Introduction. Arterial hypertension (AH) is the most common chronic non-communicable disease, especially among individuals over 60 years old, where its prevalence exceeds 60%. The relationship between blood pressure (BP) levels and the risk of cardiovascular events is observed across all age groups. The aim of the study was to assess the adequacy of antihypertensive therapy in outpatient multimorbid patients of different age groups.
Materials and methods. The study included 323 outpatient patients with verified AH (92 men and 231 women). Patients were divided into three age groups: middle-aged, elderly, and old age. The frequency of achieving target BP levels, the structure of antihypertensive therapy, and the prescription of lipid-lowering and antiplatelet agents were evaluated.
Results. The severity of AH did not differ between the groups. In the elderly groups, patients with high cardiovascular risk and comorbidities such as type 2 diabetes and osteoarthritis predominated. The most frequently prescribed medications were inhibitors of the renin-angiotensin-aldosterone system (94.1%). Target BP levels were mainly achieved due to systolic pressure (60%), while diastolic pressure was only controlled in 22% of cases.
Discussion. The results are consistent with previous studies.
Conclusion. AH in elderly patients is associated with high comorbidity and cardiovascular risk. Achieving target BP levels is possible with combination therapy, including renin-angiotensin-aldosterone system blockers and calcium antagonists. Additional treatment strategies are needed to reduce the residual risk of cardiovascular diseases.

The aim of the study — to find the features of the history, symptoms, laboratory and ultrasound data in patients with different stages and localization of endometriosis.
Materials and methods. This retrospective controlled study included 99 patients with different stages according to the rASRM and localization of endometriosis who were divided into 3 groups: A1 (n = 34) — women with deep infiltrating endometriosis (DIE); A2 (n = 17) — with stages III–IV endometriosis without infiltration; B (n = 48) — with stages I–II ovarian endometriosis (OMA).
Results. The severity of pain according to the visual analogue scale was 4 [3; 6]: A1 — 5.00 [4.00; 6.75]; A2 — 6.00 [4.00; 7.00]; B — 4.00 [2.00; 5.50] (p = 0.050). The duration of the symptoms of endometriosis was 8 [3; 36] months: A1–12 [6; 36]; A2 — 24 [7; 60]; B — 6 [1;24] (p = 0.010). According to the transvaginal ultrasound enlargement of the adnexa was found in 86/99 patients: A1 — 27/34; A2 — 11/17; B — 48/48 patients (p = 0.009). Intraoperatively adhesions were found in 86/99 patients: A1 & A2 — 48/51; B — 38/48 patients (p = 0.028).
Conclusion. Women with DIE and stages III–IV endometriosis have a more severe chronic pelvic pain than women with stages I–II OMA. The severity of pain has no connection with the presence of intrapelvic adhesions. Adhesions of the pelvic organs are more often found in women with stages III–IV endometriosis. Transvaginal ultrasound is an effective imaging method for diagnosing OMA and DIE.

The relevance of the problem. Late diagnosis of gonarthritis (GA) based on radiological criteria determines a decrease in the effectiveness of chondroprotective drugs (CD).
The aim is to identify early changes in the hyaline cartilage of the knee joints and evaluate the effectiveness of chondroprotective therapy at an early stage of the disease.
Materials and methods. 186 patients with high risk of GA were examined. All patients signed an informed consent. 119 patients took CD for two years, 67 patients did not receive therapy. The control group consisted of 31 healthy people without GA risk factors. Initially and 2 years later, everyone underwent ultrasound examination of the knees. The dynamics of the minimum thickness of hyaline cartilage (HC) was evaluated.
Results. After 2 years, the HC height in the control group decreased to (2.84±0.16) mm and had no statistically significant differences from the initial value. In the comparison group in which patients did not take CD, HC decreased by (0.24±0.15) mm, which is 2.7 times more than in the group of patients receiving CD and 4.8 times more than in the control group (p = 0.01). In the group receiving CD, the minimum thickness of HC decreased by (0.09±0.12) mm and was comparable with the indicators of the control group (p = 0.49).
Conclusions. In patients at high risk of GA, an initially low minimum cartilage thickness is determined, and its intensive loss is noted, compared with the control. The use of CD in patients at high risk of GA prevents the loss of HC at an early preclinical stage.

Introduction. Rosacea is a chronic inflammatory dermatosis primarily affecting the central facial skin. The localization of lesions on visible areas significantly worsens patients’ quality of life, leading to psychosomatic disorders. Endothelial dysfunction plays a key role in the pathophysiology of rosacea, contributing to inflammation, persistent capillary dilation, and vascular hyperreactivity.
Purpose of the work — to evaluate endothelial function and hemostatic system parameters in patients with erythematotelangiectatic rosacea (ETR) and papulopustular rosacea (PPR).
Materials and methods. 60 patients (30 (50 %) — ETR; 30 (50 %) — PPR) were examined, including 44 (73.33 %) women and 16 (26.67 %) men, with a mean age of (40.24±2.25) years and an average disease duration of (3.55±1.20) years. The control group consisted of 30 healthy individuals, including 17 (56.67 %) women and 13 (43.33 %) men, aged 26–55 years (mean age (38.10±1.26) years). Vascular wall and microcirculation assessments were performed using photoplethysmography (AngioScan‑01P). Hemostasis was analyzed with a “Thrombodynamics Analyzer T‑2” (LLC “GemaKor”) simulating physiological blood coagulation conditions.
Results. Endothelial dysfunction was identified in rosacea patients, more pronounced in PPR, manifesting as increased vascular biological age and stiffness (p < 0.050). Initial clot formation rate and clot density were significantly higher in PPR patients (p = 0.031 and p = 0.014).
Discussion. Comparative analysis of photoplethysmography and thrombodynamics data confirmed endothelial dysfunction and microcirculatory disturbances in both rosacea subtypes, more pronounced in PPR, highlighting their role in disease pathogenesis.
Conclusion. ETR and PPR are associated with structural and functional vascular abnormalities, microcirculatory disturbances, hypercoagulation, and an elevated risk of thrombosis.

Introduction. Chronic heart failure (CHF) leads to a steady deterioration in the quality of life (QOL) and a decrease in exercise tolerance of patients. Numerous studies have confirmed the role of increased heart rate in worsening the prognosis of CHF — heart rate more than 75 bpm needs reduction to optimize the clinical status of patients.
The purpose of the study is to analyze the effect of heart rate on QOL and exercise tolerance in patients with CHF with a low left ventricular ejection fraction.
Materials and methods. A prospective comparative study was conducted. 80 patients (54 men and 26 women, verage age — (66.3±7.9) years) with postinfarction cardiosclerosis and sinus rhythm, with CHF II–III NYHA functional classes with an ejection fraction less than 40 % were examined.
Results. Significantly better QOL indicators were noted in patients with heart rate 60–69 bpm. The lowest indicators of functional activity were noted at 55–59 bpm, and socio-psychological activity at 70–75 bpm. Exercise tolerance is higher in patients with a heart rate of 60–69 bpm, its lowest rates were noted at 70–75 bpm.
Discussion. The optimal heart rate range determination in patients with postinfarction cardiosclerosis and CHF allows targeted titration of the β-blocker dosage, achieving an improvement in QOL and the clinical and functional status of patients.
Conclusion. In patients with CHF careful selection of β-blockers and ivabradine therapy demonstrates the most optimal indicators of physical activity and QOL with a heart rate of 60–64 bpm and 65–69 bpm.

Introduction. The problem of chronic kidney disease (CKD) in children is relevant. Studying the structure of kidney diseases is important for developing prevention.
Purpose — To analyze the structure of pathology in children at a nephrologist’s appointment at different age periods, to provide a comparative assessment with the incidence rates and established disability due to kidney disease in children in Russia and in the subjects of the Ural Federal District.
Materials and methods. Analysis of child morbidity in the class of “Diseases of the genitourinary system”, disability of the child population and report of a nephrologist of the Children’s City Hospital No. 8 (Ekaterinburg).
Results. The decrease in the incidence in the group “Glomerular, tubulointerstitial kidney diseases, other kidney and ureter diseases” contradicts the growth of “Renal failure”. 70 % of visits to a nephrologist are due to microbial inflammatory diseases, with the peak at 5–9 years, at an early age urodynamic and dysplastic diseases predominate.
Discussion. The nephrourological diseases associated with developmental anomalies leads to CKD in 42.5 %. In Russia 30.1 % congenital anomalies increased in children of the first year, with a proportion of urinary system defects of 25–50 %, indicates an increase their, worsening the prognosis of nephrourological diseases.
Conclusions. The decrease of urinary system diseases, according to official statistics, doesn’t reflect the problem of CKD in children. We need to identify the period of early age and register urinary system anomalies in the forms of official statistical observation.

Introduction. The priority in preserving and maintaining the health of the nation is the protection of the reproductive health (RH) of citizens, the formation of favorable conditions for starting a family and having children.
The purpose of the study is to identify the attitude of students during higher education towards reproductive health and childbearing.
Materials and methods. The study was conducted among 1 419 students (306 men (21,6 %) and 1 113 women (78,4 %)) by anonymous questioning. The work uses the sociological method, the method of descriptive statistics.
Results and discussion. 639/1 419 (45,0) %) of the students noted the presence of chronic diseases. The respondents’ positive focus on improving their health was revealed (1 391/1 419 (98,0 %)) mainly through sports, weight control, etc. Among the respondents who had sexual relations (960/1 419 (67,7 %), 720/960 (75,0 %) people are aware of the ways of safe sexual behavior and use them in life, which prevents the risk of sexually transmitted infections (STIs). It has been established that the majority of people plan to start their families between the ages of 24 and 27; prior to starting a family, it is essential for 951/1 419 (67,0 %) students to gain self-sufficiency. 809/1 419 (57,0 %) of the respondents want to have two children. The Internet is a popular source of information on RH issues among young people. It is important to develop and implement educational programs to conduct educational seminars aimed at gaining knowledge about RH and STI prevention.
Conclusions. Most of the students take care of their health, have a positive attitude towards starting a family and childbearing.

Introduction. Delay in calling an ambulance is one of the main factors for late admission of a stroke patient to the hospital. It is important to define the target groups for information campaigns, as well as the main causes for ambulance calling delay.
The aim of the study — to determine factors associated with the prolonged time of ambulance calling in stroke patients in Moscow for target information materials development.
Materials and methods. We prospectively included 152 patients with stroke. Patients or their accompanying persons were surveyed to obtain the information about the circumstances of calling the ambulance.
Results. In 89.5 % of cases, the ambulance was called by people who found the patient with a stroke or were nearby at the time of stroke onset. The longest time between the symptoms detection and the ambulance call were observed when the call was made by the patient him/herself (10.00 [3.75; 23.88] h). The fastest calls were from colleagues at work or passers-by in public places (11 [5; 20] min). Time delay inversely correlated with NIHSS score (rS = –303; p < 0.0005). In patients with NIHSS ≤5, the time from symptom detection to ambulance calling was 1,75 [0,25; 11,00] h, while in patients with NIHSS >5 this time was 0,20 [0,08; 3,00] h (p < 0.001).
Conclusion. The ambulance was most often called by witnesses of stroke onset, and not by the patient him/herself. One of the key factors associated with the prolonged time interval of calling an ambulance was the severity of the neurological deficit.

Background. Recent studies emphasize the heterogeneity of cryptogenic ischemic stroke (IS), highlighting the importance of identifying clinical and genetic risk factors.
Objective. This study explores the associations between genetic markers affecting spontaneous and induced platelet aggregation (PA) and clinical parameters in patients with unspecified IS according to TOAST criteria, aiming to uncover potential risk factors and understand the disease’s pathogenetic mechanisms.
Materials and methods. The study included 196 patients diagnosed with unspecified ischemic stroke. We examined the associations of various gene polymorphisms (ITGB3, GPIba, TBXA2R, ITGA2, PLA2G7, HMOX1, PTGS1, PTGS2, ADRA2A, ABCB1, PEAR1) with clinical and laboratory parameters.
Results. The G/G rs1062535 ITGA2 genotype was linked to significantly lower spontaneous aggregation rates than the G/A+A/A genotypes. Patients with the C/C PLA2G7 genotype had a significantly lower spontaneous aggregation level (SA %) compared to T/C+T/T genotypes (p = 0.041). The C/C genotype rs4523 TBXA2R showed a significantly lower ADP-induced PA rate compared to C/T+T/T (p < 0.050). Similarly, those with the C/C genotype rs5918 ITGB3 had significantly lower adrenaline-induced PA rates compared to T/T+T/C. Conversely, patients with the A/A genotype rs1062535 ITGA2 exhibited significantly higher ristomycin-induced AT rates than G/G+G/A genotypes.
Conclusion. The G/A+A/A ITGA2, T/C+T/T PLA2G7, C/T+T/T TBXA2R, and A/A ITGA2 genotypes may serve as potential markers for the course of unspecified ischemic stroke.

Introduction. In developed countries, there is a trend towards a decrease in the prevalence of H. Pylori associated gastritis, which leads to an increase in the relative frequency of chronic autoimmune gastritis in the structure of gastric lesions in biopsy material. The observed trends, as well as the presumed underdiagnosis of autoimmune gastritis in the Russian Federation make it relevant to discuss the principles of diagnostics of this disease.
Objective. Provide current data on the criteria for morphological diagnosis of chronic autoimmune gastritis.
Materials and methods. Data on the problem were searched in the databases of scientific publications PubMed, Web of Science, Scopus, eLibrary.ru. The depth of the scientific search was 175 years (1849–2024).
Results and discussion. The diagnosis of autoimmune gastritis is reduced to endoscopic examination with biopsy sampling according to the OLGA/Modified Sydney System diagnostic protocol (antral, incisura anglularis and body of the stomach). At the same time serological methods (detection of specific antibodies) do not always allow to confirm or refute the diagnosis, due to the existence of seronegative variant of the disease, which determines the primary role of morphological examination. The publication discusses the differential diagnosis of different stages of autoimmune gastritis with other types of chronic gastritis.
Conclusion. Chronic autoimmune gastritis is a diagnosis that involves a gastroenterologist, endoscopist, and pathologist. The leading role of morphological methods in the diagnosis of chronic autoimmune gastritis is determined and substantiated.

Introduction. Typical diabetic sensorimotor polyneuropathy is one of the complications of diabetes mellitus, occurring in 50 % of patients with this pathology. Diabetic neuropathy as a complication of diabetes mellitus requires additional drug correction in order to improve the quality of life.
The aim of the work is to study modern approaches and the effectiveness of pharmacological correction of diabetic polyneuropathy based on scientific literature data over the past 10 years. Materials and methods. Analysis and systematization of scientific publications posted in the PubMed, Scopus, Web of Science databases for 2014–2023.
Results and discussion. The work presents the clinical characteristics of typical diabetic polyneuropathy. Particular emphasis is placed on pharmacological correction and consideration of most classes of drugs that can relieve pain. Treatment tactics are built not only on relieving the main symptoms, but also on eliminating the pathophysiological component of the disease. However, treatment is based not only on symptomatic therapy, but also on the elimination of pathogenetic links of this pathology.
Conclusion. Diabetic polyneuropathy is a formidable complication in people suffering from diabetes mellitus. The main goal of treatment is to relieve pain and prevent the development of complications. Correction is provided by a wide range of pharmacological drugs.

Together with (physical and mental) exercise, diet, and social activities, sleep is a key health behavior that occupies one third of our lives, yet remains neglected. In the first part of this review, we present the current knowledge on how sleep promotes body, brain, mental, occupational, and social health as well as creativity, productivity, and well-being. In the second part, we discuss how good sleep and screening for sleep–wake disorders may improve health and reduce the burden of brain, mental, cardiovascular, metabolic disorders and cancer. We also review the literature on measurements of sleep health and present the Bernese Sleep Health Questionnaire, a new and simple tool to assess sleep health and screen for sleep–wake circadian disorders in clinical practice.