Terapevt Arkh
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An accurate quantitative assessment of myocardium necrosis area and the viable zone (stunned and hibernating) in patients with myocardial infarction is crucial for the preoperative patient selection and predicting the cardiac surgery effectiveness. Currently, researchers and clinicians are most interested in the problem of determining the viable myocardium zone. However, only the necrosis zone area directly correlates with the patients prognosis and determines the heart pathological remodeling processes. ⋯ Thus, the necrosis zone and the viable myocardium zone are two parameters that need to be monitored in dynamics in all patients after myocardial infarction. The most accurate and reproducible method for determining the necrosis area is contrast magnetic resonance imaging of the heart, however, this technique is still inaccessible in most hospitals. In this regard, it remains relevant to estimate the necrotic myocardium area by ubiquitous non-invasive methods such as electrocardiography and echocardiography.
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Low patient compliance due to the development of adverse events in the form of antibiotic-associated diarrhea (AAD) is considered as the main reason for the failure of the eradication of optimized anti-Helicobacter therapy regimens. A key mechanism for the development of AAD is to reduce the number and species diversity of bacteria that form butyric acid.
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The difficulties of verification of pulmonary embolism (PE) are well known and have not been overcome to date, despite significant progress in approaches to managing patients with this pathology over the past 1015 years. Due to the nonspecific clinical picture, cases of a long and difficult journey to this diagnosis are not exclusive. In large studies have shown that the most frequent symptom of pulmonary embolism shortness of breath. ⋯ Modern low-dose oral contraceptives are considered quite prosperous in terms of the development of thrombotic complications and cause a slight (1020%) increase in fibrinogen concentration, factors VII, VIII and X, as well as a decrease in the content of active protein S by 1020%. But in the case of the presence of diseases and conditions that increase the risk of venous embolism, this effect may be sufficient for the realization of life-threatening pulmonary embolism. In this regard, it is important to provide a combined effect on the prognosis of the pathology of the patients and the chosen method of contraception.
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Review
[Socio-economic burden of pulmonary hypertension: relevance of assessment in Russia and the world].
Pulmonary hypertension (PH) is a progressive disease which is characterized with the increase of pulmonary artery pressure and pulmonary vascular resistance. Such condition leads to right ventricular heart failure and premature death of patients. Pulmonary arterial hypertension (PAH) has the status of an orphan disease. ⋯ The lack of criteria for revising this list as well as the imperfection of legal regulation in the field of drug support for orphan diseases leads to high disability, a significant decrease in the duration and quality of life of patients with PH. As part of a multicriteria approach, a clinical and economic analysis of the disease burden can be one of the tools for policy development and decision-making on the distribution of funding in the healthcare. The article provides a review of the economic burden of various forms of PH in the world.
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Due to the global aging of the population, the deteriorating ecology and lifestyle changes, patients with isolated cardiovascular diseases (CVD) are becoming less common, and the portrait of a comorbid patient comes first in the structure of patients with CVD. Among a number of diseases complicating and concomitant with cardiovascular, a special place is occupied by chronic obstructive pulmonary disease (COPD). The prevalence of COPD among CVD patients can reach 60%. ⋯ The most common cases of COPD are arterial hypertension, coronary heart disease, heart failure, and atrial fibrillation. Given the close relationship between COPD and CVD, it is clear that treatment for one condition can affect another. This review discusses current positions about the influence of both groups of diseases on each other, and also observes the effects of drug therapy of both diseases.