The article is a review of the literature, which deals with the classifi cation, etiology, pathogenesis and risk factors of cardiomyopathies, analyzes the results of diagnostics with the use of modern technologies. The presence of cardiomyopathy always means a diffi cult life prognosis in patients. It determines the social signifi cance of the problem connected with this pathology, which is the cause of disability and mortality of most active working age patients.

Vitamin B₁₂ (cobalamin) is a collective name for a group of water-soluble cobalt-containing biologically active compounds belonging to corrinoids. Vitamin B₁₂ is essential for hematopoiesis, the formation of epithelial tissue; as a coenzyme, it is involved in the metabolism of fatty acids, carbohydrates, nucleic acids. Cobalamin defi ciency is associated with the development of anemia, polyneuropathy, and decreased cognitive function. Due to the nonspecifi city of symptoms and the possible development of severe and potentially irreversible complications, it is important to conduct timely screening among patients from risk groups. Among endocrine disorders, vitamin B₁₂ defi ciency is found in patients with diabetes mellitus, obesity and autoimmune thyroid disease mostly. In particular, metformin may cause a decrease in vitamin B₁₂ levels and polyneuropathy, which is diffi cult to diff erentiate from diabetic polyneuropathy. In patients with autoimmune thyroid lesions, other autoimmune diseases are often observed, atrophic gastritis and pernicious anemia notably. Vitamin B₁₂ malabsorption can lead to defi ciency even when consumed adequately, which possibly explains the relatively high prevalence of B₁₂ defi ciency in patients with autoimmune thyroid disease. This literature review summarizes recent advances on the role of vitamin B₁₂ metabolism, potential risk groups for vitamin B₁₂ defi ciency among common endocrine diseases, and the benefi t for its replacement with high-dose oral forms, cyanocobalamin 1 mg in particular

Infections associated with the suction of ticks, the so-called tick fever, refer to natural focal diseases and are seasonal in nature. Currently, it is known that ticks are carriers of a number of viruses, bacteria, spirochetes that cause diseases in humans. The diagnosis for a signifi cant part of these infections remains unverifi ed. A common clinical symptom for all infections caused by ticks is fever, which is part of the general infectious (febrile-toxic) syndrome, which, in turn, may have features inherent in one or another infection. This review provides clinical characteristics of tick-caused infections registered in Russia: febrile tick-born encephalitis, ixodic tick-born borreliosis, babesiasis, ehrlichiosis, tick-born rickettsial disease, hemorrhagic fevers, tularemia, bartonellosis. The basic criteria for the diff erential diagnosis of general infectious syndrome as the main manifestation of the onset of these diseases are presented. It is shown that due to the similarity of symptoms, especially in mixed-type foci, specifi c laboratory diagnostics should be regarded as determinative in diagnosis

In 2020, the Russian Society of Cardiology published the clinical guidelines for the diagnosis of acute coronary syndrome and acute myocardial infarction with the use of electrocardiography terms and symbols. Currently, a specialist in functional diagnostics often has questions when formulating an ECG diagnosis. The formulations accepted for describing ECG for coronary circulation disorders («focal myocardial changes»), and non-specifi c repolarization abnormalities stated («diff use myocardial changes») in the Russian methodology [1] are not always related to a coronary disease. The article presents an overview of currently existing ECG criteria of myocardial infraction to be used by a specialist in functional diagnostics in an automated workplace. It is suggested to prepare an ECG report for patients with acute coronary syndrome (particularly those with myocardial infarction) based on the presence of areas of myocardial ischemia, damage and necrosis.

Purpose. To determine the frequency and risk factors for the development of internal spontaneous internal hemorrhage and clinical manifestations in patients with COVID-19 undergoing inpatient treatment. 
Material and methods. In the period from10.20 till 06.2021, 28 cases of spontaneous internal hemorrhage in patients with confi rmed COVID-19 complicated by bilateral interstitial polysegmental pneumonia were analyzed at the COVID-19 Clinical Center of Moscow State Medical University named after Evdokimov. Anamnesis, age, gender, objective examination data, concomitant diseases, laboratory blood counts, CT results, soft tissue ultrasound, treatment regimens, characteristics of hematomas (volume, localization) and hospitalization outcomes were analyzed. 
Results. Summarizing the results of our own observations, a low number (no more than 1%) of hemorrhagic complications in patients with coronavirus infection were noted. In more than half of the patients, spontaneous internal hemorrhages were detected during the 2^nd–3^rd weeks of treatment, for 17.4 ± 2.7 days on average. The main risk factors for the development of internal spontaneous hemorrhage with the formation of hematomas in patients with COVID-19 should be considered old age, female sex, and the presence of hypertension, diabetes mellitus, and anticoagulant therapy. Hemorrhages of any localization and intensity, both isolated and combined, can develop regardless of the severity of lung damage and respiratory failure. In case of a decrease in the level of hemoglobin in the dynamics of treatment, fi brinogen, hypotension, the appearance of pain syndromes of various localization (against the background of a decrease in C-reactive protein (CRP), and an increase in leukocytes in the blood), emergency computed tomography (CT) is indicated for timely diagnosis of hemorrhage and the formation of hematomas. Surgical treatment is indicated for hemodynamically stable patients with large-volume soft tissue hematomas (more than 500 ml) with signs of suppuration according to ultrasound or CT. The prescription of anticoagulants and antiplatelet agents, regardless of the dosage, can lead to hemorrhagic complications, which requires constant monitoring of coagulogram parameters in order to correct the dose.

Diabetes mellitus (DM) is an adverse premorbid background for the development, course and outcome of infective endocarditis (IE), and therefore the combination of these diseases requires study. 
Objective: to study the clinical features and outcomes of infective endocarditis in patients with diabetes mellitus. 
Material and methods A retrospective (from 2001 to 2007) and a prospective (from 2008 to 2018) analysis of 347 patients with specifi c IE, 243 men and 104 women, aged from 17 to 83 (median age 44.8; 34–54). 
Results. 22 patients with IE, were diagnosed with diabetes, that is, the incidence of this pathology was 6.3%. Type 1 diabetes was observed in 7 (2% of the total number of patients and 32% among patients with a combination of IE and diabetes). Type 2 diabetes was diagnosed in 15 patients (4.3% and 68%, respectively). In subgroups of patients with IE and diabetes and without it, statistically signifi cant diff erences in age (p < 0.05), Charlson comorbidity index (p < 0.001), incidence of neurological complications ((p < 0.05), hospital mortality (p < 0.05) were noted, while patients with IE on the background of type 1 diabetes, had a more severe course of the disease. According to key characteristics of the pathological process in IE, localization, severity of systemic infl ammation, clinical and biochemical parameters, no signifi cant diff erences in the studied groups were found. 
Findings. The obtained results confi rm the literature data on fundamentally identical regularities of the course of IE in patients with and without diabetes. At the same time, the development of IE on the background of diabetes is a prognostically unfavorable combination of comorbid conditions, which requires special attention of physicians to such a contingent of patients, interaction of specialists for their successful management.

The article presents data on the opening of the fi rst therapeutic clinic in the Main Building of the Medical and Surgical Academy, its structure and location. The article provides information about the teaching staff of the clinic and its further fate.

The article presents data on blood transfusions at diff erent stages of medical evacuation of army and front-line areas during the Great Patriotic War. It is emphasized that in the system of treatment of the wounded during the last war, great importance was placed on early transfusion therapy, transfusions of banked blood, its components and preparations, as well as blood substitutes. The experience of the Great Patriotic War testifi es to the huge role of blood transfusions in the treatment of the wounded.

The variety of chemical compounds and their widespread use in industry and in everyday life pose a risk to chemical safety. Despite the experience gained over the past century since the fi rst use of medical protective equipment, medical toxicology and the system of providing specialized medical care for chemical trauma require further improvement and development. The continuing risks of industrial production, damage by chemical hazardous substances, the threat of the use of toxic substances in local military confl icts and chemical terrorism make it necessary to maintain an advanced readiness to eliminate the medical consequences of chemical trauma.

The article presents data and some information (legends) on the history of the Military Medical Academy, the historical toponymy of the Vyborg side, the history of buildings and leading experts.

In 1846, the faculty surgery clinic of the Medical Faculty of Moscow University was established. An important role in its formation and further development was played by prominent surgeons who managed this clinic at various times (F.I. Inozemtsev, V.A. Basov, N.V. Sklifosovsky, A.A. Bobrov, N.N. Burdenko etc.). The contribution of all mentioned before is covered in detail in this article.