Russia is among the countries where using of mucolytic drugs in clinical practice is widespread. In chronic bronchitis, chronic obstructive pulmonary disease, acute respiratory syndrome with prolonged cough, pneumonia, tuberculosis and many other pathologies using of expectorants and mucoregulating drugs is common. Among the synthetic mucolytics benzyalamine bromhexine has been introduced for a long time in practice; and then its derivative — ambroxol hydrochloride which has better pharmacokinetics and pharmacodynamics. Using of ambroxol (Ambrobene) in patients with cough, accompanied by difficult expectoration, is useful as it promotes the implementation of the protective cough reflex, providing evacuation of viscous mucus or foreign particles from the respiratory tract.

Ischemic renal disease for a long time has no specific symptoms. This work is aimed at finding markers of early diagnosis of ischemic renal disease in patients with coronary heart disease. The patients’ age, duration of ischemic heart disease, lipid disorders are risk factors for ischemic nephropathy. Given pathognomonic of arterial hypertension in patients with ischemic nephropathy, hyposthenuria can be included into the complex criteria for its early diagnosis.

The study involved 112 patients with chronic obstructive pulmonary disease (COPD) of varying severity, and 13 patients with coronary heart disease (CHD). Patients with COPD and comorbidity CHD revealed increased activity of systemic inflammation in the form of increased serum levels of leukocytes, fibrinogen, CRP, TNF-α, IL-8, IFN-γ, as compared with isolated COPD. High activity of cytokines TNF-α, IL-8 correlates with the severity of bronchial obstruction, myocardial dysfunction, severity of comorbidity. The correlation between high activity TNF-α, IFN-γ with dyslipidemia and atherosclerosis.

Today medical literature rarely discusses medical ethics. We do not consider the causes of loss of interest in such an important position of social humanism of modern medicine, as main purpose of our study is the differentiated assessment of the situation today — trend of dehumanizing doctor and patient relationship.

Until now some aspects of relation between atherosclerosis in coronary heart disease and type 2 diabetes mellitus remain unclear. This review reflects role of free fatty acids, cytokines and hormones produced by adipocytes, the mechanism of insulin resistance in type 2 diabetes. Effect of insulin on oxidative stress, endothelial dysfunction development, reduced nitric oxide secretion, smooth muscle cell hyperplasia, changing the content of plasminogen activator inhibitor were studied. We also showed possible mechanisms of insulin resistance and coronary artery disease drugs influence on prevention of atherosclerosis used in the treatment of patients with type 2 diabetes.

Aim – to define cardio and nephroprotective properties of statins inclusion in a treatment of patients with diabetes 2 types with arterial hypertension.The decrease cholesterol level in statin group of patients with diabetes 2 types with arterial hypertension was revealed. Cardioprotective action of statins expressed in lack of increase of myocardium mass is noted. Reduction of expressiveness of a microalbuminuria and lack of decrease in speed of GFR is revealed at statin group.

The article discusses the questions of pathogenesis, clinic, diagnosis and differential diagnosis of fever, caused by visceral non-infectious pathology, including tumors, haemopathies, rheumatic diseases ,imunocomplex and neuroendocrine abnormalities. Are some of the algorithms of diagnostics at the hyperthermia for General practitioners, including assessment of haematologia.

Окончание статьи читайте в № 5 журнала «Архивъ внутренней медицины».

The problem of effective neuroprotection is one of the most actual till now. Administration citicoline for achieve neuronal membrane metabolism normalization was discussed according to evidence-based medicine. Results of metaanalyzes including safe use of citicoline in both oral and parenteral were showing same effects.

Authors provide results of their own clinical experience of treatment patients with gastro-esophageal reflux disease. Authors use two types of treatment (both for 12 weeks) with inhibitors of proton pomp: in standard and high doses of omeprazole and pantoprazole. Design of trail was prospective, 76-weeks of follow up. End points: frequency of relapses as an integral indication of effectiveness of basic treatment.

We carried out a comprehensive evaluation of cellular and humoral immunity, nonspecific inflammation markers and their relationship to the thickness of the intima-media of the carotid arteries and the impact of changes in these parameters on the nature of coronary artery disease. The study included 44 patients with chronic forms of coronary artery disease and 35 healthy individuals. In patients with ischemic heart disease has changed mainly of innate immunity, such as the activation of NK-cells (CD16, CD 56), CD 4+CD25+, with regulatory activity in respect of the synthesis of pro- and — inflammatory and anti-inflammatory cytokines, as well as an increase in the level of antiphospholipid antibodies, CRP and the thickness of the complex of intima-media of the carotid arteries, the degree of change in the links of the immunity reflects the severity of the disease.

Different psychotropic medicines and psychotherapy are used for correction of psychopathological disorders in cardiac patients. We present experience of separate monopsychofarmacotherapy and combined with psychotherapy in 242 cardiac patients with hypertension, atrial fibrillation, ischemic heart disease. Positive effect of pharmacotherapy observed in average in 68,2% cases, pharmacotherapy combined with psychotherapy - in 75,6% of cases. It is shown that taking psychotropic drugs and psychotherapy tends to reduce the frequency of exacerbations of heart diseases, reduces frequency of visits to a cardiologist.

The all-Russian frequency data of ulcerative colitis and Crohn’s disease are resulted in the article, the case report reflecting the difficulties of differential diagnostics of ulcerative colitis and Crohn’s disease is presented.

In line with the few, including controversial, publications authors analyze clinic illness and cause of death of Alfred Nobel — the man who established a prestigious award which is annually given to the most worthy people from different corners of the globe.