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Objectives: The goal of this work was to study the immunological and virological efficacy of the domestic antiretroviral drug nicavir (at the optimal dose, as proven by previous clinical studies) with lamivudine, in comparison with other drugs of the group of nucleoside reverse transcriptase inhibitors in combination with kaletra in perinatal HIV chemoprophylaxis regimens., Methods: 658 pregnant women aged 16-39 years and children born to them were examined. The first group (281 people) and the third group (66 people) received the nicavir (manufactured by AZT PHARMA KB LLC) with lamivudine in combination with calyx; the second (281 people) and the fourth (30 people) of the comparison group, stag and zidovudine, respectively, with lamivudine in combination with calyx. The effectiveness of CP was assessed from the increase in the number of CD4 lymphocytes, reduction of the viral load, and the number of children born without HIV DNA in the blood., Results: Against the backdrop of the therapy, the viral load below the detectable level and the positive dynamics of CD4 lymphocytes were registered in all examined women prior to childbirth. When applying the scheme of niacavir + lamivudine + kaletra, a more rapid decrease in the level of BH, most pronounced by week 4 of therapy, was found, as compared with the rate of decline of the same index in pregnant comparison groups., Conclusions: The obtained results allow us to consider ART with the inclusion of nicavir effective and recommend its priority use in perinatal prevention of mother-to-child transmission of HIV., Competing Interests: The authors declare no conflict of interest.

Aim: To compare an efficacy of primary surgical (epicardial bipolar pulmonary veins isolation) and pharmacological (amiodarone) prevention of postoperative atrial fibrillation., Material and Methods: The study included 117 patients with coronary artery disease without previous paroxysms of atrial fibrillation who were randomized into 3 groups. The first (I) group (n=39) included patients who underwent coronary artery bypass grafting without radiofrequency ablation of pulmonary veins and prophylactic amiodarone administration. The second (II) group (n=38) consisted of patients who received amiodarone as a prevention of postoperative atrial fibrillation. In the third (III) group (n=40) simultaneous CABG and pulmonary veins isolation were made., Results: The incidence of atrial fibrillation in early postoperative period was significantly lower in the 3rd group compared with control group (90% vs 69.2%, p=0.021). 1-year freedom from atrial fibrillation was 97.5% in group III vs. 84.2% in group II (p=0.004). In group I the incidence of early postoperative atrial fibrillation was 30.8% with following decrease to 17.9% in 12 months., Conclusion: Simultaneous preventive pulmonary veins isolation during CABG is safe and effective, significantly reduces duration of hospital-stay and incidence of postoperative atrial fibrillation.

After 100 extensive resections of a liver for excision of metastasises of a colorectal cancer, the different drugs protecting a liver were used for prophylaxis of a liver failure., Material and Methods: Patients were distributed on 2 equivalent groups. Patients of the first group received Ademetionin in a dosage 400 mg 2 times a day within 7 days. Patients of the second group received Remaxol in a dosage 400 ml within 7 days once a day., Results: Frequency of cases of an acute liver failure in the first group of patients was 38%, in the second group of patients - 20% (p<0.05). Patients of the second group had milder course of an acute liver failure (by criteria of ISGLS, 2011) in comparison with patients of the first group. Postoperative bed - days in the first group of patients lasted 13 (11-15) days, in the second group of patients - 11 (10-13) days (p<0.05). There was no postoperative lethality.

The review is dedicated to studying the effect of perioperative use of statins while performing vascular operations, examining possible aftermaths of statins discontinuation in the perioperative period and discussing safety of perioperative use of statins. Cardiovascular complications constitute the most common cause of perioperative mortality while performing major noncardiac operations. Clinical studies demonstrated a favourable effect of statins on the cardiovascular complications rate in the perioperative period, therefore use of statins for prevention of cardiovascular diseases seems substantiated appropriate. Acting upon the levels of blood serum lipids, statins also influence various signal cellular pathways, exerting anti-inflammatory, antithrombotic and vasodilating effects. Thus, they may be used not only for patients with lipid metabolism impairments. However, currently required are further studies in order to determine optimal dosage, as well as the terms and duration of therapy with statins in the perioperative period.

Aim: Comparative morphologic assessment of the liver tissue response to the preoperative infusion of octreotide and prednisolon after the major hepatic resection was studied in rats., Material and Methods: 25 male Wistar rats weighing 230--280 g were used. All rats underwent 70--80% hepatectomy. The rats were divided into three groups according to the infusions before hepatectomy: group 1 (n=7) -- received octreotide, group 2 (n=8) -- prednisolone, group 3 (n=10) -- 0.9% saline solution as the control. Histologic features of the remnant liver were evaluated in the sacrificied rats after 72 hours post-hepatectomy., Results: In the group 1 we observed more rapid decrease of edema and tendency to the accelerated regeneration process of hepatocytes., Conclusion: Octreotide infusion before the major hepatic resection may have protective effect on hepatocytes and accelerate the regeneration in the remnant liver.

The publication contains a review of present-day positions on prolonged prevention of venous thromboembolic complications. This is followed by considering the role of risk factors, probabilistic value of prognostic scales, as well as reflecting the provisions of the recent Russian and international consensus documents concerned. Careful consideration is given to the major possible parameters a physician could be guided by in real clinical practice while choosing and deciding upon appropriate terms of prevention. Also shown are possibilities of using novel oral anticoagulants in practical implementation of such regimens.

We studied the effect of rosuvastatin on the development of early postoperative cognitive dysfunction (POCD) in patients after coronary artery bypass grafting (CABG). One hundred nine men aged 45-70 year was divided into two groups. Group 1 comprised 69 patients (mean age 56.8 ± 5.2 years) who were given 20 mg of rosuvastatin for 10-14 days before CABG and until discharge. Patients of group 2 (n=40, mean age 55.9 ± 5.3 years) did not take rosuvastatin. It was shown that patients of group 2 had better neuropsychological parameters after CABG in comparison with the patients of group 2. Patients of group 1 had lower concentrations of interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor α, high sensitivity C reactive protein, and higher concentrations of IL-10. Group 2 patients had worse neuropsychological parameters which were associated with higher concentrations of proinflammatory cytokines. These results may indicate that preoperative therapy with rosuvastatin had decreased the severity of systemic inflammatory response and reduced the development of early POCD after CABG.

There is evidence that acetylsalicylic acid (ASA) is effective in preventing events in a number of cardiovascular diseases. However, there is a number of unresolved problems concerning the efficiency and suitability of its use as an agent for the prevention of cardiovascular events (CVEs) (myocardial infarction (Ml) and/or ischemic stroke (IS) and/or death) in subjects without any clinical manifestations and/or diagnosed coronary heart disease (primary prevention of CVEs). The aim of the review is to compare the current recommendations of, professional communities for the.use of ASA as an agent for the primary prevention of CVEs, to analyze cohort studies and meta-analyses that are not included in the above recommendations (2013-2014), and to consider particular issues on ASA administration (resistance to ASA; barriers to its preventive use). The analysis performed suggests that there is no convincing evidence that it is reasonable to use ASA as a population-wide prevention strategy. The studies and meta-analyses often show conflicting data, which is likely to be associated with the clinical features of population groups included in the studies, with the presence or absence of ASA resistance and motivation for therapy. According to the current clinical recommendations, the results of studies and meta-analysis, and expert's opinions, deciding whether it is expedient to use ASA as an agent for the prevention of primary MI and/or IS and death from atherosclerostic vascular events should be based on the assessment of an individual's risks for the above disorders, which are related to a risk for hemorrhages due to ASA intake.

The authors investigate the results of prophylaxis of venous thromboembolic complications (VTC) during 24 years in onco- logical surgery. The multicentric study shows that common frequency of occurrence of such VTC was reduced due to period of routine prophylaxis of VTC to 3.4%. The strategy of active revision and escalation of preventive measures in the third period of study in comparison with the second period resulted in the decrease of VTC. Patients with moderate risk degree had the results from 3.2% to 1%, patients with high risk degree moved from 4.1% to 13%. The fatal thromboembolism of the lung artery was 0.1%.

The present paper reports a rare combination of Cooley's disease (thalassemia B) and the decompensated variant of chronic tonsillitis in a 14-year old girl. The patient presented with the severe form of hypochromic anemia and degenerative changes of erythrocytes. She was treated by means of bilateral tonsillectomy associated with the high risk of postoperative hemorrhage. In the preoperative period, the child received drop intravenous infusion of tranexam at a dose of 15 mg/kg body weight together with hemostatic agents. Hemorrhage during the surgical intervention was stopped by pressing tampons impregnated with tranexamic acid known to exert local and systemic hemostatic and antifibrinolytic action. The patient was discharged from the hospital for the further treatment of the primary disease.

Tachyarrhythmias (TA) - dangerous postoperative complications of coronary artery bypass grafting, threatening the lives of patients and found, according to different authors, in 13-40% of cases. VFS - an antiarrhythmic drug that belongs to a class 1C, is effective in the treatment and prevention of a variety of cardiac arrhythmias. The aim of the work was to study the clinical efficacy of VFS CHD patients with a history of tachyarrhythmias during the perioperative period of coronary bypass surgery, as well as its comparison with other antiarrhythmic drug (amiodarone). Clinical efficacy was evaluated in 218 patients with coronary heart disease at baseline with a history of tachyarrhythmia (paroxysmal atrial fibrillation or premature ventricular high grade (IV and V class on classification of Lown B. and Wolf M. in the modification of Ryan M.). Shown that the VFS is more effective than amiodarone, both in paroxysmal atrial fibrillation and ventricular arrhythmias when high gradation.

We analyzed effectiveness and safety of anticoagulant therapy in patients with prostheses of cardiac valves at the background of educational program and without special training. We revealed positive effect of educational program during participation in which in 80 cases (67.8%) patients determined international normalized ratio every month and in 50 of them (62,5%) level of hypocoagulation corresponded to target range (p=0.001). At the background of educational program rate of thrombotic complications was 2.73% per patient year, at the background of no educational program - 4.90% per patient year (p=0.040) while rates of hemorrhagic complications were 2.73 and 7.20% per patient year, respectively (p=0.002).

Aim: To evaluate the preventive efficacy of the Russian antiviral drug ingavirin (vitaglutam) in the epidemiological foci with the peak incidence of acute respiratory viral infections (ARVI)., Subjects and Methods: Four hundred men and women aged 18 to 65 years from the epidemic foci of ARVI who had been in close daily contact with the patients whose diagnosis was verified by laboratory tests were examined. Two hundred persons received prophylaxis with ingavirin (a 90-mg oral capsule once daily for 7 days) and 200 took placebo according to the same scheme. The efficiency index and coefficient were calculated and the relative risk of the disease was estimated to evaluate the efficiency of ARVI prevention. A pharmacoeconomic analysis was made., Results: There is evidence that the administration of 90-mg ingavirin capsules (OAO "Valenta Farm", Russia) caused a reduction in morbidity rates among those who had been in contact by 63% and in the risk of ARVI by 2.7 times. There was a reduction in the duration of fever by one day and a milder course of respiratory disease in the ingavirin-treated contact persons who developed ARVI., Conclusion: Ingavirin meets all requirements for current drugs for the nonspecific prevention of ARVI at the peak of its incidence. It has a pronounced protective effect and broad-spectrum activity, low toxicity and high safety, which allows it to be recommended for the emergency intrafocal prevention at the peak of the incidence of influenza and ARVI in adults.

Analysed in the article is the incidence rate of the development of venous thromboembolic complications in a total of 79 patients presenting with various-aetiology intracranial haemorrhage in different regimens of heparin-mediated prevention. The authors have revealed that early (on day 2-4 after the onset of the disease) administration of preventive doses of heparin in patients with intracerebral and intracranial haematomas is a safe and efficient regimen, since it decreases the rate of venous thromboses in the system of the vena cava inferior and fatal thromboembolic complications as compared with a later term (on day 5 and more) of initiating heparin-mediated prevention.

Examination of 270 children and 74 adolescents by the currently available studies using the NBT test with specific antigens (BCG and tuberculin) could first diagnose the circumscribed forms of pulmonary and extrapulmonary tuberculosis in 6.7%. There was evidence for the persistent activity of inflammation in the presence of calcifications in 39 (11.3%) of the pretreated tuberculosis patients. The diagnosis in all the patients was associated with a positive NBT test. The latter could define indications for chemoprophylaxis of tuberculosis in 109 (31.7%) subjects, rule out a need for drugs in this period in 109 (31.7%) patients, and establish no need for phthisiatricians to follow up 135 (39.2) patients. NBT test was shown to be a tool to confirm or exclude the activity of tuberculosis infection in children and adolescents.

The results of sanatorium treatment were analyzed in 156 children and adolescents aged 11-17 years at high risk for tuberculosis. All the patients had been long infected with Mycobacterium tuberculosis with hyperergic tuberculin sensitivity; they had comorbidity and were susceptible to frequent respiratory diseases. A course of percutaneous low-intensity laser irradiation was incorporated as a new method into a complex of prophylactic treatment. The time course of changes in tuberculin sensitivity, serological values, and clinical data were estimated. The proposed treatment regimen was shown to have some advantage over the conventional treatment one.

109 children at risk of tuberculosis frequently suffering from acute respiratory diseases (ARD) and 87 children with rare ARD have undergone a 3-month course of isoniazide chemoprophylaxis. In 95.0% of the examinees the above chemoprophylaxis lowered ARD morbidity to 1-2 times a year, reduced and stabilized tuberculin sensitivity, prevented tuberculosis. Isoniazide treatment of 87 children whose parents worked with cattle that might be infected prevented tuberculosis in them, diminished tuberculin sensitivity. It is thought valid that chemoprophylaxis should be given in sanatoria primarily to children exposed to two and more risk factors (epidemiological, age-sex, medicobiological, social).