The course of two pandemics (syndemic) — HIV & COVID-19, demonstrated the synergistic eff ect of SARS-CoV-2 & HIV on the human body.

The aim of the study was to identify the features of diagnosis, course, treatment and outcomes of coronavirus infection (COVID-19) in HIV infected patients admitted to an infectious hospital.

Materials and methods: the retrospective data of 1,250 patients with COVID-19/HIV coinfection admitted to ICH No. 2 in Moscow in 2021 have been analyzed. Laboratory and instrumental diagnostics were carried out to clarify the diagnosis and severity of the condition. Statistical processing was performed using Excel (Microsoft) and StatTech v. 1.2.0 software. The diff erences were considered statistically signifi cant at p <0.05.

The results of the conducted studies of 1,250 patients with coinfection have shown that HIV infection does not aff ect the risk of contracting SARS-CoV-2, and at the same time, the key predictors that cause high mortality in COVID-19 against the background of HIV infection are age over 55, avoidance of regular checkups and antiretroviral therapy (ART), severe immunodefi ciency (CD4+ < 200 μl^–1), concomitant pathology (HCV, liver cirrhosis, damage to the cardiovascular system) and a combination of SARS-CoV-2 with various opportunistic pathogens. Late diagnosis of HIV infection contributes to a more severe course and unfavorable outcome of COVID-19 in HIV infected patients in the future. Counting the potential cost and benefi ts for each individual patient has proved that the use of biological therapy in patients with coinfection is recommended only after monitoring the immunological status indicators. Benefi cial eff ect factors in relation to HIV/SARS-CoV-2 coinfection include vaccination of HIV infected patients against COVID-19, which shows the greatest eff ectiveness in people receiving ART, with the amount of CD4+ ≥ 350 μl^–1, thus preventing infection, reducing the risk of severe disease and the frequency of hospitalization and mortality rate.

Alcohol-containing drinks are widespread throughout the world, and alcohol ingestion is a part of the culture of diff erent peoples and an integral part of their daily diet. At the same time, alcohol abuse leads to adverse consequences such as home accidents, poisoning and various somatic diseases. However, there is also an opinion that alcohol can have a benefi cial eff ect on the body by its vasodilation and blood circulation improvement. The review analyzes the data of works that studied the positive and negative eff ects of alcohol on the visual organ, while highlighting the problems of acute intoxication and chronic alcohol ingestion.

This article, based on the guidelines of the European Society of Cardiology (ESC), Russian clinical recommendations and large randomized trials, summarizes information about traditional radial access used in X-ray endovascular interventions. We present a description and characteristics of a new distal radial approach. It is a puncture of the deep palmar branch of the radial artery (DLV LA) and catheterization of the radial artery distal to its bifurcation to the superfi cial and deep palmar arches.

The aim of this study is to present real time data about distal radial access as current clinical guidelines do not contain information about this new method; to evaluate its advantages and disadvantages, and to assess the frequency of complications. Analysis of references showed that the new distal radial approach is safe, eff ective, competitive and it may be the method of choice for endovascular interventions.

Objective. To establish the features and interrelation of the levels of hemodynamics and the activity of immune reactions regulation in practically healthy people and patients with coronary heart disease living in the European North and the Arctic of the Russian Federation.

Material and methods. The study included 430 people aged 21 to 55, 274 women and 156 men, living in Arkhangelsk region (Arkhangelsk, settlements of the Konosha district; 60° N.L., 40° E.L.), Murmansk region (settlements of Revda and Lovozero; 67° N.L., 34° E.L.) and the Spitsbergen archipelago (Barentsburg; 80° N.L., 10° E.L.). 244 of those were practically healthy at the time of the examination and 186 patients were diagnosed with coronary heart disease. The research included the study of hemogram, content of phenotypes of CD3+, CD4+, CD8+, CD16+, CD71+ lymphocytes, concentrations of sCD71, transferrin, IL-1β, epinephrine, norepinephrine, dopamine, Nt-pro-BNP, endothelin-1, total NO, endogenous NO2, nitrate NO3, cGMP, cAMP, antibodies to cardiolipin, antibodies to phospholipids, CEC IgM.

Results. It was found that practically healthy residents of the Arctic, compared to people living in more favorable climatic conditions, are 2–2.5 times more likely to have elevated concentrations of transferrin, sCD71, dopamine, cortisol, endothelin-1 and Nt-pro-BNP, as well as autoantibodies to cardiolipids and IgM CIC in the plasma of venous peripheric blood. In patients with coronary heart disease, the frequency of elevated levels of trasferrin, endothelin-1, and cortisol in the blood is 1.5–2 times higher, and concentrations of natriuretic peptide, antiphospholipids, CIC and a free pool of transferrin receptors are 4–5 times higher than those in healthy people. The strongest correlations of all these factors with the concentration of the cardiomyocyte damage marker were found in sCD71, which confi rms the involvement of elevated concentrations of the serum transferrin receptor in the mechanisms of tissue damage.

Conclusion. Hyperfunction of the cardiovascular system is provided by elevated reactions. A systematic increase in the levels of hemodynamic reactions, intercellular interactions, and integration of homeostasis regulation mechanisms provide correction of a certain stage of regulation and may lead to a reduction in reserve regulatory capabilities and excessive severity of adaptive processes.

Purpose: To study the prevalence of cardiovascular diseases and the correlations of left ventricle global longitudinal strain (LV GLS) in patients 3 months after proven COVID-19 pneumonia.

Material and methods. 369 patients with proven COVID-19 pneumonia underwent a comprehensive clinical examination and echocardiography (EchoCG) after 3 months ± 3 weeks after their discharge from the hospital. Mean age of the patients was 54 [46; 61]; 50.9% of them were women. LV GLS was studied in 284 (77%) of patients with optimal visualization quality during echocardiography. LV GLS was considered reduced in the limit of > –18%. Study Registration: ClinicalTrials.gov ID: NCT04501822.

Results. 3 months after discharge, obesity was noted in 46.5% of patients, cardiovascular diseases were diagnosed in 73.4%, including de novo in 8.4%. Arterial hypertension occurred in 71.5% of patients, coronary artery disease — in 22.5%. The average left ventricle (LV) ejection fraction was 67.8 ± 5.0%, the average LV GLS was –19.5 ± 2.3%. LV GLS was reduced in 24.4% of the patients. LV GLS showed no correlation with the patient age, NYHA functional class and LV ejection fraction. Reduced LV GLS was independently associated with male sex (OR 1.399; 95% CI 1.239–1.580; p < 0.001), obesity (OR 1.268; 95% CI 1.132–1.421; p < 0.0001), diabetes mellitus (OR 1.204; 95 % CI 1.017–1.425; p = 0.031) and hypertension (OR 1.120; 95% CI 1.002–1.252; p = 0.046). LV GLS showed moderate positive correlations with echocardiographic parameters of right ventricle (RV): the length (r = 0.346), diastolic (r = 0.333) and systolic area (r = 0.326), width at the basal (r = 0.358) and midlevel (r = 0.321), as well as with the dimension of the proximal RV outfl ow tract (r = 0.302, all p < 0.001). LV GLS showed a weak correlation with the severity of lung lesions during hospitalization (r = 0.184; p = 0.002).

Conclusions. 3 months after COVID-19 pneumonia, cardiovascular diseases were diagnosed in 73.4%. Reduced LV GLS was observed in 24.4% of survivors and was associated with male sex, obesity, diabetes mellitus, arterial hypertension and linear and planimetric RV dimensions.

The experience of organizing specialized care for patients with a new coronavirus infection on the basis of Central Military Clinical Hospital named after P.V. Mandrykа is summarized and analyzed.

The purpose of the study is to give scientifi c substantiation and to develop organisational tips for the reorientation of the structural units of the hospital in order to create non-standard infectious diseases center. During the pandemic, the hospital operated under the conditions of a partial antiepidemic regime, which means the allocation of a “red zone” for patients with a new coronavirus infection on the hospital area, while maintaining the remaining area for providing emergency and planned medical care to persons of the dispensary group. A system of providing specialized medical care to patients with a new coronavirus infection with the established routing and algorithms was created in Central Medical Hospital named after P.V. Mandrykа.

Conclusion. The system of medical care created in the hospital under the circumstances of the COVID-19 pandemic, made it possible to ensure the preservation of the ability to perform tasks for the intended purpose of monitoring and treatment of the attached military personnel contingent. The data obtained are the basis for the reorientation of the structure of the military medical organization and its units (without a need to increase personnel), ensuring the therapeutic and diagnostic process by functional zones and taking into account the possible occurrence of mass infectious diseases.

The article discusses the issues of epidemiology, etiology, clinical manifestations, diagnosis, treatment and prevention of travelers’ diarrhea (TD). This disease most often has a bacterial nature, but can also be caused by viruses and protozoa. TD usually has a favorable course and ends with self-healing. In mild forms of TD, rehydration therapy is suffi  cient, as well as the appointment of loperamide or bismuth subsalicylate. In moderately severe and severe forms, the use of antibiotics (fl uoroquinolones, azithromycin, rifaximin) is necessary. Prevention of TD is reduced to compliance with hygienic measures. The appointment of antibiotics for this purpose — taking into account the growing resistance to them — is carried out only for special indications.

Osteoarthritis (OA) is a heterogeneous condition, which is based on low-intensity infl ammation that aff ects all tissues of the joint, and allows it to be considered as an organ pathology, that is, a disease of the whole organ — the joint. The article presents algorithms for managing a patient with OA, including non-drug, pharmacological treatment and surgical interventions. Drug treatment consists of three stages of sequential prescription of medications. The early use of symptomatic slow-acting drugs in osteoarthritis (SYSADOA) is emphasized. It increases the eff ectiveness of treatment, reduces pain, improves joint function, and thereby improves the quality of life of patients.

Systemic lupus erythematosus is a chronic rheumatic autoimmune disease characterized by polysystemic lesions and a variety of clinical manifestations. This disease often aff ects the respiratory system, represented mainly by pleurisy or pulmonary hypertension. However, this publication describes a clinical case in which lung damage in a patient who has had systemic lupus erythematosus for over than 25 years, manifested itself as interstitial lung disease (ILD), which is more typical for other rheumatic diseases, such as  diff use scleroderma, Sjogren disease. ILD manifested with an atypically bright clinical picture, progressed and required the prescription of genetically engineered biological drugs. Their use was complicated by recurrent urinary tract infection, and therefore these drugs were withheld. A peculiar feature of ILD is its blurred clinical picture, which causes additional diffi  culties in diff erential diagnosis, especially during the period of widespread new coronavirus infection, taking into account similar clinical manifestations and changes detected by computed tomography of the lungs, so it leads to a late start of pathogenetic therapy. In this regard, the episode of recrudescence of the patient’s condition manifested by a clinical picture and a pattern of changes on a CT scan, similar to both progressive IPL and pneumonia associated with a new coronavirus infection, which complicated diff erential diagnosis and management tactics, deserves special attention.

The article presents data on the activities of medical institutions of the Military Department and the Red Cross in the Active Army of the Russian-Japanese War. The personal data of doctors of some military hospitals, ambulance trains and infi rmaries of the ROCC are presented. Following the results of the war, the reorganization of medical institutions of the Russian Imperial Army was carried out.

The article presents the facts concerning the life and career development of an outstanding organizer of military fi eld surgery, an excellent clinician, a wonderful teacher, a well-known public fi gure, academician of the USSR Academy of Medical Sciences, Honored Scientist of the RSFSR, Lenin Prize laureate, Hero of Socialist Labor, lieutenant general of the medical service Pyotr Andreyevich Kupriyanov.

The article presents brief characteristics of the activities of the Directors of Medical and Sanitary Services of the fl eets during the Great Patriotic War, who developed plans for organizing medical defense of the fl eets during the war years.