2016 Issue №2

The author uses the notion of residual risk for the assessment of myocardial infarction (MI). In the acute phase of myocardial infarction, the majority of patients have remodelling of the myocardium with a predominant combination of cavity dilatation and hypertrophic left ventricle. One third of patients having endothelial dysfunction have remodelling of the myocardium. It explains a greater frequency of angina pectoris and the development of heart failure symptoms. Persistent remodelling is associated with impaired endothelium-dependent vasodilation; a significant number of patients develop paradoxical vasoconstriction. A combination of these factors largely determines the degree of residual risk after myocardial infarction. In addition to standard therapy, post-MI therapy should be aimed at correcting the remodelling of blood vessels and the myocardium. It will prevent the development of delayed complications.

The authors evaluated the effectiveness of a complex conservative therapy in childless women of reproductive age having atypical endometrial hyperplasia and well-differentiated endometrial carcinoma. The study examines the effectiveness of combining the gonadotropin-releasing hormone agonist (GnRH) and the levonorgestrel-releasing intrauterine system. All patients had immunohistochemical staining for ER, PR, ki-67, bcl-2, p 53, E-cadherin before and after treatment. From 2008 to 2015, none of the patients had a progression of the disease; all patients have exceeded the five year survival rate. 15 patients (30 %) had spontaneous pregnancy. A combination of GnRH and LNG-IUD proved to be highly efficient for treating atypical endometrial hyperplasia (AEH) and EC-G1.

The author studies pain relief effect of flupirtine in patients with diabetic polyneuritis. In the conducted study, 112 patients were treated with flupirtine: 102 (91.1 %) men and 9 (8.9 %) women. All patients had diabetes with clinical manifestations of sensorimotor polyneuropathy accompanied by pain. The author proves that flupirtine can be successfully used for pain relief as part of a complex therapy in both inpatient and outpatient departments.

The article describes endosurgical treatment of obstructive jaundice caused by large and multiple calculi of the bile ducts. The authors analyse reasons for a decreasing efficiency of the method and offer a more advanced operating technique. The article contains a comparative study of the proposed technique and the traditional endosurgery and open surgery methods.