarin was shown to 96.6% of patients, because of the high risk of bleeding in practice was appointed only 37.9%. Complications of therapy in the form of bleeding were 9.1%. Tactics of rhythm control by antiarrhythmic drugs I and III classes has remained in 36.7% of patients with paroxysmal AF. -adrenoblockers were constantly taken by 63.3% of the patients using antiarrhythmic drugs I and III classes for relief of arrhythmia during her recurrence (the strategy of "pill in pocket").

[Clinico-economical aspects of cardioversion of paroxysmal atrial fibrillation at phehospital stage and during hospitalization].

We carried out clinico-economical analysis of 2 tactics of rhythm restoration in patients with paroxysmal atrial fibrillation (AF) lasting less than 48 hours: cardioversion at prehospital stage with intravenous procainamide and inhospital cardioversion with any method. This retrospective study was based on the data from department of urgent aid of an outpatient clinic. The results showed that within 48 hours inhospital was a was more effective, safe, and more economically profitable compared with administration of procainamide at prehospital stage. Intravenous procainamide resulted in effective cardioversion in 70.6% of patients. It was associated with arterial hypotension and proarrhythmogenic action in 14,7% of cases. Patients with effective cardioversion with procainamide had lesser mean values of left ventricular anterior-posterior dimension (echocardiography) and shorter duration of arrhythmia.

[Newly developed atrial fibrillation among patients under active observation by an outpatient clinic].

We carried out prospective cohort study of incidence of new cases of atrial fibrillation (AF) in a sample of Moscow population (patients under observation in our policlinic). Total incidence of AF between 2003 and 2009 was 7.7 per 1000 patient/years, it was higher among men than among women. Incidence of AF progressively increased with age reaching maximum in age group more or equal 85 years. Most frequent baseline disease in patients with first appearance of AF was hypertensive disease (71%). Ischemic heart disease diagnosed according to strict criteria (postinfarction cardiosclerosis, revascularization procedures) was registered in 20.1%, diabetes - in 15.7%, chronic heart failure - in 13%, valvular heart disease - in 5.6%, and history of acute ischemic stroke - in 2.5% of patients.

[Prevalence of atrial fibrillation among patients under observation by an outpatient clinic].

Prevalence of atrial fibrillation among patients attending our policlinic (2.44 and 3.78% in 2002 and 2009, respectively) was higher among men than among women and progressively increased with age achieving maximum in the group of patients aged more or equal 85 years. Paroxysmal and persistent forms were more frequent than permanent AF. Thromboembolic complications, heart failure and valvular heart disease were to a greater degree characteristic of permanent AF.