SUMMARY Ethmozin, a phenothiazine derivative, is an antiarrhythmic drug synthesized in the USSR. Preliminary data suggest that it is effective against a diversity of ectopic arrhythmias. The present study, carried out in the USSR, was designed to assess efficacy and patient tolerance of this new drug. Thirty-seven patients with chronic, persistent, frequent and symptomatic ventricular premature complexes (VPCs) were studied. VPCs were exposed by means of 24-hour ambulatory monitoring and exercise stress testing. Two drug schedules were used. Group 1, consisting of 11 patients, received 225 mg/day of ethmozin, while group 2, consisting of 26 patients, received 600 mg/day. Acute drug testing with a single large dose of ethmozin was followed by multiple dosing for a minimum of 4 days. Placebo was given in a single-blind fashion only to responders.Only two patients in group 1 had a significant reduction in VPCs as evaluated by both monitoring and exercise testing. Fourteen patients in group 2 (54%) showed striking suppression of VPCs. Mild and transient effects were encountered in only four of the 37 patients. We conclude that ethmozin appears to be a welltolerated, relatively effective agent for controlling VPCs.PATIENTS with ventricular arrhythmias are being detected in increasing numbers because of the widespread use of ambulatory monitoring and exercise stress testing. Currently available antiarrhythmic drugs, however, are not consistently effective, safe, or well tolerated. There is an urgent need for drugs that suppress ventricular arrhythmias, cause minimal adverse reactions and have a prolonged duration of action so as to gain patient acceptance and adherence.In 1965, the Institute of Pharmacology of the USSR Academy of Medical Sciences synthesized a new antiarrhythmic drug, ethmozin, the hydrochloride of 1 0-(3-morpholinopropionyl)-phenothiazine-2-carbamic acid, ethylester ( fig. 1). Early reports in the USSR have shown that ethmozin effectively controls From the

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The article gives a critical assessment of the so-called obesity paradox. Methodological errors that occur in the organization of studies that studied the obesity paradox and the formation of comparison groups are highlighted. There are also examples of the disappearance of the obesity paradox when taking into account additional risk factors. The organization of prospective studies or more careful consideration of all currently known risk factors for cardiovascular diseases (CVD) will significantly improve the results of the study of the effect of overweight and obesity on mortality in patients with CVD. Thus, despite the biological possibility of the existence of a positive effect of adipose tissue in CVD, the presence of a large number of errors identified in the analysis of the work of researchers obesity paradox require to reconsider the existence of this phenomenon, it should be taken into account the possibility that the obesity paradox may be a consequence of improper design studies to investigate this phenomenon.