Background. Cardiovascular diseases occupy leading positions among other diseases and disabilities in most economically developed countries of the world. The growth of morbidity among the population of our country determines the need to assess the quality of life of people suffering from chronic diseases. The study of the quality of life is considered an integral approach that allows combining objective and subjective criteria for assessing health: the degree of adequacy of medical care, determining how the patient copes with the disease and what areas of life are limited by the presence of the disease.

Objective. Assessing the quality of life of patients with diseases of the circulatory system.

Materials and methods. The study examined the quality of life of 98 patients with circulatory system diseases who applied to a medical organization in Astrakhan. The age of the patients ranged from 45 to 70 years. The international certified Russian-language version of the Medical Outcomes Study Form (SF-36) questionnaire was used to register the quality of life. Statistical processing of the study results was carried out using the computer programs Microsoft Excel 2010 (Microsoft, USA), Statistica 12 (Software, USA).

Results. The results of the study indicate that the overall quality of life of patients in Astrakhan suffering from circulatory system diseases is average. The physical and psychological components of health, regardless of gender, do not reduce the daily physical and social activity of the population. The influence of the physical condition on daily role activity, leading to a decrease in these indicators, was revealed among all patients. In most cases, role functioning due to the emotional state, social functioning is assessed as decreased. The psychological component of health in most cases corresponds to reduced values.

Conclusion. The results of the study are applicable in practical healthcare to determine activities aimed at improving the quality of human life.

Background. The increase in the number of cardiac surgeries has also led to a growth in cases of infective endocarditis of prosthetic valves and intracardiac devices. Both endocarditis are associated with difficulties in diagnosis, treatment and poor prognosis, which makes it relevant to analyze the clinical manifestations of these forms of endocarditis, especially in comparison with the results of other studies.

Objective. To identify the features of clinical manifestations of infective endocarditis of prosthetic valves and endocarditis of intracardiac devices.

Materials and methods. We analyzed clinical manifestations, laboratory, echocardiographic data and their dynamics during therapy in patients with infective endocarditis localized on the prosthesis (37 patients) or electrodes in the heart (15 patients). In the comparison group there were 21 patients with IE of the native valve.

Results. Older patients were observed in the infective endocarditis group of valve prostheses and intracardiac devices. In all forms of infective endocarditis, the most common symptoms were fever, weakness and malaise; laboratory indicators included accelerated ESR and leukocytosis, and increased CRP. Manifestations of heart failure were more often observed in the group of prosthetic endocarditis (59.4%), in the group of native valve endocarditis in 40% of cases, in the group of electrode endocarditis less often – in 20% of cases. The most common causative agent of infective endocarditis was Staphylococcus aureus. We analyzed diseases and previous operations of infective endocarditis, as well as the time of onset of symptoms.

Conclusion. The type of prosthesis and its location do not exclude the possibility of endocarditis. In patients with electrode endocarditis, the infection was localized in 2/3 of cases only on the electrode, in 1/3 of cases – on the electrode and the tricuspid valve. For instrumental diagnosis of prosthetic and electrode endocarditis, transesophageal echocardiography was more informative. Conservative treatment was successful in 75% of patients with prosthetic infective endocarditis, and with electrode infective endocarditis, surgical intervention was required in 53.3%.

Objective. Currently, in Russia, as well as all over the world, an increase in morbidity and mortality from pathologies of the cardiovascular system is registered. Employees of petrochemical production are exposed to a large number of additional factors of the production environment, which in turn increases the cardiovascular risk in this cohort of the population. Petrochemistry is also one of the main industries of great economic and social importance for our country, which makes the study of this problem more relevant.

Results. According to the results of many studies, the most common cardiovascular pathology in the studied population is arterial hypertension. Many researchers associate the high prevalence of this nosology not only with the direct influence of production factors, but also with the number of years worked at petrochemical enterprises. The main production factors contributing to the development of circulatory system diseases in petrochemicals employees were identified, for example, noise, exposure to chemical harmful substances, increased stress levels and tension during the work process. These factors act on the worker's body constantly and contribute to an increased risk of developing cardiovascular diseases. The main aspects of the pathological influence of production factors on the health of the workers' organism are analyzed. With the help of the obtained data, ways to solve the problem under study were proposed. The presented materials will help to develop measures for the prevention of the development of diseases of the circulatory system in more detail and narrowly, taking into account the influence of not only the main known risk factors, but additional impacts during the labor process.

Conclusion. The proposed measures should be aimed at modifying and improving existing preventive and hygienic measures, as well as contribute to improving the health of petrochemical production workers and reducing the incidence of these nosologies, which in turn will prolong the working capacity of employees and reduce economic losses in production.

Background. Changes in body composition are associated with the course of diseases, including chronic heart failure. In chronic heart failure, changes in body composition such as sarcopenia, obesity, sarcopenic obesity and cachexia are common. The association between obesity and chronic heart failure is especially characteristic for patients with preserved ejection fraction. At the same time, the researchers note the mutual influence of the disease and body composition due to pathogenetic changes in the neurohumoral system, which is supported by metaflammation in CHF. C-reactive protein is a marker of systemic inflammation, and the combination of weight loss and systemic inflammation are criteria for cachexia.

Objective. To study the association of changes in the level of hs-CRP with the clinical status and body composition of patients with chronic heart failure.

Material and methods. The body composition and clinical characteristics of the disease course in 298 patients with chronic heart failure due to cardiovascular diseases and hypertension were evaluated. The patients were divided into 5 groups depending on body weight and the presence of sarcopenia. The functional activity of patients, systolic function of the left ventricle, and the level of hs-CRP were determined.

Results. HFpEF was more common in obese patients. The worst results of functional activity were typical for patients with reduced body weight and sarcopenia, while the rates of patients with sarcopenic obesity were worse than those of patients with obesity alone or sarcopenia alone. The level of the hs-CRP marker in the group of patients with sarcopenic obesity (Ме 6.53 mg/l [3.95-8.01]) significantly differed from the indicator in the groups of patients without sarcopenia (Ме 3.89 mg/l [3.85-5.46]), without obesity (Ме 3.9 mg/l [3.15-5.37]) and without disorders body composition (Ме 4.4 mg/l [2.78-5.23]). The values were comparable in the groups of patients with sarcopenic obesity and with reduced body weight and sarcopenia.

Conclusions. The course of chronic heart failure varies depending on body composition. The HFpEF phenotype is more often associated with obesity. The level of hs-CRP reflects the level of systemic inflammation, which is the pathogenetic basis of both chronic heart failure and sarcopenic obesity. The activity of metaflammation in sarcopenic obesity affects the functional activity of a patient with chronic heart failure.

Background. Meningococcal infection (MI) remains relevant in the modern world. In the Russian Federation, there is currently an increase in cases of meningococcal infection in the adult population. While the generalized form of meningococcal infection presents a recognizable clinical picture with the development of hemorrhagic rash and meningitis, localized and rare forms of this infection are diagnosed extremely rarely. The true proportion of rare forms in the structure of meningococcal infection remains unknown. Cardiac involvement is the most commonly registered rare form of meningococcal infection after pneumonia; it can manifest as endocarditis, myocarditis, and pericarditis. The present paper provides a literature review of available data on the forms, pathogenesis, clinical picture, diagnosis, and approaches to the treatment of meningococcal pericarditis, myocarditis, and endocarditis. The nonspecificity of clinical symptoms and laboratory tests makes it difficult to suspect meningococcal infection in patients with cardiac infections. The lack of availability in real clinical practice of diagnostic methods such as MRI, endomyocardial biopsy, and pericardiocentesis leads to low detection of these forms, especially in patients with isolated cardiac involvement of meningococcal etiology. The need for selective nutrient media to detect the pathogen also contributes to the lack of identification of the etiological factor.

Conclusion. A significant problem is the absence of clinical recommendations and treatment protocols for meningococcal cardiac involvement in patients without signs of the generalized form of MI. The complexity of diagnosing and treating meningococcal pericarditis is illustrated in the present paper by a clinical example.

Background. Glycemic variability (GV) is a new risk factor for the development of vascular complications in patients with diabetes mellitus (DM). Clinical indicators associated with increased GV in patients with type 2 DM have not been sufficiently studied. Objective. To evaluate factors associated with increased GV in patients with type 2 DM.

Materials and methods. We examined 88 patients with type 2 DM (mean age 55,3 ± 5,5 years, 65% women) with disease duration from 0,6 to 20 years. Ten patients with type 2 DM received only metformin (MF), 26 – MF in combination with sulfonylureas, 44 – insulinotherapy in combination with MF, and 8 – insulinotherapy. Patients with chronic kidney disease stages 3a-5, severe somatic pathology were excluded. GV was determined by calculating the standard deviation (SD) and coefficient of variation (CV) of glycemia, which was measured in the laboratory 3-4 times a day for 3 days. The relationship between CV and clinical and laboratory parameters and various glucose-lowering therapy regimens was searched for.

Results. There was a positive correlation of CV with the duration of type 2 DM (rs = 0,28, p < 0,01), with the level of daily albuminuria (rs = 0,27, p = 0,011) and a negative correlation with the level of total cholesterol (rs = -0,26, p = 0,012) and low-density lipoprotein cholesterol (rs = -0,32, p < 0,01). There was no relationship between CV and age, body mass index, HbA1c, fasting and postprandial glycemic levels, estimated glomerular filtration rate, and insulin resistance indicators. A tendency towards an inverse correlation of CV with the level of C-peptide (rs = -0,24, p = 0,071) and insulin (rs = -0,25, p = 0,082) was revealed. CV was higher (p < 0,01) in patients with type 2 DM on conventional and intensive insulinotherapy (23,5% [19,3; 29,5] and 22% [20,1; 31,7], respectively) than on MF therapy (14,8% [9,8; 16,9]) or treatment of MF in combination with sulfonylureas (18,3% [14,8; 24,6]). CV > 36% was detected in 12 patients with type 2 DM and was associated with higher rates of daily albuminuria compared with CV < 36% (95 mg/day [55,8; 150] vs. 25,5 mg/day [11,5; 137,7], p =0,036).

Conclusion. The main clinical factor associated with increased GV in patients with type 2 DM is the presence of microalbuminuria. An increase in glycemic fluctuations is detected in patients with type 2 DM on insulinotherapy more often than on treatment with MF in combination with sulfonylureas or MF monotherapy.

Background. Nonimmune hydrops fetalis is a heterogeneous disorder characterized by generalized hyperhydration caused by extracellular accumulation of fluid in the tissues and serous cavities of the fetus, in the absence of signs of immune sensitization. The prevalence of nonimmune hydrops fetalis, according to various data, ranges from 0.05 to 0.5%, or about 1:4000 live births. Nonimmune hydrops fetalis is based on more than 150 different nosologies. A significant proportion of all the causes leading to nonimmune hydrops fetalis are disorders in the genetic material of the fetus: chromosomal abnormalities, genetic and genomic disorders, RAS pathologies. Most often, nonimmune hydrops fetalis accompanies mutations with a change in the number of chromosomes, such as Down syndrome, Edwards and Turner. In addition, perinatal viral infections, malformations of the lymphatic, cardiovascular, musculoskeletal and endocrine systems, lysosomal accumulation diseases and other pathologies play an important role in the development of nonimmune hydrops fetalis. The improvement of prenatal diagnostic methods, especially cytogenetic research methods, made it possible to identify the genetic cause of nonimmune hydrops fetalis in a large number of cases, while reducing the group of idiopathic nonimmune hydrops fetalis. Modern ultrasound screening methods make it possible to suspect the presence of a genetic anomaly and associated nonimmune hydrops fetalis already in the first trimester of pregnancy. The identification of the etiology of nonimmune hydrops fetalis, in turn, is a determining factor in choosing the tactics of pregnancy management, determining the possibilities and prospects of intrauterine treatment. Targeted therapy is an effective therapy for genetically determined nonimmune hydrops fetalis, which is a promising direction in the treatment of certain pathologies and is actively developing today. The development of genetically engineered therapy, in addition to correcting the underlying pathology, can lead to a decrease in mortality in nonimmune hydrops fetalis, which currently reaches 90%.

Conclusion. This work reflects the etiological structure of nonimmune hydrops fetalis with an emphasis on genetic disorders, and also notes the diagnostic, therapeutic and prognostic features of pregnancy management with nonimmune hydrops fetalis.

Objective. The aim of the research was to study of the obstetric complications and perinatal outcomes in patients with chickenpox.

Materials and methods. A retrospective analysis of 47 case histories of patients who had chickenpox within 3 weeks before labor and women who became ill within 48 hours postpartumn, was carried out. The average age of the patients was 28.38 ± 4.96 years. The clinical features of the course of chickenpox in the perinatal period, the structure of obstetric complications, features of the course of labor and outcomes for newborns were established. Statistical data processing was carried out with the IBM SPSS Statistics 27.0 program and the online calculator https://www.medcalc.org/calc/odds_ratio.php.

Results. In the study group, multiparous patients predominated – 30/47 (63.83%). At the time of birth, most of the patients were in the period of early convalescence – 20/47, 13/47 in the period of rashes, 12/47 in the period of late convalescence, 2/47 in the incubation period for chickenpox. There was a statistically significant decrease in Apgar scores at 1 minute of life in newborns (p = 0.04) in the group of women in labor with active viremia (48 hours before the onset of maternal illness – day 5 of rash (n = 15) compared with the group of women in labor in the period of late convalescence. In the study, complications such as premature rupture of the foetal membrane and subinvolution of the uterus were more frequent than in the general population, and were 13/47 (27.7%) and 5/47 (10.6%), respectively. The most frequent complication during pregnancy was preeclampsia (13/47 of patients). The incidence of congenital varicella in newborns was 3/47 (6.4 per cent), mortality rate among newborns with congenital varicella was 33.33 per cent. We found evidence of a significant association between preeclampsia and congenital varicella (OR = 23, 95% CI: 1.1-482.12, p < 0,05). Preeclampsia patients also had an extended rash period (p = 0.009).

Conclusion. The number of complications of pregnancy, labor and the post-partum period is high among patients with chickenpox. Preeclampsia is a risk factor for neonatal varicella and lingering varicella in the mother.

Background. To date, there is quite a lot of international experience with uterine artery embolisation. This method is an alternative to classical myomectomy and differs from it by less invasiveness and surgical trauma, and faster rehabilitation. Endovascular intervention, despite a fairly good evidence base for its effectiveness, still cannot be used routinely for reasons of fertility preservation, oncovigilance, and effectiveness. There is a need to study the postoperative results of uterine artery embolization in patients with uterine myoma from two approaches (transfemoral and transradial), compare them with each other and with the results of hysteroresectoscopy.

Results. This retrospective single-center study evaluates the results of treatment of a single symptomatic submucous myoma up to 7 centimeters in size. Such treatment methods as classical hysteroresectoscopy and uterine artery embolization from transradial and transsphenoidal approaches are compared. Clinical observations for 24 months were collected, according to the results it was noted that endovascular interventions are safer (lower frequency of early postoperative complications of pulmonary embolism and panmetritis), at the same time, the effectiveness of the intervention is lower if we evaluate such parameters as recurrence of abnormal uterine bleeding, time to restoration of the normal menstrual cycle.

Conclusion. Endovascular embolization of uterine arteries in comparison with hysteroresectoscopy is a safer intervention, which can be concluded when evaluating early postoperative results. At the same time, in terms of effectiveness in the treatment of uterine fibroids, endovascular intervention is inferior in terms of freedom from recurrence of abnormal uterine bleeding, time of normalization of the menstrual cycle. The choice of endovascular access for endovascular embolization of uterine arteries does not affect the gynecological outcome of treatment, at the same time, with transradial access, a lower frequency of hematoma formation is noted.

Background. Viral respiratory tract infections treatment, especially during epidemic outbreak, is a main priority for pediatricians and physicians of other specialties. After the COVID-19 pandemic, a need to assess the efficacy and safety of the interferon inductor drug arose due to the changes of respiratory viruses circulation.

Objective. To evaluate the effectiveness of drug within the complex therapy of viral respiratory tract infections in children aged 3 to 18 years, in comparison with standard therapy in routine outpatient practice.

Materials and Methods. The study included 534 children aged 3 to 18 years diagnosed with mild to moderate viral respiratory tract infections with a disease duration of no more than 3 days at the time of enrollment in the observational program. Standard therapy was prescribed by the attending physician in accordance with current Clinical Guidelines and Treatment Standards. Additionally, Кagocel® tablets, 12 mg, were administered at the physician’s discretion, in doses of 6 or 10 tablets over a period of 4 days. Symptom dynamics, disease duration, incidence of complications, antibiotic prescriptions, recurrent viral respiratory tract infections, and viral pathogen elimination based on PCR diagnostics were assessed. Safety assessment included adverse event recording.

Results. Incorporating of interferon inductor into standard therapy reduced the duration of the primary disease and accelerated symptom resolution, decreased the frequency of complications, antibiotic prescriptions, and recurrent viral respiratory tract infections. Complex therapy with an Кagocel® provided twice the effectiveness in terms of viral elimination rates compared to standard therapy without antiviral agents on days 5-8 from the start of treatment. Кagocel® demonstrated a good adverse event profile, with no AEs recorded.

Conclusion. The significant efficacy of interferon inductor in the complex treatment of viral respiratory tract infections compared to standard therapy without antiviral agents in real-world practice has been demonstrated. The therapy demonstrated an excellent adverse event profile in children aged 3 to 18 years.

Background. Immune thrombocytopenic purpura is an immune-mediated disease that develops as a result of impaired immune tolerance to platelet antigens and the formation of antibodies to them, followed by a decrease in platelet levels per unit volume of blood, which can lead to the development of hemorrhagic syndrome. The pathological process in immune thrombocytopenic purpura is based on the breakdown of immunological tolerance to its own antigen. Thrombocytopenic purpura is observed in various age groups. In children, the development of immune thrombocytopenic purpura observed after an infectious disease (influenza, measles, rubella, chickenpox, HIV, etc.), vaccination, and the persistence of viruses (Epstein – Barr, cytomegalovirus, parvovirus B19). Some medications can also cause diabetes: antibiotics, nalidixic acid, trimethoprim, paracetamol, salicylic acid, various nonsteroidal anti-inflammatory drugs, heparin, etc. Objective. The purpose of the publication of this clinical case is to familiarize the medical community with the development of purpura in children after viral infections (from the Herpesviridae), as well as, most importantly, against the background of the recent epidemic of a new type of coronavirus infection (COVID-19). Raising awareness about the possible development of thrombocytopenic conditions in children will allow a more thorough approach to diagnosis and treatment, as well as determine the vector of observation of such patients after diseases in order to prevent the development of life-threatening bleeding with the progression of thrombocytopenia.

Materials and methods. The patient (aged 13) suffered from immune thrombocytopenic purpura: Data from a clinical examination, the results of clinical and instrumental studies were used. Information about the history of life and disease is presented in detail.

Results. The described case of immune thrombocytopenic purpura was probably associated with a new type of coronavirus infection, as well as infection with Epstein – Barr virus. The data presented in the observation correlate with foreign and domestic publications, which emphasizes the importance of timely diagnosis and treatment of viral infections that can cause the development of hematological disorders in childhood.

Conclusion. Given the variability and large number of trigger agents for immune thrombocytopenic purpura, it is necessary to raise awareness of the medical community about the possible causes of immune thrombocytopenic purpura. Timely diagnosis, an integrated approach and therapy are reliable assistants in the practice of a doctor, contributing to achieving stable remission and avoiding relapses of the disease.

Background. Butyric acid (butyrate) is a short-chain fatty acid produced by anaerobic bacteria of the species Eubacterium rectale, Eubacterium ramulus, Eubacterium hallii, Roseburia cecicola, Roseburia faecis, Faecalibacterium prausnitzii and Coprococcus faecalis, as well as Fusobacteria, non-pathogenic Clostridium species, plays a key role in the physiology of the gastrointestinal epithelium. The protective effect of butyrate is realised on the part of gastric and intestinal mucosa by stimulation of anti-inflammatory and antioxidant mechanisms. Being a source of energy, it affects a wide range of cellular functions, exerting cytoprotective effect and maintaining homeostasis within the gastrointestinal tract. Butyric acid maintains the integrity of the mucosal barrier, stimulating the production of protective mucus and antimicrobial proteins, and increases the density of epithelial contacts with each other, as well as has an anti-inflammatory effect. Due to pH regulation (creates a slightly acidic environment) promotes the creation of favourable conditions for the growth of its own beneficial microbiota and unfavourable for opportunistic and pathogenic microbiota. In addition to pleiotropic effects on the human macroorganism, butyric acid and its derivatives have a direct antibacterial effect. Uric acid is able to inhibit the growth of Helicobacter pylori and have a destructive effect on the cell membrane of the microorganism, reducing cytoplasmic pH and accumulating toxic anions to prevent colonisation of Helicobacter pylori, generating hydrogen peroxide and damaging pathogenic proteins, membrane lipids and DNA of the bacterial cell.

Conclusion. In Russia, as a source of butyric acid (butyrate), a preparation has been registered which, in addition to butyric acid, contains a second active component – inulin, a soluble dietary fibre, which creates a nutritious environment for the intestinal microbiota, thus stimulating the growth of beneficial bacteria and having a prebiotic effect.

Background. Osteoarthritis is a heterogeneous disease characterized by lesions of one or more joints, diversity of clinical features, and a large palette of biochemical and molecular characteristics, which together suggests the existence of multiple phenotypes and endotypes of osteoarthritis. In modern medicine, osteoarthritis is considered as part of a multisystem active pathologic process in the human body, triggered by a group of systemic (genetic, transcriptomic, metabolomic, proteomic, neuroimmunoendocrine) and local (biomechanical) factors. Today, osteoarthritis should be treated as a systemic disease, taking into account individual patient factors such as genetics, inflammatory response, and lifestyle.

Objective. The purpose of the review of medical literature was to search for modern effective and safe therapeutic interventions for generalized osteoarthritis (GOA).

Results. An analysis of the results of studies of the epidemiology of GOA, genetic characteristics and data on pheno- and endotyping of GOA was carried out. Current mechanisms of development of GOA are presented, including the role of neoangiogenesis and neoinnervation. The multimodal approach and modern directions and classification of disease-modifying therapy for GOA are considered. An analysis of the mechanisms of action, effectiveness and prospects for the use of chondroitin sulfate (CS), glucosamine sulfate (GS) and undenatured collagen (UC) type II was performed, taking into account the endotype for a specific phenotype of GOA with the development of personalized regimens therapy of OA for the parenteral form of CS.

Conclusion. Therefore, GOA should be treated as a systemic disease, taking into account its genetics, inflammatory response and lifestyle, and medical care should be more holistic and personalized.

Background. Currently, to the use of medicinal cosmetics is given a special role in the therapy of chronic dermatoses. Taking into account the fact that the treatment of diseases such as eczema and atopic dermatitis is predominantly external, a constant search is being carried out for means and methods that, while highly effective, would be safe and well tolerated with long-term use. The basic external drugs are topical glucocorticosteroids, but their use over a long period of time is unacceptable due to the possible development of local and systemic side effects. Atopic dermatitis and eczema are chronic itchy dermatoses, in which one of the key links in the pathogenesis is skin barrier disorders and immune-mediated inflammation. Since xerosis and epidermal barrier disorders impair the absorption of external glucocorticosteroids and prevent their penetration into the dermis, where infiltration and production of proinflammatory cytokines predominantly occurs, it is necessary to prescribe emollient therapy from the first day of treatment as an adjunct to the main treatment. The integrity and sufficient degree of hydration of the stratum corneum, which is achieved through these agents, contribute to increased permeability for external glucocorticosteroids and, in turn, a more pronounced effect. Taking into account the certain role of epidermal barrier disorders in the development of atopic dermatitis and eczema, external therapy in the form of moisturizing and fattening agents is basic.

Objective. To study the efficacy of therapeutic cosmetics in the form of a combination of shower gel and cream for dry and sensitive skin in the complex therapy of patients with chronic pruritic dermatoses (atopic dermatitis and eczema). The prospective multicentre study included 77 patients diagnosed with atopic dermatitis and eczema, including 51 women and 26 men.

Conclusion. The results of the conducted study demonstrated high efficiency of the joint application of shower gel and cream for dry and sensitive skin in the complex therapy of atopic dermatitis and eczema.

Background. In the XXI century, there is a rapid increase of chronic non-communicable diseases, leading to population disability and mortality. Anaemia is one of the most frequent comorbidities in cardiac patients and is associated with increased risks of adverse outcomes. The incidence of anaemia, as well as cardiovascular disease, increases with age. According to the World Health Organization (WHO), one of four patients with a chronic disease has concomitant anemia. A special place in chronic pathology is occupied by anemia of chronic diseases, which is in second place after iron deficiency anemia in terms of frequency of spread. In the development of anemia of chronic diseases, activation of immunocomponent cells and proinflammatory cytokines is noted, which in turn have biological effects on iron metabolism and hematopoiesis regulation, reducing the life expectancy of circulating red blood cells. It is assumed that hemorheological disorders and remodeling of the cardiovascular system occur under the influence of enhanced erythrophagocytosis by macrophages. Anemia aggravates the course of concomitant pathology and contributes to a decrease in performance, cognitive function and survival. Anemia is a predictor and risk factor for cardiovascular remodeling.

Materials and methods. The analysis of literature sources in the database "Scopus", "Web of Science", "PubMed/MedLine", "eLibrary" were carried out. The literature search was conducted using the following keywords in Russian and English: "anemia", "anemia of chronic diseases", "coronary heart disease", "myocardial infarction".

Conclusion. We have analyzed publications from 2013 to 2024. It is a literature review of cardiovascular changes in anemia of chronic diseases, examines the possible negative effects of anemia on the coronary heart disease development, presents the results of modern research and their importance in practical healthcare.

Background. Anxiety disorders, being one of the widespread mental illnesses, are often accompanied by sexual dysfunctions. In turn, pharmacotherapy used in the treatment of affective disorders can lead to adverse sexual disorders. Only a small proportion of patients report having problems in the intimate sphere when seeking psychiatric help. However, untimely detection of sexual dysfunctions can reduce adherence and effectiveness of therapy.

Materials and methods. The article is devoted to a review based on 21 sources, of which 9 are systematic reviews, as well as other studies. The data was searched by names, annotations and keywords: sexual dysfunction, anxiety and stress disorder (sexual dysfunction, anxiety and stress disorder) in the databases Elibrary and PubMed.

Results. In anxiety disorders, sexual dysfunctions are observed in both men and women and are manifested by violations of all phases of sexual reactions. The relationship of sexual dysfunction with anxiety disorders is explained by three models: the first, which includes causal relationships, suggests that the correlation between sexual dysfunction and anxiety disorders is often bidirectional, and the symptoms of sexual and anxiety disorders can manifest simultaneously; The second model assumes the presence of a common underlying factor, or hidden predisposition, causing the development of both mental and sexual disorders over time; the third model conceptualizes sexual dysfunctions as disorders unrelated to anxiety disorders.

Conclusion. Based on the conducted research, the authors recommended the following algorithm for the supervision of patients suffering from anxiety disorders and sexual disorders: at the stage of seeking psychiatric help, along with standard diagnostic methods to determine the severity of mental pathology, it is advisable to use questionnaires to assess sexual function. In addition, the possible negative effect of pharmacotherapy on sexual function should be taken into account and evaluated at all stages of treatment in order to carry out timely correction. If sexual disorders are detected in patients with anxiety disorders, taking into account the clinical situation, psychotropic drugs with no or minimal negative effect on sexual function are prescribed, if possible. In cases where it is impossible to use such drugs, after achieving correction of anxiety symptoms, the doses of psychotropic drugs used may be reduced, interruptions in their intake, mainly 1-2 days before the alleged sexual contact. If sexual disorders persist, an antidepressant with no effect on sexual function is added to the treatment regimen as an antidote, or drugs for correcting sexual disorders – type 5 phosphodiesterase inhibitors. Psychotherapeutic measures, including sex therapy, are an integral part of the treatment of sexual dysfunctions in patients with anxiety disorders.

Background. The article touches upon the issues of non-drug correction of post-stress disorders in persons of dangerous professions.

Materials and methods. There were 90 men with a high level of occupational stress aged 35 to 45 years, whose clinical picture was distinguished by the interweaving of neuropsychiatric and cardiovascular disorders. At the same time, the clinical assessment of the mental state of the individuals selected for the study was compared with the results of pathopsychological testing. In the course of the analysis of the level of cardiovascular activity, the methods of electro- and echocardiography were used, using dosed physical activity as an additional test. In the treatment phase itself, the patients, by randomization, were divided into three groups, in which medication was prescribed as the baseline. Along with this, in the first two groups, breathing-relaxation training (as a relaxation technique) or transcutaneous electrical neurostimulation was used separately, in the 3rd – a combination of these methods.

Results. At the first stage of the study, the peculiarities of the nature of neuropsychiatric and cardiovascular shifts, closely intertwined in the observed individuals, were determined. A catamnestic analysis, performed after six months, confirmed the stability of the results achieved in the case of combined exposure.

Conclusion. The developed therapeutic complex provides the proper effectiveness and therapeutic reliability of the effect, and the study itself opens up prospects for optimizing correction programs in post-stress disorders.