The use of information technologies, including the use of large databases, is a promising area of medicine. Databases are used in clinical medicine, healthcare organizations, hygiene, and occupational medicine. Studies based on a large number of observations make it possible to analyze the diagnosis, prognosis of diseases, evaluation of the rational use of medicines, epidemiology of diseases. Examples of successful use of databases in bioinformatics, biomedicine, systems biology, the study of prognostic indicators in various fields of medicine, the determination of reference values of laboratory indicators taking into account population characteristics are given. Healthcare data is plentiful, but it is stored in institutions, clinics, hospitals, registries or insurance companies, which leads to underutilization of resources, redundancy and inefficiency. An important long-term task is their integration. The review presents the requirements for databases, so that they are not just archival repositories, but databases that allow conducting research and analyzing data.

The percentage of elderly and senile patients is growing every year. Among this cohort of patients, atrial fibrillation (AF) is one of the most common rhythm disorders. At the same time, AF repeatedly increases the risk of thromboembolic complications. The course of AF in elderly patients is often complicated by chronic kidney disease (CKD). When managing patients of this group, we often encounter polypragmasia, which affects the patient’s quality of life, increases the risk of falls, and potentially reduces life expectancy. In order to optimize pharmacotherapy, STOPP/ START criteria were developed.

The purpose of the study was the analysis of drug prescriptions in patients over 65 years of age with AF and CKD for compliance with the STOPP/ START criteria.

Material and methods. 339 case histories of the cardiology department and 180 case histories of patients of the therapeutic department of the Veterans of Wars multidisciplinary hospital were analyzed. In each department, patients were divided into 2 groups: patients with AF in combination with CKD C3a and patients with AF in combination with CKD C3b and C4.

Results. In the therapeutic department, 96.1% of the first group and 100.0% of the second group of patients were not prescribed drugs that are recommended for elderly patients (START criteria). 64.7% of patients from the first group and 53.8% of patients from the second group have potentially not recommended, but prescribed drugs (STOPP criteria) in the appointment lists In the cardiology department, the percentage of patients who did not have the recommended drugs (START criteria) in drug therapy was 92% in group 3, 97% in group 4. The percentage of patients who were prescribed potentially non-recommended drugs (STOP criteria) in group 3 45%, in group 4 48%.

Conclusion. Most elderly and senile patients with AF in combination with CKD have both START and STOPP criteria, which dictates a thorough analysis of the prescribed drug therapy.

Aim: to study the features of purine, lipid and carbohydrate metabolic disorders in patients with coronary artery disease over 90 years old (centenarians).

Materials and methods. The study enrolled 225 patients over 90 years, hospitalized with coronary artery disease. The majority of patients (67.6%) were women. The mean age of the patients reached 92.5+2.2 years (from 90 to 106 years).The blood levels of uric acid, lipids, glucose and body mass index were determined.

Results. Obesity was registered in 31.5% of patients, grade III obesity – in 1 patient. Overweight was observed in 39.1% of patients, normal body mass index (BMI) – in 28.9%. An increase in the blood concentration of triglycerides was determined in 11.2% of patients. A decrease in the level of high-density lipoprotein (HDL) cholesterol was registered in 12.7% of patients. The blood concentration of low-density lipoprotein cholesterol (LDL) less than 2.0 mmol/l was observed in 23.3% of cases. Dyslipidemia was registered more often in women (p=0.02). Hyperuricemia was found in 37.3% of patients – in 41.4% of women and 28.8% of men (p=0.04). Elevated fasting blood glucose levels were determined in 23.1% of patients, but only 0.9% of patients had glucose levels above 14 mmol/l.

Conclusion. The study results indicate some features of metabolic disorders in centenarians with coronary artery disease. Most of the patients were obese or overweight. Frequent hyperuricemia was registered, but relatively low levels of atherogenic lipids and glucose.

Melatonin is a natural hormone produced by the pineal gland and is a derivative of serotonin. One of the key properties of melatonin is its chronobiological ability, realized by multilevel synchronization of biological processes. Physiologically, melatonin secretion increases at night and decreases in the morning. At present, the role of melatonin in the regulation of sleep, circadian rhythms, and adaptation of the body to a rapid change in time zones has been proven. With a decrease in the production of endogenous melatonin in a number of people (with a disorder of daily biorhythms due to long-distance flights, shift work, insomnia), the use of exogenous melatonin improves the quality of sleep.

Postcovid syndrome is a serious public health problem affecting millions of people worldwide. There is a growing body of evidence that people may exhibit symptoms after organ damage developed during the acute phase of COVID‑19, while others experience new symptoms after a mild infection, without any evidence of acquired organ or tissue damage. In this regard, understanding the determinants and regulators of COVID‑19 and postcovid syndrome pathology is an important clinical challenge that will enable better management of future variants and pandemic waves. There is presumably a close relationship between iron homeostasis, COVID‑19, and postcovid syndrome, the pathogenetic aspects of which have yet to be determined. Nevertheless, the available literature already indicates that iron deficiency and iron deficiency anemia (without inflammatory anemia) in patients with postcovid syndrome occur in 30% and 9% of cases, respectively. Given the importance and urgency of this problem and the fact that one in three patients with postcovid syndrome may have iron deficiency, this article presents a case from clinical practice in which a patient with postcovid syndrome was found to have iron deficiency and iron deficiency anemia, and treatment of this condition and disease resulted in improvement in general well-being and regression of symptoms. Thus, the effects of COVID‑19 on iron metabolism exist, and they can be corrected. The use of oral iron preparations, in particular iron sulfate, allows optimal therapeutic and clinical effects in this clinical situation along with a good tolerability and safety profile.

COVID‑19 has a negative impact not only on the respiratory system, but also on other organs and systems, including the endocrine. Cases of lesions of the hypothalamus, pituitary gland, thyroid gland, adrenal glands, gonads and pancreas are described. Hypocorticism in COVID‑19 patients can be caused by various reasons: damage to the adrenal endothelium, bilateral hemorrhages and heart attacks. Adrenal insufficiency in patients with COVID‑19 can have a negative impact on the prognosis of coronavirus infection. A clinical case of primary adrenal insufficiency is presented. The patient was hospitalized three times within 2 months with complaints of dyspeptic phenomena, weight loss. A sharp increase in complaints was noted after the transferred COVID‑19. The diagnosis of adrenal insufficiency was assumed after the appearance of a specific brown color of the skin. Hypocorticism has been confirmed in the laboratory. Cases of primary adrenal insufficiency after COVID‑19 can cause difficulties in diagnosis, because clinical manifestations are similar to the phenomena of post-ovoid syndrome in the form of asthenic syndrome: weakness, decreased appetite, weight loss.

Heparin-induced thrombocytopenia (GIT) is a paradoxical reaction of platelets to heparin (their aggregation and destruction), potentially dangerous by the development of venous and arterial thrombosis, less often bleeding. There are serious problems of timely diagnosis of this complication. They are due to both insufficient awareness of specialists and the presence of a negative psychological attitude. The article presents a clinical case of treatment of a 57-year-old patient who was prescribed local application of heparin ointment for catheter thrombosis of the superficial veins of the left upper limb. After 8 days, the patient developed a clinical and instrumental picture of occlusive thrombosis of the right brachial vein. The patient was prescribed enoxaparin 0.6 x 2 times a day subcutaneously. After 4 days since the appointment of enoxaparin, a sharp deterioration in the patient’s condition: lower paraplegia with impaired pelvic organ function developed. There was a decrease in platelet levels by more than 2 times to 49x109/l. The probability of developing GIT on the «4T» scale is 8 points (high probability of GIT). Despite the treatment, the patient’s condition progressively worsened with the development of thrombosis of the infrarenal aorta, both common iliac arteries, massive trunk thromboembolism, segmental and subsegmental branches of the left pulmonary artery, intracerebral hemorrhage with a breakthrough into the ventricular system. Conclusion: heparin-induced thrombocytopenia, a rare but extremely dangerous complication observed in patients receiving heparin. The key to preventing the catastrophic consequences of GIT is awareness, alertness of clinicians and the use of modern algorithms for the diagnosis and treatment of GIT.