Background. The relationship between diabetes mellitus, the development of arrhythmias and cardiac conduction disorders has not been sufficiently studied. Rhythm and conduction disorders are observed in diabetes mellitus in the form of atrial fibrillation and fluttering, ventricular tachycardia, ventricular fibrillation, sinoauricular, intraventricular and atrioventricular blockade, prolongation of the QT interval.

Objective. To analyze published works on the prevalence of atrial and ventricular arrhythmias, as well as conduction disorders in patients with diabetes mellitus.

Results. The analysis of studies on cardiac arrhythmias in patients with impaired carbohydrate metabolism was carried out. There is a high prevalence of atrial fibrillation in type 1 and type 2 diabetes mellitus. Diabetes mellitus is one of the most important risk factors for the development of atrial fibrillation and a predictor of its complications – stroke and thromboembolism. Diabetes mellitus increases the frequency of atrial fibrillation and other arrhythmias, and in combination with other risk factors, the frequency of life-threatening complications and the number of hospitalizations increases. Poorly compensated diabetes and concomitant diseases were associated with a higher incidence of arrhythmias. Diabetes mellitus is an independent predictor of atrioventricular block, including grade III. Prolongation of the QT interval also increases cardiovascular mortality in diabetes. The ambiguous role of hypoglycemic conditions in the development of arrhythmias is shown. Meta-analyses of the presented studies of sodium glucose cotransporter type 2 inhibitors demonstrate a decrease in the frequency of arrhythmias, especially atrial fibrillation and flutter. In cases of cardiac arrhythmias and diabetes mellitus, SGLT2i are represented by drugs with sufficiently high antiarrhythmic efficacy and having the greatest evidence base of arrhythmogenic action. The potential role of hypoglycemic drugs of various classes for the prevention of arrhythmias in patients with diabetes mellitus has been shown.

Conclusion. The link between diabetes mellitus and cardiac arrhythmias is obvious, although insufficient attention is paid to this aspect. The most common arrhythmia in diabetes is atrial fibrillation, although there are any other rhythm and conduction disorders. If there are arrhythmias or to prevent the risk of their development, it is necessary to take into account the prescribed hypoglycemic therapy.

Background. Sodium glucose cotransporter type 2 (SGLT2) inhibitors, established over the past decade, including dapagliflozin, empagliflozin, and canagliflozin, have demonstrated significant reductions in hospitalization and mortality in patients with diabetes mellitus and chronic heart failure in a series of randomized trials. Drugs in this group have a unique hypoglycemic mechanism of action, restoring renal regulation of blood sugar levels, and are also characterized by a low risk of developing undesirable effects and are well tolerated by patients. Along with a wide range of positive effects of gliflozins on the condition of patients and an improvement in the overall prognosis of the disease, data on a decrease in iron levels in the blood during long-term use of drugs in this group have increasingly appeared in the literature.

Objective. To evaluate the pathogenetic aspects of the influence of gliflozins on erythropoiesis and iron metabolism in patients suffering from chronic heart failure and diabetes mellitus.

Materials and methods. An analysis of foreign sources was carried out, which studied the effect of the use of SGLT2 inhibitors on erythropoiesis and iron metabolism in patients with chronic heart failure. This review examines the pathogenetic basis of the dynamics of hematopoiesis in patients with diabetes mellitus and chronic heart failure. Changes in hematocrit, hemoglobin, reticulocyte count, and erythropoietin reported in prospective analyzes are analyzed.

Conclusion. The increase in hemoglobin levels observed when taking gliflozins improves tissue oxygenation, thereby providing some protective effect (in particular, cardioprotective and nephroprotective effects). However, the active use of iron in the process of erythropoiesis leads to an increase in the levels of soluble transferrin receptors and iron-binding capacity of the blood serum in combination with a decrease in ferritin, transferrin saturation coefficient and hepcidin. Thus, long-term use of SGLT2 inhibitors, with a positive effect on hemoglobin levels, can lead, at a minimum, to latent iron deficiency, which requires monitoring of a clinical blood test and a biochemical blood test to study iron metabolism in patients taking gliflozins. To understand the significance of this problem, it is necessary to initiate large-scale cohort studies.

Background. The relevance of this study is explained not only by the widespread prevalence of obesity in the world, but also by a number of related diseases that lead to decreased ability to work and disability of patients. The article presents data on diseases associated with obesity, characteristics of carbohydrate and fat metabolism, characteristics of obstructive sleep apnea syndrome (OSAS), the results of psychological testing and eating disorders in these patients, and also analyzes the effectiveness of their treatment in an outpatient setting.

Materials and methods. For this purpose, 76 patients aged from 30 to 60 years who consulted an endocrinologist due to excess body weight were examined. They were ranked by degree of obesity. The examination was carried out against the background of antihypertensive, hypoglycemic, and antihyperlipidemic therapy. The majority of patients (82%) had degrees II and III obesity, with morbid obesity amounting to 49%. All patients, regardless of the degree of obesity, had abdominal type, arterial hypertension (mainly diastolic), and half of them had hyperglycemia, hypertriglyceridemia, increased levels of very low-density lipoprotein cholesterol and gamma-glutamyl transpeptidase, insulin resistance, depression, which increased with severity obesity.

Results. The data obtained indicate the lack of effectiveness of therapy carried out in outpatient settings. Treatment for obesity was carried out in almost half of those examined, but it was a course with the return of body weight after its cessation. However, it is well known that the treatment of obesity is a complex and lengthy process, which necessarily includes a psychotherapeutic approach. Most obese patients are diagnosed with OSAS, but ¼ of patients received treatment for this disorder. Almost all patients with severe obesity had eating disorders.

Conclusion. Based on all of the above, the practical significance of our research is determined. So, at an appointment with a doctor for weight correction, testing should be carried out to identify the type of eating disorder and the level of depression, as predictors of weight gain, the development of obesity and related diseases and metabolic disorders. In addition, conduct questionnaires to identify sleep disorders and select patients for polysomnography followed by CPAP therapy.

Objective. The purpose of this study was to compare the structural and functional changes of the left ventricle (LV) in patients with various forms of atrial fibrillation (AF).

Materials and methods. 70 patients with paroxysmal AF (group 1; median age 73 [64.75; 76.5] years, 49 (70%) women) and 54 patients with persistent or permanent forms of AF (group 2; median age 78.5 [68;83] years, 33 (61%) women) was included in the study/ All patients were underwent transthoracic echocardiography (EchoCG) using the speckle tracking technique.

Results. In patients with permanent/persistent AF, compared with patients with paroxysmal AF, the several parametres were significantly lower: the stroke volume (SV) (49.2 [39.8; 57.8] ml versus 54.2 [46.2; 60.3] ml, respectively, p = 0.039), LV ejection fraction (EF) (61.4% [51.2; 67.1] versus 65.9% [61.4; 70.2], respectively, p < 0.001), absolute values of the global longitudinal LV strain (–15.1% [–18.5; –9.3] vs. –19.6% [–22.2; –16.2] respectively, p < 0.001), global LV circular strain (–16.4% [–22.9; –11.0] vs. –20.9% [–25.8; –17.6], respectively, p < 0.001), end-systolic LV elasticity (3.6 [2.7; 4.57] mmHg/ml vs. 4.3 [3.3; 5.3] mmHg/ml, respectively, p = 0.011). At the same time, the end-diastolic size (EDS), the end-diastolic volume (EDV) and its index, and the end-systolic volume (ESV) did not differ statistically significantly between the groups.

Conclusion. In patients with persistent/permanent forms of AF, there is a more pronounced violation of LV systolic function compared with patients with paroxysmal AF, which manifests itself in lower values of SV, LV EF, absolute values of the global longitudinal strain and global circular strain of the LV.

Background. Eisenmenger syndrome is the terminal stage of severe shunt disease, which unites all systemic-pulmonary shunts. It is characterized by an increase in pulmonary vascular resistance, which ultimately leads to severe pulmonary arterial hypertension and is the result of a reverse progressive right-to-left shunt or bidirectional ejection of blood. The syndrome is an urgent problem in modern cardiology due to the occurrence of hypoxia and cyanosis, which inevitably lead to multiple complications – secondary erythrocytosis, hemoptysis, celebrovascular disorders, arrhythmias and right ventricular heart failure.

Objective. The purpose of the work is to evaluate and describe the complex course of Eisenmenger syndrome in a patient with an uncorrected patent ductus arteriosus.

Materials and methods. The work used examination data of a patient (68-year-old woman) who was being treated at the Arkhangelsk Regional Clinical Hospital. Since in our case specific therapy of pulmonary arterial hypertension is difficult for the patient, treatment is carried out in accordance with current recommendations for the management of patients with chronic heart failure with reduced left ventricular ejection fraction.

Conclusion. This clinical case illustrates the complexity of managing patients with uncorrected open ductus syndrome with Eisenmenger syndrome, when surgery is not indicated, and the goal of treatment is to reduce pulmonary arterial hypertension and prevent complications.

Objective. The aim of the current research is the dapagliflozin influence on the key parameters that shows the severity of heart failure among patients with chronic heart failure with low ejection fraction.

Materials and methods. The research involves 30 mail patients average aged 61,6 ± 11,1. The basis of involving the patients is the following: heart failure with low ejection fraction of any origin and common therapy of chronic heart failure including inhibitors of angiotension converting enzyme/ antagonist of angiotension II receptors, β-blockers, antagonist of mineralocorticoid receptors. The NTproBNP level in blood was defined and there were the transthoracal echocardioscopy with Doppler mapping along with ejection fraction determination according to Simpson, the 6-minute walking test, the questionnaire on health EQ-5D, the Montreal assessment scale of cognitive functions among the heart failure with low ejection fraction patients of the inception cohort and in 6-month period affected by the therapy with SGLT2 inhibitors.

Results. The therapy with dapagliflozin has caused the decrease in the NTproBNT level up to 1914,0 ± 500,7 pg/ml, p = 0,001 that 36% less then baseline indexes. There was the increase in ejection fraction of left ventricle by 15,01% comparing with the baseline (35,2 ± 8,6% – baseline, 40,5 ± 10,8% after the SGLT2 inhibitor therapy, p = 0,07). While having 6-minute walking test the significant walking distance increase was found out. It enables us to make the conclusion about the changes of the heart failure functional class according to NYHA from III to II. Analyzing the health status level (according to the questionnaire on health EQ-5D) there was the increase from 56,4 ± 20,4 to 65,8 ± 10,1. According to the Montreal assessment scale there was enhancement of indexes: 24,4 ± 1,6 – baseline, 25,3 ± 1,7 – after the SGLT2 inhibitor therapy, p = 0,34.

Objective. To assess the progression of carotid artery (CA) stenoses, the relationship to cerebrovascular events and lipid metabolism disorders in patients in the long-term period of coronary artery bypass surgery (CABG).

Materials and methods. The prospective study included 152 patients, males, median age 57 years, of whom 37% had identified < 50% СA stenosis. Neuropsychological screening, duplex scanning of brachiocephalic arteries with colored Doppler blood flow mapping and lipid metabolism parameters evaluation were performed in all patients before and at 5-7 years after surgery. Statistical analysis was performed using the Statistica 10 program (StatSoft, Inc., USA).

Results. It was found that the number of patients with CA stenosis increased to 57%, the incidence of acute ischemic stroke was 5% cases, dementia – 2.5% at 5-7 years after CABG. Also, in the group of CA stenoses, the number of cases of mild cognitive impairment increased from 18% to 23%. Only a small proportion of patients reached the target lipid concentrations, and none of patients with CA stenoses reached the target level of LDL. One-third of all patients examined at 5-7 years after CABG refused to take statins.

Conclusion. In the long-term postoperative period of CABG (after 5-7 years) there was an increase in the number of patients with CA stenoses, some patients had ischemic strokes and dementia. At the same time, only a small proportion of patients with lipid was able to reach the optimal values recommended for CABG patients, and patients with CA stenoses were unable to reach the target cholesterol LDL concentrations.

Background. Thanks to scientific and technological progress and public health achievements, life expectancy on the planet continues to increase, which leads to a change in the dominant diseases, from infectious to chronic non-communicable diseases manifested by systemic inflammation. With the help of modern methods of biotechnology and engineering, humans have managed to synthesize genetic engineered biological drugs (GIBD) that contribute to an increase in life expectancy and quality of life, and improve the prognosis of many nosologies, including oncological and immuno-mediated diseases. Unfortunately, some representatives of this group of drugs have demonstrated a cardiotoxic effect, which in a number of patients causes their withdrawal. Cardiotoxicity is a term that includes various adverse events against the background of drug therapy associated with effects on the cardiovascular system. Drug-induced cardiotoxicity may appear both on time and after treatment. Effective strategies for predicting and preventing cardiotoxicity of genetic engineered biological drugs are of great importance. One of the possible ways of prevention is a multidisciplinary approach in the curation of patients receiving genetic engineered biological therapy, as well as their dynamic observation and examination. At the same time, some studies have demonstrated the cardioprotective effect of some representatives of genetic engineered biological drugs.

Conclusion. In the presented literature review, we focused on how genetic engineered biological therapy can negatively affect the cardiovascular system, contribute to the development and progression of cardiovascular diseases, or, conversely, have a cardioprotective effect. We have considered the possibilities of both early diagnosis and prevention of cardiotoxicity of genetic engineered biological drugs, we have focused on effective and affordable solutions to this important problem.

Background. Protein growth factors such as vascular endothelial growth factor and insulin-like growth factor are involved in the pathogenesis of hypertension and psoriasis, and endothelial dysfunction is also noted in these diseases. Despite extensive studies of these nosologies, there is still insufficient information about the nature of remodeling of the cardiovascular system in the case of a combination of these pathologies.

Objective. The aim of the study was to study the content of circulating growth factors — vascular endothelial growth factor, insulin-like growth factor, and compare myocardial remodeling in hypertension in men with and without psoriasis.

Materials and methods. 165 male patients who were on outpatient treatment for stage 2 hypertension, average age 53,1 ± 7,2 years, were studied. The patients were divided into 2 groups: group 1 (comparison group) of 80 patients with hypertension, group 2 (main group) of 85 patients with hypertension with psoriasis vulgaris. Plasma concentrations of growth factors were assessed in all patients and echocardiography was performed. In the group of patients with hypertension and psoriasis, the level of vascular endothelial growth factor (p = 0,0002) and insulin-like growth factor (p = 0,0001) is higher than in patients with hypertension without psoriasis.

Results. It was revealed that in patients with a combination of arterial hypertension and psoriasis, the left ventricular myocardial mass index (145,2 ± 21,4 g/m2) was significantly higher (p = 0.041) than in patients with arterial hypertension. In patients with arterial hypertension and psoriasis, concentric hypertrophy of the left ventricle was significantly more common (χ2 = 4,27, p = 0,039).

Background. The problem of the clinical course and complications of a novel coronavirus infection (COVID-19) in children is given special attention in pediatrics. Early detection of renal lesions in children with rheumatic diseases remains difficult. Early diagnosis of possible complications of a new coronavirus infection (COVID-19) in children remains relevant at the present stage. The study of the features of the course of the novel coronavirus infection (COVID-19) in children is necessary to identify a group of patients at high risk for the development of complications after infection in the early and long-term periods. Objective. The purpose of the work was to determine the features of the clinical course of the novel coronavirus infection (COVID-19) in children. To analyze a clinical case from real medical practice in order to draw attention to the problem of complications after suffering a novel coronavirus infection (COVID-19) in children.

Materials and methods. The study was conducted at the Department of Polyclinic Pediatrics of the Federal State Budgetary Educational Institution of Higher Education Orenburg State Medical University of the Ministry of Health of the Russian Federation on the basis of the territorial children's polyclinic No. 3 of the Children's City Clinical Hospital of Orenburg.

Conclusion. The novel coronavirus infection COVID-19 in children has a diverse clinical picture, including hyperthermic, catarrhal, dyspeptic syndromes. The vast majority of children are ill between the ages of 5 and 12, infection occurs mainly in organized groups (schools, kindergartens). Most children are slightly ill, however, there is a high probability of developing neurological, cognitive, psychiatric and other complications after suffering a new coronavirus infection COVID-19.

Background. According to Russian studies, the average age of Duchenne muscular dystrophy diagnosis is 7-8 years. This is because, on one hand, Duchenne muscular dystrophy is a rare disease, and a doctor may never see it throughout their clinical practice. On the other hand, the clinical picture of the disease is diverse and does not have pronounced symptoms in the early stages of development. Doctors often make mistakes in diagnosis by considering the consequences of the disease or focusing on one manifestation without seeing the entire complex of symptoms and its root cause. For example, one of the manifestations of the disease is elevated liver enzymes: transaminases (ALT, AST) and LDH. About 50% of misdiagnoses in Duchenne muscular dystrophy are related to liver damage. These children may be observed for years by infectious disease specialists or pediatric gastroenterologists with unspecified diagnoses, undergoing new and sometimes invasive tests.

Conclusion. Currently, many patients with Duchenne muscular dystrophy have access to pathogenetic therapy. Unfortunately, it does not restore lost functions but can preserve existing ones and clinically convert the aggressive form of Duchenne muscular dystrophy into a milder Becker form. This is why it is crucial to inform primary care pediatricians, pediatric gastroenterologists, and infectious disease specialists about the mechanisms of non-hepatic transaminase elevation and diagnostic algorithms for muscular dystrophies.

Background. Acute respiratory viral infections are the most common reason for seeking care from outpatient physicians. Most cases of acute respiratory viral infections are caused by different serotypes of respiratory viruses, which cause diseases with very similar clinical symptoms. Acute rhinosinusitis holds one of the leading positions in the clinical picture of acute respiratory viral infections. Approaches to the therapy of this disease include the influence on various links of the pathological process. Preference is given to drugs that have a wide range of therapeutic effects with minimal or no side effects. Plant medicines that have a complex secretolytic, secretomotor, mucoactive, anti-inflammatory, antiviral, antibacterial and antiseptic action may become the drugs of choice in the treatment of patients with acute viral rhinosinusitis. Medicines of plant origin have a number of undoubted advantages, such as the breadth of therapeutic effect, compatibility with other drugs and among themselves, the possibility of safe and prolonged use in uncomplicated forms of disease, use to improve the effectiveness of specific treatment and supportive therapy, the possibility of use at home. All this makes them one of the essential components of treatment of patients in outpatient and polyclinic practice, especially since modern herbal medicines, having a pronounced effect on cold symptoms, do not show significant side effects.

Conclusion. Convincing evidence-based data on the efficacy and safety of herbal preparations allow to prescribe them both as monotherapy and as part of the complex treatment of diseases of the nose and sinuses to reduce the severity and duration of symptoms of acute viral rhinosinusitis, as well as to prevent the development of complications.

Background. Irritable bowel syndrome with a predominance of constipation is a common chronic pathology in the population. The main drug therapy for irritable bowel syndrome with a predominance of constipation remains the prescription of laxatives. One of the drugs with proven effectiveness is lactulose. However, taking into account the complaints of patients with irritable bowel syndrome with a predominance of constipation, it seems relevant to use drugs whose action is aimed at influencing several stages of pathogenesis and combating symptoms such as constipation, abdominal pain, bloating. These drugs include a combination drug based on lactulose and simethicone.

Objective. The purpose of this study is to compare the effectiveness and safety of a combination drug based on lactulose and simethicone in comparison with a group receiving therapy in the form of a combination of two monotherapy drugs (lactulose and simethicone) and a group receiving lactulose monotherapy patients with irritable bowel syndrome with predominant constipation.

Materials and methods. A single-stage open randomized comparative clinical trial was conducted from January 16, 2023 to June 29, 2023. The study included 150 patients diagnosed with irritable bowel syndrome with predominant constipation, aged 18 to 55 years, who were examined and treated for based on the State Budgetary Institution of the Ryazan Region "City Clinical Hospital No. 4", evenly randomized into 3 groups.

Results. Fixed combination of lactulose + simeticone is superior in effectiveness to lactulose monotherapy in terms of stool frequency per week, stool shape, flatulence, and relief of abdominal pain. An additional analysis established the superior effectiveness of a drug based on lactulose and simethicone, an oral emulsion, in comparison with a combination of drugs simethicone, 40 mg capsules + lactulose syrup for the treatment of adult patients with irritable bowel syndrome with a predominance of constipation.

Background. On May 5, 2023, World Health Organization announced the end of the COVID-19 pandemic. However, the question of studying the long-term consequences remains open today and will not lose its relevance for many years. Respiratory syndrome is a common and most characteristic of this disease. But the more cases were identified in different countries of the world, the more significantly the data on various extrapulmonary manifestations and complications of Corona Virus Disease 2019 (COVID-19) were expanded. The accumulated information made it possible to consider coronavirus infection as a multisystem disease with a variety of clinical manifestations. Corona Virus Disease 2019 (COVID-19) is capable of affecting any organs and systems, the musculoskeletal system is no exception. The article highlights two rare pathologies of the musculoskeletal system that occur after a coronavirus infection – sarcopenia and aseptic necrosis. Sarcopenia is a muscular disease (muscle failure) characterized by loss of muscle mass and muscle strength with an increased risk of adverse events such as impaired mobility, deterioration in quality of life or death. Aseptic bone necrosis consists in spontaneous segmental death of the spongy bone and bone marrow in the subchondral parts of the epiphyses.

Objective. The aim of the work is to establish the distinctive features of sarcopenia and aseptic bone necrosis in Corona Virus Disease 2019 (COVID-19) based on studies published in scientometric databases.

Materials and methods. A search was conducted for modern literary sources that highlight the topic of sarcopenia and aseptic bone necrosis in Corona Virus Disease 2019 (COVID-19). The search was conducted in foreign and domestic scientometric databases PubMed, MedLine, Scopus, Google Academy, RSCI. The search was carried out by keywords: COVID-19, sarcopenia, aseptic necrosis, postcovoid syndrome. The search was limited by the publication date. For further analysis, sixteen articles (eight in English, eight in Russian) published over the past five years were selected. There was no sorting by the language in which the study was published.

Conclusion. Sarcopenia and aseptic bone necrosis in COVID-19 are currently poorly covered in the scientific literature. Further study of this topic may find application in clinical practice, contribute to the improvement of methods of diagnosis and treatment of these pathologies.

Background. COPD causes significant damage to the health of the population, is characterized by a high rate of morbidity and mortality. Late presentation, when persistent changes in bronchopulmonary tissue have already been formed, is associated with a limitation of the treatment efficacyand an increase in medical expenses. In addition, the true prevalence of COPD is distorted, and the low percentage of person’s identification with COPD risk factors development limits preventive measures aimed to timely and rational pulmonological care to patients.

Objective. To study the COPD morbidity, to assess its structure and preventive measures, as well as COPD mortality among the adult population of Lipetsk.

Materials and methods. 9900 patients aged 18 and over were examined, taken under follow-up care in Lipetsk adult polyclinic N 4. There were preparation of the study protocol, screening by computer database "Register of patients with COPD", formation of a clinical examination group, analysis of statistical data of Public health department of Lipetsk Region and indicators of follow-up care of certain groups of the adult population at Lipetsk adult polyclinic N 4 in the study.

Results. COPD is a common disease among residents of Lipetsk, developing in both men and women, with smoking being the leading risk factor for the disease development. The preventive measures taken are insufficient. Thedetection of COPD by medical aid appealability prevails, and the detected COPD were moderate and extremely severe course, and according to group B and D (GOLD, 2022).

Conclusion. To reduce the COPD prevalence, risk factors, disease progression, exacerbations frequency, clinical symptoms control, stable course, and as a result, improve COPD prognosis and reduce COPD mortality, it is advisably to continue to improve the quality of preventive measures, improve early COPD diagnosis at the primary care stage, detect and prevent complications of the disease in a timely manner.

Background. Medium chain triglycerides are absorbed and metabolized faster than long-chain fatty acids, as they bypass the steps necessary for the absorption of long-chain fatty acids. So, they use in various malabsorptive disorders as a source of calories.

Objectives. Retrospectively evaluate the clinical effectiveness of nutrition supplements (a fat emulsion consisting of medium chain triglycerides), used by patient with cyctic fibrosis.

Materials and methods. 39 children with cyctic fibrosis aged 1-17 years were observed at Morozovskaya Children's Clinical Hospital. WHO-Anthro and WHO-Anthro Plus were used to determine their nutritional status.

Results. At the beginning of the study, all patients with cyctic fibrosis had a body mass index < 25th percentile. The median percentile of body mass index was 7,8. 0% of patients had a Z-score body mass index > 0.25,6% of patients had a Z-score body mass index from 0 to –1. 51,3% of patients had a Z-score body mass index from –1 to –2.23% of patients had a Z-score body mass index < -2. At the end of the study, 28% of patients with cyctic fibrosis had a body mass index > 25th percentile. The median percentile of body mass index was 16,1. 18% of patients had a Z-score body mass index > 0.38,4% of patients had a Z-score body mass index from 0 to –1.25,6% of patients had a Z-score body mass index from –1 to –2, 18% of patients had a Z-score body mass index < –2.

Conclusion. The use medium chain triglycerides could improve nutritional status and alleviate steatorrhea in patient with cyctic fibrosis.

Report from the XX Interdisciplinary Conference with international participation "Veinovskie Chtenia", "Difficult Patient" section, which was held on February 19, 2024. The issues addressed were vascular cognitive disorders in young patients and the relationship between arterial hypertension and neurological diseases, as well as up-to-date epidemiological data and diagnostic and therapeutic approaches with the analysis of efficacy and pharmacokinetics of products.

Background. On February 20, 2024, as part of the anniversary XX Interdisciplinary Conference with international participation "Veinovskie Chtenia", a round table was held on the topic "Modern solutions to improve the quality of medical care for stroke patients". The round table was attended by leading experts in this field. The experts focused on improving approaches to rehabilitation as the main task of improving the level of medical care, as well as the regulatory framework and practical solutions, including international experience in organizing nutritional support for stroke patients at all stages of rehabilitation.

Conclusion. It was noted that adequate nutritional support for stroke patients leads to an increase in their rehabilitation potential, a reduction in hospital stay, an improvement in the quality of life and indicators of physical recovery.