Terapevt Arkh
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The review on the problem of the pulmonary heart pursues two goals: firstly, to restore historical justice and to show the priority studies of doctor Dmitry D. Pletnev on such problems as diagnosis of right ventricular myocardial infarction, clinical characteristics of congestive heart failure of the right ventricle; secondly, to outline the modern concept of the pulmonary heart. ⋯ Much attention is paid to echo cardiography data and biological markers are emphasized in assessing the function of the right atrium, right ventricle, tricuspid valve regurgitation, pulmonary artery pressure. Prognostically unfavorable signs of the course of the pulmonary heart have been identified, which include a high degree of tricuspid valve regurgitation, the amplitude of movement of the fibrous valve ring (TAPSE) and atrial fibrillation developing with dilation of the right atrium.
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A meeting of Interdisciplinary Expert Panel with leading specialists in the field of orthopedics/traumatology, surgery, rheumatology, and neurology was held in Moscow on February 10, 2023. The purpose of the meeting was to discuss the current status of local injection therapy (LIT) in Russia and the rationale behind the use of collagen-based products for various musculoskeletal disorders. The experts considered the following issues: (1) General contraindications to the use of medical products based on tropocollagen as well as an algorithm for actions in case of adverse events; (2) Guidelines regarding LIT in general and LIT using tropocollagen in particular, including in combination with other LIT products; (3) Particular indications and approaches to the treatment of patients with abnormal changes in appendicular joints and spine with damage to both intra-articular structures and periarticular soft tissue.
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Review
[Chronic thromboembolic pulmonary hypertension: current diagnostic and treatment options: A review].
The article reviews current approaches to diagnosing and treating chronic thromboembolic pulmonary hypertension (CTEPH). The definition of the CTEPH is given, and its main risk factors are described. ⋯ The most rational approach to CTEPH therapy is provided; the possibilities and limitations of pulmonary endarterectomy, transluminal balloon angioplasty of the pulmonary arteries, and specific therapy of pulmonary hypertension in such patients are described. The clinical presentation and treatment of CTEPH according to the Russian Pulmonary Hypertension Registry are reviewed.
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The adverse outcomes in patients with COVID-19 in the initial phase of the disease are often due to the development of cytokine storm, endothelial dysfunction, shifts in the hemostasis system, microangiopathy, angiocentric inflammation, and pathological angiogenesis, which require targeted therapy. Unfortunately, to date, there is still no drug with proven high efficacy. This review is to analyse the literature data on the pathogenesis of vascular homeostasis lesions and possible ways to correct the existing shifts in patients with COVID-19. ⋯ That is why exogenous of succinic acid can enhance the adaptive capabilities of the organism and improve the prognosis in patients with COVID-19. Succinic acid preparations contribute to normalization of energy exchange and reduction of oxidative stress, especially in combination with inosine, nicotinamide and riboflavin and are widely used in clinical practice in various nosological forms. Taking into account the analysis of data on the mechanisms of clinical effects of succinate-containing preparations, this group of drugs can be considered as promising with regard to the correction of vascular disorders in COVID-19.
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Heart rhythm disorders are one of the most common complications of coronavirus infection. Heart rhythm disorders can develop in 6-17% of hospitalized patients, and in convalescents, COVID-19 can manifest itself up to 12 months after the completion of the acute phase of the disease. ⋯ Despite a significant amount of research, the literature data on the prevalence of certain types of cardiac arrhythmias (especially in COVID-19 convalescents), as well as methods for their correction, are somewhat contradictory and need to be clarified. Taking into account the impact of arrhythmia on the quality of life and mortality, active monitoring of convalescents of coronavirus infection, identification and development of approaches to the treatment of heart rhythm disorders in patients who have had COVID-19, seem to be relevant and promising areas in modern cardiology.