№3, 2021, volume 17

Purpose: on the presented clinical case, to show the difficulties of diagnosing late cardiovascular syphilis. The difficulties of diagnosing late cardiovascular syphilis are largely determined by the extreme variability of the clinical manifestations of the disease and the lack of awareness of dermatovenereologists and other doctors (primarily therapists, cardiologists and cardiac surgeons). A feature of this case is the "cardiac" mask of the disease debut.

The review work is devoted to the analysis of current research results and new original approaches to studying space weather influence on human health. For information retrieval, materials of the indicated topic for 2005-2020 were used, published in the electronic databases PubMed and eLibrary. The review presents an analysis of 15 works. Analysis of the literature showed the connection between geophysical disturbance and the state of human health. There is a tendency towards an increase in the number of persons sensitive to geophysical manifestations of solar activity, which is especially pronounced among elderly and senile people, as well as people with diseases of the cardiovascular system.

The review summarizes actual information on inflammatory myocardial injury in COVID-19. The most update works from 2020-2021 were used as the literature sources, as well as earlier research containing fundamental information on the relevant topic. The substantial information is reflected in the review. Used queries: myocarditis, myocardial injury, COVID-19 — in the search engines PubMed/MedLine, eLibrary. The analysis of current international literature has demonstrated convincing evidence of the possible development of myocarditis in case of new coronavirus infection. The histological verification of myocardial injury associated with COVID-19 presents significant difficulties, since in conditions of a severe course of infection; it is not always possible to perform endomyocardial biopsy. In this regard, the statistics do not reflect complete information on the prevalence of COVID-19 associated myocarditis. All mechanisms of the pathogenesis of inflammatory myocardial injury have not been completely clarified. Due to the ambiguity of the prognosis of patients with COVID-19 associated myocarditis, further study of the problem is required.

Purpose: to present a clinical case demonstrating the features during infectious endocarditis in a patient with congenital heart disease due to the development of an asymptomatic complication — the spleen abscess. In addition, to draw the attention of doctors to the need to be alert in connection with the possibility of developing infectious endocarditis in congenital heart disease patients with an increase in body temperature and the onset of "signs of acute respiratory disease".

The article presents a clinical case (with examination and treatment data) of chronic B-lymphocytic leukemia, detected in arterial hypertension patient, and induced by multiple new coronavirus infection. It is concluded that it is necessary to conduct more careful monitoring of the general blood test and the state of the lymph nodes in persons with coronavirus infection.

The review evaluates, according to the literature, the clinical and pathogenetic significance of anemia in patients with acute coronary syndrome (ACS). In this clinical situation, the problems of choosing the optimal therapy associated with the smallest evidence base are highlighted. For this, the results of clinical studies published in bibliographic databases: PubMed, Publons and eLibrary were analyzed (the review included 40 publications for 1989-2020). The epidemiological features of the anemia syndrome in patients with ACS are most well studied. Anemia is often circulated in ACS and is associated with an unfavorable prognosis. The question remains whether anemia plays a direct causal role in the deterioration of short- and long-term morbidity and mortality, or is it rather an indicator of a poor clinical condition. A separate study for ACS in patients with anemia, due to the minimal evidence base, requires the choice of optimal antithrombotic therapy: specific drugs and the duration of their administration.

Comorbidity risk factors in chronic obstructive pulmonary disease (COPD) is largely determined by the systemic effects of chronic inflammation. Individual phenotypes of the disease have different prognostic significance. The review presents an analysis of literature data about cardiovascular risk in COPD, depending on the nutritional status of a patient. Literature sources were searched using PubMed, CyberLeninka, MedLine, Global Health, eLibrary, Google Scholar databases on queries: comorbidity with COPD, systemic inflammation and COPD, cardiovascular pathology and COPD, obesity and weight deficiency with COPD. The work includes 40 literature sources over the past 10 years on the risk factors of comorbidity in view of systemic inflammation. Four works from an earlier period were also used, demonstrating fundamental and historical information from the point of view of the authors. As a result of the search, the factors of the worst prognosis in COPD patients with weight deficiency and the protective sense of obesity are clarified. This effect allows you to personalize dietary recommendations. Nevertheless, there are not enough data about mechanisms of chronic inflammation with weight deficiency.

Objective: to assess the dynamics of hemodynamic, metabolic, hematological parameters and myocardial contractility markers in patients with chronic coronary syndromes who have undergone a new coronavirus infection (COVID-19), according to the time since its manifestation. Material and Methods. The one-center observational study of patients with chronic coronary syndromes (CCS) who underwent COVID-19 (1-10 months, n=138) was carried out. assessment of The basic clinical, laboratory and instrumental parameters were assessed depending on the time since COVID-19 manifestation. To assess the duration of post-COVID changes in continuous variable, the deviation index from normal values was calculated. Results. The median duration of the post-COVID changes in the studied parameters was 4 months. In patients with CCS, against the background of a relatively constant amount of total protein, there was an increase in the level of albumin by 12.3 (11.5; 25.1) %, with minimal values in patients survived COVID-19 within a month, p=0.008. The decrease in the leukocytes count was revealed with minimum by the 10th month since the COVID-19 manifestation: 9.0 (6.4; 10.9), *108/L(1 month) to 5.5 (4.9; 6.1), *108/L(10 months), p=0.001. Heart rate decreased by 28.2 (22.1; 31.1) %, p=0.001, and was accompanied by the left ventricular ejection fraction augmentation from 58 (59; 64) % (1 month) to 69 (67; 71) % (10 months), p=0.027. Conclusion. In patients with chronic coronary syndromes, the main long-term trends of post-COVID changes in metabolic, hematological, ECG parameters and characteristics of myocardial contractility, routinely determined in real clinical practice, were revealed.

Purpose: to perform a comparative analysis of the hemostasis state in patients with a SARS-CoV-2 infection (CO-VID-19) hospitalized in the intensive care unit (ICU). Material and Methods. The retrospective analysis of the medical data of patients with COVID-19 (n=105), admitted to ICU in the «COVID hospital», consisted of the following: complete blood count test; screening global clotting tests routinely performed at admission (activated partial thromboplastin time (APTT), prothrombin index, international normalized index, fibrinogen). Results. We detected sex differences in COVID-19 patients referring hemoglobin level (lower in women, p<0.05) and thrombocytopenia rates (more often in men, p=0.032). There were moderately strong negative correlations between the duration of hospitalization and the leukocytes count at admission (R=0.410; p=0.037), platelet count at admission (R=0.402; p=0.046). In COVID-19 patients we detected increased fibrinogen with a normal or slightly lower platelet count, and normal or slightly increased prothrombin time and APTT. Conclusion. The major coagulation parameters associated with COVID-19 are increased fibrinogen with a normal or slightly lower platelet count, and normal or slightly increased prothrombin time and APTT. COVID-19 associated coagulopathy is characterized by sex differences, which partly determines the specifics of the clinical course of the disease in men and women patients.

Purpose: to assess the volumetric blood flow distribution during the formation of different clinical and pathogenetic variants of hypertension. Material and Methods. A total of 128 patients were examined, in whom the indices of volumetric blood flow in the aorta and brachial artery were determined. Results. In vasoconstrictor hypertension, the stroke volume in the brachial artery and the blood flow distribution coefficient were 4 times less than in patients with volumetric hypertension. In patients with hyperkinetic hypertension, the energy of blood ejection and the blood flow distribution coefficient was more than 3 times higher than the same indicators in other variants of hypertension. Conclusion. Characteristic hemodynamic signs of the blood flow distribution that can be used to diagnose various pathogenetic pheno-types of arterial hypertension are identified.