Background. Chronic heart failure (CHF) is an increasing public health issue, particularly among individuals over 30 years old. Modern diagnostic methods, including biomarkers, contribute to the early detection and monitoring of patients after myocardial infarction (MI). Key biomarkers include NT-proBNP, sST2, C-reactive protein (CRP), and cardiomyocyte microRNAs. Aim. To assess the diagnostic significance of biomarkers of endothelial dysfunction and myocardial fibrosis in patients with varying severity of CHF after MI. Methods. Patients were divided into three groups based on left ventricular ejection fraction (LVEF). Inclusion criteria: consent to participate, CHF diagnosis, and MI diagnosis upon hospitalization. Exclusion criteria: oncology, blood disorders, heart defects, and history of coronary artery bypass grafting. The diagnostic process included medical history collection, echocardiography, coronary angiography, and biochemical analysis. On the first day, coronary angiography was performed to assess coronary artery stenosis (≥70% considered significant, ≥50% for LCA and RCA). Within 48 hours, systolic and diastolic left ventricular function was assessed. On the third day, venous blood was collected to analyze CRP, NT-proBNP, sST2, and VEGF levels. Data analysis was performed using R statistical software, including methods for evaluating differences, relationships between variables, and logistic regression (p<0.05). Results. Patients with reduced LVEF had significantly elevated NT-proBNP and sST2 levels (p<0.05). VEGF levels showed no significant differences among the groups. The analysis demonstrated that increased NT-proBNP and sST2 levels correlate with CHF severity. The development of adverse cardiovascular events within a year was associated with renal dysfunction and elevated CRP, NT-proBNP, and sST2 levels. Conclusions. A significant correlation was found between NT-proBNP and sST2 levels and LVEF in CHF patients after MI. High levels of these biomarkers are characteristic of HFrEF, confirming their association with worsening cardiac function. VEGF levels did not show significant variation depending on CHF severity.

Aesthetic gynecology is one of the fastest growing healthcare sectors in Russia and worldwide. The existing not fully resolved problems, starting from legal problems and culminating with the aesthetic gynecology technologies/techniques, do not allow the clinician to work within the legitimate field. The paper considers controversial issues of aesthetic gynecology, points out and estimates the near-term prospects.

Acute stroke is the most common cause of seizures and epilepsy in elderly people. Post-stroke epilepsy (PSE) develops in approximately 2–11% of patients who have experienced a stroke, according to various estimates. The article discusses modern aspects of the pathogenesis of PSE, including neurotransmitter imbalance, hormonal dysregulation, blood-brain barrier damage, changes in neural networks, oxidative stress, glial proliferation, and genetic mechanisms. The main prediction methods and possibilities of pharmacotherapy for PSE are also discussed in detail. Despite significant advances in understanding the pathogenesis and treatment of PSE, many questions remain unanswered. There are several promising directions for further research on PSE. The development and refinement of biomarkers of epileptogenesis will allow us to predict which patients may experience seizures after a stroke. This knowledge will also be useful for conducting research on epilepsy therapy. It is extremely important to investigate the impact, tolerability, and interactions of AEDs in patients who have suffered a stroke. It is also necessary to study the interaction of AEDs with oral anticoagulants. Finally, more accurate biomarkers of ongoing epileptic activity are needed to determine which patients may benefit from stopping AEDs. This will optimize treatment and improve the quality of life of patients after a stroke.

The regular increase in the number of patients with addiction on several psychoactive substances in the total mass of drug patients and the insufficient effectiveness of existing therapies make the study of the dynamics of the main life spheres of patients with this pathology in the rehabilitation process an urgent and important task. Aim. To evaluate the dynamics of psychosocial and addiction characteristics in patients with addiction on several psychoactive substances the rehabilitation program. Materials and methods. 214 patients with addiction on several psychoactive substances were examined while undergoing medical and social rehabilitation at the Department of Medical Rehabilitation of the Moscow Scientific and Practical Center of Narcology. Methods: clinical and psychopathological, psychometric Addiction Severity Index (ASI), anamnestic, catamnestic, statistical. Results. Patients with addiction on cannabinoids and psychostimulants and alcohol and psychostimulants are distinguished by the positive dynamics of psychosocial and narcological characteristics as a result of rehabilitation measures and longer periods of sobriety. Patients with addiction on opioids and psychostimulants and addiction on several surfactants at the same time are distinguished by low dynamics of psychosocial and narcological characteristics as a result of rehabilitation measures and shorter periods of sobriety. Conclusion. It is necessary to assess the state of the main psychosocial spheres of patients with addiction on several psychoactive substances for differentiated planning of rehabilitation measures and increasing the effectiveness of care for these patients.

Insomnia disorders are a common problem among patients with type 2 diabetes mellitus, which can negatively affect their overall health and disease management. This paper discusses the basic principles of insomnia treatment in this group of patients, including cognitive behavioral therapy, pharmacotherapy, and non-medicinal methods. Special attention is paid to the clinical features of insomnia in the context of diabetes, such as the effect of hypoglycemia and chronic stress on sleep quality. Lifestyle correction approaches are also being considered, such as dietary recommendations and physical activity that can help improve sleep. The need for an integrated approach to the treatment of insomnia disorders is emphasized, with an emphasis on individualizing therapy depending on the clinical characteristics and needs of the patient.

In the modern world, the role of the attending physician is large and ambiguous. The attending physician is a specialist who is not only responsible for the diagnosis, treatment and monitoring of the patient, but is also a key link between the patient and the healthcare system, providing an individual approach to each patient and coordinating the work of other specialists. The article discusses the concepts of "doctor", "attending physician", tasks, functions and assigned responsibilities, correlates with the concepts of "consultant physician" and "doctor on duty". To date, the concept of "attending physician" in primary health care, where the patient is examined simultaneously by specialists of completely different profiles, does not disclose any of the current regulatory legal acts. Today, taking into account the increasing specialization of medical care, changes in the model of interaction with patients, the introduction of new forms of organization of medical care, there is a need to change the paradigm, improve this concept, clarify the role of the "attending physician" depending on the form, type and conditions of medical care.

The article presents a clinical case of a patient suffering from a chronic generalized sarcoidosis with lungs, intrathoracic lymph nodes, heart and kidneys involvement, the results of examination and treatment.

Drug-induced lung injury (LIPL) is caused by the reaction of lung tissue to various drugs. One of the pharmacological groups capable of leading to drug damage to the lungs include monoclonal antibodies against T-lymphocyte receptors to enhance their cytotoxic function in order to treat unresectable or metastatic melanoma. As a result, the normal regulation of the immune system is disrupted, which can lead to immune-mediated side effects. One of the most dangerous complications of monoclonal antibody therapy is pneumonitis. Due to the variety of clinical and radiological manifestations of the disease described in the literature, it is necessary to consider LIPL as a diagnosis of exclusion, which requires the accumulation of data for effective diagnosis and management of patients. The purpose – to present for the first time a clinical case of lung damage in a patient with metastatic melanoma on the background of the use of a combination of Nurulimab and Prolgolimab. According to the clinical observation data of a 68-year-old woman, the importance of a detailed medical history collection for diagnosis has been demonstrated.

Lactating adenoma is a rare pathology found in pregnant women. A clinical case is presented in which typical clinical, cytological and histological signs characteristic of this neoplasm are described.