Vol 16, No 12 (2014)

Arterial hypertension (AH) remains one of the most important medical and social problems due to its wide spread and the fact that the AH is a major risk factor for major cardiovascular diseases which mainly determines the high rate of mortality in Russia. This article is devoted to the history of active AH research, such as: improving perceptions of its pathogenetic features, the target level of blood pressure, the system of stratification of risk of cardiovascular complications, the choice of rational tactics of patients in the context of National guidelines on the prevention, diagnosis and treatment of hypertension.

The article describes the epidemiology, risk factors, pathophysiological mechanisms of brain damage and differentiated approaches to the management of patients with cerebral stroke. Optimal system is a landmark assistance, which includes: prehospital phase of intensive care, rehabilitation treatment stage and dispensary stage.

The article describes the destructive processes in the lungs that occur with different clinical symptoms, but a similar X-ray picture. Presented are pathognomonic symptoms, differential diagnostic criteria and diagnostic algorithms allowing to timely and properly assess the clinical situation, and, therefore, to choose adequate treatment policy option.

The article is devoted to theone of the most complex and diverse branches of medicine - uretral reconstructive surgery. The reasons of damage to the ureter, the amount of preoperative examination (excretory urography, ante - and retrograde urethrography, multislice computed tomography to assess both the localization and extent of the obstruction), the nuances of surgical interventions and their effectiveness, are presented by their own data.

Among all human malignancies gastric cancer (GC) is in 4th place in the incidence of, and in the 2nd - among the leading cancer mortality causes world - wide. Despite the trend of morbidity reduction in some parts of the world, GC continues to represent a serious clinical problem, because in most cases the disease is diagnosed at later stages and is associated with poor prognosis. Carcinogenesis GC is a complex and multifactorial process defines various causative and triggering factors, including genetic and epigenetic alterations. Many risk factors of gastric cancer, have been identified so far, and Helicobacter pylori, smoking, high salt intake and genetic predisposition are the most studied. Given the key role of H. pylori in the genesis of gastric cancer, eradication of the pathogen is regarded as the main tactic of cancer prevention.

The spread of resistant gram-negative microflora leads to a limited selection of antimicrobial drugs, an increase in the duration of treatment and increased mortality. In the absence of new antibacterial agents active against polyresistant strains, it is important to obtain maximum benefit from existing antibacterial agents that can be achieved by optimizing their pharmacological parameters. In addition, the need to expand the experimental and clinical studies to facilitate the study of the conditions of the development of resistance of microbes in the course of treatment with antibiotics, detailing the impact of other factors allows to overcome this process and optimize antibiotic therapy.

Article is dedicated to one of the pressing problems of neurology - prevention of repeated violations of blood circulation. Hyperaggregation of platelets is one of the leading risk factors for ischemic heart attacks, so the use of antiplatelet agents is shown in almost all subtypes of ischemic stroke. Detailed are the features of the chosen medication for antiplatelet therapy, its efficacy and safety.

The article describes algorithms for selecting a maintenance dose of warfarin in atrial fibrillation with control of the international normalized ratio (INR) once in 2-3 days and once a week. It’s discussed the advantages of the algorithm with a weekly INR control in the outpatient setting. It’s given a version of this algorithm, adapted to the use of warfarin tablets 2,5 mg.