The article discusses the pathogenetic and clinical aspects of gastrointestinal bleeding (GIB) in patients with a novel coronavirus infection (COVID-19). The possibility of direct interaction of the coronavirus with the receptors of the angiotensinconverting enzyme 2 (ACE-2) of the mucous membrane of the gastrointestinal tract with the development of its damage and subsequent bleeding has been shown. The value of anticoagulant therapy as a risk factor for the occurrence of GIB is evaluated inconsistently. In most patients with COVID-19 infection and GIB conservative hemostatic therapy is eff ective. The infl uence of GIB on the course and prognosis of a novel coronavirus infection has an contradictory interpretation. Given the lack of knowledge of the pathogenetic and clinical aspects of GIB in patients with COVID-19 infection, this problem requires further research.

Infl ammatory bowel diseases (IBD) are common autoimmune diseases with gastrointestinal and extra-intestinal manifestations and complications. The most common infectious complication associated with IBD is infection with Clostridium diffi cile (C. diffi cile). Active IBD predisposes to C. diffi cile infection due to changes in the intestinal microbiome. C. diffi cile is a toxinproducing bacterium that leads to a worsening of the course of the main IBD, increasing the risk of ineff ective treatment of IBD, increased risk of hospitalization and surgery.

Acute kidney injury (AKI) is a clinically common and life-threatening disease. AKI has become a global problem for human health due to its high prevalence, increased risk of complications, high mortality and high medical costs. Initially, researchers believed that the kidneys had an eff ective ability to regenerate and recover, but studies over the past 20 years have shown that it’s rarely true when we speak about the damage caused by AKI. Even when serum creatinine levels return to baseline, structural damage to the kidneys persists for a long time, leading to the development of chronic kidney disease (CKD). The mechanism for the transition of AKI to CKD has not been fully established. Epigenetic changes, such as histone modifi cation, DNA methylation, and noncoding RNAs, can play an important role in this process as regulators of gene expression. Epigenetic modifi cations are induced by hypoxia, which promotes the gene expression associated with infl ammatory factors and collagen secretion. This review discusses in detail the role of epigenetic modifi cations in the progression of AKI to CKD, the diagnostic value of biomarkers of epigenetic modifi cations in the chronic outcome of AKI, and the potential role of infl uencing epigenetic modifi cations that inhibit the transition of AKI to CKD and improve disease prognosis.

The determination of the range of norm variability, the boundaries of the transition of norm to pathology, and the study of the dynamics of the transition of adaptive reactions to pathological ones is a key link in understanding the pathogenesis and clinical manifestations of diseases in modern clinical medicine. The construction and angioarchitecture of the hemocirculatory bed are caused and directly related to the topographic and anatomical features of organogenesis, formation of the structuralfunctional units and, therefore, ensuring the functional purpose of the organ and its changes of an adaptive and pathological nature. The issues of angioarchitecture plasticity and tissue architecture of blood vessels walls of the hemocirculatory bed, in which adaptive mechanisms that compensate for hemodynamic disturbances and ensure the suffi ciency of blood circulation are implemented, need to be further developed. The identifi cation of systemic changes in vascular structural and functional modules can become an objective basis for the systemic association of diseases, the occurrence and development of which is reliably associated with the transformation of hemocirculatory architecture of organs. Determining the nature and dynamics of these changes can also contribute to the development of a systematic approach to the choice of treatment tactics and therapy for these diseases.

The signifi cance of assessing the quality of life (QoL) in patients with glaucoma among those with other ophthalmic diseases has been established based on the analysis of literature. Due to the high risk of complete loss of vision, it is important to stop the progression of glaucoma. To do this, developing disorders of visual functions are monitored by the level of QoL and disability. The literature emphasizes the importance of adequate control over the course of the disease and off ers various methods for assessing QoL. Nevertheless, the goal of fi nding more sensitive methods of the earliest clinical manifestations detection, remains unresolved. This problem is important for monitoring adherence to treatment, since the progressive vision deterioration due to glaucoma, aff ects QoL, so such monitoring is widely used in chronic diseases, which include glaucoma. Understanding the impact of the disease on the life of patients allows one to choose the right treatment strategy, improve cooperation with the patient and his compliance, that is, compliance with the doctor’s recommendations.

At present, the prevention of sudden cardiac death in athletes is of great interest. A large amount of literature data concerning the correlation between the length of the QT interval and the proarrhythmic potential of the myocardium has been accumulated. However, new potential predictors of the fatal arrhythmias occurrence in athletes have emerged in recent years — an increase in the dispersion of the QT interval, as well as short-term variability in repolarization. This review provides detailed data on the diagnosis, prevalence, classifi cation, etiology of long QT as one of the manifestations of QT variance. The variety of causes leading to long QT syndrome (LQTS) causes diffi culties in the diff erential diagnosis of this condition and, and as a result, LQTS often remains outside the attention of practitioners. The data of recent studies of the athlete’s heart remodelling are presented as well.

The article is devoted to investigation of infl uence of tetramethyltetraazabicyclooctandionum (mebicar) on cerebral blood circulation by help of transcranial dopplerography in patients with hypertension and ischemic heart disease. There are presented authors data, concerning about this drug as adaptogen in condition of meteo-geomagnetic activity.

Despite the prevalence of arterial hypertension among both sexes, there are data on the presence of gender diff erences in its formation and course.

The purpose of the study: to identify gender characteristics in the clinical and biochemical status of patients suff ering from stage 1 and 2 of arterial hypertension.

Material and methods. 80 patients of the second mature age with confi rmed arterial hypertension were examined. The patients were divided into 2 groups: the fi rst group consisted of 44 patients with stage 1 arterial hypertension (11 men and 33 women), the second group consisted of 36 patients with stage 2 disease (25 men and 11 women). All patients underwent a biochemical blood test; the glomerular fi ltration rate, the thickness of the Intima-media complex of the common carotid artery with the processing of the results by the Smirnov–Kolmogorov test were determined.

Results. With the stage I arterial hypertension in both sexes, the level of blood pressure was corresponding to it. With stage II, the blood pressure in men corresponded to the level of the 1st stage, and in women to the level of the 2nd stage arterial hypertension. The level of total cholesterol and low-density lipoprotein cholesterol in all cases exceeded the normal level, prevailing in both groups in women. This was accompanied by an imbalance in the levels of thromboxane B2 and 6-ketoprostaglandin F1α at stage I hypertension, which was more pronounced in women and increased with the higher stage of the disease. The glomerular fi ltration rate in men of both groups was intact. In women, it was reduced at the onset of the disease, and kept decreasing at stage II. The width of the intima-media complex in women prevailed over this indicator in men at stage I and further increased at stage II.

Conclusion. From the start of the development of arterial hypertension, women have had more pronounced and faster progressive lipid, hemostatic, renal and sclerotic changes compared to men.

Objective. A clinical case of a 38-year-old female patient with STEMI in the early postpartum period describes the complex issues of diff erential diagnosis with imaging methods application.

Results. During the patient’s fi rst hospitalization with STEMI, additional intravascular imaging techniques such as intracoronary ultrasound and/or optical coherence tomography, could help to determine the nature and signifi cance of the coronary lesion. Due to the inability to perform IVUS and OCT, we performed a coronary angiography. According to the results, there were no obvious signs of coronary dissection. Using additional intravascular imaging techniques, we might have obtained diff erent results and would have chosen a diff erent tactic of treatment.

Conclusion. The case described indicates the need for a comprehensive diagnosis of MI in women in the postpartum period.

The article presents data on little-known pages from the history of the Caucasian Native Cavalry Division (Savage Division) and its military doctors. Biographical information about the doctors of military units and fi eld hospitals during the First World War and the immediate post-war period is given.

The article represents brief characteristics of the consulting physicians to the fl eets who developed plans for medical aid and treatment organization during the years of the Great Patriotic War.

The article presents integrated data on the sea-going forces and the location of ships of the 1st Pacifi c Squadron during the Russian-Japanese War of 1904–1905. Particular attention is paid to the distribution of doctors of the Siberian and Kwantung naval crews among the ships of the fl eet. The most complete data on the participation of navy doctors in battles and in the defense of Port Arthur are presented. Their fate after the wreck of the squadron is traced.