Terapevt Arkh
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To show distribution of the investigated patients into diagnostic groups, find out the diagnostic value of the levels of hemoglobin and packed cell volume as possible markers of absolute erythrocytosis in the group of patients with polycythaemia. ⋯ Red cell mass and plasma volume measurement is easy and necessary procedure for estimation absolute and "apparent" polycythaemia. Rather common occurrence of different forms of erythrocytosis and in particular "apparent" erythrocytosis must determine certain diagnostic approach according to specific clinical case.
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The lecture analyses current tools of anti-inflammatory treatment of patients with chronic obstructive pulmonary disease (COPD). Anti-inflammatory treatment is aimed at a key element of COPD pathogenesis. The results of treatment with main anti-inflammatory drugs and methods in COPD management are reviewed as well as efficacy of a new anti-inflammatory drug roflumilast in COPD patients.
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The paper discusses issues related to the role of basic studies in the development of practical medicine and to the integration of basic science and medical treatment.
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Leptospirosis (Weil-Vasiliev disease) is a zoonotic natural focal disease running as an acute fever with severe intoxication, lesion of the kidneys, liver, CNS, hemorrhagic syndrome, complications, frequent lethal outcomes. Clinical features of leptospirosis in patients with comorbid diseases are not studied adequately. Lethal outcomes are often caused by such serious complications as infectious-toxic shock, acute renal-hepatic failure, massive hemorrhagic syndrome, infectious myocarditis, etc. ⋯ It is shown that leptospirosis runs a very severe cause in exacerbation of preexisting infection or somatic disease. The necessity of consideration of the background pathology demands an early and individual correction of diagnostic algorithms, conduction of etiotropic and pathogenetic therapy, rehabilitation measures. Comorbid diseases in leptospirosis patients have an essential negative effect on leptospirosis clinical picture, on a course of infectious process (aggravation of endogenic intoxication, polyorganic disorders, nonspecific complications).
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Modern diagnosis of rheumatoid arthritis (RA) is based on the ARA criteria with seropositivity detection by the rheumatoid factor (RF). In a clinically evident stage of the disease this factor is highly sensitive and specific (about 90%), but in early RA efficacy of this diagnosis is considerably less. RF-IgM phenotype has limitation: frequent detection of this factor in the absence of RA and unstability of RF-IgM phenotype. ⋯ As specificity of combination of these autoantibodies is almost 100%, their simultaneous determination is indicated in patients with undifferentiated arthritis for specification of the diagnosis. ACCP and antibodies to modified citrullinized vimentin (AMCV) significantly correlate with RA activity, are prognostic factors of rapidly progressive course and can be used for the disease prognosis at its early stage. Present-day data on comparative specificity and sensitivity of ACCP and AMCV are not certain and need further study.