Long Course Of Disease Research Articles

СУЧАСНІ АСПЕКТИ ДІАГНОСТИКИ ГАСТРОЕЗОФАГЕАЛЬНОЇ РЕФЛЮКСНОЇ ХВОРОБИ

Резюме: Гастроезофагеальна рефлюксна хвороба (ГЕРХ) надзвичайно поширене захворювання зумовлене порушенням моторно-евакуаторної функції органів гастроезофагеальної зони, яке характеризується спонтанним закидом шлункового або дуоденального вмісту в стравохід, що призводить до ураження його дистального відділу з розвитком у ньому запальних та ерозивно-виразкових уражень. Серед дорослого населення поширеність ГЕРХ становить до 40%.Мета роботи − проаналізувати сучасні погляди науковців і основні методи діагностики ГЕРХ.В діагностиці ГЕРХ потрібно орієнтуватися на рекомендації Монреальського консенсуса, згідно якого захворювання може бути діагностовано при наявності як мінімум одного із трьох критеріїв: а) характерних симптомів захворювання; в) інструментального підтвердження наявності патологічного гастроезофагеального рефлюксу в осіб з симптомами ГЕРХ; с) змін слизової оболонки стравоходу, гістологічного дослідження біоптату.Згідно V Маастрихтcького консенсусу рекомендовано проводити ерадикацію H-pylori незалежно від наявності чи відсутності симптомів ГЕРХ при наявності прямих показів.Діагноз ГЕРХ встановлюється на підставі клінічних критеріїв, якщо пацієнта турбує печія більше ніж двічі на тиждень впродовж трьох місяців і довше. Для діагностики ГЕРХ запропоновані тест з ІПП, альгінатний тести. Показом до проведення езофагогастродуоденоскопії (ЕГДС) у пацієнтів з ГЕРХ є наявність тривожних симптомів (дисфагія, нудота, кровотеча, зменшення маси тіла), неефективність пробного лікування (негативні альгінатний або омепразоловий тести), тривалий перебіг захворювання, вік більше 50 років. ЕГДС виконують для виявлення або виключення значних пошкоджень в окремих випадках. При типових симптомах ГЕРХ проводити ЕГДС не потрібно. При проведенні ЕГДС беруть біоптат стравоходу при ускладненнях ГЕРХ, новоутвореннях, для діагностики еозинофільного езофагіту. Для кількісного визначення впливу кислоти на стравохід та оцінки асоціації між печією та епізодами рефлюксу використовують рН-метрію в стравоході або імпеданс-метрію протягом 24 год. Стравохідний імпеданс рН застосовують у пацієнтів зі стійкими симптомами рефлюксу, які погано відповіли на стандартну терапію для оцінки як кислотної, так і некислотної рефлюксної хвороби. Для виявлення мінімальних уражень слизової оболонки стравоходу у хворих на ГЕРХ застосовують хромоскопію, ендоскопію з високою роздільністю та збільшенням, вузьку спектральну ендоскопію.Таким чином, основним методом діагностики гастроезофагеальної рефлюксної хвороби є езофагогастродуоденоскопія. Сучасні ендоскопічні технології дають можливість діагностувати ГЕРХ на ранній стадії.

A Proposal for a Patient-Oriented Five-Dimensional Approach for Surveillance and Therapy in Multiple Sclerosis.

The former and current multiple sclerosis (MS) classifications are essential for describing different phenotypes and disease dynamics. To establish personalized treatment regimes, further clinical and paraclinical parameters have to be considered such as imaging, cerebrospinal fluid (CSF) findings, past disease-modifying therapies (DMTs), and disease activity under these therapies. In clinical practice, this information is often difficult to overview. Especially, patients with a long course of disease offer an extensive medical history so that comprehending all of the necessary information can be very time consuming.

Effective of Behavioral Treatment Combined with Psychological Counseling for Female Coital Disorder of Chinese

Objective: To explore the effects of the behavioral treatment combined with psychological counseling on female coital disorder in China. Methods: One hundred and sixteen female patients with coital disorder were divided into sexual behavior training combined with psychological counseling group (group A, 59 cases) and psychological counseling alone group (group B, 57 cases). Results: Forty-five cases cured (76.27%), eight eases improved (13.56%), and six cases invalid (10.17%), the general rate of effectiveness being 89.83% in group A while eleven cases cured (19.30%), twenty-one cases improved (36.84%), and twenty-five cases invalid (43.86%), the general rate of effectiveness being 56.14% in group B. The curative effect of group A was better than group B (P Conclusions: The behavioral treatment combined with psychological counseling is significantly effective in treating female coital disorder than psychological counseling alone and its long term follow-up results show that most of patients were satisfied with their sex life. However, the response of behavioral treatment of some patients who had bad experience on sexual things in the progress of their growing up or had long course of disease were not so good which deserves our special attention in the future study.

EHealth Acceptance and New Media Preferences for Therapy Assistance Among Breast Cancer Patients.

BackgroundElectronic health (eHealth) and mobile communication-based health care (mHealth) applications have been increasingly utilized in medicine over the last decade, and have facilitated improved adherence to therapy regimens in patients with chronic conditions. Due to the long duration of breast cancer therapy, and the long course of disease in metastatic breast cancer, a need for more intensified physician-patient communication has emerged. Various support mechanisms, including new media such as mHealth and eHealth, have been proposed for this purpose.ObjectiveThe aim of this study was to analyze the correlation between sociodemographic factors, as well as health status of breast cancer patients, and their current utilization of new media, or their willingness to use Internet and mobile phone apps for improvement of therapy management.MethodsThe survey for this study was conducted anonymously during the 2012 Mamazone Projekt Diplompatient meeting (Augsburg, Germany), which hosted approximately 375 participants per day. A total of 168 questionnaires were completed. The questionnaire aimed to assess sociodemographic status, disease patterns, and current use of new media (ie, Internet, mobile phone, and mobile phone apps) in breast cancer patients. Habits and frequency of use for these new technologies, as well as patients’ affinity towards eHealth and mHealth tools for therapy management improvement, were investigated.ResultsAlmost all participants used the Internet (95.8%, 161/168), with 91.5% (151/165) also utilizing this technology for health-related issues. Approximately 23% (38/168) of respondents owned a mobile phone. When asked about their preferences for therapy assistance, 67.3% (113/168) of respondents were interested in assistance via the Internet, 25.0% (42/168) via mobile phone, and 73.2% (123/168) via call center. Patients diagnosed with breast cancer <5 years before the survey were significantly more interested in a call center than patients diagnosed >5 years before survey participation.ConclusionsThe vast majority of breast cancer patients accept the Internet for therapy assistance, which indicates that eHealth is a promising medium to improve patient-physician communication. Such technologies may improve individual disease management and ultimately lead to an enhanced adherence to therapy regimens.

The clinical features and value of macular ganglion cell complex thickness patterns in patients with optic chiasma lesion

To evaluate patterns of macular retinal ganglion cell complex thickness (mRGCCT) in patients with two types of neurologic lesions in optic chiasm region. Retrospective case review study. Visual field test was conducted with automated perimetry (HAAG-STREIT OCTOPUS101 V6.07g Seven-in-One and 2010(HFA Ⅱ750-40220-5.1.1/5.1.1) Carl Zeiss Meditec), and visual field in the central 30 degree region was measured. Three types of thickness mapping including macular retinal thickness (MRT), macular ganglion cell complex thickness (mGCCT) and peripapillary retinal nerve fiber layer (pRNFL) were recorded with TOPCON 3D-OCT 2000 spectral domain OCT. The results of OCT were compared with visual field. Sixteen cases were included in this study, male 10 cases, female 6 cases. Age 5 to 77 years (average 48.2). Neurologic lesions including pituitary tumor (9 cases), craniopharyngioma (3 cases), optic canal dysplasia in optic chiasm region (1 case), meningioma (1 case), hemangioma (1 case) and aneurysm (1 case). 14 cases have chronic, progressive, long course of disease, OCT showed characteristic perpendicular bisector delimitation, bilateral nasal mGCCT atrophy and corresponding temporal hemianopsia. 2 cases (both were pituitary tumor ) have a chronic, short duration, accelerated attack, visual acuity and visual field rapidly declined, mGCCT is swelling or approach high limit of normal range. In pRNFL thickness map, atrophy of mRNFL in temporal peripapillary and nasal macular region could be observed. Chronic, progressive, long course of disease, combined with characteristic perpendicular bisector delimitation, bilateral nasal mGCCT atrophy and corresponding temporal hemianopsia is helpful to predict lesion of disease. mGCCT map is of equal importance with visual field test for diagnosis of lesion within optic chiasm. In cases with a chronic, short disease course, and accelerated attack, mGCCT could be swelling, but pRNFL could be thinner in temporal peripapillary and nasal macular region of single or both eyes, and visual field test is thus necessary in these cases.

Epidemiology and health care situation of chronic wounds in Germany

SummaryChronic wounds are of great socioeconomic importance. Usually they are associated with a long, complicated and burdensome course of disease and require high nursing and medical expenses. The quality of life of patients with chronic wounds is substantially impaired. This article provides a systematic overview of current studies on the morbidity and the health care situation of patients with chronic wounds, especially in patients with leg ulcers in Germany.Analyses based on routine data of statutory health insurances show higher incidence and prevalence rates, for example of patients with leg ulcers, compared with previously regional surveys. The quality of care is inadequate, particularly in diagnostics and therapy of patients with leg ulcers. To date, there is undersupply and a lack of execution and deficient knowledge about the compression treatment in patients with venous leg ulcers.Thus, there is need for further action in order to establish better implementation of guidelines in the management of patients with chronic wounds.

Juvenile chronic non-bacterial osteomyelitis (CNO): Long term course of disease and response to treatment in a large institutional cohort

Chronic non-bacterial osteomyelitis (CNO) is an inflammatory disorder of the skeletal system of unknown etiology. Long-term follow-up and response to treatment data have rarely been reported. The aim of the study was to characterize the clinical, radiological, histological and laboratory data at juvenile CNO onset, and to analyze the long term treatment response.

THE METHODS OF LABORATORY DIAGNOSTICS OF UROGENITAL INFECTIONS ASSOCIATED WITH MYCOPLASMA HOMINIS AND UREAPLASMA SPP.

Wide distribution of urogenital mycoplasmas in the population, the high frequency of carrier state and a long asymptomatic course of disease, the lack of specific clinical symptoms making the diagnosis impossible without using of special laboratory tests. The review focuses on indications for mycoplasma infection screening and for an appointmentof antibiotic therapy. The most commonly used laboratory diagnostic methods of urogenital infections, associated with Mycoplasma hominis and Ureaplasma spp., with their characteristics, advantages and disadvantages are described.

Glycemic control in 374 outpatients with type 2 diabetes mellitus

Objective To analyze the glycemic control and other metabolic profiles in outpatients with type 2 diabetes mellitus(T2DM) who were only taking oral antidiabetic drugs(OADs).Methods The clinical data and laboratory findings(past 3 months) of 374 T2DM outpatients who were followed up in our hospital were collected by questionnaire survey.The participants were grouped by the types of OADs they were taking(single drug group,two drug group,and three or more drug group).The relationship of the control status of each parameter with complications or/and other metabolic abnormalities was analyzed.Results The mean glycosylated hemoglobin A1c(HbA1c) of these patients was(7.46±1.22)%,with 40.64% of them achieving the recommended glycemic target(HbA1c7.0%).Participants with body mass index(BMI) less than 24 kg/m2 achieved better glycemic control compared with those with BMI more than 24 kg/m2(P0.05).Sulphonylureas and biguanides were the most commonly used options,accounting for 51.35% in the two drug group and 71.09% in the three or more drug group.The proportion of participants with poorly controlled glycemic status (HbA1c≥8.0%) in the three or more drug group(34.12%) was significantly higher than that of participants in the other two groups(20.86%,P=0.005).Logistic regression analysis indicated that the long course of disease(OR=1.64),high BMI(OR=1.60) and the more comorbidities and complications(OR=1.60) were the risk factors of poor glycemic control(all P0.01),and age was a protective factor for glycemic control(OR=0.695,P0.01).Conclusion The status of blood glucose control in the outpatients of our hospital is not satisfactory,which is due to factors such as "therapeutic inertia".When multidrug therapy fails to achieve the recommended glycemic targets,the treatment strategy should be adjusted promptly.

Left Ventricular Diastolic Dysfunction — Early Cardiac Impairment in Patients with Polymyositis/Dermatomyositis: A Tissue Doppler Imaging Study

To investigate early cardiac involvement in patients with polymyositis/dermatomyositis (PM/DM), and to evaluate the risk factors for early cardiac impairment. The study population included 46 patients with PM/DM who did not have overt cardiovascular manifestations and 21 age- and sex-matched healthy controls. Traditional echocardiography and tissue Doppler imaging (TDI) were used to evaluate cardiac function in both groups. Clinical characteristics were recorded. Multivariate logistics regression analysis was applied to investigate risk factors for early cardiac impairment in patients with PM/DM. No significant difference was found between patients and controls by traditional echocardiography. However, compared to controls, PM/DM patients had a significantly lower ratio of early diastolic mitral annulus velocity to late diastolic mitral annulus velocity (Em/Am; 1.23 ± 0.52, 1.79 ± 0.37, respectively; t = -4.485, p < 0.001) and a higher ratio of peak early diastolic transmitral flow velocity to Em (E/Em; 8.26 ± 2.57, 6.76 ± 1.17; t = 3.287, p < 0.05) as found by TDI measurements. There was no significant difference between the TDI variables of patients with PM and DM. The multivariate regression analysis showed that female sex (OR 11.044, 95% CI 1.066-114.357, p = 0.044), late onset (OR 1.157, 95% CI 1.047-1.278, p = 0.004), and duration of disease (OR 1.060, 95% CI 1.008-1.115, p = 0.023) were risk factors for abnormal left ventricular filling pressures. TDI is useful for detecting early cardiac impairment in patients with PM/DM. Left ventricular diastolic dysfunction is an early feature of cardiac involvement. Female sex, late onset, and long course of disease are 3 independent risk factors for predicting left ventricular diastolic dysfunction in patients with PM/DM.

Clinical study of invasive fungal infection secondary to systemic lupus erythematosus

To study the clinical characteristics of invasive fungal infection secondary to systemic lupus erythematosus (SLE). We observed the clinical features and experimental examination in 91 patients treated in Xiangya Hospital in recent years, of which 48 patients with invasive fungal infection and 41 patients without invasive fungal infection. The invasive fungal infection secondary to SLE mainly occurred in the lungs, nervous system, and urinary system. The fungi were mainly Candida albins and Aspergillus. The rate of invasive fungal infection in SLE patients and the level of CRP and TNF-α in these patients were significantly increased. The occurrence of invasive fungal infection was positively correlated with the prolonged course of disease, long-term use of immunosuppressants and antibiotics, and occurrence of complications, such as hypoproteinemia, leukocytopenia, and so on. The levels of C-reactive protein (CRP) and tumor necrosis factor-α(TNF-α) were increased in SLE patients with invasive fungal infection. The clinical features of SLE patients with invasive fungal infections are long course of disease, long-time use of immunosuppressants or antibiotics, and occurrence of complications, such as hypoproteinemia or leukopenia. The level of CRP and TNF-α can be used as an important reference index for diagnosing invasive fungal infections.

Positive Histological Inflammatory Margins Are Associated With Increased Risk for Intra-abdominal Septic Complications in Patients Undergoing Ileocolic Resection for Crohn’s Disease

Rates of postoperative complications are particularly high among patients with Crohn's disease. The aim of this study was to assess whether positive inflammatory histological margins, among other factors, pose a risk for intra-abdominal septic complications in patients with Crohn's disease undergoing ileocolic resection. A retrospective study of patient records, during 2000-2010, was conducted. This investigation was performed at a single medical center. Included were 166 individuals with Crohn's disease (85 males, mean age 35.6). Ileocolic resection with primary anastomosis was performed. The primary outcomes measured were postoperative intra-abdominal septic complications. Twenty-five patients (15%) developed intra-abdominal septic complications, including anastomotic leak, intra-abdominal abscesses and collections, and enterocutaneous fistulas. There were no postoperative deaths. Univariate analysis revealed that a long course of disease before surgery, an emergency surgery, steroid treatment of more than 3 months before surgery, additional sigmoidectomy, and positive surgical margins detected on histopathological examination were associated with intra-abdominal septic complications. In a multivariate analysis, only disease duration longer than 10 years (OR 4.575 (CI 1.592-13.142), p = 0.005), additional sigmoidectomy (OR 5.768 (CI 1.088-30.568), p = 0.04), and positive histological resection margins (OR 2.996 (CI 1.085-8.277), p = 0.03) were found to be independent risk factors. This study was limited by the incomplete data regarding preoperative albumin levels. Positive histological margins, disease duration of more than 10 years, and added sigmoidectomy are independent risk factors that are associated with postoperative intra-abdominal septic complications in patients undergoing ileocolic resection for Crohn's disease. These risk factors should be considered when the need for a diverting stoma is questionable. A frozen section of the margins may assist in the decision as to a temporary ileostomy construction.

The effect of preoperative factors on the function of the cervical spine after cervical artificial disc replacement: a minimal 3 years follow-up

To evaluate the effect of preoperative factors on the function of the cervical spine after Bryan artificial disc replacement. Fifty patients who underwent cervical disc replacement from December 2003 to January 2006 were investigated. The preoperative factors such as long course of disease, lose of motion or disc height at the operation level were evaluated for their effects on the motion of the operated disc and clinical results at the time of final follow-up. There were 35 males and 15 females. Thirty-nine patients received one-level disc replacement, 11 patients received two-level disc replacement. The age of patients was from 25 to 73 years, average was 49 years. Until January 2009, 50 cases of all the 53 patient who got operation for more than 3 years were followed up. The follow up period was from 36.0 to 55.6 months, which showed a skewed distribution, with a median of 41.9 months. The patients, who got neural syndrome for more than 3 years, would have worse JOA recovery rate through the surgery compared with the patients who got neural syndrome less than 3 month. As for radiographic results, the preoperative range of movement (ROM) at the implanted disc spaces was 10.4 degrees +/- 5.0 degrees which had significant correlation with the most recent follow-up ROM which was 8.6 degrees +/- 4.8 degrees (r = 0.325, P < 0.05). The group which height ratio of the operative disc and the adjacent discs was less than 0.87 would have worse JOA recovery rate and range of motion at operated level at the most recent follow-up than the group more than 0.87 with statistical significance. For the patients with cervical spondylosis or cervical disc herniation who get nervous syndrome for more than 3 years, will have worse JOA recovery rate through the surgery, so the patient should get the operation in time to achieve better improvement. When the operated level is severe degenerated, the motion of the replaced disc and the clinical results is dissatisfied at the time of final follow-up, so it is the relative contraindications for the cervical disc replacement.

Research about quality of life of type 2 diabetes patients with over 10-year course of disease and related factors

Objective In order to know the influence factors of quality of life of patients with type 2 diabetes with long course of disease, and then carry out certain countermeasures to improve these patients'quality of life. Methods Interviewed 197 patients with type 2 diabetes with 10-year course of disease by questionnaire, and then evaluated their quality of life by DSQL, analyzed the data by Logis-tic. Results There was no significant difference of DSQL scores among patients with different gender, age, marital status and educational background. There were significant difference of DSQL scores among patients with different degree of depress, anxiety, course of diseases and complications, the influence factors of quality of life for patients with type 2 diabetes were depress degree and numbers of complica-tions. Conclusions Positive treatment should be used for patients with complications of type 2 diabetes, emotional guidance and more solicitude should be used for patients with depress, which can effective cor-rect patients' adverse behaviour, release their negative mood, and then improve their quality of life. Key words: Type 2 diabetes; Quality of life; Influence factors

Spinal muscular atrophy combined with sporadic olivopontocerebellar atrophy

The combination of spinal muscular atrophy (SMA) with a variety of neural and extraneural defects, particularly pontocerebellar hypoplasia, has been reported. To date, all of the reported SMA with pontocerebellar hypoplasia was from infants; however, here we report a SMA with sporadic olivopontocerebellar atrophy (sOPCA) in an adult patient. The 68-year-old male patient displayed various clinical symptoms including progressive proximal muscle weakness, muscle atrophy and muscle fasciculation with a long course of disease. EMG demonstrated that amyotrophy was due to the impairment of lower motor neurons. The clinical symptoms and the EMG were consistent with the diagnosis of SMA. The presence of cerebellar ataxia, limb tremors, muscle atrophy and weakness in the patient led to the diagnosis of sOPCA that was confirmed by the MRI results. To our knowledge, this is the first case report of combination of SMA with sOPCA in an adult. It is yet unclear whether there is a common pathogenesis between the two diseases.

The progression of pathology in longitudinally followed patients with Parkinson’s disease

The present study describes the pathological progression of longitudinally followed cases with levodopa-responsive Parkinson's disease who came to autopsy during the Sydney Multicenter Study of Parkinson's disease. Standardised clinical and neuropathological assessments over five epochs of time verified three different clinicopathological groups. A group of younger onset patients with a typical long duration clinical course of Parkinson's disease. This group of cases had Lewy body distributions consistent with the Braak staging of disease. In this group, brainstem Lewy bodies dominate in those surviving to 5 years; by 13 years, 50% of cases have a limbic distribution of Lewy bodies; and by 18 years, all will have at least this pathological phenotype. Approximately 25% of cases had an early malignant, dementia-dominant syndrome and severe neocortical disease consistent with dementia with Lewy bodies. The last group had an older onset, shorter survival, and a more complex disease course with higher Lewy body loads and a higher proportion with additional neuropathologies. These cases with higher loads of Lewy bodies and shorter survivals suggest that widespread Lewy body pathology either occurs at the onset of clinical disease or rapidly infiltrates the brain. In these cases with shorter survivals, there was more plaque pathology, supporting a more aggressive and linked phenotype. Our data suggest that the selection of similar study cohorts by pathology alone would not be able to differentiate the three different phenotypes identified. The data are also not consistent with a unitary concept of the pathogenesis of Lewy body disease.

The need for regulatable vectors for gene therapy for Parkinson's disease

Gene therapy is now a very promising approach for the treatment of Parkinson's disease, for which there are currently few treatment options. However, gene therapy is invasive and irreversible, and its long-term effects are not yet known. Regulatable vectors allow the expression of the introduced gene to be adjusted or stopped by changing the dose of an oral inducer drug, thus adding an important safety mechanism as well as the ability to tailor the dose to an individual patient's needs. Although the use of conventional gene therapy should not be delayed until regulatable systems are available, clinical trials of regulatable gene therapies are imminent. Regulatable systems provide the best hope for safely delivering effective, flexible treatments over the long course of Parkinson's disease, and their development should be actively supported.

Biochemical Markers of Bone Metabolism in Children with Helicobacter pylori Infection

We investigated the biochemical markers of bone metabolism in children with Helicobacter pylori infection. Biochemical markers of bone metabolism and serum levels of vitamin B12, ferritin and estradiol were measured in 41 H. pylori-positive (+) children (23 girls, 18 boys; aged 11.8+/-3 years). Serum levels of intact parathyroid hormone, ss-collagen I carboxy terminal telopeptide, total alkaline phosphatase (ALP), bone-specific ALP, N-terminal cross-links of human procollagen type I, N-mid-osteocalcin, calcium, phosphate, ferritin, and estradiol did not differ significantly between H. pylori(+) and H. pylori negative (-) children. Vitamin B12 levels were significantly decreased in H. pylori(+) compared to H. pylori(-) children. H. pylori infection was not accompanied by significant changes in markers of bone metabolism in children, although vitamin B12 levels were decreased. Further studies are required to clarify whether H. pylori infection causes time-dependent changes in bone turnover markers during the long course of this inflammatory disease.

Recent advances in the studies of genetic polymorphisms in diabetic retinopathy

Diabetic retinopathy is one of the most serious complications of diabetes mellitus, which affects the health and life quality seriously. The development of procedures for prevention and treatment of diabetic retinopathy is one of the most important problems that should be solved. Epidemiological studies indicate that the development of diabetic retinopathy is not only determined by duration of diabetes and blood glucose control; individual diversities also play an important role. Some patients have a long course of disease and poor control of blood glucose, but they do not have diabetic retinopathy or only show slight pathological changes after a long term follow-up. Other patients only have a short term disease and well control of blood glucose, but they develop serious proliferative diabetic retinopathy. These patients usually have a positive family history. This phenomenon may relate to various genetic liabilities. This review introduce the recent advances in the studies of genetic polymorphisms in diabetic retinopathy.

Infective endocarditis as a result of obstetric and gynecological sepsis

The special place taken the problem of infectious failure of endocardial structures in obstetric-gynecologic practice. In this article given the analyses of the results of leading research and treatment of women patients with infectious endocarditic in puerperal period. The actuality of this problem is determined by the increasing of women with infectious endocarditic, being developed in the period of after childbirth and abortion, because of the late diagnostic and consequence, high mortality. The question of developing endocarditic at women in the period after childbirth and abortion, as in our, so in modem literature is partly shown and there are only descriptions of some cases of appearing the disease or findings failured endocarditic at autopsy of women, died because of sepsis. The researches shown, that infectious endocarditic of puerperal period has itsown distinctive features: the first endocarditic with often localization of infection in the right heart section; the leading among the stimulyses IE is golden staphylococcus, taking the first place in etiology of pus-septic infections in obstetric-gynecologic practice; long and sub acute course of disease till the moment of stating the final diagnoses, and late beginning of adequate treatment and consequence, high mortality. The questions of developing IE after childbirth and abortion demand the further researching with the aim of prophylaxis, early diagnostic and choice of early adequate complex treatment as surgical, so therapeutic.