Ginkgo Biloba as a cognitive enhancer

Ginkgo Biloba preparations exhibit nootropic activity in the absence of side effects, which is confirmed by numerous experimental observations and clinical results. The neuroprotector effect of these drugs is based on the antitoxicant action, antioxidant properties, and the ability to normalize the neuromediator and energy transfer mechanisms in cerebral neurons. In this review, recent data on the influence of various Ginkgo Biloba preparations on the cognitive functions in animals and humans and neurochemical mechanisms of the nootropic effect are summarized.     

Diagnostic and management algorithm of acute pancreatitis

The analysis of diagnostics and treatment of 602 patients with destructive pancreatitis has shown that definition of etiological and pathogenetic forms of pancreatitis defines strategy of treatment. In this way, patients with biliary pancreatitis require emergency operative treatment with use of endoscopic interventions without dependence from a stage of disease. To patients with alcoholic or alimentary pancreatitis in the stage of enzymatic toxemia conservative treatment should be spent only, until shock and/or delirium won't be reduced. Endoscopic retrograde cholangiopancreatography + endoscopic papillosphincterotomy with concrement removal from common bile duct--is the operation of choice in case of acute biliary pancreatitis at the first stage. Laparoscopic cholecystectomy is the operation of choice at the second stage of disease. At destructive pancreatitis of other origin in a stage of the infection or necrotic suppurative inflammation use of open and closed small invasive methods of intervention is most proved. Given tactics of treatment has allowed to lower severity of clinical course, frequency of complications and lethality.     

Antiischemic efficacy of trimetazidine in patients with intermittent claudication and effort angina

Male patients (n=42) with atherosclerosis obliterans and stage IIA-III ischemia of lower extremities combined with class II-III angina pectoris were divided into 2 groups. Patients of group 1 (n=21) were given simvastatin (10-20 mg/day), clopidogrel (75 mg/day) and trimetazidine (60 mg/day) for 6 months, those of group 2 - simvastatin and clopidogrel also for 6 months. Statistically significant decreases of frequency of attacks of angina, nitroglycerine consumption and increases of walking distance occurred only in group 1.     

The detection rate and clinical and diagnostic values of L forms of the pathogen in patients with pulmonary or extrapulmonary tuberculosis

The detection rate and clinical and diagnostic values of L-forms of pathogens were determined in patients with pulmonary and extrapulmonary tuberculosis. Simultaneous culturing the specimens for typical and L forms of Mycobacterium tuberculosis (MBT) increased the number of positive results by isolating only L-forms by 10.3% in patients with pulmonary tuberculosis and by 27.7% in those with extrapulmonary tuberculosis. No bacterial isolation in tests only for typical forms of MBT is shown not to be true and a purposeful search for L-forms of MBT enhances the efficiency of a bacteriological test. This is of great significance in confirming the specific nature of the disease, its progression, in choosing a treatment policy, in evaluating is efficiency, in defining prognosis, and in correcting preventive measures in the focus of tuberculous infection. With extrapulmonary tuberculosis, the tuberculous nature of isolated L-forms has been evidenced by the polymerase chain reaction.     

Genotyping of spotted tick fever rickettsiae, detected in Russia and Kazakhstan

R. slovaca was first detected in the ticks D. marginatus gathered in the Stavropol Territory and the Voronezh Region (European Russia). The recently discovered rickettsial genotype DnS14 was first found in the ticks D. silvarum from Buryatia and D. niveus from the Karaganda Region (Central Kazakhstan). The rickettsial genotype RpA4 was most common in the ticks of the genus Dermacentor in Russia and Central Kazakhstan. An analysis of the spread of rickettsias of the STF group shows their close ecological relation to definite types of Ixodes. The rickettsias R. slovaca and RpA4 co-exist in the ticks D. marginatus and D. reticulatus (the western part of a Dermacentor area in Eurasia) and DnS14 and R. sibirica do in D. nuttalli and D. silvarum (the eastern part of the area). D. marginatus and D. reticulatus in the areas characterized by the most specific saturation of a Dermacentor area (the south of West Siberia) are carriers and reservoir of R. sibirica. The rickettsial genotype DnS28 may be now considered to be environmentally associated with one species of ticks--D. nuttalli. At least 6 genotypes of STF rickettsias--R. sibirica, R. astrahan fever (R. conorii), R. slovaca, RpA4, DnS14, DnS28--has been currently identified in Russia and Kazakhstan.     

The no-reflow phenomenon and its clinical significance

The no-reflow phenomenon is characterized by inadequate myocardial perfusion without angiographic manifestations of mechanical vascular occlusion. The phenomenon occurs after coronary vascular interventions (coronary angiography, percutaneous coronary angioplasty, stenting, coronary artery bypass surgery). The development of the no-reflow phenomenon significantly worsens clinical evolution of disease increasing the number of cases of congestive heart failure and hospital mortality. Changes of endothelial function and morphology, changes of blood rheology and microvascular autoregulation are important for pathogenesis of the phenomenon. The treatment include intracoronary introduction of verapamil, adenosine, intravenous introduction of activators of KATP channels (nicorandil), inhibitors of glycoprotein IIb/IIIa receptors. The reasons for early preventive use of intracoronary introduction of verapamil and other drugs in the presence of risk of development of no-reflow phenomenon are presented. The interrelationship between no-reflow phenomenon and syndrome X is also stressed.