Gout new diagnostic criteria are reflected in the presented translation of new international guidelines (ACR/EULAR 2015).

Disruption of biological rhythms is a relevant factor contributing to the etiology and pathogenesis of depression. This review provides the evidence of desynchronization in the clinical presentation of onset and relapse. The results of own study revealing frequency of sleep disturbances and effects of seasonality on depression risk are presented. According to chronobiology, the current opportunities and promising directions of personalized therapy development are considered.

In recent years, medical community has come to the conclusion that the currently used prognostic criteria of the course of COPD, do not allow to predict the further development of the disease, its complications and outcomes with high accuracy. The most popular predictor in clinical practice remains the determination of the level of FEV1. However, the need to expand the list of criteria for determination of a more precise prognosis and clinical outcome of the disease is obvious. The main task of modern pulmonology is the search for prognostic markers of several complex parameters, capable of ensuring the timely prognosis and choice of adequate therapy. The presence of comorbid diseases and high frequency of exacerbations in COPD patients should be treated as such markers.

For a long period of time adipose tissue was regarded as nonfunctioning ‘store’ of triglycerides. In our day and age there are enough evidence which confirm that, beside being a main source of energy, adipose tissue is an active endocrine organ, which plays a crucial role in maintaining homeostasis and taking part in the pathogenesis of many diseases. It`s excess is accompanied with hyperactivation of local renin-angiotensin-aldosterone system, increasing of local and systemic concentration of aldosterone and eventually leads to formation of secondary hyperaldosteronism. Aldosterone, in turn, has a direct effect on adipose tissue through a large number of mineralocorticoid receptors expressed on the surface of adipocytes. This leads to an accelerated maturation of the adipose cells and further increase in the amount of adipose tissue Reaching systemic circulation and influencing other organs, the excess of the hormone leads to the insulin resistance, atherosclerosis and progression of systemic inflammatory reactions. The role of aldosterone in the onset and progression of all components of metabolic syndrome — obesity arterial hypertension, glucose metabolism and dyslipidemia — are analyzed in this article. The possibility of usage of selective and non-selective antagonists of the mineralocorticoid receptor in complex treatment of patients with obesity is discussed. Who knows, maybe their usе will become a key to the preventing of the obesity-associated complications.

Purpose: study of the peculiarities of progression of gastroduodenal ulcer with associated chronic duodenal insufficiency.

Material and methods. Verification of ulcer disease was performed clinically and by fibrogastroduodenoscopic researches. In determination of chronic duodenal insufficiency there were used data of contrast duodenography and cavitary manometry. We have studied motor performance of the stomach and gastroduodenal ulcerwith a help of peripheralelectrogastrograph ЭГГ-4М. We also conducted cavitarypH measurement of stomach and gastroduodenal ulcer.

Results of research. We have carry out complex examination of 80 patients with ulcer disease with associated chronic duodenal insufficiency (study group) and 30 patients without chronic duodenal insufficiency (group of comparison). It’s noted pains in epigastric area (91,5% and 84,6% respectively) in patients with gastric ulcer of the study and group of comparison but with associated chronic duodenal insufficiency they have mainly aching character, and without chronic duodenal insufficiency they are more intensive (77,8%). Untoward reaction test is positive in 23,8% of patients in group of comparison — 57,2%. According to the data of electrogastrography on an empty stomach in patients with gastroduodenal ulcer with associated chronic duodenal insufficiencyit’s noted bradygastritisand isolated progression of ulcer disease, hypokinesis, postprandial electric activity decreases. In group of comparison there was detected tachygstritis, these indices increases postprandialy. Untoward reaction test is positive in 34.7% of patients with gastroduodenal ulcer with associated chronic duodenal insufficiency and 63,6% in patients with gastroduodenal ulcer without associated chronic duodenal insufficiency. Postprandial electric activity in study group increases, in experimental group it decreases. There were noted peculiarities of changes pf pH-medium and duodenum with gastroduodenal ulcer with associated chronic duodenal insufficiency and isolated progression of ulcer disease.

Conclusions. Carried out researches extend the knowledge about negative influence of chronic duodenal insufficiency on the progression of ulcer disease. It can be supposed that correction of motor activity of the stomach and duodenum as part of co mplex therapy can be promising tendency in treating of patients with ulcer disease with associated chronic duodenal insufficiency.

In case of patients with alcohol addiction haloperidol is used to control the exacerbation of the addiction, but the empirical dose selection of haloperidol often results in adverse side effects. Enzyme CYP2D6, which has encoded by gene CYP2D6 has high variability of activity, which depend from polymorphism of gene CYP2D6. P- glycoprotein, which has encoded by gene ABCB1 has high variability of activity, which depend from polymorphism of gene ABCB1. The study involved 20 men with alcohol addiction. The efficacy and safety of haloperidol was evaluated by international psychometric scales. The genotype of CYP2D6 was investigated by real-time PCR. The study revealed a statistically significant patterns between the polymorphism of CYP2D6 and the efficacy and safety of haloperidol. The genotype of ABCB1 was investigated by real-time PCR. The study revealed a statistically significant patterns between the polymorphism of ABCB1 and the efficacy and safety of haloperidol.

Describes the algorithm for generating the patient as a medical technology school and social work in the provision of out-patient assistance to those elderly and senile patients with severe chronic disease and high demand for palliative care. With this educational program for individuals with no medical training, employed in care, is part of a medical and social service, implemented by means of Internet technologies. The school’s patient is a functional Association expertise, providing palliative assistance to older age groups. Assessment of its effectiveness reliably showed that levels of depression in patients decreases in 2,2 times, families-in 1,6 times.

Chronic obstructive lung disease is a significant medical, social and economic problem because of its high prevalence. This disease can be prevented, that’s why its early detection is very actual. The article presents an overview of recent data on screening methods and biomarkers that reflect the course of the disease. The article shows the importance of finding new methods of screening in smokers and in people, who are exposed to secondhand smoke.

Objective: comparative assessment of the quality of life of IBS patients in the treatment process with the use of specific and non-specific questionnaires.

Materials and methods: a dynamic study of quality of life in 40 patients of IBS with the use of questionnaires GSRS and SF-36.

Results: marked decrease in the severity of syndromes on all 6 scales of the questionnaire GSRS, and after 1 to 3 weeks of treatment dynamics was gained statistically significant, and total score improved significantly already after 1 week of therapy. Positive dynamics was obtained on the two scales of the questionnaire SF-36 (social functioning, and emotional functioning), as well as physical and psychological components of health.

Conclusions: the high sensitivity of specific questionnaire GSRS and diagnostic significance of nonspecific SF-36 questionnaire in patients with IBS, the necessity to combine them.

This is a case report of pulmonary damage in the form of intestinal pneumonitis with severe respiratory failure during administration of acetaminophen (paracetamol). In addition, significant increase of ALT and AST levels without clinical signs of liver damage was observed in this patient. After glucocorticoids administration regression of radiological abnormal findings in the lungs along with normalization of liver enzymes values were registered. The rarity of interstitial pneumonitis induced by acetaminophen (paracetamol), especially in combination with liver damage, is emphasized. The presented patient history is the first case report of drug-induced hepatopulmonary syndrome during acetaminophen (paracetamol) administration.

Now purulent cholangitis has acquired the status of an independent problem on which solution further progress of surgery of a gepatobiliopancreatoduodenal zone depends. Substantially it is caused by increase in number of patients with the complicated cholelithiasis form, especially at elderly people with immunodeficiency and accompanies pathology, tendency to development of a purulent сholangitis and biliary sepsis. The clinical case of the acute purulent cholangitis caused by Klebsiella pneumoniae in the elderly man, and which was complicated by biliary sepsis is presented in article. The surgical decompression of bilious ways in combination with drug therapy (cephalosporin ΙΙΙ generations) was ineffective. The microbiological blood test has helped to specify the activator of septic process, to appoint effective antibacterial therapy that has defined a favorable outcome of a disease at the patient.

The report presents two clinical cases of acute coronary syndrome complicated by the development of cardiogenic shock. For hemodynamic stabilization prolonged intraaortic balloon counterpulsation was conducted.

In recent years, in Russia an average of 400 thousand people receives or medical aid after tick bite. The urgency of the problem of infections transmitted during tick bites is caused by the expansion of the range of ticks spread and increasing incidence of “tick” infections. Still clinical and laboratory diagnostics of tick-borne infections causes difficulties for doctors. The purpose of communication is to describe the clinical case of tickborne rickettsiosis with the development of specific community-acquired pneumonia.