In the August issue of European Heart Journal the guidelines, devoted to a problem of the acute coronary syndromes in patients presenting without persistent ST-segment elevation, which are developed by leading experts of the European Society of Cardiology, were published. The aim of these recommendations is to provide clinicians with brief statement of the modern management that could be successfully applied in practice. In this overview we present basic statements of this document.

The main pathogenic effects of the original nativedrug — remaxol combining properties of balanced polyionic solution (methionine, inosine, nicotinamide and succinic acid were introduced additionally), antioxidant, antihypoxant and hepatotropic agent are considered in review. The results of its application in clinical practice among patients with alcoholic fatty liver disease, metabolic disorders, viral hepatitis, drug hepatotoxicity and in the perioperative period are presented.

This review presents recent data on the main causes of lymphopenia. Hereditary immunodeficiency, infectious and autoimmune diseases, malignant tumors, medications, and other conditions when the level of lymphocytes decreases are reviewed.

Following article based on the literature and our own observations presents a brief analytical review covering clinical and epidemiological characteristics of hepatitis associated with TT virus, as well as modern methods of diagnosis and approach to the treatment of infectious diseases. The clinical observation showed symptoms of acute inflammation of the liver caused by TTV-infection. Characteristics of epidemiological anamnesis confirms that besides the main parenteral mechanism there is also a fecal-oral mechanism of infection TT virus. Following observation verifies a longterm persistence of TT virus in the body and complete absence of spontaneous elimination.

According to The Third Definition of Myocardial Infarction there are five types of myocardial infarction depending on pathogenesis. This review provides actual data about myocardial infarction type 2 mechanism including diagnosis management, epidemiological characteristic and patient prognosis. Previously published data shows discordant information about myocardial infarction type 2 frequency, treatment and diagnostic options. Our clinical observation illustrates these severities in diagnosis construction, disease feature in acute period in casual clinical practice.

The aim. Research the clinical features, functional state of duodenum among patients with chronic pancreatitis and accompanying duodenostasis.

Materials and methods. The clinical course of chronic pancreatitis with accompanying duodenostasis (85 cases) and isolated chronic pancreatitis (56 cases) has been studied. Along with the general clinical data the study includes the results of exocrine pancreatic function examination (fecal elastase-1, blood alpha amylase and lipase) and its endocrine function (insulin and С-peptide). Regulating hormonal factors (gastrin and somatotropin) have been studied. Was used results of rentgenology and endoscopic examinations, intraduodenal manometry results in verification of duodenostasis.

Results. In the observation group resistant pain syndrome was revealed in 93% cases (at patient with isolated pancreatitis in 57% cases) and in more degree was expressed coprological syndromes (amilorhea in 82,29% cases, creatorhea in 82,14% cases, steatorhea in 87,5% cases). In the observation group were significantly more diagnosed hyperperistaltic (in 88% cases of observation group and in 9,4% cases of the comparison group) and duodenal hypertension (in 22% cases of observation group and in 0.0% cases of the comparison group). The phenomenon of «semolina» was reveals more often in observation group (in 31,9% cases of observation group and in 5% cases of the comparison group).

Among patients with chronic pancreatitis and accompanying duodenostasis decrease the level of C-peptid and increase secretion of insulin, somatotropin and gastrin.

Conclusion. It reveals that according to the comprehensive clinical and functional investigation chronic pancreatitis with accompanying duodenostasis gets a more severe course in comparison with isolated pancreatitis.

The Purpose of this research was to study indicators syndrome of endogenous intoxication in patients with erysipelas and herpes infection that can be used to predict relapse in these diseases.

Based on the goal were examined in 54 patients with primary, erythematous form of erysipelas of different localization and 42 patients with the localized form of herpes infection in the dynamics of these diseases.

Determined the level of substances of low and medium molecular weight (HV and SMM), and oligopeptides, as well as the Integral index of intoxication by the method of M. I. Malakhov (1994) and Lowry (1991). To assess the value of the Integral index of intoxication in the prediction of relapses were calculated odds ratio.

Revealed the dependence of studied parameters of disease and completeness of recovery.

Level measurement HV and SMM and oligopeptides allows us to calculate the Integral index of intoxication, which can be used as a prognostic criterion of recurrence as erysipelas, and herpes infection.

Aim: to analyze the prognostic value of gene polymorphisms ACE (D/I), SLCO1B1 (Val174Ala), LIPC (C514T), CYP2C19*2, CYP2C19*3, ADRB1 (Ser49Gly), ADRB1 (Arg389Gly) of patients with ST-segment elevation myocardial infarction (STEMI).

Materials and methods. 155 patients with STEMI from 45 to 75 years of age were involved into the study. All patients were prescribed all recommended preparations improving prognosis (statins, angiotensin-converting enzyme inhibitors, beta-blockers, clopidogrel as part of dual antiplatelet therapy) from the fi rst day of hospitalization. Prognosis was assessed by endpoints: cardiovascular mortality, nonfatal myocardial infarction throughout 12 months.

Results. Carriers genotypes *1*2 and *1*3 had in 3,27 times higher risk of recurrent myocardial infarction within 1 year from the STEMI (р=0,03). There was no effect of gene polymorphisms ACE (D/I), SLCO1B1 (Val174Ala), LIPC (C514T), ADRB1 (Ser49Gly), ADRB1 (Arg389Gly) on the probability of recurrent myocardial infarction (p>0,05). Associative links studied polymorphisms with the cardiovascular mortality is not installed (p> 0,05).

Nowadays neurosurgery has come to an absolutely new level. Modern techniques allow to perform complex operations on the brain, spinal cord and spine. Despite the possibilities of neurosurgery the rehabilitation questions remain significant in the postoperative period. Personality features of patients play a direct role in the manifestation of spinal cord disease, and spinal somatic diseases. Stress, previous illness and injury contribute to the formation of pain behavior habits. Experienced pain is fixed in our emotions causing fear which is fixed and reproduced in the future. Because of past events consequence expectation of the future events are formed. Not adequate fixation of negative emotions, in its turn, leads to obsessions, phobias, mania. Various studies confirm the reduction of patients anxiety using art therapy. A new component of this research is to study the use of art therapy (projective drawing technique) to raise the paitients autopsychology competence level.

In this analysis were examined 45 patients of spinal department (21 women and 24 men), medium age 39,22, with diagnoses: spondylolisthesis, spinal stenosis, hernia, tumors.

Nowadays interest in channelopathies is growing, and developing diagnostic capabilities make Brugada syndrome much more actual problem than ever. Conception of «primary electric heart disease», which earlier was so popular, now couldn’t explain the absence of single genetic syndromes’ substrate, its’ common combinations with another arrhythmias and the presence of Brugada phenocopy. Conjunction of Brugada syndrome with morphological changes in myocardium , especially myocarditis, is an area of special interest. Infl ammation associates with clinical manifestation of the syndrome, and this situation forces to think about channelopathies’ primacy and to look for another possible mechanisms of Brugada syndrome.

Inflammatory bowel disease (IBD) is an immune-pathological disorder characterized by chronic progressive inflammatory destructive lesion of the gastrointestinal tract. The etiology of the IBD remains unknown. An example of clinical observation is presented to show the difficulty of differential diagnosis between Crohn’s disease and intestinal tuberculosis (TB) in a child with nodular pulmonary TB.