Terapevt Arkh
-
Cardiogenic shock is the pathology most commonly encountered by intensive care physicians. Its frequency averages 410% in STEMI (ST-elevation myocardial infarction) patients and 24% in NONSTEMI (non-ST-elevation myocardial infarction) patients. Effective shock therapy is impossible without understanding the hemodynamic mechanisms of its occurrence. ⋯ In this article, the authors emphasize the importance of measuring central hemodynamic parameters in patients with predominantly cardiogenic shock. We have tried to structure the knowledge about different techniques of central hemodynamics monitoring, considered advantages and disadvantages of each of them. We believe that the data obtained by hemodynamic monitoring should be closely studied and used, because sometimes multidirectional mechanisms may be involved in the genesis of shock; therefore, therapy should be based on the data obtained in a particular patient.
-
To determine the clinical efficacy and safety of the sorbed probiotics Bifidobacterium bifidum 1 (5108 KОЕ) and B. bifidum 1 (5107 KОЕ) in combination with Lactobacillus plantarum 8P-А3 in the complex therapy of pneumonia caused by SARS-CoV-2 in adult patients without severe risk factors. ⋯ The use of sorbed B. bifidum 1 (5108 KОЕ) improved the well-being of patients without risk factors with moderate viral (SARS-CoV-2) pneumonia and reduced the duration of diarrheal syndrome in a short time. The safety profile of their use was high. More research is needed to clarify the anti-inflammatory effects of the sorbed probiotic.
-
Recently, the role of cardiac magnetic resonance imaging (cardiovascular magnetic resonance) in the diagnosis of coronary artery disease and acute myocardial infarction has increased significantly. This method is defined as the gold standard for differentiation between ischemic vs non-ischemic and acute vs chronic myocardial injury. This part of the review summarizes the main methods of cardiovascular magnetic resonance, its safety, indications and contraindications.
-
Differential diagnosis of causes of the pulmonary embolism in patients can be associated with certain difficulties and requires the exclusion of a wide range of diseases. There is a description of a clinical case of pulmonary embolism caused by verified thrombophilia. Features of tactics of management and treatment of the patient according to modern views are given.
-
The article provides an overview of an innovative software product for a comprehensive assessment of cardiovascular risk in cardiac patients in the Russian Federation. Based on the new recommendations of the Russian National Atherosclerosis Society (2020), the Aterostop application allows to assess cardiovascular risk, determine the patients achievement of target levels of low-density lipoprotein cholesterol, and also provides recommendations for correcting lipid-lowering therapy. The calculator is implemented as a web browser version, as well as a mobile application for Android and iOS platforms.