Transient ischemic attack is a clinical variant of acute cerebral circulatory disorders without signs of damage to brain tissue. A transient ischemic attack increases the likelihood of stroke, myocardial infarction, and other vascular events. There is an obvious similarity between transient ischemic attack and acute coronary syndrome without St elevation. The authors discuss the possibilities of aggressive therapeutic tactics for managing patients with transient ischemic attacks based on the results of high effi ciency of such treatment in acute coronary syndrome.

This review considers the relationship between functional dyspepsia and irritable bowel syndrome. The high overlap rate of two prevalent types of functional gastrointestinal disorders is explained by the commonality of a number of etiological and pathogenetic factors of both diseases, which should be taken in account in the treatment of such patients.

The review evidences the imbalance in innate and adaptive immunity in severely ill patients with COVID-19. In this case, the complement system is activated, the relationship between individual subpopulations of T-lymphocytes is disrupted, and the content of pro-inf ammatory cytokines and chemokines increases, thus leading to the development of the so-called «cytokine storm». At the same time, there occurs a hypercoagulation, accompanied by an increase in the expression of tissue and von Willebrand factors on the blood vessel endothelium, increased platelet aggregation, and an increase in the D-dimer and f brinogen/f brin degradation products. These processes are concomitant with the development of microangiopathy, immunothrombosis, disseminated intravascular coagulation and multiple organ failure. Under the inf uence of the virus and the developed immunity and hemostasis shifts, complications in the following systems and organs may occur: respiratory system (pneumonia, acute respiratory distress syndrome), cardiovascular system (up to an acute heart failure and myocardial infarction), the gastro-intestinal tract, liver, kidneys and central nervous system (up to encephalitis and stroke). Therefore, peptide immunity modulator Thymalin, anticoagulant Heparin and anti-platelet agents are recommended to supplement conventional therapy in high-risk patients from the f rst day of their hospitalization in order to correct above disorders. The search of papers for this review has been made through PubMed in the English and Russian languages. The review includes papers published in the period of 2000—2020.

A review of available domestic and foreign literature on the impact of comprehensive cardiological rehabilitation on the ability to work of people and the level of disability after coronary artery bypass grafting (CABG) has been performed. In the Russian Federation (RF), the incidence and mortality from coronary heart disease (CHD) among the working population is several times higher than in other European countries. One of the important social tasks of the surgical treatment of coronary heart disease is to return the patient to work. According to the results of domestic work in our country, patients resume professional work much less often than in Europe and the USA. The low share of labor recovery dictates the urgent need for an active program for the rehabilitation of patients after CABG in order to restore labor potential. Both domestic and foreign authors have shown a positive impact on the labor potential of full-f edged comprehensive cardiological rehabilitation. A large number of works have been accumulated that demonstrate the positive impact of cardiorehabilitation on the quality of life, and the return to work of patients after surgical treatment of coronary artery disease. Particular importance is attached to the third rehabilitation phase, which is carried out at the level of outpatient care. Currently, only in the framework of scientific work is the introduction of the outpatient rehabilitation phase noted, and despite the small scale of these works, an undoubted positive effect is shown in the issues of recovery and return to work. Russian researchers have not established a significant effect of cardiac rehabilitation on the level of disability of people who underwent surgical revascularization.

The acute coronary syndrome (ACS) develops in 1.9—4.2% of patients with the diagnosis «an oncological disease» (OD) in different time.

Material and methods. The research included 2 groups of the patients hospitalized with ACS: the main group (n = 88), which had OD in the anamnesis (the period of verif cation of OD<10 years) and the group of comparison (n = 88) created by the «сoру-couple» method on a sex, an age, a structure of ACS. The mean age of patients was 66.6 ± 9.5 years, men prevailed (57.9%), non-ST elevation ACS was at 58% of patients. The level of the statistical signif cantly is р < 0.05.

Results. The most frequent localization of OD: lungs (15.9%), a digestive system (15.9%) and hematologic diseases (14.8%). The patients with ACS and OD, compared with patients with ACS without OD, were signif cantly often with: an atypical anginous attack (15.9% compared with 4.5%, р = 0.025), the main complaint — an asthma or the general weakness (27.3% compared with 14.8%, р = 0.04), the crepitations in lower parts of the lungs (20.5% compared with 9.5%, р = 0.03), an acute left ventricular failure of Killip II—IV (31.8% compared with 15.9%, р = 0.01). The invasive tactics signif cantly was less used in patients with ACS and OD compared with patients with ACS without OD (79.7% compared with 95.5%, р = 0.002). The signif cant differences on defeat of coronary arteries were not revealed. The urgent cardiovascular complications developed more often in patients with ACS and OD compared with patients with ACS without OD (28.2% compared with 6.8%, р = 0.0004), there was higher hospital mortality (12.5% compared with 3.4%, р = 0.048), especially less than 24 hours (7.9% compared with 1.1%, р = 0.03).

Conclusion. The studying of the clinical peculiarities of patients with ACS and OD is necessary for treatment optimization. 

Myocardial infarction in old age is the leading pathology and cause of deaths.

The aim of the study was to evaluate the prognostic signif cance and informative value of cardiac markers of blood in elderly patients with myocardial infarction.

Material and methods. The study of cardiac markers in 107 patients with myocardial infarction at the age of 65--75 years and in 83 patients with myocardial infarction at the age of 50-60 years was carried out by immunochromatographic, bioluminescent methods and by electrophoresis on cellulose acetate, followed by the calculation of informativeness and prognostic coefficients. 95 persons aged 65-75 years without myocardial infarction served as control.

Results. Troponin T, brain natriuretic peptide, glucose-6-phosphate dehydrogenase and lactate dehydrogenase-1 have the most informative and prognostic signif cance in elderly patients with myocardial infarction.

Conclusion. The use of these cardiac markers will improve the diagnosis and isolation of patients with myocardial infarction at high risk.

The purpose of this study was to evaluate the frequency and features of iron-deficient conditions among women of reproductive age.

Material and methods. The study included 2401 female patients who applied to the Clinic SBEI HPE KSMU in 2019. The average age of the patients was 36.71 ± 6.32 years. The patients received therapeutic and gynecological treatment (including surgery). Adherence to treatment was determined by the Moriski Green questionnaire.

Results. The incidence of anemia in the cohort was 46.1%. All the examined patients had anemia def ned as iron deficiency. The f rst detected anemia was registered in 70.3% or 32.5% of the entire cohort of women of reproductive age; in 29.7% of the surveyed, this diagnosis was established earlier (χ² = 15.32; p = 0.001). Latent iron deficiency and mild anemia were most frequently detected (46.7% vs 34.5%, respectively), and severe anemia was registered signif cantly less frequently — in 0.5% of patients (χ² = 6.5; p = 0.05). The structure of gynecological diseases was represented by: uterine myoma — 34.9% of patients; endometrial pathology — 23.7%, ovarian disease — 16.8%, adenomyosis — 9.6%, cervical pathology — 7.4% and infertility — 7.6% of patients. By the end of the study, the number of adherents increased by 24.7% (41.9 vs 17.2%; χ² = 75.13; p = 0.002), insuffi ciently committed — by 12.8% (44.9 vs 32.1%; χ² = 15.325; p = 0.001), and the percentage of non-adherents decreased by 33.9% (50.6 vs 13.1%; χ² = 95.09; p = 0.001). In 100% of patients, the effect of therapy was obtained, but it diff ered in terms of subjective improvement and depended on concomitant gynecological pathology.

Conclusions. A high incidence of iron deficiency was found in women of reproductive age. The combination of individualized therapeutic treatment and specialized gynecological care increases adherence to treatment and makes it possible to achieve iron deficiency compensation in 100% of patients.

The article provides a retrospective analysis of the activities of the regional vascular center (RCC) of the Moscow City Clinical Hospital named after M.P. Konchalovsky, working in the framework of the Regional program of specialized medical care for acute coronary syndrome (ACS). A multidisciplinary team of doctors based on the RIC has been created at the hospital. Organizational measures allowed to reduce the time interval from the moment a patient with ACS arrives at the hospital admission department until the mechanical recanalization and stenting of the infarct-related artery begins, increase operative activity and reduce the average hospital bed-day of the patient's hospital stay.

At the present time, there is a lot of information about clonal plasma cell processes, def ned as the plasma cell dyscrasiаs. We present a case of TEMPI syndrome, which was f rst detected in Russia and belongs to a rare form of plasma cell dyscrasia, with a description of the clinical symptoms, difficulties in differential diagnosis in the patient, and the genetic form of thrombophilia detected in this syndrome. The main manifestations of TEMPI syndrome are telangiectasias, erythrocytosis, monoclonal gammapathy, perinephric f uid collections, and intrapulmonary shunting. Currently, the mechanisms of the systemic effect of monoclonal secretion in this form of plasma cell dyscrasia have not yet been clearly established, and moreover, therapeutic approaches to its treatment have not been developed. The use of bortezomib in the onset of the disease and, further, as part of rotating courses with dexamethasone and cyclophosphane, gave a clinical and hematological effect.

Objective — to study the presented clinical case from the perspective of differential diagnosis of 2 pathologies: rheumatoid arthritis and stenosing ligamentitis. Material and methods. Patient M., 40 years old was examined. We studied complaints, an anamnesis of the disease and life, data from medical documentation. Description of the clinical case. Patient M. was admitted with a diagnosis of probable rheumatoid arthritis (RA) in the department of rheumatology to verify the diagnosis. The diagnosis was established based on damage to the hands, positive rheumatic tests. It turned out that the patient worked as a typesetter. And with a detailed analysis of the clinical picture, it turned out that polyneuropathic signs prevail over the articular syndrome. On the basis of ultrasound examination of the hands, electromyography data, and X-ray data, the presence of carpal tunnel syndrome was established. After a consultation with a traumatologist, the diagnosis of stenotic ligamentitis (SL) was verif ed. Conclusion. Study of complaints, anamnesis allows timely and high-quality differential diagnosis of SL and RA, prescribe adequate treatment and timely prepare for surgical treatment.

The professional experience of a doctor is the basis of his activity. A step-by-step mechanism for the formation of experience in medicine is given. The negative and professional experience of the doctor is presented in comparison. The connection of the doctor's experience with the analysis of errors is shown. The components of experience are considered. The phenomenon of stereotype and its role in the experience and occurrence of errors in doctors are discussed. The structure of the causes of a single doctor's error is given. The importance of understanding the relationship of error and experience in solving the problem of errors in medicine is emphasized.

The article presents data on the first handwritten textbook on surgery (military field surgery) for training military doctors in the Russian Empire in the early 18th century at the Moscow Hospital (Moscow Medical and Surgical) School. The author of the textbook was the Chief Doctor of the Moscow Hospital and the Director of the School Nicholas Bidloo. The textbook consists of 4 parts (129 chapters and 8 signs) in the main areas of medicine. The article provides a summary of Leib-medic Peter I Nicholas Bidloo.