Extemporal drugs are an important component in pharmaceutical practice, allowing the provision of dosage forms or dosages that are not commercially available, and the personification of drug therapy. These drugs are most in demand in pediatrics, gerontology, oncology, palliative medicine, dermatology. A number of measures are necessary for the introduction of extemporal production of medicines into modern practical medicine: changing regulatory legal acts regulating the manufacture of extemporal medicines; improvement of modern methods of quality control; updating of the collection of extemporal medicines; ensuring the introduction of the use of extemporal medicines in practical healthcare; modernization of pharmacy equipment; organization of advanced training of medical and pharmaceutical specialists in the field of prescribing, manufacturing complex dosage forms in pharmacies and control of their production.

Patients who have suffered a myocardial infarction have a high risk of recurrent cardiovascular events – almost every fifth patient develops new episodes of acute myocardial ischemia during the first year [5]. One of the most important tasks of the therapy of these patients is the most effective and early reduction of atherogenic lipoprotein fractions to target values. The initiating basic therapy is statins, which have proven to be highly effective. However, in a number of patients, the necessary high-dose statin treatment cannot be implemented due to developing side effects or intolerance. The article discusses the issues of combined antihyperlipidemic therapy with a discussion of the role of all available groups of drugs. A possible clinical and pharmacological niche of phyto-steroid saponins is being considered.

Relevance. Anemia is detected in chronic heart failure (CHF) in 50–60% of patients, second in frequency only to arterial hypertension and coronary artery disease. Most often it is iron deficiency anemia (IDA), the cause of which is both absolute and functional iron deficiency (ID). IDA with absolute ID in patients with coronary artery disease may manifest symptoms similar to the manifestations of CHF, which leads to unfounded prescription of iron preparations for intravenous administration.

Purpose. Determine the need for a thorough examination of patients with coronary artery disease and IDA, taking into account existing clinical guidelines to exclude overdiagnosis of CHF.

Materials. A clinical observation is presented demonstrating that a full examination of patients, including the determination of erythrocyte and ferrokinetic parameters, the level of natriuretic peptides and the left ventricular ejection fraction, makes it possible to distinguish between absolute and functional ID and differentiate the symptoms of IDA and CHF. Identification of the cause of ID, often associated with the use of anticoagulants and disagregants, and its correction using oral forms of iron sulfate avoids both overdiagnosis of CHF and unfounded prescription of drugs for parenteral administration. This avoids undesirable effects of therapy, improves prognosis and improves the patient’s quality of life, and reduces the burden on the health care system.

Labor migration has socio-economic significance in the interests of both the host country and the country of origin. Difficult working conditions, unfavorable living conditions increase the risk of developing diseases. An analysis of the health status of migrant workers in different countries revealed that infectious diseases, injuries, including industrial, acute intoxication and acute surgical pathology are most common. Women’s health requires special attention. A study conducted at the GBUZ «GCB No. 13 DZM» revealed that the largest number of patients were from Kyrgyzstan, Tajikistan, Uzbekistan. Acute surgical pathology, injuries, gynecological diseases prevail among the reasons for hospitalization. Among the diseases of the therapeutic profile, cirrhosis, hepatitis, acute intoxication, diseases of the urinary and reproductive system, diseases of the circulatory system and cerebrovascular diseases are most common. Attention is drawn to the short period of stay in the hospital –2.4 days. Russia has taken measures aimed at preserving the health of migrant workers. Since December 2021, a medical examination has become mandatory. The developed measures to improve the quality of medical examinations of migrant workers are aimed at early detection and prevention of diseases.

Anxiety and sleep disorders are an urgent problem of modern healthcare, which should be treated at the earliest possible stages, since this would prevent the development of a wide range of complications of these conditions. At the same time, given the bidirectional relationship between anxiety and sleep disorders, the search and development of safe and effective remedies for their correction is becoming increasingly relevant. The prescription of a set of measures of nonmedicamental and medicamental nature is considered to be the main methods of therapy for anxiety and sleep disorders. This article presents diagnostic tools that allow the general practitioner to identify anxiety and sleep disorders (insomnia) in a patient as early as possible, and discusses the therapeutic strategies for using a combination of glycine and melatonin in appropriate patients.

The study aim was to analyze the prevalence and course of locomotive syndrome in patients in the geriatric hospital.

Materials and methods. This work was a cross-sectional study performed on the basis of the Moscow War Veterans Hospital N3. The study enrolled 58 patients – 43 women (74.1%) and 15 men (25.9%) hospitalized in the geriatric department of the hospital. The mean age of study patients was 82.7+5.9 years, varying from 75 to 96 years. A comprehensive geriatric assessment was performed, including the Age Is Not a Barrier Questionnaire, the Basic Daily Activity Scale (Bartel Index), the Instrumental Activities of Daily Living (IADL) Scale, and the Morse Falls Scale. Questionnaires were filled out to assess the locomotive syndrome – GLFS‑5 and GLFS‑25. A 2 step test was carried out.

Results. In 48 out of 58 patients (82.8%), locomotive syndrome was found: in 88.4% of women and in 66.7% of men (p=0.05). Locomotive syndrome was diagnosed in all centenarians, in 82.7% of patients aged 80 to 89 years and in 75% of patients aged 75–79 years. The main cause of the locomotive syndrome was degenerative-dystrophic changes in the spine and joints observed in all patients. Only 1 patient had stage I locomotive syndrome, all the rest had stage II. Patients with locomotive syndrome had lower levels of activity in everyday life – 84.3±11.2 and 93.0±6.3 points according to the Barthel index, respectively (p=0.01), greater severity of pain syndrome according to VAS – 4.2±1.8 and 1.7±1.6 points, respectively (p=0.003) and a shorter distance of 2 steps (123.3±30.9 and 148.1±20.7 cm, respectively (p=0.003). Direct correlations were established between the values of the GLFS‑5 locomotive function scale and the age of patients (r=0.33; p=0.01), as well as the severity of chronic pain syndrome according to VAS (r=0.55; p=0.00007). Inverse relationships were registered between the indicators of the GLFS‑5 scale and the Barthel index (r= –0.44; p=0.0005), the IADL scale (r= –0.41; p=0.001) and the distance traveled in the «2 steps» test (r= –0.52; p=0.0007). Inverse correlations were observed between the values of the GLFS‑25 scale and the Barthel index (r= –0.41; p=0.008), the IADL scale (r= –0.59; p=0.00008), the Mini-COG test (r= –0.37; p=0.02), as well as indicators of bone mineral density in the proximal femur (r= –0.39; p=0.04 – r= –0.54; p=0.002). Conclusions. The study results indicate that patients in the geriatric hospital very often have locomotive syndrome associated with the pathology of the musculoskeletal system. The severity of the locomotive syndrome correlates with the indicators of the functional activity of patients, the intensity of the pain syndrome and the bone mineral density.

An online survey of students of higher educational institutions was conducted to study the spread of smoking, obesity, physical inactivity. A comparison was made between students of medical and non-medical universities. It was revealed that 21% of physicians smoke, 47% of non– medical students. Among medical university students, 18% were overweight, and 75% were irrational eating with fast food consumption. Irrational nutrition (insufficient or excessive nutrition) was also common among students. The number of students engaged in sports sections or having a subscription to fitness clubs, respectively, was 11% and 23%. The percentage of students with low physical activity in medical and non-medical universities did not have a statistically significant difference and was less than 20%. The most popular classes that evoked positive emotions among students were sports games: volleyball, basketball, badminton. The girls positively assessed gymnastics classes. Among the factors influencing motivation to study in sports sections, the possibility of improving sports skills and participation in competitions was indicated. Students expressed satisfaction with classes in health groups, the program of which took into account the individual characteristics and capabilities of the individual. Physical inactivity and poor nutrition are related behaviors that affect health and well – being, as well as maintaining a healthy weight. The results of the study showed the need for comprehensive measures to increase the motivation of medical university students to a healthy lifestyle.

Relevance. Conservative treatment of cholelithiasis is most effective in the early stages of the disease. The use of ursodeoxycholic acid preparations is most justified, taking into account the pathogenesis of the disease. Effective conservative treatment can prevent the development of postcholecystectomy syndrome, the most common complication of surgical treatment. This is a socially significant task.

Goal. Conducting conservative treatment with ursodeoxycholic acid to a patient with GI with dynamic monitoring and evaluation of the effectiveness of the therapy. Identification of early signs of the development of cholelithiasis and prevention of factors of the development of concretions in the gallbladder.

Materials and methods. A patient with newly diagnosed cholelithiasis was prescribed ursodeoxycholic acid preparation under the control of laboratory and instrumental research methods. Dynamic observation of the patient was carried out during 1 year of treatment, and the previous results of ultrasound examination were also analyzed, which made it possible to identify predisposing factors of stone formation. The appointment of the drug ursodeoxycholic acid made it possible to achieve the goal – to «dissolve» gallstones. Regular ultrasound examination, even in the absence of clinical manifestations, is one of the methods for detecting cholelithiasis at an early stage – biliary sludge in the gallbladder.