Search

Non-vitamin K antagonist oral anticoagulants (NОАСs) are highly effective drugs that prevent venous thrombosis and stroke in atrial fibrillation. Their use has difficulties that are associated with the need for laboratory control and with the influence of many factors on the activity of these medications. The emerged direct oral anticoagulants have some advantages over NOACs. Nevertheless, there are a number of pathological conditions, in which NOACs remain first-line drugs. These include prosthetic mechanical heart valves, a glomerular filtration rate less than 60 mL/min/1.73 m2, and left atrial thrombus.

Aim: To examine diagnostic potential of arthrosonography (ASG) in diagnosis of tendenitis in combination with synovitis in patients with gonarthrosis stage I-III by Kellgren's classification., Material and Methods: A total of 40 patients with gonarthrosis exacerbation were examined with x-ray and ultrasound scanning (80 joints). ASG was made on Aloka-SSD-630 device using two-dimentional scanning in 4 longitudinal and 4 transverse positions., Results: Clinical symptoms of synovitis were predominant in patients with gonarthrosis x-ray stage II (68.3%). In ASG synovitis was detected in 41 (51.25%) of 48 knee joints with clinical picture of synovitis. Ultrasound detected such synovitis signs as increased amount of water in the knee joint cavity and b. suprapatellaris, thickening of the synovial membrane more than 0.3 cm and changes in its structure. Six (7.5%) joints were affected with subclinical synovitis diagnosed only in ASG. Ultrasound visualized Baker's cyst in 5 patients and in 5 knee joints. Periarthritis was detected in 77.5% joints, in 46.25% joints it combined with synovitis, ASG provided differential diagnosis of synovitis with periarthritis. Thinning of the cartilage was detected in most of the joints both in synovitis and in its absence but it was more significant in synovitis (62.5 and 40%, respectively)., Conclusion: ASG is an informative diagnostic method in periarthritis and synovitis, including subclinical, and give additional information for x-ray diagnosis in gonarthrosis stage I-III.

Aim: To examine the relationship between the vascular response of the microcirculatory bed to vasoactive agents and lipid peroxidation (LPO) and antioxidative defense in patients with unstable angina pectoris., Materials and Methods: Thirty male patients (mean age 58.0 +/- 2.4 years) were examined. The patients were divided into 2 groups: 1) those with high alpha-cholesterolemia alone and 2) those with high alpha-cholesterolemia concurrent with hyperglyceridemia and elevated total cholesterol levels. Photoplethysmographic determination was used to evaluate vascular responses to norepinephrine (vasopressor function) and histamine (vasodilating function), the blood levels of cortisol, LPO products, antioxidative protection components, histamine, and serotonin., Results: Vascular dilating function was found to be most pronounced in Group 1. Moreover, Group 1 patients had a significant depression of the antioxidative defense system and the highest blood levels of cortisol, and serotonin. The levels of LPO products did not differ significantly in both groups though they were significantly higher than those in healthy individuals., Conclusion: Impairment in the antioxidant system and in coordination of vasodilating function to histamine stimulation are typical of patients with unstable angina.

Analysis is done of the work of the inpatient department of a polyclinic belonging to the VPO "Orenburggazprom". In that department, the treatment is mainly given to the persons of a capable age with different visceral diseases. The authors have worded indications for referral of the patients to the indicated department, evaluated the social and economic advantages of that form of rendering medical services.

A new method for radionuclide measurement of gastric juice proteolytic activity (GJPA) is described. GJPA is determined according to the time of dissolution of the protein capsule filled with 99mTc-pertechnetate solution. In vitro experiments made with 342 samples of gastric juice revealed a correlation (p1 less than 0.01) between the time of dissolution of the 99mTc-pertechnetate capsule and proteolytic activity measured according to Metta's method. No correlation was established between GJPA (measured by Metta's method and by radionuclide method) and gastric juice acidity (p greater than 0.05). In 63 patients examined, the time of capsule dissolution was 15 to 18 minutes with GJPA being normal, 8 to 14 minutes (p less than 0.01) with elevated parameters of GJPA, and 19 to 37 minutes (p less than 0.01) with GJPA being reduced. The given method is a physiological one, sufficiently precise and can be recommended for a screening analysis of GJPA.