The article reviews data on pharmacokinetics, pharmacodynamics, efficacy and safety of ebastine, presents reviews of the most significant clinical trials in the treatment of allergic diseases (allergic rhinitis, urticaria) and comparative studies with other antihistamine drugs available in the arsenal of a modern practical doctor. Data of multiple preclinical and clinical trials presented in domestic and foreign sources allow to demonstrate its effectiveness and safety widely. Ebastin is characterized as medicine with high enough safety profile due to absence of sedative, atropine-like and cardiotropic effects, absence of tachyphylaxis and interaction with other medicines, absence of influence on ability to drive motor transport and complicated mechanisms. Pharmacokinetic properties of ebastine characterize the drug as a highly selective H1-histamine-blocker of long action, which can be taken regardless of meals. High therapeutic efficacy of ebastine in treatment of various allergic diseases and conditions has been confirmed by numerous clinical studies. Including the effectiveness of the drug in long-term courses of therapy, ebastin when taken for 1 year retains its antihistamine activity, which makes it possible to prescribe the drug for 3-12 months. Antihistamine and anti-inflammatory effects of ebastine allow to stop the main symptoms of allergy, as well as throat fart, coughing fits, olfactory disorders and skin peeling. Thus, the antihistamine drug ebastine has pharmacological characteristics with a high degree of compliance with the requirements for an "ideal" antihistamine drug.

Persistent cognitive impairment is observed in a significant number of patients after coronavirus infection (COVID-19). Research is needed to study the structure of cognitive changes, the dynamics of their occurrence and the duration of their persistence. The purpose was to study the dynamics and structure of cognitive impairment in patients who had a moderate coronavirus infection within 12 months after discharge from the hospital. The study involved 200 patients with a confirmed diagnosis of a moderately severe novel coronavirus infection COVID-19, complicated by respiratory failure against the background of bilateral polysegmental viral pneumonia caused by SARS-CoV-2, aged 24 to 92 years. All patients were divided into two main groups by age: the first – persons under 65 years of age, the second – persons over 65 years of age, each group was divided into a subgroup by gender. Conducting a cognitive examination was carried out twice – 6 and 12 months after discharge from the hospital. Cognitive function was assessed using the modified Addenbrugs Cognitive Scale and frontal dysfunction test battery. All study participants had impairments in at least one cognitive domain, regardless of age and gender. The most vulnerable cognitive functions during coronavirus infection were the anterograde and retrograde components of memory and speech activity. The number of points for this domain ranged from 22,6 ± 2,5 to 17,6 ± 4,3. At the same time, the subjects showed a clear trend towards a gradual decrease in this function by 12 months after discharge from the hospital. Speech activity was significantly reduced in all age groups – in patients from the first group in dynamics, the average score was 11,2 ± 0,8 after 6 months and 9,9 ± 1,0 after 12 months, and in the second group 8,4 ± 2,1 points and 8,7 ± 2,2 points, respectively. Our study showed that after a coronavirus infection in the long term, serious cognitive impairments occur in both young and older patients.

Understanding of the motivational factors behind food choices and eating habits is essential to combating the epidemics of obesity, diabetes, and cardiovascular disease. Eating behavior is controlled by a complex system, which includes the interaction of central and humoral links of regulation. Regarding the central mechanisms, the key role is played by the cortex and reward zones in the limbic system (″hedonic″ regulation), in which the triggers coming from the environment are analyzed: food (appearance, taste, smell of food), non-food (emotional discomfort, stress), and the hypothalamus, stimulation of the ventromedial nuclei of which is accompanied by a decrease in appetite, and stimulation is accompanied by an increase. The leading role in providing humoral (homeostatic, peripheral) regulation is played by hormones of the gastrointestinal tract and adipose tissue, which have orexigenic or anorexigenic effects, among them: ghrelin, glucagon-like peptide, obestatin, leptin, cholecystokinin, glucose-dependent insulinotropic polypeptide, secretin, peptide tyrosine-tyrosine, insulin, insulin-like peptide, neurotensin, substance P and many others. Enteroendocrine cells vary in distribution throughout the gastrointestinal tract, from the stomach to the rectum, and involve different physiological responses at each stage of the digestive process. The use of neuroimaging methods to demonstrate specific reactions in response to a food stimulus makes it possible to confirm existing humoral disorders at the ″gut – brain″ level. The study of eating hormones helps explain why cravings for certain food choices exist, how to modify these behaviors and food preferences. Knowledge of the biological mechanisms governing eating behavior will help ensure the effectiveness of the treatment of obesity and related disorders. The injection of hormones that regulate eating behavior is accompanied by the activation of the corresponding brain regions involved in the regulation of eating behavior. Personalized medicine aimed at behavioral and pharmacological correction of hormonal status disorders is a promising modern medical practice. The purpose of the review is to present new scientific data on neurohumoral mechanisms in the formation of eating behavior.

An observational study of the effectiveness of the injectable Symptomatic Slow-Acting Drugs (SYSADOA) having chondroprotective activity was conducted in the amount of 10 injections, 1 injection of 2 ml every other day for 20 days. The study included 30 patients aged 40 to 65 years suffering from low back pain caused by degenerative-dystrophic diseases of the spine. Analysis of the results showed that therapy is effective in non-specific musculoskeletal low back pain at the prescribed dose: after 20 days of therapy of the low back pain in the studied group of patients decreased statistically significantly: from 70.1 ± 10.03 to 17.47 ± 8.94 on a 100-point visual-analog scale (p < 0.05); the average indicator of health status increased from 37.03 ± 14.49 to 87.6 ± 8.93, respectively (p < 0.05). Positive dynamics after 20 days of treatment was observed in all categories of the European Quality of Life Questionnaire (EQ-5D), health levels improved statistically significantly from the beginning to the end of the course of therapy (p < 0.05). According to the indicators of 100-point satisfaction with treatment, on average, patients were satisfied with therapy by 93.9 ± 5.97 points out of 100. Chondroprotective therapy made it possible to reduce the need for non-steroid anti-inflammatory drugs in patients, reduce their dose or do without non-steroid anti-inflammatory drugs during the course of treatment. Due to the convenient dosing regimen and rapid therapeutic effect, all patients demonstrated high compliance and completed the study according to plan. Thus, the proposed treatment regimen can be recommended for patients with pain syndrome in the lower back caused by degenerative-dystrophic diseases of the spine.

After suffering a new coronavirus infection COVID-19, patients face a number of disorders, the leading of which is asthenia. The purpose of our research was to study the effectiveness and safety of the use of the new biologically active complex in the rehabilitation of patients with chronic fatigue syndrome and postcovid syndrome. 25 patients who underwent COVID-19 during the two months preceding their participation in the trial were examined. The age of patients is from 20 to 60 years. All participants complained of fatigue, weakness, lethargy, decreased performance, intolerance to high mental loads, sleep disorders. The biologically active complex was prescribed to patients 1 capsule 2 times a day for 1 month on an outpatient basis. Before and after taking of biologically active complex, all patients were assessed for ALT, AST, creatinine, urea, C-reactive protein levels, as well as an assessment of chronic fatigue syndrome on the FAS scale. After taking the biologically active complex, the blood test indices in all patients returned to normal, which indicates the relief of inflammatory processes. In two patients with initially reduced hemoglobin, an increase in the parameter to the norm was recorded. All patients noted an improvement in their physical and mental state, which is characterized by a decrease in FAS scores. None of the study participants observed any adverse reactions during the intake. There were no cases of decompensation of concomitant diseases. Biologically active food supplement should be prescribed to patients with chronic fatigue syndrome and post-ovoid syndrome. The complex has good safety and portability.

The article is devoted to the issues of the influence of diseases of the liver and biliary tract on carbohydrate metabolism and the treatment of these disorders with the help of ursodeoxycholic acid preparations. Approximately 75% of cases of non-alcoholic fatty liver disease occur on the background of obesity, dyslipidemia or type 2 diabetes mellitus. A strong pathophysiological interaction has now been demonstrated between non-alcoholic fatty liver disease and type 2 diabetes mellitus. One of the main pathogenetic causes of type 2 diabetes mellitus and non-alcoholic fatty liver disease is insulin resistance. At the same time, it is necessary to highlight the role of the intestinal microbiota and the epigenome in the manifestation and progression of non-alcoholic fatty liver disease. Therefore, treatment approachesmust be comprehensive. Diet therapy should be aimed at reducing the calorie content of food. However, in real clinical practice, clinicians face low adherence to appropriate and long-term dietary recommendations necessary for weight loss. The use of a low-calorie diet with a significant restriction of fats may increase the risk of gallstones. For the prevention of gallstone disease, ursodeoxycholic acid preparations can be recommended. The advantages of using ursodeoxycholic acid include a decrease in the severity of cytolysis and cholestasis syndromes; direct anti-apoptotic and immunomodulatory effect, antifibrotic effect; this is the only drug that has shown effectiveness in the treatment of severe cholestatic liver diseases; the drug can be used in childhood from birth, as well as in the II-III trimesters of pregnancy.

Ischemic heart disease retains its leadership in the structure of morbidity and mortality both in Russia and worldwide. Because of this, the issues of timely diagnosis of coronary artery disease are very relevant. Invasive coronary angiography remains the "gold standard" for assessing the anatomy of the coronary bed, however, not all obstructive coronary artery stenosis are functionally significant and require revascularization. This determines the need for a preliminary assessment of the coronary bed using non-invasive imaging diagnostic methods, which are an alternative to invasive coronary angiography in patients with stable ischemic heart disease. Numerous studies have confirmed the role of computed tomography angiography of the heart in the differential diagnosis of patients with chest pain. Computed tomographic angiography is preferred in patients with the lowest values of the pre-test probability of coronary heart disease, as it has a very high negative prognostic value. The growing availability of software analysis makes computed tomographic angiography of the heart a universal imaging method capable of determining the anatomical and functional significance of stenotic lesions of the coronary arteries, identifying signs of intra- and pericoronary inflammation, and evaluating non-coronary structures. Functional imaging methods (such as stress echocardiography, PET, SPECT, stress MRI) are preferred in patients with a higher pre-test probability of coronary artery disease, as they are designed to detect ischemia and determine indications for revascularization. Choosing the most informative diagnostic method in each specific situation allows you to reduce the frequency of prescribing, increase the validity and effectiveness of invasive coronary angiography and revascularization, thereby increasing the effectiveness of treatment and improving the prognosis. The purpose of this article is to systematize the modern diagnostic approach to the management of patients with stable coronary heart disease with an emphasis on imaging techniques.

Acute respiratory infections are the most common group of infectious diseases characterized by pronounced tropism to the respiratory tract. Acute respiratory infections has occupied a leading place in the structure of infectious and parasitic diseases for decades. The high prevalence of diseases, the presence of adverse outcomes and complications, the difficulty of diagnosis and the choice of an individual treatment strategy making relevant the problems of an associated with acute respiratory tract infections. The review article describes in detail the features of manifestations of acute respiratory infections of viral etiology, occupying up to 80% of all cases in the epidemic season (influenza, parainfluenza, adenoviruses, rhinoviruses, respiratory syntial virus, coronaviruses, metapneumovirus, bokavirus). The characteristics and severity of the course of acute respiratory tract infections of bacterial etiology (Streptococcus pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, Chlamydophyla pneumoniae, Streptococcus pyogenes) are also presented. The features of various clinical manifestations of circulating respiratory infections are analyzed. The features of nosological forms in acute respiratory infections are presented. Risk factors for the unfavorable course of acute infections pathways to the respiratory tract were noted. Modern methods of laboratory diagnostics of acute respiratory infections are described, illustrated in a convenient algorithm. The necessity of early etiological verification of acute respiratory infections for the timely appointment of adequate therapy, which reduces the risk of severe course and complications, is also emphasized. Thus, the similarity of clinical manifestations of acute viral infections of the respiratory tract, especially with the simultaneous circulation of various respiratory viruses during the ongoing COVID-19 pandemic, requires mandatory laboratory verification of the pathogen for timely etiotropic therapy and prevention of the spread of infection, as well as timely anti-epidemic measures.