Objective: to study the types of response to illness in patients with chronic obstructive pulmonary disease (COPD) or rheumatoid arthritis (RA).

Subjects and methods. The sample consisted of 100 patients (mean age 59.2 ± 14.4 years) from University Clinical Hospital One, I.M. Seche nov First Moscow State Medical University, 57 of whom were treated for RA and 43 were for COPD. All the patients were examined by a psychiatrist, a psychologist, and a therapist. The Beck Depression Inventory, SF-36 quality of life questionnaire, and projective psychological tests were also used.

Results. Three main types of response to illness were identified. The features of aberrant hypochondria were most common in the patients
with COPD (53.3 % (23/43)). In RA, hypochondriacal development as a confrontation with illness was intrinsic to a considerable proportion of patients (42.1 % (24/57)). The common response was hypochondriacal neurosis (health anxiety, organ neurotic and omatoautonomic disorders) that was encountered in 27 % (27/100) in the patients with COPD or RA and more common in those with RA (29.8 % (17/57)). The examination revealed nosogenic depressive reactions in 19.2 % (11/57) of the patients with RA and in 9.3 % (4/43) of those with COPD.

Conclusion. The main types of response to somatic illness in the two chronic diseases similar in their impact on quality of life have been investigated, which may be further used to manage this category of patients.

Objective: to study a relationship of QT interval to cardiovascular risk factors in women with rheumatoid arthritis (RA).

Subjects and methods. 291 female patients aged less than 60 years with a valid diagnosis of RA were examined. A control group consisted of
125 women without rheumatic diseases. In addition to the clinical manifestations, acidity, and severity of RA, the authors assessed traditional risk factors (TRF) of cardiovascular diseases (CVD), performed Holter ECG monitoring, common carotid artery duplex scanning, transthoracic echocardiographic study, and determined the levels of serum inflammatory markers.

Results. The patients with RA differ from the control group in a longer adjusted QT interval, corrected for TRF of CVD. The major factors
associated with a daily prolonged QTc interval in the women with RA are arterial hypertension, systolic, diastolic, pulse blood pressure level s, body mass index, subclinical target organ damage (carotid artery atherosclerosis, left ventricular (LV) diastolic dysfunction, LV hypertrophy
and remodeling), and the duration of RA. Leflunomide therapy is an additional factor associated with a prolonged nocturnal QT interval.

Conclusion. The RA patients with a prolonged QTc interval and no clinical signs of cardiac lesion need meticulous examination aimed to identify CVD.

Aim. To evaluate the condition of the thyroid gland in patients with ankylosing spondylitis (AS) during standard therapy and biological
therapy (infliximab).

Subjects and methods. Twenty-six patients with AS were examined; some of them received biological therapy with infliximab, while the others took non-steroidal anti-inflammatory drugs. The structuralunctional state of thyroid gland was evaluated in all patients. The effect of therapy was evaluated by the ASAS criteria. The efficiency of therapy was evaluated 24 weeks after therapy.

Results. In 15.2 % of patients with AS were diagnosed thyroid gland disorders. The level of anti-thyroid antibodies, thyroid stimulating hormone (thyroid function) were correlated with active AS (index BASDAI), and the level of anti-thyroid antibodies were correlated with Creactive protein and erythrocyte sedimentation rate, the intensity of pain in the joints, number of swollen joints and inflamed enthesis.
Therapy with non-steroidal anti-inflammatory drug is not provided significant effect on the structural and functional state of the thyroid
gland, contributing to a downward trend in the level of antibodies to thyroid peroxidase. Treatment with Infliximab reduced the levels of
antibodies to thyroid peroxidase, thyroid stimulating hormone. This treatment was more effective in improving the structural and functional
state of the thyroid gland.

Conclusions. Against the background of the therapy in patients with AS is marked improvement in thyroid function, reduction of antithyroid antibodies, accompanied by a decrease in activity and improvement of clinical and laboratory parameters of AS.

The problem of pain today remains one of the fundamental issues of medical care. It is known that the pain is the leading cause of treatment
to the doctor. Among pain syndromes, a special place belongs to the complex regional pain syndromes. They are distinguished by the multidisciplinary problem, the presence of explicit nature of the pain, difficulty of diagnosis and nature of the treatment. The article presents
modern data on the diagnosis and treatment of the complex regional pain syndromes.

Malignant oral tumors account for 6 % in the total cancer incidence. The rate of recurrent tumors ranges from 25 to 50 %. About 80 % of patients with failed treatment are to undergo radiation, chemoradiation, or drug therapy. After retreatment, severe complications occur in more than half of the patients even to death (2 %). Some progress has been made in the treatment of recurrent tumors due to the current possibilities of surgical treatment. Surgical reintervention can be made and satisfactory treatment results obtained in a number of patients even if they develop recurrent tumor after a previous saving operation.

The paper presents main approaches to the differential diagnosis of shoulder joint pathology and describes the major nosological entities of shoulder diseases. It gives data on the possibility of using nanotechnologies in optimizing the management of a patient with chronic shoulder joint pain syndrome.

Lumbago is an exceptionally common syndrome associated with sizable material costs, high recurrence incidence rates, and a risk for chronic pain. While managing a patient with lumbago, it is necessary to exclude the potential causes of secondary pain syndrome, including injuries, neoplasms, local infections, and somatic diseases. Nonsteroidal anti-inflammatory drugs and analgesics, which are responsible for side effects in a number of cases, have a good analgesic effect. Concurrently with their use, Milgamma, a neutropic vitamin B complex, produces a higher antinociceptive effect, a less need for analgesic drugs, shorter treatment, and more prolonged remission.

Sleep and awakening disorders are almost obligate manifestations of Parkinson’s disease. Primary sleep and awakening disorders in Parkinson’s
disease are associated with the degeneration of serotoninergic neurons in the dorsal raphe nucleus and cholinergic neurons in the pedunculopontine nucleus. Impaired awakening maintenance with the development of hypersomnia may result from neuron degeneration in the locus coeruleus or pedunculopontine nucleus. A certain role may be played by the pathological basal ganglionic pulsation caused by striatal dopamine deficiency, which goes to both the thalamic reticular nucleus and pedunculopontine nucleus, as well as by dysfunction of the mesocortical dopaminergic pathways involved in sleep-wake cycle regulation. Synthetic melatonin (Melaxen) is one of the effective medications for the treatment of sleep disorders in Parkinson’s disease. The drug normalizes circadian rhythms and has a hypnotic effect although it is in the usual sense not a soporific agent. Melaxen has a minimum of side effects and is well tolerated by patients from different age groups.

The given clinical example presents a case of concomitant diseases of the heart and axial skeleton. Calcific aortic stenosis detected by chance in an elderly male was associated with osteoporosis of the lumbar spine with moderate perturbation of the calcium–vitamin D–parathyroid hormone axis and with no classical risk factors for impaired bone mineral density. Possible approaches to pathogenetic therapy are described.

Clinical manifestations of atherosclerosis are the most significant medical, social and economic challenge of our time, distant from its decision. Research study of atherogenesis at the cellular level, communication mediators and receptor-activation reactions indirect immunocompetent cells identify pathogenetic parts of the atherosclerotic process. In this article the role of infectious agents in formation of endothelial dysfunction, development of system inflammatory response and lipid transformation of the vascular wall, underlying an atherosclerosis
is surveyed.

The paper gives the data of Russian and foreign studies on the pathophysiological mechanisms of brain injury in ischemic and hemorrhagic
stroke, the specific features of brain plasticity and its activation after cerebral stroke, and main directions for basic and differentiation therapy for acute cerebrovascular pathology. Particular emphasis is placed on the issues of cytoprotective and neurotrophic therapy for cerebral stroke. Analysis of the data available in the literature shows that cytoprotective and neurotrophic therapies are important components of combination treatment in patients with stroke and favorably affect the functional outcome of the disease.

Neoangiogenesis in coronary heart disease is a protective reaction aimed to improve ischemic myocardial perfusion, by increasing the number and size of arterial collaterals. Placental growth factor (PlGF) is one of the key peptides regulating angiogenic processes in atherosclerosis. In particular, a number of investigators have shown that injection of recombinant PlGF into the system or regional blood flow can stimulate neoangiogenesis. On the other hand, there is evidence confirming the involvement of PlGF in the progression of atherosclerosis and in the development of acute coronary syndrome. In this connection, the problem of investigating the efficiency and safety of possible use of PlGF preparations, as well as its place in the diagnosis of coronary heart disease and acute coronary syndrome remains urgent