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Chronic obstructive pulmonary disease (COPD) is a widespread condition markedly deteriorating quality of life; it is the fourth most frequent cause of death after cardiovascular diseases, diabetes mellitus and injuries. There is significant association between the severity of androgen deficiency occurrence, duration and pharmacotherapy of COPD. Androgen deficiency in men should be regarded as a new systemic pathogenetic mechanism of COPD complicating its clinical course, prognosis of the disease and concomitant pathologies. Therefore, pharmacotherapy of COPD should be prescribed taking into account the androgenic status of the patients.

We studied effect of time on the outcome of acute coronary syndrome and elevated ST segment at the prehospital stage. Logistic regression analysis revealed two time-dependent predictors: "symptom-needle" time and total call service time. In patients undergoing prehospital thrombolysis, these indices (88 and 85 min respectively) reliably predicted the probability of fatal outcome. Their values of 71 and 77 min respectively predicted the risk of unfavourable outcome. The total call service time may serve as an indicator of the quality of work of an ambulance crew at the prehospital stage of management of acute coronary syndrome with elevated ST segment.

Patients with acute coronary syndrome and elevated ST segment in the pre-hospital phase were treated with metoprolol succinate (MS) and thrombolytic therapy. Severe and moderate pain decreased by 54.1 and 16.1% respectively within 60 min after MS intake. Systolic (SAP) and diastolic (DAP) arterial pressure dropped by 35.7 and 16.8 mmHg during the same period. The heart rate (HR) decreased by 25.1 beats/min. 21.8 and 25.3% of the patients showed positive dynamics of ST segment 90 and 180 min after intake of MS. The height of the ST segment was normal in 18.4 and 31.0% of the patients respectively. No cases of external heart rupture were documented at autopsy whereas it was a cause of death in 39.1% of the patients given standard thrombolytic therapy. It is concluded that the use of MS starting from the pre-hospital stage in patients with acute coronary syndrome decreases pain intensity. HR, DAP and SAP and helps to prevent heart rupture.

Terminology and synonyms of comorbidity are discussed in much detail along with historical prerequisites of combined pathology, factors influencing its development and progression, and classifications of its variants. A review of advantages and drawbacks of the most popular models of comorbidity and methods of its evaluation based on standard scales is presented. Much attention is given to the structure of definitive diagnosis and principles of its formulation.

The paper is devoted to the topical problem of maintaining somatic and psychic health of the women of reproductive age by rational pregnancy planning and prevention of abortions by modern methods of contraception including combined oral hormonal contraception. Unfortunately, this approach is rarely employed in this country (5-6%). Results of retrospective analysis of medical documentation, clinical efficacy and safety of modern combined oral hormonal contraception are presented.

Combined therapy with antiaggregants and anticoagulants is a routine practice in the management of acute coronary syndrome without ST segment elevation (AC-ST) in patients with iron deficiency anemia. But some of these patients are at high risk of hemorrhagic complications. This work is aimed at choosing the therapeutic strategy for such patients. The retrospective analysis of medical cards of 2473 patients referred to the Department of Cardiac Animation with diagnosis of AC-ST included the estimation of the efficacy and safety of anticoagulant dalteparin sodium introduced in the treatment of iron deficiency anemia in terms of the frequency of thrombotic and hemorrhagic complications and prognosis of the outcome compared with the patients given no anticoagulants. The prospective study included 83 patients. The antithrombotic treatment should be prescribed to such patients taking account of the risk of thrombotic complications. High frequency of iron deficiency anemia in patients with CS-ST necessitates elucidation and assessment of hemorrhage risk factors (CRUSADE scale) the results of which determine the choice of modalities for further treatment.

The facts that the clinical manifestations of alcohol-associated urgent conditions are polymorphic, and that terms traditionally used by doctors to characterize these conditions are diverse, determine objective difficulties in rendering medical aid in such situations. However, the number of urgent alcohol-associated conditions grows every year. Analysis of diagnostic errors demonstrates that 30% of doctor's errors are subjective. Mistaken diagnosis is followed by casual treatment, independently on its cost and length. Treatment of alcohol-associated pathology is prerogative of general practitioners, which makes knowledge of clinical picture, terminology, legal aspects of rendering medical aid, expertise of the ability to work, and therapeutic tactics in urgent alcohol-associated conditions, important to doctors of all specialties.

132 patients (mean age 46.9 +/- 1.4 years) with exacerbation of gastroduodenal ulcer (GDU) positive by Helicobacter pylori (HP) were examined clinically and using laboratory tests. All the patients received treatment with anti-HP drugs. Side effects were registered in 81(61.4%) patients. Negative trend in colon biocenosis occurred in all the patients. The treatment was poorly tolerated by women, aged patients and those with ulcer in the stomach. Biocenosis aggravation is indication for administration of eubiotics.

Efficacy of a novel eradication treatment with ranitidine, trichopol and jozamycin was compared to that of the standard three-component therapy and monotherapy with ranitidine in 76 patients with exacerbation of gastric and duodenal ulcer. Therapeutic monitoring of ranitidine was performed. In relation to healing of ulcer defect and eradication of Helicobacter pylori, jozamycin is not less effective and more safe than standard three-component therapy. Interaction of the scheme components increases plasma concentration of ranitidine especially in patients with concomitant hepatic and renal diseases.

The data are reported on novel eubiotic biofor's effects on immune status of 213 patients with intestinal dysbacteriosis (39 surgical gastroenterological patients, 43 patients with diarrheal infections, 50 AIDS patients, 81 cancer patients exposed to radiation and chemotherapy). It was found that bioflor acts as an antidysbacteriosis drug and as an immunostimulator. It stimulates T-cell immunity, phagocytosis, B-cell immunity. Immunostimulating effect of bioflor depends on dysbacteriosis degree and is maximal at its first stages.

Cardiovascular disease is the principal cause of morbidity, functional disability and fatal outcomes in patients with non-insulin-dependent diabetes mellitus (NIDDM). The results of administration of eikonol, food additive containing omega-3 unsaturated fatty acids, for 3 months were analyzed for 60 elderly NIDDM patients with ischemic heart disease. A single administration of eikonol leads to a decrease in accumulation of intracellular cholesterol by 15%. Diet eikonol decreased the level of total cholesterol and triglycerides in the blood by 23 and 43%, respectively. Moreover, the higher is the initial value of these parameters, the higher is the effect of the preparation. Eikonol proved to increase the level of lipoproteins of high density, produced a positive trends in NIDDM clinical picture. Food additive eikonol is recommended for wide administration in elderly NIDDM patients with atherogenic dyslipidemias.

From before treatment throughout its course a new hypotensive drug ebrantil was studied for clinical efficacy in 52 patients with essential, renal and thyrogenic arterial hypertension. Clinical instrumental and biochemical findings support the drug efficacy in management of a hypertensive crisis and sudden AF rise. The response was registered in 83.3% of the cases. A persistent hypotensive effect of 180 mg/day course ebrantil became obvious within the first week of the treatment, passing ahead of relevant changes in central hemodynamics and myocardial contractility. The drug acts by reducing both cardiac pre- and postload, the reduction being brought about due to diuretic effect. In response to AP decrease there was neither myocardial contractility depression nor reflex tachycardia. Psychoemotional testing confirmed the central effect of ebrantil promoting adaptation of patients to stress under long-term administration. The drug demonstrated good tolerance when used orally and intravenously. No bronchial pulmonary, carbohydrate and lipid metabolism, renal and hepatic function side effects were reported. 24-h AP monitoring proved ebrantil efficacy in essential and renal hypertension patients.

In the study of 164 patients with atherogenic dyslipidemia the authors studied side effects of aiconol, concentrated cod liver oil. Its lipid component contains not less than 18% of omega-3 polyunsaturated fatty acids (PUFA). All the patients were divided into 4 groups: 51 subjects of group 1 received aiconol in the form of oil, 35 subjects of group 2 had protein dietetic caviar prepared from animal proteins with addition of 3% aiconol, 38 subjects of group 3 were given protein-oil emulsion containing 20% aiconol and 40 patients of group 4 took gelatin aiconol in capsules. Side effects of the above food ingredients enriched with omega-3 PUFA were found to be of metabolic nature. These manifested most evidently in patients on oil aiconol incorporating both maximal doses of omega-3 PUFA and the largest amounts of inert constituents acting as additional fat load on the liver and pancreas. Group 1 patients also suffered from aggravated chronic gastrointestinal, hepatic and pancreatic disorders. Because of reduced quantities of omega-3 PUFA in the diets of group 2, 3 and 4 patients, they displayed much less severe side effects.

Hepatic function was studied in 31 patients with coronary heart disease before and after treatment with nicardipine. Clinical and biochemical findings (enhanced gamma-glutamate transferase and high cholesterol, hepatobiliary syndrome) provide evidence for hepatic function disturbance associated with coronary heart disease. Nicardipine produced a good subjective response, the attenuation of hepatobiliary syndrome. Biochemical indices did not change.

Pre- and posttreatment indices of platelet and plasma hemostasis, parameters of long-term ECG-ST monitoring were measured in 30 coronary patients on long-term verapamil regimens. ++Anti-ischemic effect of the drug was dependent on clinical pattern of the disease and initial function of the platelets. Plasma hemostasis was found unaffected. Long-term verapamil treatment is indicated in stable angina pectoris class II and III provided platelets demonstrate enhanced functional activity.