LDL receptor plays a key role in the metabolism of LDL cholesterol. It have been shown that proprotein convertase subtlisin/kexin type 9 is essential for post-transcriptional regulatation of the cell surface expression of the LDL receptor by participating in its degradation. The data from large epidemiological studies indicate that persons with the loss-of-function mutations of PCSK9 have lower LDL level and CHD morbidity. Thus the development of biotechnical/pharmacological agents able to block PCSK9 can be the new option for treatment of patients with severe hyperlipidemia. Currently effectiveness of this approach is studied in large international randomized clinical trials.

Herpes virus infection (HVI) — one of the leading health and social problems in developed countries. Not examine the role of herpes viruses in chronic liver disease. A total of 94 patients with chronic liver disease (CLD), established dominance mixed infection of herpes simplex virus 1 type (HSV-1) and Epstein-Barr virus (EBV) latent and / or persistent currents. Not noted their impact on the clinical biochemical and morphological manifestations of CLD. In contrast, reactivation of HSV-2 in all patients accompanied by increased necrosis-inflammatory activity in the liver. At the alcoholic liver disease (ALD) reactivation of HSV-1 led to an increase in protein-synthetic dysfunction, cytomegalovirus — to enhance the progression of jaundice and hemorrhagic syndrome. Should consider need to identify of the herpes viruses in patients with ALD and appointment of antiviral therapy in cases of reactivation.

Syncope today is a multi-disciplinary problem. Syncope is the most common consequence of the defeat of cardio - vascular system, organic or functional CNS endocrine system. In clinical practice are not rare cases when syncope is the first and only manifestation of a disease. However, syncope can occur in the absence of organic disease in apparently healthy people. The complexity of the pathogenetic mechanisms underlying the development of syncope, a combination of different mechanisms in the same patient, the treatment of patients in the interictal period, the lack of awareness of physicians lead to late diagnosis of the true cause of syncope, the incorrect treatment of this group of patients, which further leads to a decrease in quality of life patients with syncope, in poor prognosis in these patients.

Citoprotective treatment is one of main components in treatment program of chronic cerebrovascular disease, especially in case of such comorbidities like arterial hypertension and ischemic heart disease. Citoprotective treatment could optimize energetic intracellular balance of energy, decrease oxygen stress, decrease requirement of oxygen, improve function of endothelium, improve function of heart. All these process lead to acceleration recovery of movement ability, sensitive, coordinator, intellectual functions, decrease neurological deficiency, improve social adaptation and increase level of life. For realization of all these mechanisms in patients with co-morbidities it is very useful to prescribe Actovegin. This medication can increase synaptic conductivity, increase growth of neurons, increase entrance of glucose – main oxygen saver in mitochondria.

The article presents review of main conceptions of psychosomatic disorders’ development. The most common mental disorders of non-psychotic level in general practice are described.

Tako-tsubo cardiomyopathy, also known as stress-induced cardiomyopathy or transient apical ballooning syndrome, is a distinctive reversible condition often affecting postmenopausal women after a stressful event. It is characterized by sudden temporary systolic dysfunction of the apical and/or midsegments of the left ventricle. The goal of this article is to review the actual knowledge about Tako-tsubo to help the general practitioner. We also presented the case of a 47-year-old woman victim of a tako-tsubo syndrome with delirium in first hours of the desease.

A large number of studies have produced a lot of evidence that there is a connection between the state of the autonomic regulation of heart rate and mortality from cardio-vascular diseases. To the present time enough experience in the study of heart rate variability in patients with various cardiovascular, endocrine, neurological and other disorders. This review of the literature reveals the great clinical importance of the study of heart rate variability in patients with chronic heart failure in the assessment of autonomic tone and its components, as well as the prediction of sudden cardiac death in these patients.

Hyperthermia is one of frequent symptoms to any doctor in his every day practice. It is necessary to now definitions, possible causes and additional diagnostically methods, that can help to make correct diagnosis and provide treatment as soon as it is possible. In article we can find different situations in witch hyperthermia can be one of main symptoms. Authors also provide clinical cases that very well illustrate article.

Продолжение. Начало читайте в № 5.

The analysis of diagnostic errors in 262 patients was made with proved diagnosis of infective endocarditis (IE), the frequency and causes of its occurrence were discussed. Along with the lack of orientation of primary care physicians in the problem of IE, there are objective difficulties in early diagnosis of diseases caused by a variety of clinical manifestations of IE. The most common initial diagnostic hypotheses in patients with IE were unexplained fever, pneumonia , urinary tract infections , rheumatic diseases.

Purpose: clarify the effect of patient education to improve adherence to treatment renoparenhimal arterial hypertension. For patients with a renoparenhimal arterial hypertension on the basis of the specialized nephrology hospital training was provided in a thematic «School of the patient». In it was carried out explanatory work about the importance of treating not only the main renal disease, but the syndrome of arterial hypertension. Results: with initially very low commitment to treatment renoparenhimal arterial hypertension after 6 months of training in patients with kidney disease occurred a significant increase in positive attitude to antihypertensive treatment. Subsequently all patients continued to outpatient antihypertensive therapy that has had a positive effect on the outcomes of the underlying disease. Conclusions: patient education is an important factor in improving adherence to treatment renoparenhimal arterial hypertension.

In the work the special features of the erythrocytes acid resistance (EAR) are studied dynamics at the instable stenocardia and the myocardial infarction (Q-positive and Q-negative). It is revealed that it bears phase character and depends on gravity of the coronary stress. Correlations EAR with other clinical laboratory indices are described. It is established that the development of stress is characterized by strengthening the degree of the coupling of interaction between the erythron and other systems of organism. The predominance of the stress-realizing system activity leads to the increase EAR. Reduction in the stress-realizing activity and predominance of the stress-limiting system leads to the reverse dynamics of acid-hemolytic erythrograms.

In this article you can find main stages of development of nephrology in first half of XX century in Rostov aria. Information about professors, which work was concentrated on nephrology pathology provided in article. Among them: Z.V. Gutnikov, I.F. Pozharisky, N.I. Mukhin, Sh. I. Krinitskiy, A.S. Voronov and others. It first half of XX century there were formulated clinical, scientifically and educational ways of Rostov’s internal medicine school. The main thing was – complex understanding of nephrology pathology in amount of internal diseases.