In practice any doctor, especially therapist daily meets patients who, despite the presence of a somatic pathology, have various neurological symptoms, which often require urgent consultations of the neurologist to exclude acute neurological pathology. In the article some of these neurological problems of therapeutic patients are observed.

Interest in the problem dysbiotic disorders of the gastrointestinal tract increases in modern medicine, however, representatives of the microflora have been studied for over 100 years. Microbiocenosis intestine plays an important role in maintaining and restoring human health, which is particularly important in the postoperative period. Proved that surgical patients develop intestinal dysbiosis adversely affects the postoperative period: deteriorating quality of life as a result of abdominal pain, nausea, frequent urges to defecate or, conversely, as a result of a tendency to constipation . The article describes the characteristics evolved dysbiotic conditions in patients after surgical treatment of coronary heart disease. The results of the application of probiotics in these patients, demonstrated the efficacy of the selected combination of probiotics in the normalization of intestinal microflora in the postoperative period.

The article describes the two main methods of determining the content of magnesium in patients with connective tissue dysplasia. The most informative technique that can reliably establish a deficiency of magnesium in the body.

Admission hyperglycaemia is common in diabetic and non-diabetic patients with myocardial infarction and has negative influence on prognosis. The value of admission glycaemia as risk factor is underappreciated, that causes untimely monitoring of glycaemia, infrequent treatment and inappropriate therapeutic strategy in patients without diabetes. The article shows the results of analysis of association between admission glycaemia and short-term and long-term prognosis in patients with myocardial infarction.

Warfarin by «Kanonpharma production» (Russia) and original Warfarin have the similar safety and tolerability. We need some increase of dose of Warfarin by «Kanonpharma production» to reach target rate of INR, then in case of original Warfarin usage. But for 1.5 month of treatment this characteristic doesn’t mention to reach target INR. Considering that Warfarin by ZAO «Kanonpharma production» is less expensive then original, they are comparable for ratio «price/effect».

Pulmonary embolism (PE) is the most frequent unrecognized cause of death of hospitalized patients. Mortality is about 30%, which determines the relevance of the topic. Accurate statistics regarding the prevalence of PE in Russia does not exist. The exact number of nonfatal asymptomic PE is unknown. In most cases PE is a complication of deep venous thrombosis of the lower extremities and occurs not only in patients of cardiological profile. The article considers the ways of drug therapy and clinical examples.

The results of the epidemiological research obtained on the territory of Chuvash Republic are presonted. The prevalence of arterial hypertension among the patients, sufferring from chronic heart failure was analyzed. The representative method in Chuvash Republic had proven the high prevalence (100%) of arterial hypertension in patients with inveterate cardiac decompensation. It was also established that arterial hypertension III has the same prevalence rate among both the population and the representative group. However, the severity of arterial hypertension correlates with the severity of inveterate cardiac decompensation, while the prevalence rate of arterial hypertension III is much higher among men than among women.

The article is devoted to a new direction in medical treatment of ischemic heart disease and arterial hypertension –– the use of cytoprotective and antioxidant agents. The intracellular mechanisms of development of hypoxia and ischemia, fabrics, oxidative stress, possible ways of correction of these processes are discussed. Classification of cytoprotectors considered their mechanisms of action, indications, results of their application in various forms of ischemic heart disease and arterial hypertension, and other conditions involving oxidative stress and vascular dysfunction of endothelium are given.

We investigate the frequency and reasons of liver dysfunction in the early postoperative period at patients after heart surgery. The liver dysfunction occurred at 120 from 663 (18%) operated patients in the early postoperative period. We revealed a distinct connection between a type of a surgery performed and liver dysfunction, which more frequently followed multivalve procedures and combined operative treatment like valve reconstruction and myocardial revascularization. Amongst causes, which contribute liver dysfunction we sorted 5 main ones: prolonged hypoxia in preoperative term, trauma due to surgery and intraoperative hypoxia, toxic medications, reactivation of a viral hepatitis, sepsis. A term, when liver dysfunction advances, depends on these causes.

The survey considers the role of melatonine in human body and possibility to use exogenic melatonine to correct the effect of abiotic factor with ischemic heart disease. It also includes the experimental and clinical studies to use melatonine in therapy for treatment and prevention.

Article deals with age-related hypogonadism in men as an interdisciplinary problem. Current definition, prevalence, analyzes the relationship between age and the incidents of hypogonadism were shown. The detailed overview of clinical studies, metaanalysis of causal link of androgen deficiency and erectile dysfunction, ischemic heart disease, arterial hypertension, dyslipidemia, and diabetes mellitus was presented. To date was found the relationship between metabolic syndrome and androgen deficiency. Low level of testosterone is closely connected with low libido as well as insulin resistance, abdominal obesity, dyslipidemia. Insulin resistance and hyperinsulinemia are noticed in patients with hypogonadism in comparison with obese and normal-weight patients. Therefore, metabolic risk factors are the connecting link of cardiovascular diseases and androgen deficiency. Meta-analysis of clinical trials of the effects of testosterone replacement therapy and safety of long term use was presented in the article. The article discusses the importance of a unified approach to the diagnosis and treatment of androgen-deficient conditions and cardiovascular disease.

We studied the frequency of cardiovascular risk factors, signs of subclinical atherosclerosis, erectile and endothelial function in the railway workers with high professional stress. We found higher frequency of abdominal obesity, hypercholesterolemia and hypertriglyceridemia, as well as functional features of atherosclerosis and erectile dysfunction in stressful profession patients with hypertension. In the result of the examination of patients with hypertension and occupational stress, endothelial dysfunction is detected more frequently than in those with low stress profession. Endothelial dysfunction in stressful profession patients is associated with increased waist circumference, BMI, hypercholesterolemia, atherosclerosis. In patients with arterial hypertension and stress endothelial dysfunction found more often by 17% compared with low stress ones. These patients, in most cases (82%) also had signs of atherosclerosis.

At present stage of development of psychosomatic medicine one of actual problems is mutual influence psychological frustration and cardiovascular disease. One of main reasons of the situation, that this is an actual problem – prevalence of these pathology and high risk of death in this group of patients. In article we provide review of main ways of dealing with field of psychocardiology with accent to somatocentric approach.

Research objective. To determine a functional condition of a myocardium by a method of an echocardioscopy (EHO-KS) at patients with the chronic kidney insufficiency (CKI) before and after the test of 6-minute walking. 58 patients with HPN 1, 2, 3 (on a program hemodialysis) stages are surveyed. To all patients are carried out — the 6-minute walking test, EHO-KS before and after the 6-minute walking tеst, laboratory research of creatinine, KShchS, sodium, potassium, calcium of serum of blood. Results. When progressing HPN the functional condition of a myocardium of the left ventricle (LV) worsens, pulmonary hypertensia, diastolic dysfunction accrues, at the kept LZh systolic function. At patients with HPN of 3 stages on a program hemodialysis hypertensive reaction to physical activity is observed.