Purpose. To e valuate clinical effectiveness of a new dosage form of trimetazidine for a single administration per day (Deprenorm MV 70) in patients with ischemic heart disease (IHD) and stable angina.

Materials and methods. The study included 85 patients with IHD and stable angina. Patients were randomized in groups of trimetazidine administration 70 mg once per day (Deprenorm MV 70) and placebo in addition to the standard therapy. Initially in 1 and 6 months the gravity of IHD in patients was determined with evaluation of the daily frequency of the angina attacks, the number of nitroglycerin tablet consumed per week, the physical activity by a method of bycicle veloergometries with calculation of the threshold power (TP) and the scope of performed work. Additionally evaluation of the anti-oxidative system of the body was performed in groups: concentration of the major lipid endogenous antioxidant α-tocopherol and extracellular antioxidant enzyme – ceruloplasmin.

Results. In the group with use in the therapy of the drug Deprenorm MV 70 1 tpd versus the group without trimetazidine the tolerance to stress was increased and the number of nitroglycerin tablets consumed by patients per week was reduced: by Month 1 – by 61.8%, by Month 6 – by 72.5%. In the group of Deprenorm MV 70 drug a statistically significant increase of TP was observed: in 1 month – by 32.3%, in 6 months – by 37.5% versus the initial level. Deprenorm MV 70 had a positive effect on the lipid peroxidation. Placebo administration didn’t have any effect on the value of the studied indicators.

Conclusion. The obtained data testify about reduction of depth and duration of ischemia on the background of Deprenorm MV 70 (1 tablet 1 tpd) administration in stable angina patients. Application of Deprenorm MV 70 improves the clinical course of angina and increases the anti-angina effectiveness of prolonged nitrates in their long-term use.

The review presents main provisions of the new recommendations of the European communities on the management of dyslipidemia (DLP). The emphasis on the economic component of the prevention of cardiovascular disease (CVD) is made, four groups of patients with levels of risk from very high to low, the target values of blood lipids and the importance of specific lipids and lipoproteins to determine the risk, analysis of the DLP type and goals of lipid-lowering therapy are determined. The review considers indications for prescription of statins and combination lipid-lowering therapy.

Currently cardiovascular diseases (CVD) are an urgent problem of national and international practice. The arterial hypertension takes the leading place due to the fact that the disease has acquired the character of epidemics. The medical and social importance of AH is preconditioned by the fact that this pathology is an important risk factors of major CVD – myocardium infarction and brain stroke that predetermine the high mortality rates [1].

A new strategy of management of patients with signs of alcoholic dependence based on the multi-level biopsycosocial approach presupposes complex therapeutic programs with use of innovative drugs and active participation of patients in this process. Within this strategy aimed at reduction of alcohol consumption in patients with the diagnosed alcohol addiction an innovative drug Nalmefen – a modulator of the double-action opioid system is tested as as a result of the comparative randomized studies and meta-analysis methods its safety and effectiveness are proved. A new tactics of the adjuvant therapy with use of Nalmefen becomes more widely used in Russia.

In the Russian literature the term dyscirculatory encephalopathy is most commonly used for designation of the chronic brain ischemia. The therapy of dyscirculatory encephalopathy is a problem that is far from resolution. The major modes of DE pathogenetic therapy are use of antiplatelet agents, vasoactive agents, agents of neurometabolic action. The Vinpocetine drug has pleurotropic action, including vasoactive, antiplatelet, antithrombogenic and neurometabolic effects. More than 100 experimental and clinical studies with use of more than 30 000 patients were conducted that demonstrated its high clinical effectiveness. Authors performed an observation study of Vinpocetine effectiveness in 124 patients with DE of Stage I, II and III aged from 40 to 55 years. The dynamics of subjective and objective neurologic symptoms, cognitive values (MMSE, MoCa, watch drawing test, 10 words memorizing test) was assessed, speed of simple visual and motor reaction was evaluated. The study results demonstrated high effectiveness of complex therapy with use of Vinpocetine with respect to cognitive disturbances, major neurologic syndromes and functional possibilities of the brain in conditions of chronic ischemia in DE patients of middle age.

The spectrum of the nervous system diseases in which administration of B vitamins is pathogenetically justified, especially thiamine, pyridoxine and cyanocobalamin, is varied. The diseases include dysmetabolic, toxic, infectious lesions of the central and peripheral nervous system, neurological manifestation of degenerative spine diseases, and pain syndromes. B-group vitamins possess neuroprotective and analgesic properties, can be combined with other pharmacological classes of drugs, thus allowing to achieve a positive therapeutic effect with a lower dose of those and reducing the risk of adverse effects.

The article provides current scientific data on the pathogenesis and symptoms of chronic urticaria; international recommendations for treatment and place of antihistamine drugs; clinical pharmacology of the new antihistamines of the 2nd and 3rd generation; results of clinical trials and meta-analyses on comparative effectiveness of antihistamines in treatment of chronic urticaria.

Inflammatory diseases of the oropharynx – tonsillopharyngites – take one of the leading places among all pathologies of ENTorgans by incidence among population and the amount of applications to doctors. This is related to presence of the multiple exogenous and endogenous risk factors.

In the treatment of patients with diseases of the upper and lower respiratory tract it is necessary to conduct anti-inflammatory therapy. Up to the present time two groups of anti-inflammatory drugs were used: corticosteroids (CSs) and non-steroidal antiinflammatory drugs (NSAIDs). In recent years, a new anti-inflammatory drug - fenspiride, which chemical structure and pharmacological properties different from both the CSs and NSAIDs. By the chemical structure it represents diazospyrodecanone and has anti-inflammatory properties, different from classical anti-inflammatory drugs.

A considerable segment in the structure of gastrointestinal tracts diseases is represented by the functional pathology. This sufficiently large and heterogeneous group of diseases unites nosologic forms different by pathogenesis (functional abdominal pain, functional constipation, irritable bowel syndrome (IBS), functional flatulency etc.) different by pathogenesis, the similarity of which is based on their functional nature.

Acute infectious diarrheal diseases by the terminology of the World Health Organization or acute intestinal infections (AII) as they are called in Russia is a large group of acute infectious diseases characterized by development in patient of the diarrheal syndrome. The article provides statistical data on the incidence rate of AII among children that take one of the leading places in the structure of the infectious pathology and characterizing by the high mortality rate. Special attention is given to pathogenesis and therapy of acute viral intestinal diseases.

Irritable bowel syndrome is seen as a «reference» for understanding pathogenetic essence of functional gastrointestinal disorders. At the basis of functional gastrointestinal disorders are combined morphological and physiological abnormalities associated with visceral hypersensitivity, impaired gastrointestinal motility, the protective mucosal barrier, immune function and composition of the intestinal microbiota, as well as disorders of the central nervous system. An important problem is the optimization of drug therapy in the treatment strategy implying functional gastrointestinal disorders priority to the use of drugs that have a multipurpose effect, simultaneously affecting several pathogenetic links of these diseases, or have a beneficial effect in the presence of comorbid pathology. This review considered trimebutine possibilities for the treatment of functional gastrointestinal disorders.

NSAID-induced lesions of the gastrointestinal tract gained wide spread in the recent decade. Their range includes lesion of the esophagus, syndrome of dyspepsia, gastropathy and enteropathy. Diagnosis establishment of enteropathy is complicated and became possible after introduction of the capsule endoscopy. PPI are used for treatment of gastropathy, but they are not effective for treating enteropathy. Cytoprotective prostaglandins play the key role in the development of NSAID lesions of the gastrointestinal tract. Synthetic analogues of prostaglandins of misoprostol type possess cytoprotective action, but cause a significant number of adverse events. Rebamipide, a new gastroprotective agent in Russia stimulates production of endogenous prostaglandins. This drug proved its efficacy during the clinical trials performed according to the standards of the evidence-based medicine.

Preventive measures to prevent magnesium deficit at the stage of preparation to pregnancy as well as during gestation starting from its early terms will allow optimizing the course of pregnancy, avoiding some complications and improving outcomes for the fetus and the newborn.

Human papilloma virus (HPV) infection is a major challenge to modern health care. At the moment there is only one way to effectively prevent diseases associated with HPV. There is vaccination. The available vaccines prevent most cases of HPVassociated diseases and can significantly reduce the financial burden of this infection. The article evaluated the economic and demographic burden of HPV-associated diseases in the Russian Federation, and also identifies the possible reduction of this burden with timely vaccination of girls by quadrivalent vaccine.

Prostate adenoma is a polygenic disease manifested by enlargement of the prostate gland and impaired urination. Benign prostatic hyperplasia (BPH) is quite common, many researchers say about the inevitability of this condition in men, however, prostate enlargement is not always evident clinically. The majority of patients suffering from BPH have no complaints for a long time. Depending on severity of clinical manifestations, patients may be offered dynamic follow-up, medical therapy or surgical treatment. Analysis of the existing literature has shown a possibility of effective use of Type 5 phosphodiesterase inhibitors (PDE-5) not only in the treatment of erectile dysfunction (ED) but also in the treatment of lower urinary tract symptoms (LUTS) in patients with benign prostatic hyperplasia. The only drug of the PDE-5 inhibitors group registered for treatment of LUTS in BPH is tadalafil use of which in equal shares is manifested by reduced severity of moderate and severe symptoms of accumulation and discharge in men with erectile dysfunction and not affected by it.

A deeper understanding of the pathogenesis of the 2nd type diabetes mellitus, including postprandial control of glucose homeostasis has led to new treatment strategies aimed at overcoming the dysfunction in the pancreatic islets and, in particular, acting on the incretin hormones of the gut. Inhibitors of dipeptidyl peptidase-4 (DPP-4) are one of the first classes of oral drugs for the treatment of diabetes, developed specifically as antihyperglycemics drugs. The inhibition of the destruction of the incretin hormone -- glucagonoma peptide-1 -- has a positive effect on glucose homeostasis (including potentiation of glucose-induced increase in the level of insulin and suppression of glucagon secretion). Low risk of hypoglycemia, no significant side effects and effect on body weight distinguish the class of DPP-4 inhibitors from other groups of oral hypoglycemic tools.

Diabe tes mellitus is chronical disease, lead to vascular complications. The safety of hypoglycemic therapy influences on cardiovascular complications. In this review results of some large-scale clinic trials directed to prevention of cardiovascular complications are provided.

Effectiveness of sugar-lowering therapy depends on both betimes started therapy and genetically defined features of a patient. Single nucleotide polymorphism of genes may be perspective and approved by pharmacoeconomical analyses. We observed 89 patients with newly diagnosed diabetes mellitus type 2 and 80 subjects without impaired glucose metabolism. We found out 2 types of patients- with “response phenotype“ and “fail phenotype”. CER showed that genotyping before prescribing metformin in order to find out “fail phenotype” to avoid lack of effectiveness could reduce expenses.

This paper presents the results of treatment and prevention of chronic catarrhal gingivitis by including in a set of individual hygienic measures of vegetable-based oral rinse which determines its antiseptic and anti-inflammatory properties. Also the oral rinse providing anti-caries effect can be recommended for daily prevention of periodontal disease and caries. The examination involved 40 patients aged 18–28 years old with a diagnosis of chronic generalized catarrhal gingivitis who were divided into two groups. The comparison group (20 persons) received treatment according to the generally accepted standard scheme, the main group (20 patients) received standard therapy and an oral rinse. The analysis of the obtained results indicated clinical efficiency of the use of oral rinse in a set of individual hygienic measures, exerting a positive influence on shortening of inflammation in the periodontium. Daily use of oral use based on vegetable components and fluoride inhibits growth of pathogenic microflora of dental plaque and creates conditions for lasting remission of catarrhal gingivitis.

The article discusses possible changes in the organs and tissues of the oral cavity in diseases of the digestive system, as well as changes occurring under the influence of drug therapy of these diseases. For the prevention and treatment of inflammatory changes of the oral cavity in gastroenterological patients may use drug and Parodontocide.

Parodontium inflammatory diseases is a widespread pathology. Reasonable application of oral hygiene means allows prevention of the process of formation and development of the tooth deposits and consequently avoidance of inflammatory disease development in the gum adjoining the tooth. The article provides an individual hygienic program of dental disease prevention, i.e. recommendations to clean teeth two times per day doesn’t correspond to modern ideas about oral hygiene.

The clinical course of the adenoviral ophthalmic infection is sufficiently variable. The gravity of clinical manifestations depends on many factors: the strain of the causative agent, dosage of the penetrated agent, the state of the local and systemic immunity of the patient etc. At the same time the number of patients with grave forms of adenoviral ophthalmoinfection is permanently growing. The presence of the systemic allergy in anamnesis classifies this group of adenoviral ophthalmologic infection patients in a group of hyperergic reaction risk group. The duration and gravity of the acute inflammatory process, intensity of the conducted therapy might lead to the development of grave complications.

The article deals with major complications and mistakes concerning effectiveness and safety of hypolipidemic therapy in the general clinical practice.

Enteral nutrition (EN) – the type of therapeutic or supplementary feeding special mixtures, in which the absorption of food (when it arrives in the mouth through a tube in the stomach or intestines) is performed physiologically appropriate way, that is through the mucous membranes of the gastrointestinal tract. This review will address such aspects of enteral nutrition (EN) in patients who are in intensive care unit (ICU), the composition, components, methods of delivery, complications of EP.

The article evaluated safety of laparoscopic gastric banding with alimentary-constitutional obesity, explored a possibility to prevent complications in the late postoperative period, periods of hospital treatment and temporary disability after laparoscopic gastric banding in the uncomplicated postoperative period.

In the course of work 143 medical inpatient cards were studied by a method of retrospective pharmacoepidemiologic analysis for their compliance with national recommendations and standards. Only 47.5% of patients receive the recommended basic therapy. The most common mistakes: insufficient broncholytic therapy, prescription of iGCS if there are no indications for them; excessive use of antibacterial drugs; use of irrationally lowered dosages of sGCS. The obtained results are indicative of the fact that for the purposes of increase of the therapy effectiveness educational programs on therapy of COPD for doctors of inpatient clinics as well as administrative control of implementation of federal clinical recommendations on COPD are required.