Results of a study of the efficacy and safety of multimodal prevention of venous thromboembolic complications (VTEC) after total knee and hip joint replacement in 1623 patients are presented. Two studies were carried out: the first focused on determining patient preference for the route of administration (parenteral or oral) for the prevention of VTEC. The second study analyzed the efficacy and safety of postoperative drug prevention of VTEC in routine clinical practice. In both studies the prophylaxis was conducted in accordance with local protocols. The results demonstrate great potential of the modern methods of VTEC prevention and efficiency of new oral medications. The incidence of thromboembolic complications can be reduced through systematic compliance with the protocol.

This short review is devoted to the role of α-blockers, particularly doxazosin as their typical representative, in the treatment of patients with hypertension. The role of doxazosin when used as a component of combination antihypertensive therapy in overcoming resistance to treatment is emphasized. Specific clinical conditions when doxazosin is especially effective are described.

Metabolic syndrome (MS) is a complex pathogenic condition, many mechanisms of which involve uric acid. Inflammation, endothelial dysfunction, atherogenesis and insulin resistance are largely determined by high level of uric acid. Focus on the identification of hyperuricemia is the prerequisite for successful management of cardiovascular risk. The choice of antihypertensive and lipid-lowering drugs in MS should be determined by their ability to control the level of serum uric acid.

The article is devoted to management of pregnant patients with obesity. Fat metabolism disorders are known to contribute to the development of gestational hypertension, preeclampsia, intrauterine hypoxia and fetal macrosomia, birth defects and other complications, including in the newborn. Hypertension plays an important role in the pathogenesis of those complications in pregnant women with obesity. Hypertension is at the same time a result of metabolic disorder and an exacerbating factor which adversely impacts the course and outcome of pregnancy. The article tells about rational combination therapy of hypertension during pregnancy.

The choice of antiarrhythmic drugs (AAD) should be based on a certain algorithm comprising at its first stage selection of effective drugs (if applicable), at the second stage - exclusion from the list of the selected drugs those which may be dangerous taking into account also the associated pathologies and physiological conditions of the patient, and at the third stage - "personalization" of AAD (mode of administration, frequency, duration, timing and criteria for the evaluation of both efficiency and safety of AAD). The article describes the algorithm for the selection of antiarrhythmic drugs.

More than 30 million cases of influenza and acute respiratory viral infections are registered in Russia every year. In everyday clinical practice, the focus in the treatment of ARVI is on symptomatic drugs which help to manage key manifestations of the disease. The following drug groups are used in the symptomatic treatment: antifebrile, analgetic and antihistamine medicines, and vitamins. Combination drugs whith several effects - antifebrile, analgetic and antihistamine - are the most convenient and commonly used type of treatment.

Respiratory infectious diseases represent one of the most common pathologies in outpatient care. Use of immunomodulators in multimodal treatment of infectious and inflammatory diseases has been widely discussed recently. Since immune modulation therapy is auxiliary and could not substitute etiotropic drugs, the limits for the use of immunomodulators in the treatment of infectious diseases should be clearly defined. Patients with immune deficiencies constitute a special risk group for infectious diseases. Both etiotropic and immunomodulatory therapy for such patients should be selected very carefully. The review summarizes data on immunomodulators used in Russia and discusses conditions for prescribing immunomodulatory therapy.

A medical case of a rare form of damage to the peripheral nervous system in diabetes, proximal diabetic amyotrophy (PDA), is described. PDA is characterized by asymmetric proximal lesions in the leg combined with neuropathic pain, muscle weakness and atrophy, mild sensation disorders, increased protein in the cerebrospinal fluid and severe disability. The etiopathogenesis is determined by immune-mediated lesions of vessels, nerves and nerve roots, peri-and microvasculitis, ischemia of the peripheral nervous system structures. Combination treatment with glucocorticoid medications, thioctic acid drugs (Berlithion®) normalization of glycemic profile and symptomatic treatment of neuropathic pain, resulted in a marked positive effect - decreased motor defects and pain, and significant regression of sensory disorders.

Management of patients with low back pain is a challenge for the modern healthcare. Evidence-based approach to main causes, principles of diagnosis and treatment of patients with chronic nonspecific low back pain is described. Drug therapy with non-steroidal anti-inflammatory drugs, mild opioids, antidepressants, physical therapy and cognitive-behavioural therapy within a multimodal approach proved to be highly effective.

Diabetes and its complications is one of the main causes of mortality in most of developed countries; there is solid evidence that, as its incidence continues to grow, diabetes could become epidemic for developing countries as well. Uncontrolled diabetes mellitus is associated with macrovascular complications, vision loss, chronic renal failure, neuropathy and an increase in lower limb amputations [2-6]. Macrovascular complications are the main cause of death in diabetic patients [7].

High incidence of bacterial vaginosis (BV) and its recurrence call for the introduction of new and more effective treatment schemes. A study evaluating the effectiveness of various methods which combine two stages of BV treatment demonstrated the benefits of combination with Dead Sea mud in concomitant chronic inflammation of the upper genital tract.

Iron deficiency anemia (IDA) is characterized by decreased iron levels in the serum, bone marrow and storage pools (spleen, liver, subcutaneous vascular plexus and lungs). IDA is one of the most common pathological conditions in clinical practice, found in 1.8 billion people all over the world [2]. High anaemia incidence is a public health problem both in developed and poor countries [1].

Heart failure associated with high mortality, disability of the population and representing an economic burden for the society, is one of the major challenges in the modern health care [5]. A 10-year population observation demonstrated that the incidence of chronic heart failure (CHF) grows by an average of 1.2 people per 1 thousand per year. In Russia, CHF was diagnosed in 92% of patients admitted to cardiology hospitals in 2003 [9]. The main reason for the increasing number of CHF patients and duration of hospital stay is late detection of the disease.

High incidence of cardiovascular diseases globally, including arterial hypertension (AH) and coronary artery disease (CAD), as well as a considerable social impact made by the diseases and their complications, call for finding new ways to improve effectiveness of treatment [1].

The article tells about the etiology and pathogenesis of iron deficiency, clinical manifestations and principles of treatment of iron deficiency anemia. The choice of drug therapy is highlighted. The advantages of non-ionic iron preparations (Maltofer) for patients with iron deficiency anemia are provided.

Tumors of the reproductive system account for the highest percentage of incidence in female oncological diseases in Russia 36.7%. Ovarian cancer is the leading cause of death among gynecological cancer diseases. Diagnosis and treatment of cancer may cause psychological trauma and provokepost-traumatic stress disorder (PTSD). According to various studies, PTSD incidence among cancer patients ranges from 3% (in the early stages) to 45% in patients after treatment, and up to 80% in those with recurrent disease.