Introduction. Despite modern advances in diagnostic technologies, the problem of Wilson (WD) disease prevalence remains relevant in the world; clinical and scientific interest in epidemiological studies varies in the Russian Federation and in different countries.

The aim. To study the prevalence of WD in the population of the Russian Federation and foreign countries at the present stage.

Materials and methods. The paper presents an analysis of the results of domestic and foreign epidemiological studies of WD published in the eLibrary, Google Scholar, PubMed, Springer, Scopus, Elsevier, Oxford Press, Clinical Case, Cochrane, Science Direct databases from January 01, 2018 to June 01, 2023 year.

Results. In total, 14 epidemiological studies were analyzed. In the countries of North and South America, the prevalence of WD is from 4.1 per 100,000, up to 6.4 per 100,000 and in European countries from 1.44 per 100,000 to 9.0 per 100,000, in Asian countries – from 1.793 per 100,000 to 4.81 per 100,000.

Conclusion. Results of epidemiological studies prevalence of WD depended on design and methodology: with using the method of genetic screening of the population for WD, the prevalence rates were much higher and reached 40 per 100,000 in Europe, 19.6 in Asia due to detection of early stages of disease development (asymptomatic forms).

Aim. To evaluate skeletal muscle mass, muscle strength and physical performance in rheumatoid arthritis (RA) women with biological therapy.

Materials and methods. The study included 63 women (average age 60.3 ± 8.9 years) with confirmed RA treated with biological therapy and 117 age-matched RA patients who had never previously treated with biological therapy. Clinical and laboratory examination, evaluation of body composition using dual-energy X-ray densitometry and tests to assess muscle strength and physical performance were carried out.

Results. The frequency of sarcopenic phenotype among RA patients was 23.3 %: in those who received biological medication – 27.0 %, in the control – 21.4 % (p > 0.05). There were no differences between the groups based on the results of muscle strength assessment tests, however, patients on biological therapy performed significantly better the short physical performance battery (SPPB) and had a higher walking speed (p = 0.016 and p = 0.002, respectively). Univariate linear regression analysis confirmed the relationship of the presence of biological therapy with the functional status of the muscles according to the results of SPPB (b* = 0.24; p = 0.018) and walking speed (b* = 0.28; p = 0.006).

Conclusion. The frequency of sarcopenic phenotype among patients with RA was 23.3 % and was comparable in those who received biological therapy and without it. There were no differences in muscle strength depending on the presence of biological therapy, but the functional status of skeletal muscles was significantly better in women who received such treatment.

Aim. To study the features of the course of COVID-19 in pregnant women, the outcomes of a new coronavirus infection and pregnancy, the effect of concomitant pathology on the severity of the course and the frequency of complications of COVID-19.

Materials and methods. In the course of the work, a retrospective analysis of 109 medical histories of pregnant women who were treated in the infectious diseases department in 2021 with a diagnosis of COVID-19 was carried out. Anamnesis, concomitant pathology, results of objective examination, laboratory and instrumental methods of research, therapy, complications, outcomes of COVID-19 and pregnancy were evaluated.

Results. The majority of pregnant women had moderate – 55 % and severe – 24 % COVID-19, 7 % – extremely severe and only 14 % – mild. A third of pregnant women had concomitant pathology, arterial hypertension was the most common; 80 % of pregnant women had complications of COVID-19: cytokine storm – in 50 % of patients, acute respiratory distress syndrome – in 17 %, of which 5 % required artificial lung ventilation. The mortality rate was 4.6 %. The structure of pregnancy complications was dominated by gestational hypertension, gestational diabetes, premature placental abruption, preeclampsia. Complications of childbirth – premature birth and premature discharge of amniotic fluid. However, in most cases, pregnancy (75 %) and childbirth (71 %) proceeded without complications. Women in 95 % of cases were discharged from the hospital with recovery or significant clinical improvement.

Conclusion. Despite the prevalence of moderate and severe forms of COVID-19 in pregnant women, a high percentage of concomitant pathology and complications, in most cases favorable outcomes of both COVID-19 and pregnancy were noted. The presence of hypertension syndrome should probably be considered as a prognostically unfavorable marker of severe course and adverse outcomes of COVID-19 in pregnant women.

Aim. To study gender characteristics of affective disorders (prevalence and severity of anxiety and depression) and quality of life in patients with coronary heart disease (CHD) according to screening and psychometric tests.

Materials and methods. Five hundred seventy six patients with a verified diagnosis of CHD were tested using the Screening Questionnaire for Affective Spectrum Disorders (SQASD): 385 (67.8 %) men and 191 (33.2 %) women. From the total screening group using, 383 patients were examined with the Beck Depression Inventory (BDI), while examination with the hospital anxiety and depression scale (HADS) included 351 patients with CHD. The quality of life index was determined in 242 patients with CHD using the Modified Seattle Angina Questionnaire (SAQ).

Results. In the general group of patients with CHD examined by SQASD, anxiety and depressive disorders (ADD) were diagnosed in 81 %, the absence of ADD – in 19 %, p < 0.0001. In the group of patients examined using SQASD and the BDI scale, the presence of ADD was noted in 78.9 %, the absence – in 21.1 %, p < 0.0001. Screening of patients examined with the BDI scale revealed higher incidence of ADD in women: 95 % vs. 71.5 %, p < 0.0001. The overall score on the HADS anxiety scale in the men’s group was 7.9 ± 4.7, in the women’s group – 10.28 ± 3.9, p < 0.0001, while according the HADS depression scale – 6.32 ± 3.92 and 7.7 ± 4.18, respectively, p < 0.004. The level of depression by BDI scale in the men’s group was 14.07 ± 9.82, in the women’s group – 17.75 ± 8.42, p < 0.0004. Absence of symptoms of depression according the BDI scale was observed more often in the group of men compared with the group of women: 36.9 % and 19.2 %, p < 0.0005. The frequency of severe anxiety (45.8 % and 28.7 %, p < 0.002) and depression (26.2 % and 11.5 %, p < 0.0004) according the HADS was higher in the group of women compared to the group of men. The value of the IUCN quality of life index was higher in the group of men (25.4 ± 7.1 and 22.4 ± 4.8, p < 0.001).

Conclusion. In this study, screening of CHD patients using SQASD and psychometric tests (BDI and HADS) has revealed higher incidence of ADD and psychosocial risk factors (anxiety and depression) in the group of women compared with the group of men. The results of screening are generally consistent with the survey data of psychometric tests and QOL indicators.

The era of the Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2) virus has shown that non-core specialists can be involved in the treatment of epidemic diseases. However, the entire burden for the prevention and treatment of venous thromboembolism (VTE) falls on doctors – cardiovascular surgeons, phlebologists. It should be borne in mind that most of the thromboses – more than 2 million cases per year – are asymptomatic, and only a small part has pulmonary embolism, pulmonary hypertension, and death. The survival rate of patients with deep vein thrombosis (DVT) for 8 years is 65 %, with a combination of DVT with pulmonary embolism; the survival rate does not exceed 34 %, so a doctor of any specialty should know how to suspect VTE. The clinical picture of DVT is not always pronounced. Most often, with DVT, patients complain of swelling and pain in the affected lower limb, a decrease in the volume of active movements, and skin cyanosis. Diagnosis of DVT and thromboembolic complications at the non-specialized level should initially consist of assessing the risk of VTE using special scales, among which the Wales scale is of the greatest importance. The gold standard for diagnosing DVT is duplex ultrasound. Among the main indicators for hospitalization is not the fact of the established diagnosis of DVT, but the presence of comorbid pathology, chronic lung diseases, and old age. Additional risk factors include extended DVT, suspected pulmonary embolism, and pregnancy. The goal of anticoagulant therapy is to stop the process of pathological hypercoagulability, the progression of thrombus formation and create conditions for restoring vascular patency, while the pathological idea is that anticoagulants “dissolve the thrombus”. In this regard, anticoagulant therapy is the mainstay of treatment for DVT. To determine the duration of anticoagulant therapy, the etiology of thrombosis is of particular importance – the trigger that led to the formation of thrombotic masses.

Back pain constitutes one of the major medico-social problems of healthcare. The development of a unified approach to the diagnosis and treatment of back pain is hindered since it is difficult to assess the various approaches to its treatment, especially its chronic forms. Yet recent data witnessing the important role of the neuroinflammatory process in the pathogenesis of the degenerative forms of discopathy suggest that the traditional treatment approach, which includes physical therapy exercises and non-steroidal anti-inflammatory drugs and myorelaxants, could be enhanced by using drugs characterized by slow structure-modifying action on the structure of the cartilaginous tissue of intervertebral discs and joints. Given the intelligent use of manual therapy, needle reflex therapy, kinesiotherapy, as well as modification of psychosocial factors that pre-determine the yellow flag phenomenon, the application of sustained-release symptomatic drugs increases the efficacy of therapy and prevents subsequent pain episodes. As of today, a placebo-controlled study has proven the action of Alflutop, which can be administered both intramuscularly and paravertebrally. This approach not only improves the patients’ condition but also reduces the burden associated with chronic back pain problems for the society.