Aim: complex investigation of the small intestine functional condition in metabolic syndrome.

Materials and methods.120 patients with metabolic syndrome were examined. We used clinical data and complex examination of the small intestine function. Hormon and vegetative status in patients with metabolic syndrome were estimated.

Results. In majoriti of patients (82,9 %) the clinical local and common signs of small intestine lesion were revealed. In study of intestine function the disturbances in all stages of hydrolysis and resorbtion simultaneously with hypomotor dyskinesic of small intestine in postprandial period and hypersympaticotonia were found. The role of hormones in disturbances of digestion, absorbtion and motor function was revealed.

Conclusion. Changes of the small intestine functional condition take the important part in metabolic syndrome its progressing.

The goal of the research was to value monitoring results of periodic health examination of the patients with stenocardia for management decision making within primary prevention of myocardial infarction. It was found the quality of periodic health examination of the patients with stenocardia is low. There is no mitigation of myocardial infarction risk in the patients with stenocardia within periodic health examination as preventive technology.

Purpose of investigation. To study the effectiveness of a modifi ed method of mitral valve prolapse diagnosis and its fl ow dynamics in children in terms of time (10–15 years old).

Materials and methods. 75 children in age of 3–18 years old with undifferentiated connective tissue dysplasia and also with incorporation of modifi ed method of mitral valve prolapse diagnosis were examined and its evolution in 30 adult patients (average age is 27,5years old) was studied together with the diagnosis, established 10–15 years ago.

Results. The mitral valve prolapse in 30,7 % of children with undifferentiated connective tissue dysplasia at rest is “dumb”. It was established, in terms of time that is in adulthood, mitral valve prolapse is characterized by progression of clinical and echocardiographic parameters.

Conclusion. The study showed the diagnostic value of the optimized method for the diagnosis of mitral valve prolapse in children with undifferentiated connective tissue dysplasia, providing its preclinical diagnosis. Stressed functioning of the cardiovascular system in patients with mitral valve prolapse, in adulthood, dictate the need for timely correction of the daily routine, reasonable therapy, reasoned and controlled exercises to be done.

The frequency of risk factors for cardiovascular disease in the adult population analyzed of the Tomsk region (n = 8150), who visited a health center in 2012. Gender differences and increase with age of the characteristics of the distribution of risk factors are described. Among men, smoking more frequently (39 %) and high blood pressure (33 %), among women — abdominal obesity — (33 %), with age, regardless of sex reduces the incidence of smoking and increasing the frequency of biological (metabolic) risk factors: high blood pressure, overweight and obesity, hypercholesterolemia.

The article discusses the quality of life in patients with undifferentiated dysplasia of connective tissue, obtained by «SF-36 Health Status Survey», assessment of anxiety along “The Scale of assessment of the level of reactive and personal anxiety” and General psychological state on the questionnaire “Health, activity, mood”.

In clinical studies in 119 pregnant women aged between 17 and 27 years , who after 20 weeks gestation diagnosed with gestational hypertension (GAH ) . At dividing the patients into groups, we considered baseline BP level in terms of till 20 weeks of pregnancy. Depending on the method of treatment, each group was divided into two subgroups — A and B. Subgroup A included pregnant with GAH, who in complex treatment received L-arginine, subgroup B included pregnant with GAH without correction. Studies have shown that the development of the GAG and the frequency of hypertensive complications such as preeclampsia (PE) is determined in impaired NO-system and the degree of endothelial dysfunction (ED), which stimulates the vasoconstrictor effect of ET-1, causes endothelial damage and increased in the systemic circulation amount of circulating endothelial cells (CEC). Therefore , an important regulator of DBP in women with GAH was endothelial dysfunction. The use of L-arginine prevented the imbalance in the NO- system in pregnant women with GAH . This was manifested by reduction to control values in the blood of pregnant women subgroups , 1st and
2nd groups eNOS enzyme activity and, consequently , a positive development content of NO, inhibition of the activity of iNOS, ONO2- , ET-1 , CEC and ultimately restores DBP . Applications L- arginine prevents the development of ED in pregnant women at risk of GAH .

Aim. To evaluate the intensity of influence of intravascular administration of contrast media (CM) on inhibition renal filtration in patients with acute coronary syndrome (ACS).

Material and methods. The degree of increase in serum creatinine in patients with ACS was compared.

Results. The incidence of contrast-induced nephropathy (CIN) was significantly higher in 76 patients treated with CM — 32.9 % of cases, compared to 6.3 % in 80 patients without intravascular administration of CM.

Conclusion. The results show that the cause of CIN may be not only the effects of CM administration, also prevention of disorders in the kidney filtration should be performed in all patients without waiting for the increase of level of serum creatinine

The aim of the study was to examine the plasma concentrations of galectin-3 and brain natriuretic peptide (BNP), indicators of antioxidant protection, oxidative stress, systemic inflammation and endothelial dysfunction, central hemodynamic parameters.

Materials and Methods: The study included patients with CHF without metabolic disturbances (n = 30) and with the combination of heart failure and diabetes mellitus (DM) type 2 (n = 60). 

Results: Patients with chronic heart failure, having as co-morbidity of DM have higher levels of biomarkers of heart failure (galectin-3 (R≤0,001), BNP (R≤0,001), as well as more significant changes in hemodynamic parameters. In the group of patients with CHF with preserved ejection fraction (EF) revealed higher levels of galectin-3 (0.955 [0.886; 1,010] ng / ml) compared to patients with reduced ejection fraction (0.816 [0.776; 0.934] ng / ml) (P = 0,01). The level of galectin-3 above 1ng / ml is associated with a poor prognosis for the frequency of hospitalizations in patients with CHF.

The article contains an analysis of the clinical case of Graves disease in the elderly. The features of thyrotoxic disorders in the elderly, the reasons for their development are presented. It describes characteristic manifestations of diffuse toxic goiter in geriatric patients, pathogenesis, diagnosis and treatment principles.

In article we provide description of clinical case — 32 years old patient with noncorrected atrioventricular communication. This case demonstrate a rare congenital heart disease in adult (epidemiologically 96 % of deaths till the age of 6).

Tremor disease Wilson’s is demands obligatory differential diagnosis with multiple sclerosis. The article presents a clinical case of mistaken diagnosis, “Wilson’s disease” rather than the diagnosis “multiple sclerosis” in young men.

Background: To improve differential diagnosis of chronic obstructive pulmonary disease (COPD) and bronchial asthma (BA), identification of new biological markers is needed. Aim: To differentiate between COPD and BA using modern immunological methods. Results: Conducted a comparative study of surface markers of peripheral blood lymphocytes in peripheral blood lymphocytes, expresarse antigens CD3, CD4, CD8, CD16, CD20, CD23, CD25, CD54, CD71, CD72, HLA-DR, CD95 and membrane immunoglobulins mIgM and mIgG in patients with chronic obstructive pulmonary disease (COPD) and atopic asthma in the acute stage. Shows significant differences in the changes of surface phenotype of lymphocytes in the studied diseases. In addition, in COPD, there is a considerable increase in the content of cytotoxic lymphocytes (CD 4+, CD8+ and 34 %, CD16 + NK cells by more than 33 % of normal ) in the blood is not dependent on stage of the disease. It is suggested that the high cytotoxic potential of the immune system is the cause of more damage to the lung tissue, causing the development of pulmonary
fibrosis, emphysema and systemic damage in COPD. In patients with ABA during remission of the activity of cytotoxic cells is reduced, and observed the predominance of the processes of activation of apoptosis of lymphocytes (CD95) on their willingness to differentiation and acquisition of late differentiation antigen (HLA-DR). Received various changes in the immune response in patients with ABA and COPD allow a better understanding of
the features of chronic inflammation in these diseases.

This article is a review of modern views on etiology of severe community-acquired pneumonia, resistance to antibiotics and key bacterial agents. We observe recommendations on antibiotic choose in different situations in adults. We provide descriptions of several clinical cases of severe pneumonia, caused by different bacterial agents.

Aim of prospective clinical study was to evaluate effectiveness, safety and convenience of treatment deep vein thrombosis with oral anticoagulant — Rivaroxaban from the 1st day of treatment. Study population: patients with verified acute deep vein thrombosis admitted to surgery clinic. 39 patients were included in study. Treatment: from the 1st day — Rivaroxaban 15 mg twice a day for period of three weeks, then 20 mg daily. Full treatment period was 3 months for distal vein thrombosis, 6 months for proximal vein thrombosis, 12 months for idiopathic, recidivous deep vein thrombosis and in case of deep vein thrombosis in patients with oncology. For the all period of treatment there were no recurrence, progression of deep vein thrombosis, hemorrhagic ccomplications and pulmonary embolism. Results of this study show, that Rivaroxaban is well tolerated and well compline drug for such type of patients.