The correction of anemia in severe resistant heart failure with erythropoietin and intravenous iron prevents the progression of both the heart and the renal failure and markedly reduces hospitalization

Both Congestive Heart Failure (CHF) and Chronic Renal Failure (CRF) are increasing steadily in the community. We propose that there is a vicious circle established whereby CHF and CRF both cause anemia and the anemia then worsens both the CHF and CRF causing more anemia and so on. We call this the Cardio Renal Anemia (CRA) syndrome. By the combination of active treatment of the CHF and control of the anemia with subcutaneous erythropoietin and intravenous iron, the progression of both the CHF and the CRF can be slowed or stopped in most cases, the quality of life improved and the need for recurrent hospitalization reduced. This will involve cooperation between internists, cardiologists, and nephrologists to allow early and maximal therapy of both the CHF and the anemia.     

Oxyhemoglobin produces apoptosis and necrosis in cultured smooth muscle cells

Confluent rat aortic smooth muscle cells were treated with OxyHb in a concentration- and time-dependent manner. A high concentration of OxyHb (100 microM) within 24 h decreased cell density. DNA analysis showed a smear pattern characteristic of cell necrosis. Transmission electron microscopy demonstrated disintegration of the cell membrane and destruction of cell organelles. Western blotting using PARP antibody revealed that 116 kDa PARP was not cleaved to 85 kDa, an apoptosis-related fragment. On the contrary, a low concentration of OxyHb (10 microM) produced apoptotic cell death at 72 h that was supported by DNA analysis and TUNEL staining. These results demonstrated that a high level of OxyHb induced necrosis within 24 h and a low concentration of OxyHb produced apoptosis after 72 h in cultured smooth muscle cells. Morphological alterations induced by OxyHb might contribute to the vascular wall changes in the cerebral arteries following subarachnoid hemorrhage (SAH).     

Alternative hospital forms of medical care in Russia and abroad

According to the available statistical data 80% of the patients begin and complete treatment in polyclinic. Now it becomes necessary to use more widely the low-expensive hospital-substitutive technologies, i.e. the day hospital and the hospital at home. Since 1989 the day hospital containing 10 beds and with two shift system functions on the base of RF MD CDC N 52. The bed turnover is not less than 3, 5, the mean bed/day is 12. 1500 patients are treated every year, among them 63% are therapeutic, 26% are surgical and 10.4% are neurological patients. More than 40% of those who need the hospital treatment are treated here. In the hospital at home 71% are the patients with diseases of lower extremity vessels, 12.5%--with trauma, 9.45%--with cardiovascular pathology and 6.3%--with respiratory diseases. Compared with the hospital beds the savings amount to 60-70%.     

Single-chip microcomputer system for auricular diagnosis and treatment

All-Union Biomedical Engineering Research and Development Institute, USSR Ministry of Health Care, Moscow. Translated from Meditsinskaya Tekhnika, No. 2, pp. 25–27, March–April, 1990.