According to the World Health Organization, about 2 billion people currently live in conditions of natural iodine deficiency, and iodine deficiency diseases are classified as the most common non-communicable human diseases. Almost throughout Russia there is an iodine deficiency of varying severity, including the Saratov region, which belongs to the zone of moderate iodine deficiency. We have analyzed the general incidence and morbidity rate of thyroid diseases in Saratov region based on the data gathered during the federal statistics survey No. 12 «Information on diseases diagnosed in patients residing within the hospital service area» conducted in the years 2009 and 2018; said survey used official population data for people of both sexes within the age range of 18 to 76. According to the survey, the epidemiological characteristics for Saratov region of 2018 had no significant discrepancies from the parameters established in 2009. Analysis of statistical parameters for specific thyroid diseases has shown that over the last ten years the incidence rate of goiter decreased from 26,02 ± 4,7 to 16,66 ± 4,68 (p < 0.05), while the morbidity rate of goiter also decreased from 1,7 ± 0,35 to 0,41 ± 0,1 (p < 0,05); the similar statistical parameters of thyroid insufficiency increased over the same period. According to the results of analysis of epidemiological parameters of various territories of Saratov region, in 2009 there were nine territories (Saratov, Ivanteevka, Engels, Ozinki, Novye Burasy, Turki, Dergachevo, Kalininsk anl Petrovsk territories) with the greatest goiter indicidence rate. Both in 2009 and in 2018, the highest values of epidemiological parameters were observed for Kalininsk and Petrovsk territories, however, the general decreasing trend was observed even there. In order to evaluate the population awareness of iodine deficiency problems (as currently, it is regarded as a primary cause of goiter), we have carried out a survey (questionnaire) among the population of the nine territories mentioned above. The awareness of population of Saratov region of iodine deficiency problems in Russian Federation is 72%; the primary sources of information among 70,7% of respondents are television programs and websites. 46% of respondents take regular preventive measures against iodine deficiency with 36% using iodinated salt or iodine-rich food and 10% taking their iodine supplements via medicine.

Diabetes mellitus and cancer are common diseases that affect 425 million and 33 million people worldwide, respectively. Possible biological links include hyperinsulinemia, hyperglycemia and chronic inflammation caused by obesity, as well as insulin-like growth factor-1, excessive cytokine production. The risks of cancer associated with diabetes mellitus type 2 are more than 2 times higher for liver, pancreatic and endometrial cancers, 1,2 and 1,5 times higher for colon, breast and bladder cancers. The prevalence of pre-existing diabetes in cancer patients with cancer of any localization was estimated at 20,7% and appears to be high in patients with liver and pancreatic cancer, regardless of gender. Different types of diabetes mellitus are associated with different localization of cancer: diabetes mellitus type 2 is associated with an increased risk of breast, colon, and pancreatic cancer, while diabetes mellitus type 1 is closely correlated with cancer of the stomach, pancreas, endometrium, and cervix. Obesity, coupled with diabetes, is also associated with an increased risk of endometrial malignancies, colorectal cancer and postmenopausal breast cancer. The increased risk of pancreatic cancer in patients with newly diagnosed diabetes compared to long-term diabetes indicates a complex and bidirectional relationship. Long-term diabetes mellitus is a predisposing factor for pancreatic cancer, increasing the risk of malignancy by 1,5-2 times, and first-time diabetes may be an early manifestation of a tumor.Antidiabetic drugs also have an impact on cancer risk, and drugs used to treat cancer can either cause diabetes themselves or worsen existing ones. There is a relationship between cancer and both type 1 and type 2 diabetes. Metformin may reduce the risk of cancer. Clinical studies performed on insulin glargine give contradictory results, and it is impossible to confirm or exclude the carcinogenic risk of long-acting insulin analogues. When managing patients with diabetes mellitus, especially during its primary diagnosis, it is advisable to undergo cancer screenings recommended according to age and gender.

The objective is to study occurrence of alexithymia in patients with type 2 diabetes mellitus (DM-2), arterial hypertension (AH) and their combination. 3 groups of patients have been examined. Group 1 included 25 patients having DM 2 without AH (55 {51; 59} y.o., 7 (28%) men); group 2 included 25 patients of the same age and gender having DM-2 combined with AH; group 3 included 25 patients having AH and normoglycemia (57 {48; 62} y.o., 7 (28%) men). A number of evaluations have been done, such as a survey based on Toronto Alexithymia Scale (TAS-26), clinical and laboratory studies. The patients in all the 3 groups had a similar age, level of education and the number of working people didn’t differ. The patients in groups 1 and 2 received the same therapy for DM-2, level of glycosylated hemoglobin and incidence of DM-related chronic complications proved similar in these groups. High-grade alexithymia was detected in 14 (56%) patients in group 1, in 12 (48%) patients in group 2 (summary 52% patients with DM-2), in 9 (36%) patients in group 3. Group 3 showed absence of alexithymia (score TAS-26 < 62) more often (10 (40%)) as compared with groups 1 and 2 (3 (12%) patients in each group; χ² 1-3, р = 0,02). A higher score according to TAS-26 was detected in patients having DM-2 (group 1 + group 2) as compared having AH and normoglycemia (74 {69; 79} vs 69 {59; 74}, Mann – Whitney T-test, р = 0,022). 26 (52%) patients with DM-2 were detected to have high-grade alexithymia, while its occurrence was not connected to the presence of AH. Comparing with the patients having AH and normoglycemia, the patients with DM-2 more rarely showed the absence of alexithymia; the latter also had the higher score TAS-26.

Hormone therapy is the most effective treatment for menopausal symptoms. The benefits of using menopausal hormone therapy outweigh the risks for healthy women. However, the situation is more complicated in women with one or more chronic diseases. These are primarily age-associated diseases, such as hypertension, obesity, fatty liver disease, atherosclerosis, type 2 diabetes mellitus, as well as varicose veins of the lower extremities and others. Factors under hormonal control are involved in the pathogenesis of these conditions, so the use of hormone-active compounds can have both a sanogenetic effect and exacerbate the patient's morbid condition. Optimization of menopausal hormone therapy requires in-depth knowledge of the effects of hormones and their synthetic analogs on the biochemical checkpoints of age-related diseases. The pharmacological effect of menopausal hormone therapy depends not only on the dose and duration, but also on the time of onset, which translates the use of hormones from a therapeutic plane into a prophylactic one. The gestagenic component of MHT, due to additional properties, can reduce the positive metabolic effect of estrogens. A comparative analysis of the properties of progestogens showed that micronized progesterone and dydrogesterone are the safest options, with a lower risk of cardiovascular disease, thromboembolism and breast cancer compared to other progestogens, and are the drugs of choice in women with high breast tissue density, diabetes mellitus, obesity, smokers and risk factors for venous thromboembolism. Pharmacokinetic profiling shows a number of advantages of dydrogesterone: reliable quantitative accounting, the absence of biologically active metabolites (fewer side effects, including central ones), fewer contraindications for prescribing. This article presents data on the features of the use of menopausal hormone therapy in women with such chronic diseases as obesity, arterial hypertension, dyslipidemia, diabetes mellitus, venous thromboembolism.

The aim was to study alcohol-induced changes in the electrical inhomogeneity of the myocardium and the level of vascular endothelial growth factor in blood serum in young patients. 92 patients were examined. The first group consisted of 30 men and 30 women in a state of acute intoxication with subsequent examination of the withdrawal state in the clinic, the second group included 16 men and 16 women in a withdrawal state upon admission to the clinic. Age of patients in the first group: 36,00 (33,75-40,00) years (women) and 37,50 (33,75-41,25) years – men, age of patients of the second group: 36,00 (35,00-39,75) years (women) and 37,50 (34,25-39,75) years (men). The control group consisted of healthy individuals: 15 men aged 35,00 (29,00-39,00) years and 15 women aged 31,00 (28,00-40,00) years. The dispersion of the QTd interval was assessed using a high-resolution electrocardiography apparatus Poly-Spectrum 8/EX (Russia), in 12 standard leads, lasting 10 seconds. The concentration of ethanol in the blood was determined by an Agilent 6850 chromatograph (USA). Serum concentration of vascular endothelial growth factor was assessed using the Vector-Best reagent kit (Russia) on an enzyme immunoassay analyzer Hospitex diagnostics Plate Screen (Italy). Evaluation of the serum concentration of vascular endothelial growth factor in young alcohol-dependent patients showed an increase in its content, both in the acute and withdrawal periods, compared with patients in the control group. At the same time, there was a trend towards higher vascular endothelial growth factor values in men compared to women. It was found that the prehospital course of the withdrawal period is characterized by higher concentrations of serum vascular endothelial growth factor, compared with patients in whom the withdrawal period began in the clinic after acute alcohol intoxication. The hospital withdrawal period was accompanied by an increase in the value of the corrected dispersion of QTcd among women and men, compared with the acute period. Analysis of the incidence of violations of the processes of repolarization of the ventricular myocardium in the withdrawal period revealed its predominance in women compared to men. The development of a strategy for early prenosological diagnosis of myocardial arrhythmogenic activity, including the assessment of electrical inhomogeneity, made it possible to reveal the prevalence among young women of a more frequent occurrence of arrhythmogenic myocardial vulnerability in the withdrawal period of alcoholic excess compared to men. Alcohol-induced electrical inhomogeneity of the myocardium is accompanied by an increase in the serum concentration of vascular endothelial growth factor in young patients without overt cardiac pathology.

Cardiac patients are at risk for a severe course of coronavirus infection, as treatments for COVID-19 may have side effects on the cardiovascular system. Also, patients with pre-existing cardiovascular diseases risk factors and cardiovascular diseases are among the most vulnerable, with a potentially high risk of infection, cardiovascular events, and adverse outcomes. COVID-19 is associated with many direct and indirect cardiovascular complications. In this regard, we analyzed a large amount of literature in the CochraneLibrary, ScienceDirect, PubMed databases, summarized modern scientific data and identified the features of the management of cardiac patients during the COVID-19 pandemic. It has been noted that careful monitoring of highly sensitive troponin I and troponin T can aid in the early detection of cardiac damage and possibly prevent further deterioration with appropriate treatment. Elevated troponin is indicative of myocardial injury, which can be caused by cytokine storm, hypoxic injury, coronary spasm, microthrombi, myocarditis, or plaque rupture. Systemic inflammation and hypoxemia caused by COVID-19 may also contribute to the development of various types of arrhythmias. In addition, severe inflammation can cause hemostasis disorders, including disseminated intravascular coagulation, microclot formation in the lungs, and intravascular coagulopathy. An increase in troponin levels may be secondary to, and not due to, plaque instability. At the same time, to date, the strategy for managing cardiac patients during a pandemic is not clearly defined and is mainly focused on supportive therapy, as well as on the treatment of the infection itself.

The high-risk groups for the development of severe forms of a new coronavirus infection include elderly people with concomitant pathology of the respiratory system, cardiovascular system, etc. The report describes a clinical case of recurrent disease with a new coronavirus infection (COVID-19), in a patient aged 74 years, which occurred with lung damage on the background of myocardial infarction. The repeated disease developed in the presence of specific IgG class antibodies in the amount of 3,9 units and proceeded with lung damage (up to 20%) in the form of bilateral polysegmental pneumonia with subpleural changes of the «frosted glass» type, which is typical for patients with COVID-19 complicated by pneumonia. According to the assessment protocol (NEWS) – the patient's condition, at the beginning of the disease and in  the following days, of moderate severity. The disease proceeded without respiratory failure, with an oxygen saturation of 96-97%. The etiology of the disease was confirmed in the laboratory by PCR of a pharyngeal smear on SARS-CoV-2 RNA and by the ELISA method. The patient completed the course of treatment with positive dynamics. He was discharged for the outpatient stage of treatment on the 12th day from the onset of the disease in a satisfactory condition with a final diagnosis: COVID-19 coronavirus infection, the virus was identified as a moderate form. Community-acquired bilateral polysegmental pneumonia. Ischemic heart disease, Q-forming myocardial infarction of the lower wall of the region from 21.01.2021 Gravity class according to Killip I. Stenosing atherosclerosis of the coronary arteries. Arterial hypertension is 3 art.risk. Dyslipidemia, Chronic heart failure 1 with a preserved ejection fraction of 58%. Hypertensive crisis from 21.01.2021 We hope that the article will be of interest to doctors of practical healthcare in terms of medical education on the problem of coronavirus infection.

Since the end of 2019, the world has been gripped by a pandemic of a new coronavirus infection caused by SARS-CoV-2. From the first days, the international medical community has been actively studying the acute phase of this infection, but gradually the understanding has come that the number of people with long-term consequences, which can be of the most diverse, including multisystem nature, is increasing more and more. The review of the literature reflects current ideas about the short-term and long-term impact of infection with the SARS-CoV-2 virus on the development of electrolyte disorders and the course of cardiovascular pathology, including those that developed de novo. The debatable issues of definition, risk factors, pathogenesis, course of post-COVID syndrome are discussed with the introduction of the official term «states after COVID-19» and its interpretation, according to the World Health Organization definition proposed in the fall of 2021. Separately, the problems of cardiac arrhythmias are highlighted with an emphasis on atrial fibrillation and chronic heart failure, primarily diagnostic ones associated with non-specific dyspnea in such patients and a frequent increase in natriuretic peptides due to non-cardiac causes. It should be emphasized that information on the clinical outcomes, prognosis and pathogenesis of atrial fibrillation in COVID-19 remains controversial, which is due, on the one hand, to the influence of viremia, intoxication, and fever as obvious transient causes of this arrhythmia, and, on the other hand, to the longitudinal prothrombotic status characteristic of SARS-CoV-2 infection. It is known that the largest number of hospitalizations and deaths in the world associated with a new coronavirus infection occurs in elderly and senile people. The atypicality of the clinical picture, polymorbidity, polypharmacy, the presence of geriatric syndromes occupies a special place in the supervision of the gerontological contingent of patients, to which the authors of the review also draw the attention of clinicians.

Currently, the problem of obesity and overweight has covered all countries of the world, including Russia. The number of children, including preschool-aged children, is growing. Which causes particular concern, since at this age food habits and taste preferences are formed, which determine the contribution for all subsequent periods of life. The issues of prevention of obesity and overweight come to the fore, in order to prevent the development of metabolic disorders (diabetes mellitus, dyslipidemia, pathology of the gastrointestinal tract and others). The main principles of prevention of obesity and overweight are dietotherapy, regular physical activity, reduction of time spent in front of the screen, normalization of sleep, instilling the rules of proper nutrition in the family. Dietotherapy includes a reduction in the total caloric of the diet, due to an increase in the use of fruits and vegetables, as well as a reduction in fats and refined carbohydrates. Attention is focused on the need to exclude sweetened beverages, while fruit juices can be used in nutrition, however, the amount consumed should be strictly limited. According to international recommendations, the intake of fruit juices is possible from the age of one year. From one year to three years, the maximum allowable consumption of fruit juice is 120 ml, from four years 120-180 ml. According to Russian recommendations, the introduction of fruit juice is possible from the age of 8 months. Physical activity at an early age should be at least 180 minutes a day. And the time spent in front of the screen should not exceed 60 minutes a day. The child's parents should actively participate in the process of obesity prevention. To improve psychological interaction, it is desirable that meals are carried out together with parents. You should not force a child to eat by force. Food should not be as a means of encouragement or repression.

Since first cases of a new coronavirus infection (COVID-19) were detected, as well as World Health Organization named the COVID-19 outbreak as a pandemic, data on the pathogenic potential of the causative agent of SARS-CoV-2 infection has continued to accumulate. In particular, the neurotropic potential of the pathogen was revealed, the mechanisms of microvascular complications were clarified, the persistence of some symptoms within postcovid syndrome was detected. Considering extremely active agent circulation and rapid spread of the new coronavirus among the world's population, high morbidity, the emergence of new strains, vulnerable patient populations, which include people with chronic diseases, require special attention. This article summarizes current data on the pathogenesis and clinical course of the new coronavirus infection in patients with chronic cerebral ischemia and neurodegenerative diseases, draws historical parallels with neurological phenomena that occurred after the well-known pandemics of respiratory infections, in particular, influenza, as well as the impact of the current epidemiological situation, modification of the medical care system with conversion to work with COVID-19, and social restrictions on patients with chronic neurological diseases. The modern updates of the recommendations of the American Academy of Neurology, important for practicing physicians, are given: a new guide to the initial dopaminergic therapy of motor symptoms in Parkinson's disease. A variant of patients managing during a pandemic is proposed in the aspect of organizing doctor – patient interaction and prescribing pharmacotherapy with a pathogenetically justified mechanism of action. Emphasis is placed on the correction of GABA-ergic transmission, which is responsible for a number of functions of the central nervous system (cognition, executive functions, modulation of motor activity), the violation of which is shown both in the acute period of COVID-19 and after its termination in the framework of the postcovid syndrome.

Acute bronchitis is one of the most common reasons for patients seeking medical care on an outpatient basis, the incidence of it reaches 30-40% and depends both on seasonality (from late December to early March) and on the epidemiological characteristics of the population under study (children's organized groups, military personnel in long-term care facilities) and on the epidemic rise in the incidence of influenza. The actual incidence of acute bronchitis may be higher, which is associated with self-medication and the lack of seeking medical help for mild forms of the disease. This article discusses modern approaches to understanding the problem of acute bronchitis. The decisive role of respiratory viruses in the etiology of this disease, predisposing factors to its development and the main pathogenetic links and mechanisms are emphasized. At the same time, Mycoplasma pneumoniae and Chlamydophila pneumoniae, as well as Bordetella pertussis, are shown to be crucial in the formation of prolonged forms of acute bronchitis due to the long persistence of these microorganisms. Emphasis is placed on pathogenetic and symptomatic therapy, which is sufficient in the treatment of 90% of cases of this disease. Errors and unreasonable prescriptions of antibacterial drugs for acute bronchitis are considered. At the same time, the necessity of etiotropic (antibacterial) therapy in the case of a disease caused by intracellular pathogens, taking into account modern clinical recommendations, is emphasized. Indications for the appointment of macrolides, features and advantages of the clinical use of azithromycin, as well as its non-antibacterial properties are considered. The advantages of the dosage form of the dispersed tablets in comparison with traditional dosage forms for oral administration are evaluated. The pharmacokinetic advantages of dispersible tablets in the form of their improved bioavailability, their favorable safety profile and ease of use in various categories of patients, as well as potentially higher clinical efficacy are analyzed.

The review is devoted to the urgent problem of world health – acute respiratory diseases. This is the most common group of diseases in the human population. Regardless of the type of pathogen, acute respiratory disease manifests itself with similar symptoms, of different duration and severity. More often, respiratory pathogens affect the upper respiratory tract and are limited to the development of catarrhal manifestations with a typical clinical picture in the form of fever, general non-specific/flu-like symptoms and intoxication syndromes. The review presents the results of experimental and clinical studies of a new antiviral drug with antibacterial activity. The drug affects key targets involved in the process of recognizing an infectious pathogen, triggering an immune response and eliminating the pathogen. A series of preclinical studies have demonstrated the efficacy of the drug in viral and mixed viral-bacterial infections. Pharmacological effects of new drug include antiviral, immunotropic, antibacterial and anti-inflammatory activity. The antiviral efficacy of drug components (technologically processed antibodies to IFN-gamma and CD4 receptor) has been previously demonstrated by numerous studies and confirmed by long-term experience with the use of precursors. The new components included in the composition of the drug directly affect the molecules of the major histocompatibility complex and provide not only an increase in the antiviral effect, but also an antibacterial effect. Drug own antibacterial effect was noted, as well as its ability to increase the efficacy of therapy when used in combination with an antibacterial drug. The results of clinical studies have shown the ability to significantly reduce the duration of acute respiratory viral infection and prevent the development of bacterial complications. In the reviewed works, positive data on a favorable safety profile of the drug were obtained. It is considered appropriate to continue clinical studies of the drug in adult and pediatric populations (including children aged 12-18 years).

The frequency of post-COVID syndrome in patients treated on an outpatient basis ranges from 10% to 35%, while in patients who have had a severe disease requiring hospitalization, the frequency of post-COVID syndrome can reach 80%. Increased fatigue, defined as a feeling of physical and mental fatigue or exhaustion in the form of muscle weakness, slow reactions, drowsiness and reduced concentration, is the most common (17,5-72%), often the leading complaint of patients with post-COVID syndrome. In 63% of patients, even 6 months after discharge from the hospital, increased fatigue and muscle weakness were noted. Since there is reason to believe that hypoxia and acidosis with a violation of the processes of formation and use of energy occur in asthenic syndrome, it seems appropriate to use metabolic correctors in this situation, which include the drug meldonium. Meldonium works as an antihypoxant, antioxidant, cytoprotector, angioprotector and energy protector, which gives grounds to speak of the so-called multimodal or supranosological effect of the drug. This article describes the mechanism of action and the main clinical effects of meldonium. Meldonium reduces the synthesis of carnitine, which leads to inhibition of β-oxidation of free fatty acids, glycolysis is activated and the formation of adenosine triphosphate in cells increases. Data are given on the effectiveness of meldonium in coronary heart disease and coronary brain disease, chronic heart failure, diabetes mellitus and asthenic syndrome. The positive effect of the drug on lipid and carbohydrate metabolism is described. Two clinical cases are presented confirming the effectiveness of meldonium in post-COVID syndrome and such a common manifestation of it as asthenia. The conclusion is made about the expediency of including meldonium in the complex therapy of patients with post-infectious asthenic syndrome in a pandemic.

Due to insufficient oxygen supply to the fetus, which is called hypoxia, adverse changes occur in its body. In the total number of births, it is 10,5%. Fetal hypoxia is not an independent disease. It is a consequence of various pathological processes in the body of the mother, fetus and in the placenta. The health of a child is formed even during his intrauterine development, in this regard, fetal hypoxia at the present stage is an important medical and social issue, since it is directly related to the level of health of the population. The article analyzes the main factors contributing to the occurrence of hypoxia during pregnancy and childbirth. These can be diseases of the mother, such as: cardiovascular and pulmonary diseases, anemia, intoxication and others. It can also be a violation of the fetal-placental blood flow: gestosis, fetal prolongation, the risk of premature birth, pathology of the placenta and umbilical cord, various abnormalities of labor. The research was carried out on the basis of the Arzamas Maternity Hospital. Cases of development of fetal hypoxia, outcomes of pregnancies and childbirth in women with fetal hypoxia were analyzed. The aim of the study was to study the factors influencing the development of fetal hypoxia during pregnancy and childbirth in order to determine priority preventive measures to prevent this pathology in the city of Arzamas and Arzamas region. Retrospectively, 821 birth histories were analyzed – form No. 096/y, for the period 2017-2019, reporting data for the Arzamas maternity hospital. Based on the results obtained, in order to reduce fetal hypoxia, it is necessary to improve the quality of health improvement of the population at the pregravid stage, to allocate women with a complicated obstetric history to highrisk groups, to hospitalize women with pathology in the appropriate departments when their condition worsens and before childbirth. It is necessary to carry out psychoprophylactic preparation of pregnant women for childbirth, prohibit the work of women in hazardous work by law, organize physical culture breaks for women whose work is associated with physical inactivity.

The influence of natural and anthropogenic ecological and hygienic factors in the Republic of Dagestan on the incidence of cervical erosion in the adult female population, especially in rural areas of the republic, has been established. The degree of influence on the growth of cervical erosion incidence from exposure to various chemicals, including pesticides and fertilizers, has been revealed. The data of statistics of the combined effects of compounds in the incidence of cervical erosion, cases of the neutralizing effect in the combined total exposure are considered. The relationship between the spread of cervical erosion among the female population of rural areas with the intensity of the use of organochlorine compounds and nitrogen fertilizers, as well as compounds of copper, cobalt, hydrocarbons, has been studied. The conclusion is formulated and substantiated that today there is a direct correlation between the intensification and modernization of agriculture and the increase in the incidence of these diseases in women. As part of the study of substances and compounds that affect the woman's body, it was found that the incidence of cervical erosion among women depends on the intensity and degree of exposure to harmful substances on the body, and the greatest harm in this case is caused by ketones, aldehydes and hydrocarbons. It is noted that it is these substances that are actively used in agriculture, which is assessed by the author of the article exclusively from a negative point of view. The article also focuses on the fact that often these substances have a negative effect on the woman's body in the aggregate, which only enhances their negative impact. It is indicated that according to statistics, with the total effect of these substances on the female body, the incidence rate does not increase, however, general data indicate the danger of the current situation.

Nutritional support has firmly entered the complex of therapeutic measures widely used in patients with stroke, oncological diseases, a new coronavirus infection, as well as in many other serious diseases and conditions. The evaluation of the clinical effectiveness of the use of specialized nutrition products in patients in severe conditions and the practical issues of organizing the continuity of nutritional support at all stages of treatment and rehabilitation «hospital – outpatient link» was devoted to the round table of the Nutricia company entitled «Healthy nutrition – one of the most important links Stroke Therapy and Beyond», which took place on February 12, 2022 as part of the XVIII annual interdisciplinary conference «Veynovskiye chteniya – 2022» with the participation of leading experts in the field of nutrition, neurology and palliative care. The event discussed the use of specialized therapeutic food products in patients with stroke and its complications based on updated clinical guidelines and the results of ongoing research 2020-2021. During the round table, the main clinical effects of the use of nutritional support in various categories of patients and their impact on the healthcare system as a whole were also considered. Among the main effects of nutritional support, such indicators as improved indicators of physical recovery, increased rehabilitation potential and improved quality of life of patients, including a reduction in the length of stay of patients in the hospital and pharmacoeconomic benefits for the healthcare system, were especially noted.