Thrombin activatable fi brinolysis inhibitor (TAFI) is one of the key proteins of fi brinolysis and infl ammation systems. Based on  literature data, information is presented on the biological eff ects of TAFI, the mechanisms of its activation, gene polymorphism  that determines the duration of its action and activity. Nosological forms are listed, where TAFI is important in the pathogenesis  of the development of diseases, its role in experimental and laboratory studies, and the possibility of pharmacological infl uence  on the activity of this protein.

Primary hyperaldosteronism (PHA) is the most common cause of secondary arterial hypertension among endocrine disorders.  Given that patients with this pathology are at a higher risk of developing fatal and non-fatal cardiovascular events, early  diagnosis and timely treatment are of great importance. Currently, the two main forms of PHA are aldosterone-producing  adenoma and bilateral adrenal hyperplasia, which are treated with laparoscopic adrenalectomy or pharmacotherapy with  mineralocorticoid receptor antagonists. Although most patients experience restoration of their functional and metabolic  status after surgical intervention, some may develop postoperative adrenal insuffi ciency, which requires long-term hormone  replacement therapy. This review examines the options for organ-preserving surgeries, such as partial adrenalectomy and  selective embolization of the adrenal artery.

This publication deals with the issue of adjuvant (non-antimicrobial) therapy for community-acquired pneumonia. A critical analysis is provided on the appropriateness of using various drugs (mucolytics, non-steroidal anti-infl ammatory drugs, immunoglobulins, etc.) and physical methods of chest impact for community-acquired pneumonia, and recommendations are given for their clinical use. Special attention is paid to the use of systemic glucocorticosteroids and inhaled nitric oxide.

According to a significant amount of scientific research, it is known that the deterioration of public health and the tendency  towards certain types of disease cannot be explained only by conventional factors. It has been proven that a patient’s attitude towards their disease determines their response to the pathology and their adaptation to their new condition. The aim of this  work is to analyze research, views, and beliefs of doctors and psychologists on the influence of a patient’s perception of their  own illness and their attitude towards it on the course of the disease. This review presents an analysis of numerous scientific  works aimed at identifying types of attitudes towards disease that are characteristic of various nosological forms, both mental and somatic. As a result of the literature analysis, a set of conditions and factors that determine the nature and intensity of the influence of attitudes towards disease on its course and outcome were identified. These include the volume and nature  of information about a specific disease, which is understood by the patient according to their intellectual and psychological  readiness to perceive and interpret it; the way in which a doctor provides information about the course of the disease, possible  outcomes, and planned treatment methods; age and gender; the nature and severity of the disease itself, as well as the mental  health of patients.

Due to the wide spread in the population and high risk of complications, atrial fibrillation is an important nosology, and  doctors of both outpatient and hospital departments should be prepared for its early detection and diagnosis. The absence of  specific symptoms and clear causes of onset, as well as the many associated clinical conditions, mean that knowledge of atrial  fibrillation, especially its debut — the first diagnosed atrial fibrillation — is particularly necessary for general practitioners.  This article analyzes literature on first diagnosed atrial fibrillation, focusing on the peculiarities of the disease’s course,  diagnosis, choice of tactics, and treatment. The article introduces readers to information from modern publicly available  publications on this topic, providing an overview of the key stages in the historical development of medicine in this area.  Based on literary sources, existing problems of underestimating the danger of the disease, lack of unified approaches to patient  management, and key definitions and concepts are revealed today.

Dyslipidemia is the main factor in the initiation and progression of atherosclerosis. The search for probable factors aff ecting  lipid metabolism is relevant. The aim of the study was to evaluate the parameters of lipid metabolism in the blood serum  of men exposed to elevated noise levels. Material and methods. 293 men with no confi rmed atherosclerotic cardiovascular  diseases were examined. Among the surveyed, 2 groups were identifi ed: 203 men who work under the infl uence of noise, and  90 men who do not come into contact with harmful production factors. Total cholesterol, triglycerides, low- and high-density  lipoproteins, and the level of oxidized low-density lipoproteins were determined. Remnant cholesterol, atherogenic index and  atherogenic plasma index were calculated. Results. Among persons under 55 years of age working in noise, an increase in total  cholesterol (p = 0.02) and remnant cholesterol (p = 0.0006), a decrease in high-density lipoproteins (p = 0.03) and a tendency  to increase the atherogenic index (p = 0.05) and the atherogenic plasma index (p = 0.07) were revealed. The prevalence  of hypercholesterolemia was comparable in the main and control groups and amounted to 56.7 and 47.4%, respectively  (p = 0.17). The median level of oxidized low-density lipoproteins in people working with noise did not exceed the upper limit  of the norm. Conclusions. In men younger than 55 years old, working under conditions of exposure to increased noise levels,  some features of the blood lipid spectrum are observed. The revealed changes may indicate an increase in the atherogenic  potential of the blood serum

The course of renovascular (resistant) arterial hypertension was analyzed in 60 patients (45 men, 15 women) with isolated  atherosclerotic stenosis of the renal artery of more than 75% (group 1), and in 30 patients (26 men, 4 women) who, in addition  to unilateral stenosis of the renal artery of more than 75%, also had stenoses of the brachiocephalic arteries up to 60% of  the vessel diameter (group 2). The mean age of the examined patients in group 1 was 52.4 ± 6.9 years, and in group 2 it was  53.2 ± 7.4 years. Endovascular correction of hemodynamically significant stenosis of the renal artery leads to a significant  decrease in systolic and diastolic blood pressure levels, a reduction in the number of antihypertensive drugs from 5-4 to a  3-component scheme in most cases, and an improvement in the functional state of the kidneys. At the end of the 2-year observation  period, in patients with multifocal lesions of the renal and cerebral arteries (group 2), both systolic and diastolic blood pressure  levels corresponded to “high normal” values, while in group 1 (isolated renal artery lesions) they corresponded to “normal”  blood pressure levels. Patients in group 2 had metabolic disorders such as atherogenic dyslipidemia, hyperuricemia, and  significant signs of renal dysfunction. The multifocal nature of atherosclerotic vascular lesions contributes to a more “severe”  course of the disease, which should be taken into account when conducting treatment measures.

The study of the influence of inhalation psychoactive substances (PAS) on the respiratory system is an important issue, given the  speed and trend of the spread of various inhalation devices. Hookah is a device for smoking tobacco, the essence of which is  the passage of tobacco smoke through a container with water or other liquids (milk, alcohol). The study was conducted among  students of the Northern (Arctic) Federal University named after M.V. Lomonosov (SAFU), and the population permanently  residing in the city of Arkhangelsk. The study was conducted from 2020 to 2022. The aim of this article is to compare the  indicators of external respiration in individuals using PAS in different ways. Material and methods. External respiration was  assessed by spirometry. Spirometry is a fairly simple, non-invasive and informative method for measuring airflows and volumes.  The article presents an analysis of spirometry data from 155 people. Group I included individuals not using tobacco products,  Group II included cigarette smokers only, and Group III included individuals using tobacco with a hookah. Results. Volume  indicators (FVC, FEV1) in Group I were significantly higher than in representatives of Groups II and III (p > 0.01); Also, in  Group I, speed indicators were significantly higher. A significant decrease in the FEV indicator was found in Group III compared  to Group II (p > 0.01). Also, members of Groups II and III had a significant decrease in speed indicators compared to Group I.

Essential hypertension (EH) is the most common cardiovascular disease and the leading cause of chronic kidney disease  (CKD) worldwide. The aim of the study was to investigate the frequency and nature of kidney damage in hypertension. 189  patients (69 men and 120 women) with hypertension (stages I, II, and III) aged 43 years and older were examined. The average age of the patients was 61.2 ± 8.7 years. Clinical and biochemical tests were conducted on all patients, including red blood  cell indices, C-reactive protein (CRP), lipid profile, fibrinogen, electrolytes, glucose, uric acid, creatinine, and cystatin C. The  duration of hypertension was also recorded for each patient. Kidney function was assessed using serum creatinine (CKD-EPI)  and cystatin C (F. Houcke). Patients were categorized according to the degree of decrease in glomerular filtration rate (GFR)  based on the recommendations of the Russian Nephrology Society. Patients with kidney damage were divided into two groups:  Group 1 consisted of patients with hypertension without signs of CKD (GFR calculated by cystatin C ≥ 60 ml/min), while  Group 2 consisted of patients with hypertension complicated by CKD. The results showed that hypertension was accompanied  by target organ damage in 70.8% of cases. The prevalence of CKD among patients with hypertension was 28.5%. Proteinuria  was mainly detected in patients with renal insufficiency. The frequency of GFR categories according to CKD-EPI and F.  Houcke formulas was as follows: G1 — 54.4% and 13.7% (p < 0.05); G2 — 35.9% and 57.6% (p < 0.05); G3a — 5.2% and  19.5% (p < 0.05); G3b — 3.1% and 5.2% (p < 0.05); G4 — 0.5% and 3.1% (p < 0.05) and G5 — 0.5% and 0.5%, respectively.  There was a strong correlation between GFR and serum creatinine (r = –0.439; p < 0.05) and cystatin C (r = –0.866;  p < 0.0001). Patients in Group 2 (hypertension with kidney damage) had significantly higher levels of CRP, low-density  lipoprotein cholesterol, cystatin C, and longer duration of hypertension, but lower levels of total calcium than patients in  Group 1. In conclusion, CKD was present in 28.5% of patients with hypertension, and proteinuria was mainly detected in  patients with renal insufficiency. Serum cystatin C levels most accurately reflect kidney filtration function.

 Mirror therapy as a rehabilitation method for stroke patients. Stroke claims millions of lives every year worldwide. Its severity is  associated with the damage to important brain structures and severe disruptions of various physiological functions in patients, making the investigation of methods to alleviate the consequences of stroke relevant. The aim of this study is to highlight  the methods of mirror therapy, their effectiveness, and to examine some possible mechanisms underlying the positive effects  of mirror therapy on the recovery of limb functions. Materials and Methods. A review and analysis of literature data were  conducted. Literature search was carried out in Scopus and Pubmed databases. Technical implementation of mirror therapy.  Various three-dimensional structures are used to implement the method of mirror therapy, allowing the patient to perceive the  work of the working limb as the work of an immobilized leg or arm, which has a positive effect on the rehabilitation process.  In many studies, the effectiveness of mirror therapy has been demonstrated both in the chronic and acute phases after stroke.  Several hypotheses have been put forward by scientists about the mechanisms of the effectiveness of mirror therapy, suggesting  the activation of motor neuron centers and zones in the brain cortex. Conclusion. According to the results of numerous studies,  mirror therapy shows a sufficiently high effectiveness in the rehabilitation of stroke patients and improves their quality of life.

The article presents an analysis of the provisions of the consensus meeting “Maastricht-VI”, dedicated to the treatment  of Helicobacter pylori (H. pylori) infection. The expediency of preliminary testing for H. pylori sensitivity to antibiotics is emphasized. Since this strategy has not yet been implemented in everyday clinical practice, empirical therapy is often carried  out based on the results of the assessment of H. pylori resistance to antibiotics in this region. The sequence of administration of  eradication regimens of the 1st, 2nd, 3rd, 4th lines, optimal duration of treatment, new therapy regimens (with rifabutin, double  therapy with proton pump inhibitors and amoxicillin in high doses) are considered. The implementation of the new consensus  meeting will contribute to improving the results of eradication therapy of H. pylori infection.

The frequency of gastrointestinal stromal tumors (GISTs) is 0.1–0.3% of all neoplasms in the gastrointestinal tract. The most common clinical feature of GISTs is gastrointestinal bleeding caused by ulceration of the tumor. Based on a clinical case, the eff ectiveness of capsule endoscopy in diagnosing GISTs is demonstrated.

This article presents new information about Petr Frantsevich Lesgaft, a scientist, anatomist, and physician who founded the development of functional anatomy and a scientifi cally based system of physical education in our country.