Vol 27, No 2 (2021)

This literature review focuses on the choice of treatment strategies in patients with aortic stenosis. The main surgical techniques for this condition are presented. The rationale for the efficiency of transcatheter aortic valve implantation is provided. The results of studies comparing the outcomes of surgical and endovascular correction of aortic stenosis are analyzed. Particular attention is paid to the treatment choices in patients with aortic stenosis and a history of coronary artery bypass grafting. Conclusions on the perspectives of transcatheter aortic valve implantation in this cohort of patients are reached.

This review presents information on cases of antibiotic failure (insufficient effect) in the global population over the past three years. We analyzed scientific papers, clinical trial data, and the WHO Program for International Drug Monitoring (VigiBase) data from 2018 to 2020. The values of global success and safety rates of antibacterial drugs for medical use are presented. The findings may be of practical interest to physicians, researchers, developers, and healthcare regulators.

The peculiarities of immune responses to a novel coronavirus infection (COVID-19) and the possibility of reinfection due to the variability of humoral immunity are currently under discussion. This article presents a case of COVID-19 reinfection in a health care worker.

BACKGROUND: Despite their targeted effects, targeted drug therapies also lead to adverse events, including various cardiac effects.

AIM: This study aims to determine the possibility of treating cardiovascular diseases underlying or occurring as a side effect of ibrutinib treatment without blocking targeted therapy for chronic lymphocytic leukemia (CLL).

MATERIALS AND METHODS: From 2016 to the present, we have examined and followed 217 patients with CLL who were continuously treated with ibrutinib targeted therapy for five years. The study included patients with CLL, aged 32 to 91 years [median age of 66.0 (32.0–91.0) years], including 136 men aged 66.0 (32.0–91.0) years and 81 women aged 65.0 (39.0–83.0) years. All patients underwent electrocardiography, echocardiography, 24-hour electrocardiographic Holter monitoring, 24-hour blood pressure monitoring, assessment of comorbidities using the Charlson Index, and screening for fragility using the G8 questionnaire.

RESULTS: Active cardiac monitoring, including continuous remote monitoring of cardioprotective therapy intake and efficiency, allows oncohematological patients to achieve higher overall survival rates. The long-term monitoring group included a statistically significant number of patients with atrial fibrillation and/or arterial hypertension and patients who receive dual and triple antithrombotic therapy. This group included patients with CLL and more severe cardiac status than other patients, who were regularly observed by a cardiologist.

CONCLUSIONS: Widespread introduction of the techniques for continuous remote monitoring of the oncological patient’s condition into clinical practice will improve the patients’ quality of life and increase their life expectancy.

A high level of morbidity and mortality from cardiovascular diseases remains prevalent in the Russian Federation, despite a decreasing trend that emerged in recent years. Rhythm and conduction disorders play an essential role in the thanatogenesis of cardiovascular pathology, which determines the medical and social significance of their pharmacotherapy. This is indicated by the stable demand for antidysrhythmic drugs from both the state and the population. This is evidenced by high levels of public procurements and retail sales of “drugs for the treatment of cardiovascular diseases,” since patients take this drug group for a long time and often permanently. Our marketing analysis of the antidysrhythmic drugs market used current open data from the State Register of Medicines and the State Register of Maximum Selling Prices and available analytical data. It showed that from 54.5% (metoprolol drugs) to 100% (procainamide drugs) of the market share is occupied by generic drugs made in Russia. The presented analysis confirms the assumption of a significant increase in the share of generic drugs in public procurements. This is associated with the implementation of the drug safety program for vital and essential drugs and the optimization of costs by the state. A priority of the state drug policy in Russia is to monitor the effectiveness and safety throughout its entire life cycle. Moreover, particular importance should be given to the issue of interchangeability, which is regulated by Federal Law No. 1360 dated September 5, 2020, “On the Procedure for Determining the Interchangeability of Medicines for Medical Use.” The annual increase in the share of generic domestic antidysrhythmic drugs on the market poses the problem of selecting the most efficient and safe approach to pharmacotherapy for practicing specialists. The solution may be to develop and implement open automated information systems for the safety profiles of the original and generic antidysrhythmic drugs.

BACKGROUND: The use of telemedicine in providing outpatient care for COVID-19 patients is an integral part of the most intensively developing and promising areas of national health care.

AIM: This study aims to demonstrate the efficiency of using telemedicine technologies in outpatient care for COVID-19 patients.

MATERIALS AND METHODS: This study is the retrospective analysis of remote consultations for 57,256 patients with COVID-19 from April 1, 2020, to May 24, 2020.

RESULTS AND DISCUSSION: The results of human resource analyses, the physician workloads, and the categories of observed patient categories are presented. The majority of patients were asymptomatic (45%), a mild form of the disease was observed in 4534 (34%) patients, and moderate cases were observed in 2800 (21%) patients. Concomitant pathology was observed in 60.0% of patients. The capacity of the telemedicine center was 52.8 patients for one physician per shift.

CONCLUSIONS: The telemedicine structure of the center, which regulates the interactions of physicians with patients and other healthcare facilities, has enabled the appropriate use of human resources to ensure that therapeutic, diagnostic, and epidemiological activities are adequate and timely in outpatient settings.