No abstract

The article provides the description of the clinical importance of comorbidity, its epidemiology, the attention is focused on the highest prevalence and prognostic significance of cardiovascular and gastrointestinal pathogenetic relations complicating the course of the cardiovascular pathology by development of erosive-ulcerative lesions of stomach and duodenum, the first manifestation of which are often life-threatening gastrointestinal bleeding. Symptomatic gastroduodenal ulcer lesions (SGUL) are described in detail including their modern definition, classification, epidemiology, clinical manifestations and diagnosis with a detailed analysis of features of pathogenesis and course of patients with cardiovascular diseases. SGUL induced by nonsteroidal anti-inflammatory drugs are analyzed including those induced by low-dose acetylsalicylic acid (NDA), risk factors for their occurrence and prevention in groups at high and moderate gastrointestinal risk are considered. The need for further scientific research of topical issues of «comorbidity» to improve diagnosis and treatment of comorbid pathology in public health practice are stressed.

This paper is a result of collaboration between personnel of Saint-Petersburg and Saransk medical universities. The purpose of the investigation was to improve treatment and secondary prevention of chronic generelized periodontitis on the base of pathogenetically substantiated scheme of laser therapy. Cohort prospective study included 98 patients (31 men and 67 women) suffered from chronic generelized periodontitis at the age from 30 to 50 years with disease prescription from 3 to 10 years. All the patients were divided into three groups: standard anti-inflammatory therapy, laser therapy, antioxidant therapy. Efficiency of periodontitis treatment in the groups was estimated by clinical laboratory data, stomatological indices (РМА, SBI, API,) resistance of gingival capillaries; degree of osseous resorption. State of lipid peroxidation (LP) was estimated by the level of malondialdehyde (MDA, Fe2+-MDA) and phospholipase А2. It was found that application of laser and metabolic therapy considerably increase efficiency of standard treatment regimen and secondary prevention of chronic periodontitis, that is manifested in significant decrease structural-functional changes and in restoration of paradontium tissues microcirculation.

Arhythmogenic right ventricular dysplasia (ADP) refers to hereditary myocardial diseases, in which there are structural and functional disorders in the right ventricular myocardium, causing rhythm and conduction disorders, including fatal ventricular arrhythmias. ADP is considered one of the most common causes of sudden cardiac death in young people and people who are engaged in sports. However, in practice, there are cases of this disease in people of an older age category. Diagnosis of ADP is still difficult due to the possible long-term asymptomatic course of the disease. The article describes a clinical case of ADP in a 48-year-old man.

The difficulties of diagnosis and management of patients with alcohol-induced heart lesions, features of the clinic of alcoholic cardiomyopathy are highlighted. Excessive and prolonged alcohol consumption increases the risk of developing acute and chronic heart failure, cardiac arrhythmias and aggravates existing cardiovascular diseases. At the same time, due to insufficient assessment of the origin of cardiac manifestations (patients often hide or downplay the fact of alcohol abuse), patients do not always receive specific treatment. The management of such patients presents significant difficulties, taking into account, among other things, the defeat of the gastrointestinal tract, central and peripheral nervous system and should be carried out jointly with doctors of other specialties.