As part of the work carried out, 84 patients undergoing inpatient treatment at the City Clinical Psychiatric Hospital of Tashkent during 2017-2020 were examined. The average age of the subjects was 35 years old, the minimum age was 21 years old, and the maximum age was 57 years old. The average duration of the disease is 6-7 years, the minimum is 1.5 years, and the maximum is 26 years. Patients with a continuous (F 20.x0), paroxysmal progressive course (F 20.x1) and paroxysmal with a stable defect (F 20.x2), with leading paranoid, asthenic and astheno-depressive syndromes, apatoabulic and mixed type of developing defect were studied. A special program of psychotherapeutic correction of patients with schizophrenia has been developed and carried out. Specificity of this program: minimum of negative emotions evoked in patients; emphasis on the positive sides of the personality; interaction is built in an atmosphere of mutual acceptance, conducive to self-expression (physical and spiritual); openness, clear modulation of your emotions and reflection; active position of the leaders.

The article is devoted to Kozhevnikov's epilepsy, one of the most common and, in fact, pathognomonic manifestations of the chronic course of tick-borne encephalitis. The stages in its development, the types of the course of the formed Kozhevnikovskaya epilepsy, and approaches to therapy are described. This material presents a unique case of chronic tick-borne encephalitis (TBE) (47 years from the beginning of the disease and more than 30 years after vaccination). It is shown that the delayed development of severe neurological symptoms and disease progression occur against the background of dysimmunoglobulinemia. The strain isolated from the patient had high neurovirulence for white mice, was highly neuroinvasive, and belong to the Siberian subtype of tick-borne encephalitis virus (TBEV). As TBE progressed, a polystrain immune response and a stressed immune response with high antibody avidity developed (30-32 years after vaccination). In the neurological status – pecular postencephalitic changes with elements of cortical motor epilepsy. No significant cognitive defect was detected.

In the paper, the options of post-stress violations in persons of dangerous professions (law enforcement officers, participants in the aftermath of the Chernobyl disaster) are detailed and on this basis adequate ways of correcting these shifts are substantiated. In a study of 1,250 men associated with stress-activity, 490 individuals were selected for infused neuropsychiatry and cardio-vascular disorders. Taking into account the tasks, the mental status and condition of the cardiovascular system of patients were assessed. Originally (in addition to medical treatment) in the course of comparing the effectiveness of respiratory-relaxation training and autogenic training were noted the benefits of the first. These data identified the need to use, along with psychotherapy, a method of pulsogeoindication, which proved to be in the correction of both neurotic and somatic disorders. The proposed complex of psychocorrection and pulsogemoindication slightly increased the effectiveness of treatment of participants in local middle-aged operations. On the other hand, it was reliably more effective than the comparable approaches in older persons – both liquidators and veterans of law enforcement agencies. On the other hand, catamnestic analysis reflected the great therapeutic reliability of the complex in relation to participants in local operations. In general, the results of the study allow to consider pulsogeoindication as an effective component of rehabilitation of persons associated with stress.

In cerebral infarction, occlusion of the cerebral artery leads to focal ischemia. The ischemic focus is represented by the central zone of necrosis, which is surrounded by an area of the so-called ischemic penumbra, the neurons of which are potentially viable, but the blood supply to this zone remains for a long time at a level below the functional threshold values. Rehabilitation plays a crucial role in improving quality of life in patients after acutevascular brain disorder, as well as their relatives and others. Understandingof legal basis, most modern methods of post-stroke rehabilitation, as well as an understanding of the pathogenesis of neuronal damage and recovery allow to optimize work with these patients. The data accumulated to date indicate that with properly selected timely treatment, the restoration of lost functions after a stroke is not only desirable, but also to a large extent possible. A condition for successful rehabilitation is the use of all available methods of non-drug exposure and drug therapy.

Anxiety, depression, somatoform disorders, nosogenic reactions, adjustment disorders, neurasthenia, somatogenic asthenia in patient with chronic cerebral ischemia (dyscirculatory encephalopathy, cerebrovascular disease) (CCI) are very important for the level of social functioning and adaptation. Early initiation of CCI therapy is an important task in preventing the progression not only of cerebrovascular pathology, but also a wide range of comorbid psychopathological disorders. Treatment of patients with CCI requires an individual approach taking into account pathogenetic factors and severity of both cognitive and psychopathological disorders. It should involve a wide range of drugs, including neuroprotectors. For this purpose the neuroprotective agents ethylmethyloxypyridine succinate and citicoline can be used for independent or combined use. Patients with various forms of CCI noticed subjective improvement during treatment which includes decreasing fatigability and general weakness, reduction of symptoms of psychic and somatic anxiety, fatigability, emotional lability, increasing activity and motivation, improvement of memory, attention, ability to concentrate that positively influences their professional activity.

This article addresses issues related to the development of dyscirculatory encephalopathy (DE), in particular – against the background of what diseases this pathology arises, its social significance, prevalence of this pathological process in the territory of the Russian Federation are highlighted. We analyzed modern concepts of pathogenesis, described the parts of the brain that are damaged in the first place and how this affects the manifestations of the disease and the rate of its development. The stages of DE development, the main clinical signs and problems of diagnostics of this pathology are considered. The basic principles of therapy, indications for inpatient and outpatient treatment, groups of drugs, mechanisms of their action are presented. The article indicates modern methods of etiological, pathogenetic treatment, elimination of hypoxia, as well as foci of cerebral ischemia.

A deficiency of fat-like components leads to a thinning of the hydrolipidic film of the stratum corneum of the epidermis and an increase in its permeability, the development of dry skin due to an increase in transepidermal moisture loss. In persons with dry and sensitive skin prone to irritation, a violation of ceramide synthesis leads not only to the destruction of the protective lipid mantle, but also to a decrease in the antimicrobial protection of the skin, changes in the skin microbiota due to colonization by opportunistic and pathogenic bacteria. The article summarizes the clinical experience of the complex application of new cosmetics for the face for the care of dry and sensitive skin prone to irritation. Dynamic clinical observations, as well as the results of the assessment of the morphofunctional state of the skin (hydration, nutrition, transepidermal moisture loss, pH-metric, elasticity), prove the feasibility of using a line of specialized cosmetics to restore the protective function of the skin and a beneficial effect on the species composition of the microbiome of the facial skin.

The article describes the clinical picture of surface-spreading melanoma – the most common form of pigmented tumor. Despite the fact that at an early stage this form of tumor has pronounced clinical signs, polyclinic doctors can not diagnose it in a timely manner – in the phase of horizontal growth. General practitioners mistakenly believe that melanoma occurs as a result of trauma to a benign nevus, while Clark in 1969 established that most melanomas occur on unaltered skin and go through a long phase of superficial growth. It is concluded that increasing the level of knowledge of polyclinic doctors about the early symptoms of surface-spreading melanoma will contribute to the timely diagnosis of the tumor and reduce mortality from this disease. A significant help in the early diagnosis of melanomas can be provided by memos with color photos of surface-spreading melanoma in the horizontal growth phase, which should be provided to each polyclinic doctor. The article presents clinical cases and photos of surface-spreading melanoma in the early stage of development – in the phase of horizontal growth.

The diagnosis of primary cutaneous CD4+ pleomorphic T-cell lymphoma of the skin from small and medium-sized cells is difficult due to the rare occurrence of this nosology. The disease must be differentiated from primary B-cell lymphoma of the skin, anaplastic large cell CD30+ skin lymphoma, tumor stage of fungal mycosis, pseudolymphoma. The importance of clinical oncological alertness of doctors and the need for clinical and laboratory examination of a patient using modern histological and immunohistochemical research methods are shown. The article presents a case of diagnostics of a rare variant of primary skin lymphoma of cellular skin lymphoma – primary cutaneous CD4+ small/medium sized pleomorphic T-cell lymphoma in a 70-year-old patient. The diagnosis was verified by pathomorphological and immunohistochemical studies of the biopsy of the affected skin.

Methotrexate has established itself as a highly effective treatment for psoriasis since 1953. The effectiveness of methotrexate is due to its cytotoxic and anti-inflammatory effects. According to the draft clinical guidelines of the Russian Society of Dermatovenereologists and Cosmetologists, the use of methotrexate is justified in many skin diseases. A long history and accumulated practical experience of application do not raise doubts about the effectiveness of methotrexate due to its unique pharmacological properties, namely, antiinflammatory, immunomodulatory and cumulative effects, which allow the drug to occupy a leading position in the treatment of many skin diseases. The article describes in detail the metabolism of methotrexate and its pharmacodynamics. According to a review of modern data from the world literature, the authors presented recommendations for treatment with methotrexate, its use in children, monitoring during treatment, and also drew attention to the indications in special situations (infections, vaccinations, contraception, etc.).

Rosacea is one of the most common conditions on the face. Rosacea affecting the central parts of the face and is characterized by erythema, flushing, telangiectasia; papules and pustules. Cutaneous flushing – a common presenting complaint to dermatologists, allergists, internists, and family practitioners. Diagnosis typical cases of rosacea is not difficult, but many diseases, both benign and malignant, can be associated with facial flushing and erythema. Most cases are caused by very common, benign diseases, such as rosacea, that are readily apparent after a thorough taking of history and physical examination. However, in some cases, accurate diagnosis requires further laboratory, radiologic, or histopathologic studies. In particular, the serious diagnoses of carcinoid syndrome, pheochromocytoma, mastocytosis, systemic lupus erythematosus, dermatomyositisand anaphylaxis need to be excluded by laboratory studies. In the article, we present main diseases that dermatologysts should consider when diagnosing rosacea.

The kidneys can be involved in the pathological process in celiac disease, both in connection with severe metabolic disorders, and as an associated disease. In total, there is evidence of various types of kidney damage in patients with celiac disease, including IgA nephropathy, diabetic nephropathy, membranous nephropathy, membranoproliferative glomerulonephritis, nephrotic syndrome associated with malabsorption, oxalate nephropathy, and the association of celiac disease with chronic renal disease and terminal renal insufficiency in the literature. We describe a case of a 46-year-old man with gluten-related disorders. Given the absence of typical clinical manifestations from the gastrointestinal tract, increased antibodies IgA to tissue transglutaminase and deamidated gliadin peptides, the morphological picture of the duodenal mucosa, do not give grounds for diagnosing celiac disease, but indicate the presence of a gluten-related disorders in the patient. The patient was prescribed a gluten-free diet for a period of 6 months. As a result, an improvement in clinical and laboratory parameters was observed: more stable blood pressure values on standard antihypertensive therapy, a decrease in proteinuria, hematuria, and antibody IgA to tissue transglutaminase and deamidated gliadin peptides. The introduction of a gluten-free diet in the diet of patients with IgA-nephropathy can improve clinical and laboratory parameters, such as blood pressure, proteinuria, hematuria, and probably delay the progression of chronic renaldisease.

Neuromyelitis optica spectrum disorder is a group of rare and severe immune-mediated neurological conditions. We have discussed with Maria Davydovskaya, the Deputy Chief External Experts in Neurology, the key differences of this disease from multiple sclerosis, special aspects of diagnostics and therapy, the consequences of misdiagnose, and patients support.