Environmental change, climate warming, population density increase, high migration activity of the population and other factors provoke the emergence and spread of new infections around the world. The emergence in December 2019 of diseases caused by the new coronavirus («coronavirus disease 2019») has already gone down in history as an emergency of international importance. It is known that the most common clinical manifestation of a new infection is pneumonia, and also in a significant part of patients — respiratory distress syndrome. Our article provides a brief analytical review of these temporary guidelines Ministry of Health of the Russian Federation «Prevention, Diagnosis and Treatment of a New Coronavirus Infection (COVID-19)», version 3 (03.03.20) and other published sources. The team of authors expresses the hope that these data will be useful to doctors in providing medical care to patients with a new coronary virus infection, as well as to teachers in preparing students and residents. Source: Ministry of Health of the Russian Federation. Temporary guidelines «Prevention, diagnosis and treatment of new coronavirus infection (COVID-19)», version 4 (27.03.20). Available on: https://static-3.rosminzdrav.ru/system/attachments/attaches/000/049/881/original/COVID19_recomend_v4.pdf   

The article is devoted to one of the actual medical and social problems — primary hyperparathyroidism, the late diagnosis of which leads to the development of severe complications and an increased risk of premature death. Unlike developed countries, where 80% of cases are represented by mild forms of the disease, in the Russian Federation this indicator does not exceed 30%, while 70% are manifest forms. Widespread awareness of doctors of various specialties in the diagnosis of parathyroid adenoma is necessary for the timely detection of the disease. The article reflects the main stages of the study of the disease, the pathogenesis of the clinical manifestations of primary hyperparathyroidism, the classic symptoms of which are changes in the target organs of the parathyroid hormone — bone tissue, urinary system and gastrointestinal tract, is considered. Bone disorders are the most common manifestation of hyperparathyroidism and are characterized by increased bone metabolism with a progressive decrease in bone mineral density. Typical changes in the kidneys include nephrolithiasis and nephrocalcinosis, causing the formation of renal failure. Gastrointestinal signs of hyperparathyroidism are erosion and ulcers of the stomach and duodenum, prone to bleeding, recurrent pancreatitis. Diagnosis of the disease is based on laboratory results, characterized by elevated levels of calcium and parathyroid hormone in the blood. Visualization of the paradenomas in most cases is provided by ultrasound and scintigraphy. Removal of parathyroid adenoma is the most effective treatment. A clinical case of a severe form of the disease is presented, indicating an urgent need to take measures to solve the problem of primary hyperparathyroidism.

Monoclonal gammopathy of renal significance (MGRS) is a new nosology in modern nephrology and oncohematology. MGRS is defined as kidney injury due to nephrotoxic monoclonal immunoglobulin produced by the B-cell line clone which does not reach the hematological criteria for specific treatment initiation. Monoclonal protein’s pathological effects on kidney parenchyma result in irreversible decline of kidney function till the end stage renal disease that in line with the position of International Consensus of hematologists and nephrologists determinates critical necessity for clone specific treatment in patients with MGRS despite the absence of hematological indications for treatment initiation. Main challenge of MGRS in Russian Federation is an inaccessibility of an in-time diagnostic and appropriate treatment for the great majority of patients due to the following reasons: i) limited knowledge about the MGRS among hematologists and nephrologists; ii) lack of necessary diagnostic resources in most healthcare facilities; iii) lack of approved clinical recommendations and medical economic standards for treatment of this pathological entity. Consensus document comprises the opinion of experts — leading nephrologists and hematologists of Russian Federation — on the problem of MGRS including the incoherence in nosology classification, diagnostics approach and rationale for clone specific treatment. Consensus document is based on conclusions and agreements reached during the conference of leading nephrologists and hematologists of Russia which was held in the framework of symposia «Plasma cell dyscrasias and lymphoproliferative diseases: modern approaches to therapy», 15-16 of March 2019, Pavlov First St-Petersburg State Medical University, St-Petersburg, Russia. The present Consensus is intended to define the principal practical steps to resolve the problem of MGRS in Russian Federation that are summarized as final clauses.

The presented review highlights current understandings of prophylaxis for infective endocarditis (IE). The historic aspects of the concept development of antibacterial prophylaxis (ABP) for IE, the main approaches and the rationale for changing the principles of ABP in recent years are described. There are detailed clarifications of published international and national recommendations, in particular, of European Society of Cardiology, National Institute for Health and Clinical Excellence, American Heart Association/American College of Cardiology and Japanese Circulation Society. The critical estimation of earlier adopted international guidelines with analysis of influence of partial or absolute ABP restrictions on the incidence of IE and its complications including fatality rate are presented.

The research purpose: to study features of clinical process of a coronary heart disease when it combines with a bronchial asthma.

The materials and methods: 180 people were included in the research, 90 of them suffer from both CHD and BA (the first group), and also 90 people have only CHD without BA (the second group). The examination included complaint collection process, studying medical history, medical examination, percussion, auscultation, blood pressure measurement with the Korotkov’s method twice a day (in the morning and in the evening), heart rate measurement, 24-hour Holter ECG monitoring, echodoplercardiography. Besides, standard laboratory biochemical testing, including total cholesterol and lowdensity lipoprotein cholesterol, were made with the enzymatic colorimetric method.

The results. Dyspnoea is the main complaint among 86 patients with both CHD and asthma, humans have (95,5%), moreover, dyspnoea combines with heartbeating in 73,8%, and is accompanied by angina pectoris only in 20%. There is a significant difference between systolic and diastolic blood pressure (р=0,001) that becomes higher if CHD combines with asthma. The signs of left ventricular and interventricular septum hypertrophy were discovered in the first group, these signs statistically significantly differ from the ones in the second group. The medium pulmonary arterial pressure is significantly higher in the combined group than in the group with only CHD (р=0,001). It is revealed with 24-hour Holter ECG monitoring that cases of myocardial ischemia are more frequent in the group which consists of patients with CHD. Besides, duration of ischemic depression per day is longer in this group too. It might be that if patients have both CHD and asthma they do not reach an ischemic threshold because of dyspnoea due to a respiratory failure.

The conclusion. According to our findings bronchial asthma occurs among patients with coronary heart disease in 16.6% of cases. It is a distinctive feature of a bronchial asthma associated with coronary heart disease, that a patient often complaints to dyspnea (cardiopulmonary) and palpitation, increase in arterial blood pressure and heart rate, which appropriately indicates the activation of rennin-angiotensin-aldosteron and sympathicoadrenal systems. It requires the inclusion of appropriate drug groups in the treatment of patients.

Objective: A comprehensive study of the prevalence and structure of risk factors (RF) of cardiovascular diseases (CVD), the daily dynamics of central aortic pressure and arterial stiffness in healthy women of different age groups.

Materials and methods: the study involved 161 women aged 18 to 65 years with one or more CVD RF. All volunteers underwent a survey, 24-hour blood pressure monitoring with determination of arterial stiffness and daily dynamics of central aortic pressure, determination of carotid-femoral pulse wave velocity (cfPWV) and vascular stiffness by volume sphygmography.

Results: the examined were divided into 3 groups: 1 group of 52 women of young age from 18 to 30 years (23.8 Ѓ} 5.3 years); 2 group of 54 women from 31 years before the onset of menopause (41 Ѓ} 5.9 years); group 3 — 54 women in the postmenopausal period (55.4 Ѓ} 5.8 years). High prevalence of modifiable CVD RF among women of various ages was revealed: smoking, non-compliance with dietary recommendations, lack of physical activity. Obstetric and gynecological pathologies prevail in younger age groups. In group 1 the studied parameters correspond to normal in most parameters. Significant differences in central and peripheral pressure, arterial stiffness indicators, with the exception of cfPWV, were identified in group 2 in comparison with young women. A comparative analysis of groups 2 and 3 showed a significant difference and worsening of indicators characterizing the degree of development of arterial stiffness, the contribution of the reflected wave and the associated dysfunction of the left ventricle.

Conclusion: a comprehensive study of arterial stiffness allows you to identify subclinical changes in the vascular wall and evaluate their progression in women of different age groups.

Relevance: Non-alcoholic fatty liver disease is the most common liver disease worldwide. Although the disease usually has a favorable, asymptomatic course, in some cases it can occur in the form of non-alcoholic steatohepatitis, and some patients may develop cirrhosis of the liver and hepatocellular carcinoma. There are more and more foreign studies proving the relationship of genetic factors with the progression of Non-alcoholic fatty liver disease. However, information about this association in the Russian Federation remains scarce.

Goal of the study: to assess the prevalence of patatinlike phospholipase domain-containing protein 3 gene variants in patients with Non-alcoholic fatty liver disease-related cirrhosis of the liver in the Russian population sample and the effect of the mutation on the course of the disease.

Materials and methods: We formed three groups of patients. Group I included 30 patients with Non-alcoholic fatty liver disease-related cirrhosis of the liver. Group II included 46 patients with Non-alcoholic fatty liver disease at the non-cirrhotic stage. Group III included 25 healthy volunteers. A retrospective analysis of patient history data was performed. We analyzed the results of biochemical blood tests, coagulogram, and ultrasound examination of abdominal organs from the medical records of patients in groups I and II. Patients from groups I and II were additionally examined using hepatic shear elastometry using the aixplorer multiwave ultrasound system (SuperSonic Imagine, USA). Alleles of the patatin-like phospholipase domain-containing protein 3 gene were detected using polymerase chain reaction–restriction fragment length polymorphism.

Results. During the study, we obtained statistically reliable links between Non-alcoholic fatty liver disease and the presence of a mutation in the patatin-like phospholipase domain-containing protein 3 gene (RR-2.171; 95% CI: 1.131-4.170; χ2=6.730769; p=0.00948), between liver cirrhosis and the presence of a mutation in the PNPLA3 gene (RR-4.011; 95% CI: 1.558-10.324; p=0.0003), and the relationship between the frequency of occurrence of the GG genotype of the patatin-like phospholipase domaincontaining protein 3 gene with increasing the stage of liver fibrosis in the Russian population sample.

Conclusion: The patatin-like phospholipase domain-containing protein 3 gene polymorphism rs738409 is a factor in the progression of Non-alcoholic fatty liver disease to high stages of fibrosis and liver cirrhosis. Detecting of this polymorphism in patients with NAFLD in Russian population may be useful for identifying high-risk groups for disease progression.

The aim of the research. To assess the influence of polymorphisms of the matrix metalloproteinase genes — 2 (rs2285053), — 3 (rs3025058), and — 13 (rs2252070) on the development of coronary atherosclerosis in patients with primary osteoarthritis.

Materials and methods. The polymorphisms of the Thе pоlymоrphisms оf thе matrix metalloproteinase genes — 2 (rs2285053), — 3 (rs3025058), and — 13 (rs2252070) and their connection with development of atherosclerosis in patients with osteoarthritis were determined.

Results. In the process of studying the polymorphism (rs2252070 T/C) of the MMP — 13 gene, it was revealed that the carriage of the homozygous T allele of the MMP-13 gene polymorphism is 1,8 times higher in the group of patients without verified coronary atherosclerosis in comparison with a group of patients with verified coronary atherosclerosis. This fact shows that this genotypic variant is protective in relation to the development of atherosclerotic lesions of the coronary vessels. The heterozygous variant of the T/C genotype was more common in the group of patients with verified coronay atherosclerosis — 59%. The calculation of the odds ratio shows that the possibility of developing coronary atherosclerosis in patients with this genotype is 2,7 times higher than in patients with a homozygous grnotypic variant.

Conclusion. It is shown that the heterozygous variant of rs2252070 T/C matrix metalloproteinase 13 increases the chance of developing coronary atherosclerosis in patients with osteoarthritis.