Objective: to assess the rate of silent myocardial ischemia (SMI) and the pattern of cardiac rhythm disturbances in women with rheumatoid
arthritis (RA), their association with traditional risk factors (TRF) for cardiovascular diseases (CVD), with subclinical structural and functional
changes in the heart and vessels, with the activity and severity of rheumatoid inflammation.

Subjects and methods. Two hundred and ninety-one female patients aged less than 60 years with a valid diagnosis of RA and no clinical
signs were examined. A control group consisted of 125 women without rheumatic diseases. In addition to the clinical manifestations, activity,
and severity of RA, the authors assessed major TRFs for CVD, performed Holter ECG monitoring, common carotid artery duplex scanning, transthoracic echocardiographic study, and determined the levels of serum inflammatory markers.

Results. The women with RA differ from the control group in the higher incidence of SMI, supraventricular arrhythmias (SVA) and highgrade
premature ventricular contractions (PVC). The patients with RA and SMI are characterized in terms of age-adjustment by higher disease activity (DAS28), systemic manifestations), cumulative larger-dose glucocorticoids (GC) and a higher percentage of patients receiving disease-modifying anti-rheumatic drugs as compared with those with RA and no SMI with adjustment for age. High disease activity
(DAS28, level of inflammatory markers), IgM rheumatoid arthritis seropositivity, and GC therapy are SVA-associated factors in women with RA; larger left ventricular end-diastolic dimension and serositis are factors associated with high-grade PVC.

Conclusion. The RA women without clinical manifestations of CVD are recorded to have high rates of SMI, SVA, and high-grade PVC, which is primarily due to the activity and severity of rheumatoid inflammation.

Objective: to reveal the features of chronic heart failure (CHF) of ischemic genesis concurrent with chronic obstructive pulmonary disease (COPD) and to investigate the effect of the cardioselective β1-adrenoblocker (β1-AB) nebivolol on the course of COPD and the parameters of the bronchopulmonary system in patients with CHF of ischemic genesis during treatment.

Subjects and methods.The investigation enrolled 63 patients aged 40–70 years, including 43 patients with functional class (FC) II–IV CHF with a Simpson left ventricular ejection fraction of  45 % concurrent with COPD (a study group) and 20 patients with CHF and no bronchopulmonary pathology (a control group). The study group patients were randomly divided into 2 subgroups: 1) 23 patients who received nebivolol in addition to background therapy; 2) 20 patients in whom the therapy ruled out the use of β1-AB. The control patients were switched to nebivolol therapy. During 6-month follow-up, the authors made clinical examination, recorded the rate, duration, and severity of COPD exacerbations, performed a 6-minute walking test (6MWT), and used a clinical status scale modified by R. Cody, a dyspnea 0–10 category ratio (Borg scale), and a Medical Research Council Dyspnoea Scale (MRS scale). Besides, quality of life in patients was assessed using the specific Minnesota Living with Heart Failure Questionnaire. All the patients underwent echocardiography, bronchodilatation-induced external respiratory function test, peak flowmetry, and blood brain natriuretic peptide quantification. These studies were conducted at baseline and at 1 and 6 months of therapy.

Results. During the investigation, the patients with CHF concurrent with COPD were found to have a high rate of hypertensive disease, prior myocardial infarctions, atrial fibrillations, and higher FC exertional angina. These patients also showed a delayed optimal result achievement during the combination therapy involving the use of β1-AB. The group of patients without concomitant COPD was observed
to have lower FV CHF and significantly reduced dyspnea during exercise (Borg scale) immediately following 1-month therapy whereas these were seen only after 6 months. Nebivolol (mean dose 5 mg) included in the treatment regimen for patients with CHF concurrent with COPD failed to have a significant effect on spirometric and peak flowmetric readings, but had a clear-cut positive effect on the health indicators of CHF patients, such as FC of the disease, heart rate, 6MWT distance, degree of dyspnea degree, and quality of life.

Conclusion. Combination cardiopulmonary therapy including β1-AB leads to more effective control of comorbidity symptoms and to improvement
of patient functional status.

Purpose. The study was designed to assess the relationship between the level of plasma concentration of insulin-like growth factor-1 (IGF-1) and indices of the functional state of the liver in patients with non-alcoholic fatty liver disease (NAFLD) and its combination with diabetes mellitus (DM) 2 types depending on the trophological status.

Materials and methods. It were examined 90 patients with non-alcoholic fatty liver disease and its combination with type 2 diabetes mellitus –
with normal body weight and obesity, as well as 20 healthy individuals. The study was carried out using the following methods: clinical, laboratory and instrumental (including liver biopsy).

Results. It was inverse the relationship between the level of IGF-1, and the level of AST, ALT, AST/ALT, total and conjugated bilirubin, alkaline phosphatase in groups of patients with comorbid disorder. There was established the significant decrease of plasma level of IGF-1, and also impairment of liver function indices in all groups in comparison with the controls, and most pronounced changes in patients with comorbid disorders and obesity.

Conclusion. The established relationships suggests that the decrease of IGF-1 may represent the presence of syndromes of cytolysis and cholestasis in patients with NAFLD, type 2 DM and obesity. In order to determination the disorder of the reparative function of the liver is
recommended to determine the level of IGF-1 in patients with combination of NAFLD and type 2 DM. Patients with the level of IGF-1 < 143,9 ± 4,92 ng/ml should refer to the risk of progression of liver function disorders.

The paper shows the basic mechanisms of action of nonsteroidal antinflammatory drugs (NSAID) and their classification. It considers risk
factors for NSAID gastropathy and the possibilities of its treatment, prevention in the context of modern medicine.

Modern internal medicine was typified by the presence of the so-called problem patients whose diagnosis and treatment pose special problems.
G.B. Fedoseev and Yu.D. Ignatov have created the electronic thesaurus “Syndromic diagnosis and basic pharmacotherapy of visceral diseases” to facilitate their diagnosis and choice of personalized therapy.

The paper analyzes the causes and clinical manifestations of sleep and awakening disorders in Parkinson’s disease, describes clinical cases with dyssomnia at the early and extensive stages of the disease and the efficiency of using melatonin to normalize circadian rhythm.

The paper outlines basic principles of and new approaches to antibiotic therapy for ENT and upper respiratory tract infections, from point of view of the authors, on the basis of the data available in Russian and foreign literature.

The paper deals with the evaluation of the nasal mucosa in health and in different abnormalities. It describes the possibilities of using drugs of different groups to relieve symptoms in nasal mucosal and paranasal sinus abnormalities of different genesis, as well as the preventive effect of some of these drugs.

The article deals with the etiology, diagnosis and treatment of acute respiratory infections (ARI). Contemporary possibilities and tactics ethiotropy treatment of antiviral therapy. Given that to date the treatment of ARI is a significant problem associated with both unjustifiably
widespread use of antibiotics , as well as a huge market saturation of pharmaceutical products for the symptomatic treatment of ARI, the
author gives a critical analysis of drugs used for the pharmacotherapy of viral respiratory infections. The results of the literature review and evaluation of the therapeutic efficacy of immune-tolerance of domestic drug Ergoferon in adults and children who become ill with influenza and ARI. Displaying Ergoferon stimulatory effect on production of endogenous IFN-α and IFN-γ, as well as normalization of subpopulations of T-lymphocytes and histamine levels, thereby reducing the time of clinical signs of disease, prevent the onset and exacerbation of typical complications of chronic somatic diseases.

The paper reviews the literature characterizing the incidence of infective endocarditis (IE) in the presence of hypertrophic cardiomyopathy, as well as hemodynamic mechanisms, etiological features, valvular lesion and the course of IE in this pathology, approaches to treatment and prevention, and outcomes of the disease.

Despite a more than fifty-year period after the introduction of glucocorticoids (GCs) into therapeutic practice; they have headed the list of anti-inflammatory drugs so far. The paper analyzes current views on the terminology of GCs, mechanism of action, standardization of indications for their use in systemic lupus erythematosus, choice of a dose and a regimes of the drugs, as well as the rates of their decrease; the authors also review Russian and foreign literature on this problem and their own data.

Nearly half of patients with chronic heart failure (CHF) have a preserved left ventricular ejection fraction, known as diastolic heart failure. Echocardiography is the primary modality for evaluating left ventricular (LV) systolic and diastolic function in CHF patients. LV developed
pressure (dP/dt) is a classical index of myocardial contractility. At the same time, pulse wave velocity, which has been used as a measure of arterial stiffness, can be used as an index of LV contractile function. The maximal dP/dt of the radial pulse appears to be a good and reproducible criterion of LV systolic performance with high potential as a diagnostic method.