[The histopathological features of the severe intoxication with amatoxin (toxin contained in Amanita phalloides mushrooms)]. / Gistopatologicheskaia kartina tiazhelogo otravleniia amatoksinom (blednoi pogankoi).

Eating mushrooms known to contain amatoxin is fraught with serious complications. The analysis of the relevant literature publications revealed no article with the description of the histological picture of the internal organs in the subjects intoxicated with amatoxin. It is known, however, that such poisoning is associated with the severe irreversible injuries to all intracellular protein structures the character of which depends on time. Specifically, acute amatoxin intoxication produces the well apparent clinical picture within 6 days after intake of the poison. It is characterized by acute renal and hepatic insufficiency in the combination with the injury to the conducting system of heart and the myocrardium itself. Thereafter, the disseminated intravascular coagulation (DIC) syndrome developed accompanied by the signs of progressive tissue hypoxia that ended in death on day 9. The histological study has demonstrated necrotic foci in the liver and oedematous hepatic stroma. Kidneys underwent multiple hemorrhages, necrosis of convoluted tubules and well apparent hydropic protein dystrophy of their epithelium. The adrenal glands showed up signs of necrosis and hemorrhage. It is concluded that poisoning with mushrooms (amatoxin) should be regarded as the most probable cause of the condition requiring differential diagnostics between acute gastroenteritis and renal insufficiency.

[Daily blood pressure profiles and endothelial functions during long-term treatment of arterial hypertension with angiotensin-converting enzyme inhibitors]. / Sutochnye profili arterial'nogo davleniia i funktsii éndoteliia pri dlitel'nom lechenii arterial'noi gipertonii ingibitorami antiotenzinprevrashchaiushchego fermenta.

Clinical practice has been recently applied new approaches to classifying patients with arterial hypertension (AH), which are based on the determination of the summary risk suggesting the prognosis of the disease. This approach is quite efficient due to the fact that it takes into account a combination of the comparable clinical symptoms of AH, which characterize its course. The paper presents data on the values of blood pressure (BP) in AH and on daily BP profiles (DBPP) in 494 patients with different categories of a risk and on their endothelial function. It also gives the results of achievement of target BP levels in patients with AH having different categories of a risk during long-term (36-month) treatment with enapril and perindopril, as well as data on its impact on endothelial vasomotor function. The findings suggest that the higher the risk is, the more severe the hypertensive syndrome is; that the redistribution of DBPP occurs towards prognostically poor types and endothelial dysfunction (EDF) progresses. Treatment with angiotensin-converting enzyme (ACE) inhibitors results not only to the achievement of target BP levels and to the normalization of DBPP, but also to the amelioration of EDF. Moreover, the co-administration of ACE inhibitors and isosorbide-5-mononitrates causes additional antiischemic effects.