Terapevt Arkh
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Pregnancy in patients with liver cirrhosis and portal hypertension occurs very rare, because of their significantly derailed reproductive functions. Тhe risks for the mother and the fetus are connected with worsening of the portal hypertension, progression of decompensated liver cirrhosis and development of its complications: liver failure, ascites, hepatorenal syndrome, hepatic encephalopathy and variceal hemorrhage, and with increased incidence of spontaneous abortions and abnormal uterine bleeding. The decision for continuation of the pregnancy in cirrhotic patients must be based on individual approach and a multidisciplinary team consisting of obstetricians, hepatologists, anesthesiologists, surgeons and hematologists must participate in the therapy. We are presenting a clinical case with 34 years old pregnant woman with Child-Pugh class C cirrhosis and untreated chronic viral hepatitis C. ⋯ The pregnancy was interrupted in the Department of obstetrics and gynecology due to the high risk for mother's life. Later the patient developed severe disseminated intravascular coagulation (DIC) syndrome with life-threatening uterine bleeding. The DIC syndrome and the bleeding were resolved after therapy in intensive care unit and the patient was discharged from the hospital with stable vital signs.
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Randomized Controlled Trial
Clinical efficacy of umifenovir in influenza and ARVI (study ARBITR).
The aim of the study is to obtain additional data on safety and therapeutic efficacy of the antiviral drug Arbidol (umifenovir) in patients with a diagnosis of influenza and common cold. ⋯ The results of this study indicate umifenovir safety and confirm its effectiveness to the treatment of influenza and other acute respiratory viral infections in adult patients. It was found that effect of umifenovir in the treatment of influenza in adults is most pronounced in the acute stage of the disease and appears in the reduction of time to resolution of all symptoms of the disease, reducing the severity of symptoms of the disease.
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Currently, combinations of long-acting beta2-agonists and long-acting anticholinergics are considered as the basic therapy for majority of patients with chronic obstructive pulmonary disease (COPD). These combinations have different pharmacological characteristics and delivery devices that provides different clinical effects and new opportunities for personalized treatment of COPD. Aclidinium/formoterol fixed combination differs from other dual bronchodilators by twice-daily dosing regimen, good safety profile and a specific delivery system. Recent information on clinical efficacy and safety of aclidinium/formoterol combination in COPD patients is given in this article.