Hypertension in pregnancy is one of the most common pathology in the structure of extragenital deseases in pregnant women. Cardiovascular diseases, including strokes, account for approximately half of all cases of maternal mortality. In addition, hypertension and its complications are significant cause of fetal and infant mortality. The prevalence of this pathology increase over the past few decades. Hypertension and its complications significantly worsen the prognosis for both the mother and the fetus and newborn. Hypertension in pregnancy also causes the cardiovascular pathology in the future. Early diagnosis and adequate therapy of hypertension at all stages of preparation and the pregnancy can significantly improve the prognosis for the mother and fetus/newborn, as well as prevent possible cardiovascular diseases and complications in women in the future.

Healthcare plays an important role in solving the demographic problem. In order to raise the birth rate, a new standard of obstetric and gynecological care has been introduced. A key element of the new standard is the creation of women’s health centers. It is planned to create women’s health centers on the basis of a multidisciplinary hospital. This will make it possible to use additional hospital resources for examination, pregnancy management, maternity care, and treatment, if necessary, of the mother and newborn. As part of the medical examination, an assessment of the reproductive health of working men and women is being introduced, including screening of anti-muller hormone in women, the possibility of carrying out a genetic test of embryos, IVF, cryopreservation. All services will be provided to women through compulsory health insurance.

Atopic dermatitis is one of the most common skin diseases in children. Genetic disorders that determine the development of persistent dysfunction of cellular immunity play an important role in the development of clinical symptoms of atopic dermatitis. In the new concept of the occurrence of clinical manifestations of atopic dermatitis (AD), T-regulatory lymphocytes are assigned, in the form of CD4+CD25+ phenotype, which is controlled by the transcription factor FoxP3. The study of the mechanism of itching, which is more or less observed in all children with blood pressure, showed that in the case of the island-inflammatory course of Th2-dependent blood pressure, itching is histamine-conditioned. According to the concept of «Outside to Inside – outside – inside», the most significant mechanisms causing the appearance of blood pressure are a genetic predisposition that causes the formation of allergic reactions, changes in the permeability of the epidermal barrier, against the background of transepidermal moisture loss, the occurrence of xerosis phenomena and a decrease in the itching threshold. Significant abnormalities in the state of the skin microbiota were found in children with AD. The species composition of the intestinal microbiota in children with AD differs significantly from that in children with healthy skin. Intestinal microbiocenosis largely determines the direction of morphofunctional processes in the epidermis, by means of translocation of intestinal bacteria regulating the humoral response directly in the skin. Most often, allergic reactions are triggered when food proteins enter the body. Among other allergens, cow’s milk protein is the most significant in the development of allergic reactions in young children. In many cases, in 1-year-old children with AD, goat’s milk mixtures are a good alternative to cow’s milk-based milk mixtures. At the present stage, the most important in the complex of therapeutic measures in children with blood pressure from the first year of life are diet therapy and active external therapy, including the phased use of topical steroids, calcineurin inhibitors, emollients.

Background. Autism spectrum disorders are a pathology that is becoming increasingly widespread throughout the world, regardless of geographic, climatic, socioeconomic or other regional characteristics. Due to the wide spread of this pathology, early detection of disease predictors is of great importance. Competent observation by a local pediatrician in the first year of life is of great importance in the first determination of disease symptoms / identification of risk groups. However, clear predictors indicating the presence of pathology have not been developed due to the lack of an accurate understanding of the etiology, pathogenesis of autism and the diversity of the clinical signs. It is believed that the gastrointestinal tract, microbiota, food intolerance play a certain role in the development and severity of ASD, but further research is needed in this area.

Materials and methods. The study included 138 children with autism spectrum disorders aged 3–15 years (Me 6 [4; 7.5]) and their parents. There were 91 boys and 47 girls. A thorough analysis of the obstetric history, the course of the intranatal and neonatal periods, the nature of feeding, the neuropsychic development of children in the first year of life, and the social and everyday aspects of family life was carried out. Statistical analysis was performed using descriptive statistics methods.

Results. The perinatal period of children with autism spectrum disorders does not differ significantly from the average data in the population. It was found that the assessment of emotional development is of great importance in monitoring children in the first year of life. Despite the fact that the examined patients did not have a clinically significant delay in neuropsychic development (more than 2 epicrisis periods), it is nevertheless noted that motor development was impaired less often than emotional, play and speech skills.

Conclusions. Perinatal, social factors, the nature of feeding and past diseases do not affect the development of the disease. Among the assessment criteria in infancy, special attention should be paid to neuropsychic development, in particular emotional development and play activities.

Vitamin D plays an import role in the regulation of calcium-phosphorus metabolism, metabolic processes and the cell cycle.Over the years, the mechanisms of molecular action of vitamin D in various cells, organs and tissues have been well studied. The widespread prevalence of vitamin D deficiency, established on the basis of laboratory diagnostics, has led to the development and implementation of programs for the correction of hypovitaminosis D. However, the question of the clinical effectiveness of these programs remains open. In this article, we review studies and meta-analyses of data that have assessed the preventive and therapeutic efficacy and safety of physiological and high doses of vitamin D.

Purpose. To evaluate the accuracy of the QRS complex detectorof the Medicom-combi complex for daily monitoring of ECG and blood pressure using the MIT-BIH ECG signal test database in accordance with the requirements of GOST R IEC60601–2–47–2017, 30324.2.47–2012.

Materials and methods. During the tests, the operation of the detector was evaluated using the MIT-BIH Arrhythmia Database, containing 48 records of 30 minutes each. Each selected QRS complex was assigned one of the following types: N (supraventricular complex, normal QRS complex, including bundle branch block), V (ventricular complex), U (complex that experts find difficult to determine) and A (artifact). Rates of sensitivity (Sen), specificity or positive predictive rate (PPR), and overdiagnosis (FPR) were determined.

Results. The sensitivity of the QRS complex detector of the Medicom-combi complex for daily monitoring of ECG and blood pressure was 99,98%, and the specificity was 99,87%. The sensitivity of determining ventricular complexes was 99,97%, the specificity of determining ventricular complexes was 99,64%. Overdiagnosis of ventricular complexes does not exceed 0,03%.

Conclusion. The Medicom-combi complex for daily monitoring of ECG and blood pressure, designed for long-term ECG monitoring, has sufficient sensitivity and specificity for analyzing Holter ECG recordings, as well as identifying ventricular ectopic complexes.

Aim. To identify the relationship between the nutritional status of patients suffering from chronic heart failure (CHF) and their clinical condition.

Materials and methods. The study involved 298 people: 115 men and 183 women (the average age was 61 years). After body composition assessment, the patients were divided into 5 groups: group 1 – reduced weight + sarcopenia (n=45); group 2 – normal weight + sarcopenia (n=79); group 3 – normal weight without sarcopenia (n=49); 4th group – obesity + sarcopenia (n=72); group 5 – obesity without sarcopenia (n=53). The clinical condition of patients in the study groups was assessed with the determination of functional class (FC), ejection fraction (EF), and the analysis of laboratory parameters such as C-reactive protein (CRP), N-terminal natriuretic propeptide B-type (NT-proBNP) and galectin‑3 was carried out.

Results. The most unfavorable course of CHF was determined in patients with reduced body weight and sarcopenia. Thus, in group 1, FC IV was more common than in others (42.2%), FC II was not determined at all. The EF values were the lowest and amounted to 27–36%. The least severe course of CHF was observed in patients with normal body weight without sarcopenia. FC II was more common in group 3 (67.3%). At the same time, the EF was reduced or intermediate. In the obese groups, the course of the disease was less favorable than in the group with normal body composition. However, it is better than in patients with sarcopenia alone. In groups 4 (47.2%) and 5 (52.8%), FC III was more common, and the values of the EF exceeded 50%.

Conclusion. Changes in the body composition of patients suffering from CHF are definitely associated with the severity of the disease and relate to unfavorable prognostic factors. To choose the most effective treatment tactics for patients, it is necessary to identify the clinical phenotypes of CHF with an assessment of the components of body composition.

The teaching profession is accompanied by risk factors for cardiovascular diseases. The lifestyle of teachers is characterized by low physical activity, skipping meals, and low dietary diversity. Teachers are affected by chronic emotional stress. Stress can lead to narrowing of the arteries, promote intravascular inflammation, increase blood clotting, and may increase the risk of myocardial infarction, stroke, and sudden death. Research indicates the widespread prevalence of diseases of the cardiovascular system among teachers and, first of all, arterial hypertension. The study showed that teachers in a stressful situation were 3.027 times more at risk of developing hypertension. There is low awareness among teachers about their existing diseases and risk factors for cardiovascular diseases. Professional stress in the workplace of teachers requires control and regulation. It is necessary to inform teachers about the importance of a healthy lifestyle.

The article deals with the problem of diagnosis of pulmonary arterial hypertension (PAH) in systemic connective tissue diseases. PAH is characterized by a progressive increase in pulmonary vascular resistance, which leads to the development of right ventricular heart failure and premature death of patients. The features of the management of patients with PAH associated with systemic connective tissue diseases in real clinical practice are presented. A clinical case is presented. The importance of early diagnosis, careful differential diagnosis and its verification using invasive methods for assessing central hemodynamics is noted. Early initiation of the initial pathogenetic combination therapy based on a comprehensive assessment of the risk of mortality and disease progression can improve not only clinical symptoms, exercise tolerance, indicators of biochemical markers, but also slow down the progression of the disease, is the key to improving the prognosis in patients with PAH. Comprehensive management of patients by a team of cardiologist and rheumatologist allows improving the volume and quality of medical care, taking into account the individual characteristics of the patient, and applying a personalized approach to therapy.

Effective treatment of leukemia in children has improved both the five-year and long-term survival of patients. An increase in life expectancy requires an assessment of the long-term effects of treatment. The use of antitumor drugs such as mercaptopurin, methotrexate, tyrosine kinase inhibitors, as well as glucocorticosteroids often negatively affect the musculoskeletal system, including bone mineralization, which can lead to fractures, necrosis, arthropathy and other lesions of the musculoskeletal system, Side effects of anticancer drugs, glucocorticosteroids on bone tissue are especially important in childhood, when the skeleton is being formed and their long-term negative effect on the musculoskeletal system is no less important. The assessment of long-term consequences will make it possible to develop timely preventive measures. KEYWORDS: bone tissue, antitumor therapy, leukemia, long-term effects of treatment.

Introduction. Infiltrative pulmonary tuberculosis is a localized form of tuberculosis, in some cases preceding more common and prognostically unfavorable forms of tuberculosis. With this disease, there are no absolute specific signs in the clinical and radiological picture, which makes differential diagnosis difficult. Thus, the time to verify the diagnosis is lengthened, which leads to the development of complications. Bronchial tuberculosis is a specific inflammatory lesion of the bronchial wall caused by M. tuberculosis and usually complicating the course of tuberculosis of the intrathoracic lymph nodes (TIHLN) and lungs [1]. As an independent form, this disease is rare. More often it is complicated by the course of destructive forms of pulmonary tuberculosis, tuberculous bronchoadenitis and primary tuberculosis complex.

Target. To analyze a clinical case of a complicated form of pulmonary tuberculosis in a child.

Materials and methods. The article used an analytical method based on data copied from the medical record of a child who was being treated at the Republican Clinical Tuberculosis Hospital (RKTB MZ UR). Results. Adequately prescribed therapy helped prevent further progression of the disease.

Conclusion. The clinical example presented in the article is one of the confirmations that planned annual diagnostic measures still remain relevant for the timely diagnosis of various diseases.