The origin of hypertrophic cardiomyopathy

The author describes the clinical cases of hypertrophic cardiomyopathy (CMP). The development of obstructive CMP in a patient with hyperparathyroidism indicates a possible pathogenetic role of endocrine factors and calcium metabolism abnormalities. The familial character of the disease and its combination with hereditary diseases (familial microspherocytosis) point to the significance of genetic factors. In addition, marked hypertrophy of the myocardium (without dilatation) including hypertrophy with obstruction of the outflow tract of the left ventricle was observed in nonspecific protracted myocarditis, alcoholic injury to the heart, in athletes, in coronary heart disease (after survival of myocardial infarction). It is suggested that hypertrophic CMP (similarly to restrictive and congestive CMP) is most likely a syndrome of varying origin.     

Synthesis and investigation of viral-inhibitory activity of nitrogen-containing derivatives of adamantane

Translated from Khimiko-farmatsevitcheskii Zhurnal, Vol. 25, No. 7, pp. 46–49, July, 1991.     

Clinical characteristics of myxoma of the heart

The authors describe 3 cases of left atrial myxoma confirmed by two-dimensional echocardiography and at operation. One patient had the symptoms of embolisms to the cerebral and renal vessels in the absence of heart disease, 2 patients presented with the symptoms of congestive heart failure. In one patient, loud first sound as well as systolic and diastolic murmur at the heart apex were documented. The nonspecific manifestations (weight loss, fever, high ESR, dysproteinemia, and rheumatoid factor) were observed in all the cases. The difficulties encountered in the clinical diagnosis of heart myxoma are discussed. The differential diagnosis is made between valvular heart disease and infective endocarditis, systemic vasculitis, cardiomyopathy, etc. Echocardiography to exclude myxoma should be performed in patients with thromboembolism, rheumatic valvular disease, subacute endocarditis (particularly in the absence of the classical symptoms) and in those with fever of unknown origin.     

Diagnosis, clinical picture and therapy of acute radiation disease in victims of the accident at the Chernobyl nuclear power station. I. Conditions of irradiation, dose levels, bone marrow syndrome and its therapy

A follow-up of 115 patients with acute radiation disease resulting from external gamma-beta-radiation confirmed a high value of the previously proposed principles of predicting a degree of severity on the basis of the clinical manifestations of a primary reaction of disease and some syndromes using methods of hematological and cytogenetic analysis. Early isolation of patients with ARD of II-IV degree, selective intestinal decontamination, administration of antibiotics of a broad spectrum of action, antimycotic and antiviral drugs, and gamma-globulin can practically eliminate the risk of development of fatal infectious complications in medullary and transient types of radiation disease. The efficient use of thrombomass transfusion completely prevents development of the thrombocytopenic hemorrhagic syndrome. Experience in bone marrow transplantation requires a review of therapeutic indications.     

Asthma of physical effort and the effect of nifedipine and diltiazem]

In 13 patients with bronchial obstruction due to or enhanced by effort, the bronchodilatory effects of calcium antagonists (nifedipine and diltiazem) were studied and compared during the two-week treatment with each drug with a weekly interval. The appearance of bronchospasm at the 3d-5th minute after submaximal exercise (decrease of the volume of forced expiration during 1s by not less than 20% of the initial value) was regarded as a sign of asthma of effort. In 4 patients, bronchial obstruction in response to exercise was the only clinical sign of the disease, in 6 it was coupled with allergy, and in 3 patients, it aggravated the health status during exacerbation of bronchopulmonary infection. The patients were under observation during clinical remission of the disease. The clinical and instrumental data were estimated to reveal no well-defined correlation between the drugs. Both of them influenced bronchial patency, mainly at the level of the large and medium bronchi. Nifedipine was found to produce a more remarkable bronchodilatory effect.