The impact of human immunodeficiency virus (HIV) and antiretroviral therapy upon mineral metabolism and bone mineral density is being studied worldwide. Patients with HIV are a risk group for reduced bone mineral density as these diseases are more common in them than in healthy people. The report presents a review of the literature on the topic. The review consists of several parts, and each of them deals with the effect of HIV and antiretroviral therapy on bony tissue and osteoclastogenesis at different levels: molecular, cellular, tissue, hormonal and various extracellular protein levels. Due to modern diagnostics and treatment, the survival rate of patients with HIV infection has increased significantly. It has led to the problem of developing not only dysimmunity but also age-related diseases. When discussing the problem of bone formation and bone resorption in HIV, the multifactorial nature of these conditions must be considered to further prediction of secondary diseases development to adjust patient's management for hormonal and age-related changes, resource allocation, and educating health professionals in diagnosis and treatment. The review relies on the data from peer-reviewed medical journals, using a bibliographic search method and relevant internet resources, including PubMed.

Tuberculosis sequelae are very common after successful treatment of the disease. Airflow obstruction and restrictive impairment develop alongside with the changes. High prevalence of pulmonary impairment in patients with tuberculosis sequelae shows that lung function study and pulmonary rehabilitation should be performed. Malnutrition is very common among TB patients. The review deals with the methods of rehabilitation, which include physical training and nutritional status correction.

Viruses are the most common etiological agents of myocardium inflammation. Today the Severe Acute Respiratory Syndrome coronavirus (SARS-CoV-2) causes a high incidence of myocarditis and pericarditis. As a hypothetical scenario, we present a clinical case of a patient who underwent viral myocarditis on the background of SARS in 2004, with recurrent myocarditis in ARVI, the last of which was initiated by SARS-CoV-2. A 61-year-old male patient, in 2004 contacted a representative of the People's Republic of China and after 4 days felt the symptoms of ARVI. Before the viral disease, he had excellent health, the absence of cardiovascular diseases and pathological heredity. Fever 38–39 °C, myalgia, headache, general malaise, dry obsessive cough persisted for a week. After the addition of shortness of breath, he was hospitalized. According to the data of X-ray and computed tomography, infiltrates of the lungs of both of the "frosted glass" type were revealed. According to the clinic and laboratory data, a diagnosis of severe “atypical viral pneumonia” was made, and a diagnosis of viral myocarditis was suggested. Echocardiography showed a decrease in the left ventricular ejection fraction up to 50% for the first time, without signs of coronary heart disease based on the results of further examination. Dry cough disturbed in the next 4 months, LVEF 48–50% and 1 functional class of heart failure persisted for 10 years. The patient had a flu with mild respiratory symptoms in 2015, but it triggered a recurrence of myocarditis. The examination revealed a decrease in LVEF up to 35%, the progression of dilatation of the heart cavities also without signs of coronary heart disease according to the results of the treadmill test and coronary angiography. Post-inflammatory cardiopathy progressed relatively quickly during the year. The minimum LVEF was 23%; a cardioverter-defibrillator was implanted for secondary indications; radiofrequency ablation of fascicular tachycardia was performed. It was followed by another period of stabilization: 2 functional class of heart failure, ICD shocks did not occur. The patient underwent COVID-19 with minimal respiratory symptoms in March 2021. It provoked another recurrence of myocarditis, diagnosed with an increase in troponin, cerebral natriuretic peptide, CRP, ESR and increasing heart failure during 3 months. Persistent paroxysms of atrial fibrillation with a decrease of LVEF 15% and anasarсa. A successful radiofrequency isolation of the pulmonary vein was performed in 2021. By November 2021, in the absence of paroxysms, it was possible to achieve compensation for heart failure up to class 1 according to Vasilenko–Strazhesko and NYHA, LVEF 28%.

In order to understand the recurrent nature of myocarditis against the background of various respiratory viral infections, an analysis of the literature was carried out, including the described cases of myocardial inflammation against the background of the predecessors of the SARS-CoV-2 strain: SARS-CoV-1 and MERS. We also reviewed the data on the diagnosis of viral myocarditis in the realities of this pandemic. It reveals a large heterogeneity of signs of inflammation of the heart muscle according to different diagnostic methods and large interobserver variability, and challenges us about the need to revise the criteria for myocarditis in the case of COVID-19.

This review presents the current data on comorbidity in glaucoma patients of different age groups and highlights the problem of increasing the incidence of glaucoma due to the expected increase in life expectancy of the world population. Main factors in the development of comorbidity are chronic infections, inflammation, involutional and systemic metabolic disorders, iatrogenia, social status, ecology, and genetic predisposition. Main morphofunctional causes are damage due to endogenous changes in the aging body, external factors and the consequences of diseases associated with age in elderly people. The process of glaucoma progression often depends not only on the adequacy of the chosen tactics and the choice of medications, but also on concomitant systemic factors, so today the success of therapy is determined by a personalized approach to the patient, taking into account the manifestations of the disease and the totality of concomitant changes in the body as a whole.

Goal. Investigate the role of cortexin in stopping and achieving remission of seizures in epilepsy.

Material and methods. 47 patients with various forms of epilepsy were examined at the reception of a neurologist of the polyclinic department of the United City Hospital No. 7 during 2020–2021. To assess the psycho-emotional status, the Ziqmond scale was used. As a means of increasing stress resistance, cortexin was used. Statistical calculations of qualitative parameters were carried out using the Fisher criterion. The results are presented at the level of reliable significance p < 0.05.

Results and discussion. Psychoemotional status, determined by the Ziqmond scale before treatment with cortexin, was rated low in all patients (6.91 ± 0.13; m = 4, M = 11), and in female patients statistically significantly lower (8.05 ± 0.32; m = 6, M = 13) than in male (8.83 ± 0.21; m = 5, M = 12), (p = 0.046). During the study period (1 year), in 39 patients (35 cases from the group taking cortexin and 4 cases from the placebo group), seizures did not recur. The study proved a fairly high (72.9%) effectiveness of cortexin in improving the mental and emotional states of patients with epilepsy. didn't repeat themselves.

Conclusions. The inclusion of cortexin in the interictal period in the treatment regimen allows you to achieve a thymoleptic effect and prolong the remission of epileptic seizures.

Immunosuppressive treatment during the first year after renal transplantation leads to viral infection development in recipients, and graft dysfunction up to its loss. This original article gives data on comparison of T-lymphocytes subsets in healthy blood donors and renal graft recipients before and one month after transplantation. The influence of T-cell immunity impairment on CMV- and EBV-infection emergence were evaluated. 19 renal graft recipients were included in the study (average age — 43, m/f ratio — 14/5). 20 healthy blood donors were used as controls. A month after transplantation during induction (Methylprednisolone and Basiliximab) and basis (Prednisolone, Tacrolimus, Mycophenolate mofetil) therapy 10 (53%) patients had makers of CMV replication and 7 (36.9%) patients had markers of EBV replication. The majority of CMV- and EBV-positive patients proved reactivation of endogenous CMV and EBV (not primary infection). All patients, subsequently positive for CMV and EBV, demonstrated T-cells subpopulations discount before transplantation, such as a decrease in the total number of lymphocytes and absolute number of naïve CD4+ and СD8+ cells, effector memory CD4+ cells, T-regulatory cells (CD4+/CD25+/CD127–) in comparison to the control group. EBV-positive patients also showed the reduction of CD3+, absolute number of CD4+ and CD8+, but central memory CD8+ cells increased in comparison to the control group. Viral reactivation rate during first month after renal transplantation depends not only on immunosuppressive regimen but on T-cells subsets disproportions before graft. These indicators could be taken into account for viral infection expectancy.

Anemia is a frequently diagnosed complication in patients with various diseases of the esophagus and stomach, which negatively affects the quality of life and aggravates the course of the prior disease. There are three main mechanisms for reducing hemoglobin in the pathology of the upper gastrointestinal tract: bleeding, malabsorption, chronic inflammation. A combination of pathogenetic factors often leads to anemia associated with a deficiency of both iron and vitamin B complex. Anemia of chronic diseases is less common.

Material and methods. 38 people with diseases of the esophagus and stomach were examined: 20 women and18 men. The average age was 70 years old. All patients were divided into groups according to the diagnosed variant of anemia: iron deficiency anemia (IDA), anemia of chronic diseases (ACD) and a combination of IDA and ACD, as well as by the type of therapy performed (therapy with iron preparations, B vitamins and treatment of the prior disease).

Results. A comparative analysis of the hematopoietic lineage indices before and after the treatment was performed. A clinically significant increase in hemoglobin, erythrocytes and erythrocyte indices was observed in patients with IDA who received parenteral therapy with iron preparations, as well as combined treatment with iron preparations and B vitamins. In the ACD and ACD + IDA groups, there were no significant changes in the parameters of the hematopoietic lineage in any of the therapy variants.

Conclusion. The effect of the treatment was found only in patients with IDA who received parenteral therapy with iron preparations. The rest treatment options did not show a positive effect on the dynamics of blood indices in any of the groups. Perhaps a longer follow-up and an increase in the sample of patients will allow creating an effective individualized algorithm for anemia therapy.

The results of a comprehensive examination and treatment of a patient with new coronavirus infection COVID-19 showed the possibility of the patient recovering without the use of certain groups of drugs used to treat this disease in accordance with temporary guidelines at the time of the analysis of the clinical case. There is an attempt to define the role of the close ones and their presence at all stages of the treatment in a favorable outcome. Most people want to take care of a relative having a severe form of the disease. Thus, it is necessary to develop an algorithm for visiting the patient by near relations in the hospital. The course of the new coronavirus infection in a particular case, the psychological state of the patient's relatives, the fear of prescribing or not prescribing certain drugs, the fear of bringing a loved one to the "point of no return" are analyzed.

The article presents main provisions on the grounds of which a doctor can be hold criminally liable for harm caused to the patient's health (materially defined crime) on the basis of the Criminal Code of the Russian Federation.

Breast cancer is a leader in the structure of oncological pathology of the female reproductive system worldwide. The treatment of this disease is often associated with radical surgery, which inevitably affects the patients' subsequent quality of life. For this reason, it is necessary to practice client-centered approach in choosing the tactics of such patients' management. Surgical methods play a leading role in the treatment of breast cancer, while corrective plastic operations are currently of great importance. The article presents the clinical experience of performing oncoplastic operations for breast cancer. Cases of surgical treatment at various localizations of the oncological process, including performing one-stage reconstructions, have been demonstrated. The author proposes his own reconstruction technique for the superior medial localization of breast cancer. The experience of dealing with such a complication arising after radical mastectomy as lymphorrhea is shown.

The article presents digital material and the information concerning rehabilitation measures to create a system for the return to duty of the wounded and sick after treatment during the Great Patriotic War. It is emphasized that the main source of replacement of the Red Army and the Navy was the wounded and sick returning to service after recovery.

The article provides information on the history of the development of the Military Medical Academy. It focuses on landscape architecture originally designed by Domenico Trezzini. The historical environment of the academy park extends back almost 200 years.