The aim of this work is to systematize of the data on markers of autoimmune rheumatic diseases. The article includes basic information taking the latest recommendations of 2014 into account. All pieces of material are presented  in the form of tables for convenient use in daily practice of any specialist. 

To all people, including representatives of Medicine, it was accustomed  to recognize the axiom: if there is an alive man, it means that he/she must ill, grow old and as a result — die. At the same time in the long-term plans of Medicine stated  that it should achieve the aim, that man wouldn’t be ill, grow old for a long time and live long. It’s clear, that to realize the goal, it is necessary, at the least, to have real knowledge about true reasons and mechanisms of diseases development.  The author tries to understand,  if modern Medicine has such methods  and instruments,  allowing him to get basic notion about etiology and pathogenesis of any pathology and he comes to the conclusion, that there is no such knowledge yet. It is offered to pay attention to the functional and systematic analysis and to use it, as the basic method in studying man’s pathology.

Speckle-tracking echocardiography is a non-invasive method  for assessment of myocardial deformation, which is closely associated with its regional and global function. Although it is not yet introduced into clinical practice, deformation parameters are actively studied in different clinical conditions, particularly in acute myocardial infarction. Numerous studies show deformation  impairment may have important prognostic value at patients with a acute myocardial infarction.

Purpose: estimation  of the dynamics of distribution of the organism water environment in patients with acute coronary syndrome (ACS) taking into account the presence of myocardial hypertrophy of left ventricle, at different stages of hospitalization. Materials and methods: we have examined 120 patients  with ACS undergoing restoration of coronary blood flow. The assessment was made traditional and renal risk factors (albuminuria 30-300 mg/l, the value of eGFR), and produced the aqueous environments  of the body. All examined patients  were divided into two groups. The first group includes patients  with left ventricular hypertrophy, the second group included patients  without hypertrophy of the LV myocardium. Results: for both studied groups were characterized  by the increase in the total  water volume (TWV), the total  liquid volume (TLV), the intracellular fluid volume (IFV) at all stages of the study. Summary: in patients with ACS and the presence of LV hypertrophy found a significant increase of the average content  of TWV,  TLV, IFV at all stages of hospitalization. Also in the group of patients  with LV remodeling and hyperhydratation was observed a decrease in GFR, and the presence of albuminuria.

Conducted  a comprehensive  examination  of patients  in the  outpatient department, including laboratory  and instrumental methods,  the  test of Spielberg-Hanina to determine  the level of anxiety, the SF 36 test to determine  the level of quality of life. The survey revealed a decline in the quality of life in patients  with dyspepsia, the indicators of psychological health in organic and functional dyspepsia is lower than in healthy people. The intensity of pain was higher in patients  with epigastric pain syndrome. Lower quality of life were in the group with organic lesions of the upper gastrointestinal tract. The results of the test of Spielberg-Hanin demonstrated high personal anxiety in patients with different types of dyspepsia in comparison with healthy group. The obtained results complement the clinical and pathogenetic information regarding the different kinds of dyspepsia. 

The aim: generalize the  experience of detection  and treatment of recurrence  of sarcoidosis in outpatient practice. Materials and methods.  We investigated  the  clinical, laboratory  and  instrumental results  in the  cards  of 178 patients  with  recurrence  of biopsy-proven  sarcoidosis  and identified in Kursk from 1997 to 2014. Using cluster analysis (K-means method)  selected  3 types of relapse of sarcoidosis. Results: The type A of the recurrence of sarcoidosis is characterized by a specific x-ray features in the form of increased intrathoracic  lymph nodes without destruction  of lung tissue, seasonality manifestations, favorable response to the drug-free dynamic tactic dispensary observation. The type B is characterized by a typical mandatory  involvement of the lung tissue, the presence of respiratory distress with a predominance  of restriction, frequent  need to assign corticosteroids.  The type C marked by the appearance  of watercooling lesions, occurs in patients  with a tendency to chronicity of the process and the formation  of a pronounced  residual changes with great  frequency tolerant  to conventional  therapy.  Conclusions: Thus, typing recurrence of sarcoidosis optimise volume surveys at activation of sarcoidosis and tactics of treatment.

The aim. Specification the features of violations of the functional characteristics of the small intestine and definition the way of correction in patients with cholelithiasis. Materials and methods. 75 patients with prestone stage of cholelithiasis were examined. Clinical symptoms, cavitary, membrane digestion and absorption  in the  small intestine  were studied. The intestinal  microflora assessment by identification  of the  bacterial  overgrowth syndrome  in the  small intestine  by respiratory  tests  with lactulosum  was carried out.  Research of hormones  (gastrin,  insulin, hydrocortisone, thyroxine and thyritropic hormone)  was conducted  by method  of the electrochemiluminescence. Results. 91,3% of patients  had disturbances of various stages hydrolytic-resorbtive process in the small intestine, 64,7% of patients had bacterial overgrowth syndrome in the small intestine. Use as part of complex therapy the enzystal and the riboxin rendered a positive effect in stopping the clinical symptoms of cholelithiasis and general enteral symptoms. In the course of treatment cavitary, membrane digestion and absorption in the small intestine distinctly improved. Reliable depression of the gain of concentration of hydrogenium in the expired air from 30,68±9,89 ppm to 8,79±0,72 ppm in the first 60 minutes of research, the bacterial overgrowth syndrome in the small intestine demonstrating decrease is noted. The positive changes in secretion of hormones promoting restoration of the functional characteristics  of the small intestine are taped. Conclusion. Use the enzystal in combination with the riboxin in treatment of the enteropathy in patients with cholelithiasis is pathogenetic reasonable and clinically effective.

Aim: to evaluate the efficacy and tolerability of ornithine aspartate, probiotic Bioflorum Forte and their combination with steatosis and steatohepatitis in patients  with alcohol and non-alcoholic  fatty  liver disease. Materials and methods.  An open, randomized,  comparative  clinical study, which included 30 outpatients and inpatients with a diagnosis of steatosis, steatohepatitis. We analyzed the clinical symptoms, functional state of the liver. With the help of questionnaires  (Grids LeGo and post intoxication alcohol syndrome) have established the presence of chronic alcohol intoxication. Test transmissions of numbers used to characterize the cognitive function, as well as detection  of minimal hepatic encephalopathy. Quality of life was assessed by questionnaire for patients with chronic liver disease — CLDQ (The chronic liver disease questionnaire). The duration of treatment was4 weeks. Results: all three treatment regimens have demonstrated therapeutic  efficacy: clinical improvement, recovery of liver function and results in cognitive function. When combined therapy also produced a significant improvement  in patients’ quality of life. It is shown that  the safety and tolerability of the means employed, adverse events were not reported. Conclusion: the results obtained allow us to recommend the use of ornithine aspartate (Hepa-Merz), both as monotherapy and as part of complex therapy of steatosis,  steatohepatitis with probiotic Bioflorum Forte in patients with alcoholic and non-alcoholic fatty liver disease.

Currently in the Russian Federation or chronic hepatitis C (CHC) are still relevant Interferon-based regimens. The purpose of this study is to investigate the influence of baseline characteristics and prognosis of the patient HCV genotype 1 for the development  of leukopenia (LP) and neutropenia  (NP). We investigated  factors such as sex, age, body mass index (BMI), viral load, genotype  of Interleukin-28 B (IL-28B),  the initial level of leukocytes and neutrophils,  alanine aminotransferase (ALT), fibrosis, duration  of infection, presence  of previous therapy.  Absolute values of leukocytes  and neutrophils  were analyzed on 4, 12, 24, 48 weeks of therapy,  and at 4, 12, 24 weeks after antiviral treatment with protease  inhibitors (PI) 1 and 2 generation. Prognostic criteria were identified, indicating the possible development  of the LP and NP expressed during treatment with interferon: female  gender,  low initial load, TT-genotype of IL-28B, the  initial level of white  blood cells and neutrophils  below 5,7×109/L and 3,4×109/L, respectively. Mathematical  models predicting the onset of LP and NP, formalized in the form of decision trees were also constructed. These models have shown the greatest potential for practical use in view of highest accuracy and reliability.

Churg-Strauss  syndrome  is a  rare  autoimmune   disease  with  small-vessel  vasculitis. We report  a  case  of 60-year-old   man.  The presence  of hypereosinophilia, asthma,  sinusitis and extravascular eosinophil accumulation  led to the diagnosis of Churg-Strauss syndrome. The patient  was effectively treated with methylprednisolone, cyclophosphamide.

The report presents a case of tetanic crisis in a patient with postoperative parathyroid insufficiency after strumectomy that emergency doctors were interpreted as an acute coronary syndrome with collapse.

Considered a clinical case of pulmonary embolism (PE) in 65-year-old  patient  with frequent  exacerbations  of COPD. The difficulty was due to the diagnosis of nonspecific clinical symptoms that could correspond to both PE and exacerbation of chronic obstructive pulmonary disease (COPD) due to an infectious disease and the development  of pneumonia. The lack of specific PE changes during X-ray examination of the chest is also difficult to correct diagnosis. The article discusses the problems faced by clinicians in the diagnosis of pulmonary embolism on the background of COPD exacerbations.