Inflammatory linear verrucous epidermal nevus (ILVEN) is a rare skin disorder characterized by verrucose, linearly arranged growths on the skin on one side of the body and extremities. The etiopathogenesis of the disease remains not fully understood. To date, the main cause of the development of this pathology is considered to be somatic mutations leading to the appearance of genetic mosaicism. The clinical picture of the disease is quite typical and consists of verrucous, linearly located, unilateral growths localized both on the trunk and on the extremities. Despite the typical clinical picture, practitioners may experience difficulties in making a diagnosis during routine appointments due to the low incidence of this pathology. Also, diagnostic difficulties are due to the fact that some chronic dermatoses (some forms of lichen planus and psoriasis, other types of congenital epidermal nevi, Darier's disease, linear porokeratosis) have similar clinical manifestations to ILVEN. In addition to the similarity of clinical manifestations, there is also a commonality of the clinical picture in histopathological examination (for example, ILVEN and psoriasis), which also complicates the process of differential diagnosis and diagnosis. A correctly established diagnosis of inflammatory linear verrucous epidermal nevus can play a decisive role in saving the patient's life, because. Often, the presence of ILVEN in a patient is a marker of other severe comorbid disorders, including the pathology of various organs and systems and the presence of neoplasia. Identification and control of comorbid disorders in this case plays a decisive role in saving the life and health of the patient. ILVEN therapy includes both conservative and surgical methods. The choice of treatment method largely depends on the clinical picture of the disease. This article presents a clinical case of congenital linear verrucous epidermal nevus, as well as a review of the literature covering the known aspects of etiopathogenesis, clinical presentation, diagnosis and treatment of the disease.

Currently, the possibilities of laser radiation in the treatment of patients with acne are being actively investigated. In this regard, it is of interest to combine phototherapy based on a combination of direct bactericidal, anti-inflammatory, immunomodulatory and sebostatic action of a neodymium yttrium-aluminum garnet (Nd: YAG) laser and simultaneous elimination of local post-inflammatory vascular and pigmentary disorders using a potassium-titanyl phosphate laser (KTP). Objective was to study the clinical efficacy and tolerability of combined phototherapy with KTP and Nd: YAG lasers in the complex treatment of patients with moderate acne. 60 patients with acne of moderate severity with localization of rashes on the face were under observation, which, depending on the therapy, were divided into the main and comparison group of 30 people. All patients received topical benzoyl peroxide and clindamycin phosphate gel. In the main group, combined phototherapy with KTP and Nd: YAG lasers was additionally performed. Treatment efficacy was monitored dynamically by calculating the dermatological acne index, evaluating the processes of lipid peroxidation and local blood flow. The tolerability of therapy was studied by monitoring adverse reactions and the dermatological index of quality of life. Clinically, in the patients of the main group, by the end of the observation, a pronounced regression of inflammatory elements was recorded, characterized by significantly lower RIA values than in the comparison group. Also, in this group, a faster recovery of processes of lipid peroxidation and local microcirculation was noted, the studied parameters of which already on the 8th day of therapy significantly exceeded the values of the patients in the comparison group, and by the 12th day they did not differ from the parameters of healthy individuals. In the course of treatment, there were no pronounced local adverse reactions in any of the studied groups. By the end of the observation, the number of patients in the main group who believed that acne has an insignificant effect on their quality of life exceeded this indicator in the comparison group by 2.1 times. The inclusion of combined phototherapy with KTP and Nd: YAG lasers in the complex treatment of patients with moderate acne is accompanied by a pronounced positive dynamics of the skin pathological process, restoration of processes of lipid peroxidation mechanisms and local microcirculation, and is also well tolerated by patients.

Young adults are the most active and socialized group of the population. Involvement in social work, volunteering, tourism, active migration within the country and abroad, including for the purpose of education, give reason to consider young people potentially responsible for the spread of a new coronavirus infection. Clinical assessment of the COVID-19 course in young adults has a considerable interest due to the expansion of opportunities for early detection of the disease among representatives of this age group, as well as the timely prevention of further transmission of infection. It is known that, despite the predominance of mild COVID-19 and a better prognosis for recovery compared with older patients, cases of adverse outcomes and a variety of clinical symptoms that persist in the post-COVID period have been described in young adults. A voluntary anonymous survey of 97 senior students of a medical university who had a COVID-19 infection was conducted. During the surveywas carried out a detailed assessment of the diseasecourse, features of diagnosis, treatment and condition after clinical and laboratory recovery. Separately, questions were asked about the attitude of medical students to vaccination, and it was also proposed to give their own recommendations to people who had not yet had a new coronavirus infection based on their own clinical experience. Among young people, the prevalence of a mild form of COVID-19 was noted, while a wide variety of symptoms were revealed. The five most common clinical manifestations included weakness, taste and smell disorders, runny nose, dry cough and fever. Asymptomatic form of the disease was observed rarely. It was noted that even several months after the infection, many of the symptoms of the disease in young adults persisted. Outpatient treatment among prospective clinicians has not always been consistent with current guidelines. In some cases, young people neglect anti-epidemic rules and can serve as a source of infection for contact persons.

Along with the obvious clinical symptoms caused by the reactivity of the cytokine storm syndrome, patients experience extrapulmonary manifestations of COVID-19. A thorough analysis of large arrays of patients showed that residual symptoms in people with microbiological normalization (i. e., with negative results of the SARS-CoV-2 virus as a criterion for the effectiveness of etiotropic treatment) represent a complex of clinical manifestations that have a single etiopathogenesis, and thus the following is formed concept as post-covid syndrome. Post-covid syndrome has become one of the leading consequences of a new coronavirus infection. The physical, cognitive and neuropsychological consequences of the disease are increasingly becoming realistic, and the associated functional limitations may persist long after discharge from the hospital, negatively affecting the quality of life of patients. Modern ideas of a number of foreign scientists about the manifestations and pathogenesis of post-covid syndrome are reduced to the following aspects: symptoms caused by persistent chronic inflammation are combined with the consequences of damage to internal organs and non-specific manifestations of hospitalization and social isolation. One of the evidence of the pathogenesis of post-covid syndrome is the change in biomarkers, which are criteria for impaired cognitive-motor and psycho-cognitive states of coronavirus infection. The article analyzes the practical experience of using programs for the rehabilitation treatment of patients with COVID-19 in outpatient medical organizations, taking into account changes and prediction of further development of post-COVID syndrome based on the dynamics of concentrations of patients' blood biomarkers. Comprehensive rehabilitation treatment of patients with COVID-19, based on the individual selection of not only physical and physiotherapeutic treatment regimens, but also on the use of drugs, especially drugs that stimulate regeneration and repair, will help to avoid many of the negative consequences of the pathology.

The new coronavirus infection, which has caused significant morbidity and mortality in most countries of the world, was first identified in December 2019 in Wuhan, China. In March 2020, the World Health Organization declared a pandemic of a new coronavirus infection, which became a challenge to humanity and the medical community. COVID-19 is a highly contagious disease caused by the SARS-CoV-2 virus. Specific prothrombotic changes in the hemostasis system in COVID-19 are associated with an increased incidence of venous thromboembolic complications. One of the most dangerous and prognostically unfavorable complications of COVID-19 is the development of coagulopathy of the type of decompensated hypercoagulation, up to disseminated intravascular coagulation. There is a close relationship between hemostatic disorders and the systemic inflammatory response to viral infection. Clinical and laboratory signs of thrombotic conditions and their severity are directly correlated with the production of inflammatory cytokines: IL-2, IL-6, IL-7, IL-10, G-CSF, IP10, MCP-1, MIP-1A and TNF-α. The 

relationship between inflammation and thrombosis and the ability of these two processes to exacerbate each other have been described in many pathological conditions. Physiological pro- and anticoagulants, like platelets, have pro-inflammatory properties independent of their hemostatic functions. Mutual conditioning of thrombotic complications and systemic inflammatory response is one of the main links in the pathogenesis of COVID-19. COVID-19 associated coagulopathy is accompanied by a pronounced increase in the level of D-dimer and fibrin/fibrinogen breakdown products, while the deviation of other indicators (prothrombin time, activated partial thromboplastin time, platelet count) at the onset of the disease is relatively rare. For coagulopathy associated with COVID-19, empiric anticoagulant therapy aimed at preventing venous thrombosis and thromboembolism should be carried out in all hospitalized patients, as well as standard maintenance therapy for sepsis-induced coagulopathy or disseminated intravascular coagulation syndrome. The article is a review of the literature on the diagnosis, treatment and prevention of coagulopathy and venous thromboembolic complications associated with COVID-19.

Currently, despite significant advances in the development of medicine in general, and diagnostic and therapeutic approaches in particular, the problem of influenza is still extremely relevant. Over the past years, there has been a significant decrease in the infection rate of the population. In addition, influenza in many cases has a fairly favorable course, due to passive immunization. However, this circumstance does not negate the fact that the virus can have an extremely negative impact on the human body, which significantly reduces the quality of life and predictively has negative health consequences. Also, the incidence of influenza causes negative socio-economic consequences, which are reflected in a decrease in the working capacity and, accordingly, in the labor productivity of the population, as well as in an increase in the costs of diagnosing, treating and rehabilitating the sick. In terms of considering the course of the infectious process and its likely complications, clinicians pay increased attention to patients at risk. Pregnant women require a special approach, in which, due to the presence of physiological immunosuppression, as well as anatomical and physiological features, the flu can be quite severe with the formation of a large number of complications that have negative consequences both for the health of the expectant mother and of the outcome of gestation and further development of the newborn. The goal, which was set in the article, pursues a detailed consideration of the likely complications against the background of influenza infection, as well as ways to prevent their development through vaccination. At the present stage of development of pharmacy, doctors have drugs containing weakened pathogens that can be used in pregnant women in the II and III trimester of gestation. Numerous studies have confirmed that the introduction of a quadrivalent inactivated split influenza vaccine to pregnant women does not have any negative impact on the condition of the future mother and fetus, and the protective effect of vaccination that protects pregnant women from the occurrence of severe and complicated forms of the disease can become a guarantee of maintaining the health of pregnant women and next generation.

Currently, true acantholytic pemphigus refers to severe autoimmune diseases, which, in the absence of timely adequate therapy, can turn into autoaggression with a possible fatal outcome. Regularly received information from various regions of the Republic of Azerbaijan about the increase in the incidence in the last decade, information about the complexity of differential diagnostics, resistance to therapy of some forms (paraneoplastic, herpetiform) of pemphigus vera dictate the need to develop new provisions in the current clinical and epidemiological situation. The aim of this study was to study the epidemiological situation, dynamics and patterns of development of true acantholytic pemphigus in Azerbaijan, as well as to identify the features of the clinical course, taking into account new realities. An analysis of 554 true acantholytic pemphigus patients under our supervision over a 13-year period was carried out. With the aim of a deeper study of the intensity of the epidemiological process and obtaining more reliable data, we set the task of analyzing the increase in morbidity in long-term dynamics (coverage of a large period, together with the results of S. A. Alieva, which were obtained since 1956 to 1985). It was found that there was a steady increase in the incidence with a 13-14 year cycle of 2.5-3 times increase, and since 2006 the rate of disease growth has increased and switched to a 6 year cycle. The course of the disease has changed, it has become more severe and resistant to the therapy. The number of patients with true acantholytic pemphigus P increased in persons under 40 years of age (where there was a twofold predominance of women). The prevalence of common forms over limited, a reduction in the period of mucosal lesions, rejuvenation of the formation of the disease, resistance of the disease to the therapy (a two-fold increase in the dose of glucocorticoids) make it possible to make judgments about the change in the course of the disease. 

Influenza epidemics cause morbidity and mortality, both through the direct action of the virus during the first days of disease and through the development of secondary bacterial complications that usually occur after the first week. Studies show that up to 65% of laboratory-confirmed cases of influenza infection are accompanied by secondary bacterial infection, which may have severe consequences, especially for patients in risk groups. This study aimed to systematize the available scientific evidence on the pathogenesis of bacterial complications of influenza. The review showed that secondary bacterial infection occurs typically in patients with influenza A, and those infected with the neuraminidase N2 subtypes usually experience a more severe course of the disease. S. pneumoniae, H.influenzae and S. aureus have been the most frequent pathogens complicating the influenza since the late 1800s. Influenza virus infection has been shown to cause various changes to the respiratory tract epithelium and to alter the immune response, predisposing patients to bacterial complications. The influenza virus is able to damage respiratory epithelial cells and inhibit mucociliary clearance mechanisms. Following bacterial colonization, the development of the disease is due to the specific characteristics of the viral infection, which facilitates bacterial adhesion and penetration. In addition, cytokine profiles have been shown to change in alveolar macrophages, neutrophils, dendritic cells and NK cells, resulting in impaired function of these cells. This leads to an increased inflammatory response and decreased bacterial eradication. However, despite a growing body of work detailing different aspects of the pathogenesis of bacterial complications of influenza, determining the exact contribution of each of the factors described is a complex task to which further research may be helpful. 

Food allergies are among the most common allergic diseases in children. Allergic damage to the gastrointestinal tract in young children is associated with the influence of genetic factors and sensitization of the body to food allergens, and primarily to cow's milk proteins. Gastrointestinal allergy ranks second among the pathologies associated with food allergies. With gastrointestinal allergies caused by food allergens, allergic inflammation develops in the gastrointestinal tract. Damage to the mucous membrane is accompanied by the penetration of bacterial endotoxin (lipopolysaccharide) from the intestinal lumen into the bloodstream, which leads to disruption of microcirculation processes in the mucous membrane and the development of its ischemia. The processes of its regeneration are disturbed and the processes of damage are intensified. For this reason, children with gastrointestinal symptoms of allergy are shown to prescribe drugs that have a sorption and cytoprotective effect. A significant improvement in the morphofunctional state of the intestinal mucosa is noted as a result of the use of the enterosorbent. This study showed the effectiveness of organosilicon enterosorbent in children with gastrointestinal allergy aged 2 months to 1 year. An open prospective randomized clinical trial was conducted at the Children's Republican Clinical Hospital in Kazan. Informed consent was obtained from the parents of all children for inclusion in the study. 57 children with gastrointestinal forms of allergy were under observation. Boys made up 52.6%, girls – 47.4%. The appearance of symptoms of gastrointestinal allergy in children is associated with the transfer to artificial feeding with adapted mixtures based on cow's milk. The inclusion of organosilicon enterosorbent in the complex antiallergic therapy at an age dosage leads to a positive clinical effect in 90% of cases with a 1.5-fold reduction in the exacerbation period against the background of a decrease in the level of total IgE and specific IgE to cow's milk proteins and casein. Silicone enterosorbent can be recommended for infants with gastrointestinal manifestations of food allergy to cow's milk proteins in combination with diet therapy and antihistamines.

The article is devoted to the problem of cough in childhood. Cough in children is one of the most common reasons for visiting a doctor. There are physiological and pathological cough. With pathological cough in children, it significantly worsens the quality of life. Given the wide variety of causes of cough, finding a doctor can be difficult to diagnose. Dangerous signals/«red flags» accompanying a cough are given, which parents should pay attention to in order to seek medical advice in a timely manner. The modern capabilities of a pediatrician to identify the causes of cough are considered, including the need to conduct a thorough analysis of medical history, especially in chronic cough, the importance of assessing various characteristics of cough (frequency, timbre, rhythm, intensity, time of occurrence, duration, productivity, in the presence of the nature of sputum, etc.) to narrow the diagnostic search, depending on the nature of the cough, differentially prescribe laboratory and instrumental research methods. The article presents the most common causes of cough in children, describes the features of cough in various nosological forms of acute respiratory infections, including current variants of SARS-CoV-2. Diagnostic and therapeutic possibilities in pediatric practice are considered. One of the promising areas of cough therapy in acute respiratory infections is the use of innovative complex agents that combine plant components and vitamins that can affect various pathogenetic mechanisms of inflammation and cough. Syrup with althaea and plantain improving dry and productive cough as well coughing at night is recommended. vitamin C, althaea, plantain, chamomile, and thyme provide analgesic, anti-inflammatory, sedative, and mild immunomodulatory effects.

Ixodid tick-borne borreliosis (Lyme disease) is an infectious disease common in areas inhabited by borrelias – potential causative agents of this pathology. Currently, about 20 genospecies of Borrelia are known, pathogenicity for humans has been proven for 4 of them, but this number continues to grow. The transmissible mechanism of transmission makes it possible to classify this disease as a natural focal infection, which makes this problem particularly relevant for the territory of Siberia and the Far East. The wide polymorphism of clinical manifestations, the complexity of specific diagnostics and the lack of information both for doctors and the general population often make it difficult to verify the diagnosis and often lead to late diagnosis, which carries the risk of developing chronic forms of the disease. Neurological manifestations of Lyme disease in children are usually characterized by the development of lesions of the central nervous system. Neuroborreliosis in pediatric practice is usually characterized by the development of serous inflammation of the dura mater, but requires specific antibiotic therapy. Late diagnosis of neuroborreliosis entails an increase in the number of complications and more frequent development of neurological deficit in the outcome of the pathological process. The article provides an observation of a clinical case of the development of Lyme disease in a child, characterized by a lesion of the central nervous system in the form of serous meningitis. Noteworthy is the absence of a verified fact of tick bite, an atypical course of the disease with an initial lesion of the central nervous system and the subsequent formation of a typical annular erythema. The delayed formation of the cardinal symptom of Lyme disease in the form of erythema annulare in the above clinical observation seriously complicates timely diagnosis, and makes it virtually impossible in the absence of the doctor's alertness and the availability of specific highly selective methods of etiotropic diagnosis. In addition, the article also demonstrates the difficulties of differential diagnosis against a comorbid background.

Inflammation of the prostate occurs in men of all age groups. The incidence is comparable to that of diabetes mellitus, coronary heart disease and hypertension. Chronic prostatitis significantly reduces the quality of life of patients, disrupts copulative and generative functions. According to modern data, up to 35% of men aged 20 to 40 suffer from prostate inflammation. Thus, chronic prostatitis is not only a medical but also a social problem. The results of treatment of 48 patients with a diagnosis of «chronic prostatitis», a concomitant diagnosis of «chronic recurrent chlamydia, papillomavirus infection, human papillomavirus» were analyzed. For the analysis, three groups of 48 patients were formed who received complex etiopathogenetic treatment and symptomatic therapy in accordance with Methodological recommendations number 14 of 2019, developed on the basis of the Moscow State Budgetary Healthcare Institution «City Clinical Hospital named after S. I. Spasokukotsky» of the Department of Health of the City of Moscow, Federal State Budgetary Educational Institution of Higher Education «Moscow State Medical and Dental University named after A.I. Evdokimov» of the Ministry of Health of the Russian Federation. Patients received antibacterial therapy with fluoroquinolone and tetracycline drugs in combination with an immunomodulator. As a result of treatment of a chronic inflammatory process in the prostate gland, a stable remission was achieved, and in some cases, a complete recovery of patients, confirmed by a significant decrease in the index of the scale of symptoms of chronic prostatitis and pelvic pain syndrome in men (CP-CPPS) according to the US National Institutes of Health NIH-CPSI, as well as instrumental and laboratory data. In the treatment of concomitant diseases (persistent chlamydial and papillomavirus infection), patients showed complete elimination of the pathogen and a decrease in viral load according to the enzyme immunoassay and polymerase chain reaction analysis. There were no significant side effects during treatment.

Mixed bacterial infections cause reproductive disorders, in the form of inflammatory diseases of the pelvic organs, tubal infertility and ectopic pregnancy. A promising macrolide drug is spiramycin. Spiramycin is a highly effective drug in the treatment of uncomplicated and complicated urinary tract infections caused by chlamydia and ureaplasma, which can be used as monotherapy and as part of a complex treatment of sexually transmitted infections. Of particular importance is the proven safety of spiramycin therapy for infections at any stage of pregnancy. Therefore, the main principles of rational antibacterial therapy are the determination of the microflora that caused the infectious process, the assessment of the impact of the antibiotic on the fetus and the ways of its elimination, as well as the early start of therapy, the assessment of its effectiveness in the first 48 hours, the control of side effects. In infectious-inflammatory diseases, especially mixed bacterial infections, the use of the combined drug (ornidazole 500 mg and ciprofloxacin 500 mg) is considered justified. The results of the study of the vaginal microbiota showed that its flora is almost completely represented by anaerobic microorganisms. The appearance on the pharmaceutical market of secnidazole, a new generation antimicrobial agent, made it possible to implement a new approach to the treatment of bacterial vaginosis. Secnidazole, unlike clindamycin, does not have activity against beneficial lactobacilli and one can expect a minimal effect on the predominant Lactobacillus component of the normal healthy microflora. In the presence of intestinal dysbacteriosis, the infectious process acquires a protracted course, which requires repeated courses of antibiotic therapy and exacerbates dysbacteriosis. After the end of taking antibiotics, it is advisable to correct the state of the microbiocenosis of the vagina. Thus, the tactics of an obstetrician-gynecologist, based on the use of a set of measures for the treatment and prevention of infections, can reduce the incidence of complications in women of reproductive age.

Ulcerative colitis is a chronic disease characterized by inflammation that usually begins in the rectum and diffusely spreads proximally, involving part or all of the colonic mucosa. The etiology of ulcerative colitis is still unknown, so there are no drugs that could cure this formidable disease. The entire vast arsenal of drugs that is offered for the treatment of ulcerative colitis is aimed at various, as yet insufficiently studied links in the pathogenesis of ulcerative colitis. The emergence of a new class of medicines (genetically engineered biological preparations), unfortunately, has not solved this cardinal problem. The only way to «cure» ulcerative colitis at present is to remove the entire colon with the formation of an ileoanal reservoir anastomosis or a permanent ileostomy. However, surgical treatment of ulcerative colitis is associated with many complications and sometimes death. The main goals of therapy for ulcerative colitis are to induce and maintain steroid-free clinical and endoscopic remission, reduce the incidence of complications, disability and improve the quality of life. Severe forms of ulcerative colitis requiring hospitalization and intensive conservative treatment, and sometimes surgery, account for about 15% of all cases of ulcerative colitis. Most mild to moderate forms of ulcerative colitis can be successfully treated on an outpatient basis with conventional medicines, most notably the innovative mesalazine. A competent combination of oral and rectal forms of mesalazine allows in most cases to achieve not only clinical remission, but to achieve the modern goal of treating ulcerative colitis – healing of the colon mucosa, that is, endoscopic remission. The article presents modern views on the treatment of mild and moderate forms of ulcerative colitis with different extent of colon damage, which are reflected in the latest domestic and foreign guidelines. 

This article reveals the features and consequences of nutritional deficiency for the condition of stroke patients, shows the importance of nutritional support both in the acute stage of the disease and at the stage of rehabilitation. One of the factors that worsen the rehabilitation potential after a stroke is nutritional deficiency, which increases the risk of adverse outcomes in patients with stroke, and therefore nutrition should be the focus of attention of specialists involved in rehabilitation treatment. Nutritional deficiency has the following negative impact directly on the process of recovery of a patient after a stroke: a decrease in the degree of recovery of motor functions, a decrease in the degree of recovery of cognitive functions, a low level of social adaptation, a low level of quality of life. 50% of stroke patients are malnourished upon admission to rehabilitation centers. Conducting parenteral nutrition for more than three days is fraught with serious complications due to the lack of a stimulating effect of food. Whenever possible, the choice of nutritional support should lean towards enteral nutrition. Enteral nutrition during the recovery period of a stroke is aimed at solving the problems of preventing the development of malnutrition and complications caused by this malnutrition, therapeutic nutrition is a component of therapy in order to improve its tolerance, has a psychologically beneficial effect – accelerating socialization and the possibility of returning to normal nutrition. The article presents the features and principles of the implementation of various methods of nutrition in patients who have had a stroke. Particular attention is paid to the method of siping nutrition, carried out at the stage of rehabilitation, the main criteria for choosing the optimal mixture for such nutrition are given, the effectiveness of using a nutrient mixture for this purpose, which most fully meets all the requirements for such mixtures presented in the article, is substantiated.

Within the framework of the 17th National Congress of Therapists with International Participation, held in Moscow, dedicated to the 80th anniversary of the birth of of Yu. B. Belousov, a satellite symposium was held on the topic «New in the pharmacotherapy of common pathologies for a polyclinic therapist.» The event discussed two extremely important and most common problems in the practice of a polyclinic therapist – what to do with pain and what to do with heartburn? Modern approaches to pain therapy are considered on the example of chronic osteoarthritis as the most common rheumatic disease. Rheumatologists no longer classify osteoarthritis as a degenerative pathology, but as a disease based on inflammation caused by various factors, including biomechanical stress, such as traumatic exposure. Chronic low-level inflammation is the main mechanism of progressive cartilage cell loss, increasing pain and joint destruction. The molecular mechanisms of maintaining subclinical inflammation in osteoarthritis, which form a vicious circle of mutually reinforcing pathological processes, are already well understood. Attempts are being made to target certain pathogenetic links, the Wnt and NF-kB signaling pathways that trigger a cascade of pathological reactions in osteoarthritis. Modern data on the molecular mechanisms of action of non-steroidal anti-inflammatory drugs (in particular, ibuprofen), which inhibit the cascade of reactions, as a result of which the patient develops nociceptive pain, which eventually turns into neuropathic pain due because of mechanism central sensitization. The latest recommendations from the American College of Gastroenterology suggest that patients with classic symptoms of gastroesophageal reflux disease (heartburn and regurgitation) who do not have alarm symptoms should receive empiric therapy with proton pump inhibitors. However, this approach leads to overdiagnosis of gastroesophageal reflux disease. This problem can be overcome with the help of sodium alginate.

Once in the stomach, the drug comes into contact with hydrochloric acid and forms a kind of raft that physically prevents reflux. This is the basis of the alginate test, which serves as an additional criterion for the diagnosis of gastroesophageal reflux disease.

Within the II All-Russian Scientific and practical conference ”Musculoskeletal pain in rheumatic diseases”, held in Moscow, on September 16, a satellite symposium «Results of the clinical study ”Hummingbird”: positive experience of import substitution in the treatment of osteoarthritis”. Osteoarthritis is among the TOP 10 disea es that cause disability in older people. The incidence of osteoarthritis has been increasing in recent years and represents a rather large socio-economic burden for society, because the need for expensive operations for endoprosthetics of large joints is increasing. The problem of pain in osteoarthritis and its chronization forces specialists to look for new approaches to the treatment of the disease. According to the presented data, the Russian innovative drug, developed in the order of import substitution, significantly reduces the pain syndrome and improves the functional state of the joints in most patients with osteoarthritis. It reduces the need for non-steroidal anti-inflammatory drugs and reduces their use by an average of two times. The drug has a fairly rapid effect – after the first course, a good result is visible. Ultrasound proves the anti-inflammatory effect of the drug.