Objective. Comparative analysis of the therapeutic efficacy of the combined preparation of diosmin and hesperidin in two cohorts of patients with chronic venous insufficiency (CVI) stratified by body mass index. Material and methods. A prospective clinically controlled study of the efficacy of therapy with the combination of diosmin and hesperidin in 104 patients with chronic venous diseases (C0-C3 according to CEAR) was carried out. The efficacy of pharmacotherapy was assessed by comparative analysis between the group of patients with excessive body weight and the group with normal anthropometric indices. Results. After 8 weeks of treatment with the combination of diosmin and hesperidin a significant decrease in the severity of discomfort in the lower extremities, intensity of heaviness, leg pain and the feeling of leg oedema was observed . The effect of the therapy in both groups was a decrease in the volume of the lower leg and improvement of the CIVIQ-20 quality of life scores (p < 0.01). Conclusion. The obtained data indicate comparable high efficacy of the combination of diosmin and hesperidin for treatment of clinical manifestations of CVI in patients with both normal and overweight.

Objective. To study the peculiarities of the course of stable coronary heart disease (CHD) depending on the severity of COVID-19 infection in the acute period and to determine the probability of developing frequent ventricular extrasystole in CHD patients in the post-COVID-19 period. Material and methods. We examined 431 patients diagnosed with stable CHD who had confirmed COVID-19, with a follow-up duration ranging from 3 to 18 months. Patients were divided into two groups based on the severity of COVID-19: Group 1 (n=203) – patients with a mild form of COVID-19; Group 2 (n=228) – patients with a moderately severe form of COVID-19 in the acute period. Clinical, laboratory, and instrumental diagnostic methods were used. Results. Obesity (p=0.005), uncontrolled arterial hypertension (p<0.001), type 2 diabetes mellitus (p=0.007), atrial fibrillation , and chronic heart failure with moderately reduced ejection fraction (p=0.003) were significantly more frequent in Group 2. Multifocal atherosclerosis was detected in 91.3% and 88.5% of patients in Groups 1 and 2, respectively (p=0.416), with hemodynamically significant coronary artery stenoses being more common in Group 2 (86.4% vs. 68.0%, p<0.001). Patients in Group 2 also had a higher incidence of angina pectoris of functional class III (p=0.002). Frequent ventricular extrasystole, associated with a worsening course of CHD, was significantly more frequently recorded in history of Group 2 to Group 1 . Lipid profile parameters were also statistically significantly higher in group 2, which may indicate their role in the progression of CHD in the post-COVID-19 period. The construction of a multivariate logistic regression model demonstrated a statistically significant increase in the odds of frequent ventricular extrasystole if: the longitudinal left atrial size was greater than 5.45 mm, uric acid concentration was greater than 327.7 mmol/L, thyroid hormone levels were greater than 4.14 mU/L, hemodynamically significant coronary artery lesions were present, NT-proBNP levels were greater than 105.5 pg/mL. Conclusion. Patients with stable CHD who have undergone moderate COVID-19 represent a high-risk group for aggravation of the underlying disease and the development of frequent ventricular extrasystole.

In the 21st century, the attitude towards the diagnosis and treatment of hemorrhagic diathesis in pediatrics has changed significantly. Proper care and preventive measures remain the cornerstone of care for children with thrombocytopenia, thrombocytopathies and hemophilia. Timely diagnosis of thrombocytopenia requires knowledge of the clinical features of the disease. In addition to hormonal therapy, the arsenal of aids for idiopathic thrombocytopenic purpura has been thoroughly expanded, and the principles of treatment of chronic thrombocytopenic purpura have especially changed. The pathogenetic features of the correction of acquired and hereditary thrombocytopenia defects remain not entirely resolved. Innovations have certainly affected hemophilia. Thanks to advances in bioengineering technologies, unprecedented therapeutic progress has been achieved. Drugs with new mechanisms of action have appeared, based on restoring the formation of thrombin or simulating blood coagulation factor VIII. In addition to emicizumab, which is already approved for children with severe hemophilia A, other non-replacement drugs are being evaluated in clinical trials. Gene therapy drugs have been tested in adult patients. In this review, we provide updated information on the participation of nurses in the care and treatment of hemorrhagic diathesis in children, and the rehabilitation of patients with hemophilic arthropathy.

The long process of the incus is most often subject to destructive changes in chronic purulent otitis media. In recent years, otolaryngologists have begun to use glass ionomer cement to reconstruct the ossicular chain. Objective. To evaluate the efficiency of glass ionomer cement in ossiculoplasty. Material and methods. 11 patients with chronic purulent otitis media were treated and underwent reconstruction of the long process of the incus using glass ionomer cement. Results. Analysis of the study results showed that the use of glass ionomer cement in ossiculoplasty allows to eliminate the defect of the long process of the incus and diastasis of the incudostapedial articulation with a good anatomical and functional result.

Objective. To analyze the characteristics of the psychological status in patients after coronary artery bypass graft (CABG) with different recovery periods. Materials and methods. The study included 100 men (53.2±5.9 years) who had undergone CABG. Retrospectively, 2 groups were identified: group 1 (n=58) – patients returned to work 4 months after CABG; group 2 (n=42) – patients required rehabilitation for more than 4 months. The control group consisted of healthy volunteers (n=50). All patients were assessed for anxiety levels using the Spielberger–Hanin Anxiety Scale 1 and 4 months after CABG. Results. Patients after CABG have higher levels of personal and situational anxiety compared to the control group (p=0.001). Initially, the levels of situational and personal anxiety in patients of the studied groups were comparable (p=0.936, p=0.109, respectively). By the 4th month, the level of situational anxiety in group 1 decreased (p=0.001), while in group 2 the indicator remained unchanged (p=0.764). Regression analysis established that 82% of the variability of situational anxiety in group 2 was determined by the combined effect of age (β=0.552; p=0.001), hypertension (β=3.341; p=0.023), previous infarction (β=7.291; p=0.001), and the number of bypasses (β=4.259; p=0.001). Conclusions. There is a need to take into account the special role of psychological correction in the system of complex rehabilitation of patients with coronary heart disease who have undergone CABG.

Back pain (dorsalgia) in adolescents associated with bronchial asthma is an urgent interdisciplinary problem in modern medicine that attracts the attention of scientists and practitioners. The aim of the work was to study the frequency and structure of back pain in adolescents with bronchial asthma, substantiating the need for their correction to improve the controllability of the disease. The article analyzes differences in the frequency and structure of back pain of various localization (in the cervical, thoracic, lumbar spine and their combinations) in adolescent patients of the pulmonary allergy center with bronchial asthma (controlled, partially controlled and uncontrolled). The results of our own research revealed the features of asthma in patients, depending on the severity, phase of the disease and severity of respiratory failure. Comparability of the frequency of recurrent dorsalgia among patients with and without asthma has been established, a high incidence of cervical and combined pain localization in patients with uncontrolled asthma, pain in the thoracic spine in patients with controlled asthma, and lumbar pain localization in patients with partially controlled asthma. Conclusion. The authors conclude that it is necessary to continue scientific research on the prevalence and structure of dorsalgia in adolescents with asthma, and the validity of their pharmacological correction to increase disease control, improve treatment effectiveness, and improve prognosis in this pathology.

Objective. Based on international recommendations, to study the dynamics of quality of life (QOL) indicators of children with type 1 diabetes mellitus (DM1) and their parents to address the effectiveness of self-control training in this pathology, taking into account the length of illness, type of therapy, as well as the use of modern disease control capabilities. Materials and methods. The observation group consisted of 56 children with DM1 and their parents (the sample was created by a continuous selection method and included all patients living in cities on the territory of the closed administrative-territorial formation of the Krasnoyarsk Territory). The survey was carried out using special questionnaires of the PedsQL diabetic module, compiled in the form of tests, including blocks taking into account the age groups 5–7, 8–12 and 13–18 years for children and parents. The work was carried out in 2 stages: assessment of QOL before self-control training and after 1 year (the time interval corresponds to clinical recommendations, in which the frequency of self-control training is indicated for a period of 1 year). Results. The analysis of children's QOL on certain questionnaire questions showed a significant predominance of symptoms of decompensation of the disease (hypoglycemia, irritability and thirst) on the "Diabetes" scale and increased emotional lability, embarrassment, difficulties and awkwardness in communication and increased anxiety on the "Communication" scale in children with a disease duration of less than 5 years. Self-control training in order to maintain and expand the level of knowledge allowed parents to achieve improvements in quality of life indicators on almost all scales under consideration, and especially on the scales "Diabetes" and "Treatment. Our study showed an increase in the level of QOL on the "Treatment" scale in patients on pump insulin therapy in comparison with the use of syringe pens, as well as continuous monitoring of glycemia, the use of which significantly increased the score on the "Diabetes", "Treatment" and "Communication" scales in relation to traditional glycemic control with a glucometer. Conclusion. The study of QOL is the best option for identifying the individual characteristics of the patient's condition with further use of the results in correcting the treatment of the disease.

The article presents the results of the positive effect of the drug Cardioton on blood pressure, cardio-pain syndrome by type of cardialgia in patients with hypertension with different daily blood pressure index. It was revealed that Cardiotone relieved cardialgia-type cardio-pain syndrome in 94% of cases. 83% of patients have normalization of blood pressure, 17% have a tendency to decrease blood pressure. After treatment, the hypotensive effect of Cardiotone was observed in all groups of patients, depending on the value of the daily blood pressure index: 90% in dipper patients (with a normal decrease in blood pressure at night), 76% in non-dipper (with insufficient nocturnal decrease in blood pressure), 69% in over-dipper (with excessive decrease in blood pressure at night night time). It should be noted that blood pressure tends to normalize in almost half (43%) of people with the most unfavorable prognosis for the development of CVD with a nocturnal increase in blood pressure (the profile was assessed as night peaker). Cardioton is a natural cardioprotector; strengthens the heart muscle by improving its oxygen supply, relieves inflammatory processes in the myocardium; has antihypertensive, anti-ischemic, cardiometabolic effects. It is recommended for disorders of the cardiovascular system, with increased physical exertion. Based on the conducted research, it can be concluded that Cardiotone is well tolerated by patients and is an effective treatment

Chronic heart failure (HF) in elderly patients is characterized by high morbidity and mortality, especially in the presence of comorbidities. The article presents a review of current data on the prognostic value of blood biomarkers — N-terminal pro-brain natriuretic peptide (NT-proBNP) and soluble ST2 receptor (sST2) in elderly comorbid patients with chronic heart failure (CHF). Based on the analysis, the rationale for the combined use of NT-proBNP and sST2 for accurate risk stratification and personalization of therapeutic approaches in elderly patients with CHF and multiple comorbidities is substantiated.

In this article the relationship between COVID-19 and the onset of neurodegenerative diseases such as Alzheimer's disease and Parkinson's disease is observed. Possible mechanisms of pathogenesis are discussed: activation of microglia, formation of neurofibrillary tangles and amyloid plaques, which indicates a possible acceleration of pathological processes characteristic of neurodegenerative diseases. A review of the literature suggests that COVID-19 may act as a catalyst for the development or acceleration of neurodegenerative processes. The article presents a clinical observation of a patient admitted to the therapeutic department due to a hypertensive crisis, who developed mixed dementia after COVID-19 infection. The results of clinical and biochemical blood tests are within the reference values. On MRI of the brain – atrophy of the medial temporal lobe, signal changes in the basal ganglia, foci of vascular genesis. On EEG: Disorganized EEG type with dominance of slow activity in the theta rhythm range. Psychodiagnostics revealed cognitive decline to the level of moderate dementia (according to the MMSE scale – 13 scores). The importance of long-term monitoring of patients with post-COVID syndrome and the development of strategies for the prevention and treatment of neurodegenerative diseases in the context of the pandemic is emphasized.