This article is an analysis of the clinical case of differential diagnosis of Fabry disease. Pecular symptoms and the principles of diagnosis of Fabry disease, as well as current treatment options for this disease are presented.

The article describes the organization reveal of TB patients at medical facilities of primary health care (PHC) in Moscow. There are the main epidemiological indicators in Moscow and the features of the organization of TB detection in the city. The Quality of detection TB cases in PHC is directly depends on the attention of PHC workers to TB risk groups, the competence in the assessment of the main TB symptoms and organization of the patients’ flow for checking up for TB including sputum smear microscopy. It is proposed installation of centralized fluorography register with the option to analyze the index of “the proportion of people not examined more than two years”. The Quality of TB detection in PHC facilities can be improved by complex implementation of medical and organizational changes and indicators and their regular collection and analysis. 

Patients with mitral valve prolapse (MVP) revealed a significant deterioration in the quality of life (QOL) compared with healthy people. After a course of the Magnerot, alprazolam (Xanax), psychotherapy significantly improve was estimated. In observing these same patients after 15 years recorded a decline in all QOL parameters compared to the results immediately after treatment and from baseline. However, patients with MVP who regularly used Magnerot over the years found a significant improvement of quality of life. 

Cognitive dysfunction draws more and more attention of doctors and researchers. The article contains a detailed analysis of risk factors, clinical features and possibilities for cognitive rehabilitation. Neuroprotective therapy in conjunction with adequate correction of homeostasis and hemodynamic is of high practical importance. The suggested methodology directed towards improvement of cholinergic transmission with the use of Mildronat, Actovegin and Ceraxon is rather efficient and can be recommended as medicine of choice not only as cognitive preserved but also as cognitive restoring medicines. 

In article the results of clinical observations of mixed tick-borne encephalitis-Borrelia infection and mono infections of tick-borne encephalitis and borreliosis are described. The results of the comparative analysis of the severity of nervous system affection in patients with mixed infection and both variants of monoinfections are presented.

The problem of antibiotic-associated conditions is one of the most actual problems of clinical practice. The antibiotic-associated diarrhea is a multidisciplinary problem. Prevention and therapy an antibiotic-associated diarrhea should include probiotics using. In article foreign and domestic data containing application of various probiotics for prevention and therapy antibiotic-associated diarrhea, emphasis multispecies probiotics use are presented. 

Contemporary Russian and international experience of prophylaxis of thromboembolic complications of atrial fibrillation indicates that the most popular strategy for the prevention of stroke with warfarin is far from optimum. Measures proposed to improve it (physicians’ knowledge of pharmacodynamics features, pharmacokinetics and pharmacogenetics of the drug, regular monitoring of International Normalized Ratio) can not always be implemented in clinical practice. Introduction of new anticoagulants, as effective as warfarin, but more convenient to use, is very important now. Such anticoagulant is rivaroxaban (Xarelto). Authors believe that comparable safety with warfarin and not inferior/superior safety, ease of dosing, no need for laboratory monitoring during therapy, no adverse interactions with medications and food products will allow rivaroxaban to increase significantly the compliance of doctors and patients to anticoagulant therapy in the near future. 

This article marked one of the most significant problems of cardiology and cardiac surgery patients — mental and brain dysfunction. It was shown that depression is an independent risk factor for coronary heart disease and is associated with severe postoperative course. The material presents survey data in 316 patients aged 28 to 64 years who underwent cardiac surgical treatment: coronary artery bypass surgery, valvular prosthesis with combined lesions of the cardiovascular system. In cardiac surgery patients under cardiopulmonary bypass, cerebrotoxic and hypoxic brain injury combined therapy with ethylmethylhydroxypyridine succinate (Mexiprim) and Paroxetine have antihypoxia, antioxidant and angio-cerebroprotective action. Inclusion of antioxidants and antidepressant drugs in the complex therapy of cardiac surgery patients to prevent psychosomatic complications improves cerebroprotection and reduce the severity of the clinical manifestations of cerebrovascular and mental symptoms. 

The article is dedicated to most interesting facts of life of Paul Gachet, a doctor known for his love of painting. Exactly Gachet was Vincent van Gogh’ treating doctor and inspirer during last months of artist’s life.