The article discusses the relationship between risk factors and clinical manifestations of cardiovascular disease and periodontitis.

As is known, the most common disease in the world is acute rhinitis which in turn is caused by acute respiratory infection. Currently, there are over 200 strains of ARI and flu viruses which belong to different groups (parainfluenza, adenovirus, rhinovirus, respiratory syncytial virus (RS), etc. [1, 4, 7] At the same time, there is a certain affinity of respiratory viruses to the affected areas: rhinovirus, which constitutes about 100 strains, is the most common cause of rhinitis. On average, adults suffer from ARVI 2--4 times, and children 3--8 times per year. [6, 7].

Acute sinusitis (AS) continues to be a challenge in the present-day otorhinolaryngology, occupying a leading place in the structure of inflammatory diseases of the upper respiratory tract. Thus, patients with sinus disorders account for 15 to 36% of all patients at ENT units. The crucial aspect in the treatment of acute sinusitis is achieving persistent bactericidal concentration of antibiotic resulting in the desired eradication of the bacteria.

Chronic obstructive pulmonary disease is a leading cause of morbidity and mortality occupying the third place in the list. [31] More than 90% of patients with the established diagnosis receive no treatment under the current guidelines. [38, 9] The vital task is to develop and implement efficient algorithms for diagnosis and treatment of the pathology in line with the current understanding of the most effective methods of treatment of COPD, as well as ease of their clinical use for pulmonologists as well as for physicians, general practitioners, etc.

The relevance of ATP is explained by its high prevalence. In addition, the danger of ATP is conditioned by complications that may lead to disability as well as death of patient. The article tells about the current etiologies of acute tonsillopharyngitis. The most effective ways of diagnosing and treating tonsillopharyngitis are studied and compared. The article analyzes tonsillitis classifications in Russia and abroad, and approaches to the treatment of the nosology.

In the article "Antithrombotic therapy in atrial fibrillation: new oral anticoagulants" (Meditsinskiy Sovet, 2014, P. 38--48), the focus was on direct thrombin inhibitors and factor Xa inhibitors. This is quite justified. Currently, there is no doubt that direct oral anticoagulation (AC) for the prevention of thromboembolic events (TE) in general and in particular for ischemic stroke in patients with atrial fibrillation (AF) has a number of significant advantages over the "ancient" vitamin K antagonists. They are well known and listed in the latest Russian guidelines for the treatment of AF. These advantages include comparable efficacy in the prevention of stroke and TE with greater safety against the risk of "large" hemorrhage, particularly hemorrhagic stroke; a trend towards lower mortality; fewer interactions with other drugs and foods; no need for continuous monitoring of blood coagulation parameters. However, no one doubts that in the long-term, we will have to use the old, indirect oral AC, if only because of their low cost compared to the new drugs. However, this is not the only reason why we cannot give up the old ones in the near future. For example, new oral AC can be used only in non-valvular AF. Vitamin K antagonists as supported by stronger evidence base, should be preferred in the treatment of cancer patients. The new oral AC, definitely, "are offensive on all fronts." It is already possible to have cardioversion of AF of 48 or more hours against a background of their administration, and interventional treatment of AF is an option in the near future. In a little while, antidotes to direct oral AC will appear. But patients need treatment right now, today. Therefore, we should not forget how to use the "old" drugs.

Angina is a clinical syndrome characterized by pain, discomfort or pressure in the chest, more often behind the chest, which sometimes radiates to the neck, jaw, left shoulder blade, or arm. These sensations may occur under load (acceleration of the pace of walking, climbing stairs, psycho-emotional stress), rise in blood pressure (BP) (in this case, non-threatening cardialgia or true angina may take place). In cold windy season, angina may occur at leaving a warm room for the street. The true incidence of angina is unknown, but according to various epidemiological studies, it is found in 6--16% of men and 3-10% of women aged 65--74 years.

The article discusses the problem of using calcium antagonists in clinical practice. Taking into account the current guidelines, the place of calcium antagonists in the treatment of major cardiovascular diseases was defined: hypertension, coronary artery disease, supraventricular arrhythmias, etc. Clinical trials are described which provided the evidence base for the use of calcium antagonists. The feasibility of long-acting calcium channel blockers which represent an optimum combination of efficiency and safety is emphasized. The results of clinical trials evaluating the efficacy of diltiazem for the treatment of patients with cardiovascular diseases are discussed.

Asthenic conditions are the subject of interdisciplinary research as they belong to the most widespread disorders in practical nervous and internal medicine. In clinical practice, the most common complaints associated with decreased activity are tiredness and fatigue - non-specific symptoms that accompany various diseases or physiological condition that occurs after excessive load. Typically, fatigue is a transient symptom occurring usually after an excessive load, which ceases spontaneously without any treatment or after rest. Fatigue that occurs against a background of mental or physical load which is common for the perso,n and which persists after rest, is called "asthenia". Translated from Greek, this means "impotence", "lack of power", "weakness".

Medication-induced headache (MIH) is one of the most common forms of chronic headache (HA), management of patients with MIH remains an urgent problem of the modern healthcare. MIH is defined as HA lasting for more than 15 days per month for over 3 months against a background of excessive use of drugs for relief of HA. Epidemiological data, current diagnostic criteria, risk factors, pathophysiology and treatment of MIH are described. Risks and causes of recurrence, and prognosis of the disease are described. The only effective strategy for the management of patients is withdrawal of the drug that caused MIH. For the purpose of managing MIH and its different symptoms, a variety of symptomatic drugs with the exception of the class of drugs that caused MIH may be prescribed. The focus is on Excedrin - a combination analgesic which proved effective in the acute phase of drug withdrawal. For most patients, detoxification and preventive therapy on an outpatient basis may be feasible. An important role belongs to educational programs devoted to the aspects of MIH formation and transformation of HA to chronic.

Doctors in all specialties are visited by patients complaining of sleep disorders of various nature: dissatisfaction with the night's sleep, daytime sleepiness, insomnia, and movement during sleep. As a result of these disorders, reduced period of sleep increases the risk of hypertension, diabetes and infectious diseases, and decreases life expectancy. In doctor's practice, the most common are insomnia, respiratory and movement disorders during sleep, behavior-based sleep deprivation. Successful management of the disorders significantly affects the overall condition of patients, their emotional state and the course of chronic diseases, allowing them to lead normal life and stay socially active.

The role and relevance of therapist and general practitioner in the diagnosis and management of patients with non-alcoholic fatty liver disease (NAFLD) is increasing. Understanding the multifactorial nature of NAFLD and formation mechanisms of the associated polymorbidity could help to adequately assess the prognosis of the disease and provide appropriate medical and dietary advice at the stage of primary health care.

Proton pump inhibitors (PPI) were successfully used for the treatment of acid-base disorders, in particular GERD, for the past 20 years. However, approximately 30% of patients with gastroesophageal reflux disease (GERD) do not adequately respond to standard PPI therapy due to the impact of many factors: patient-specific PPI metabolism in the liver, concomitant pathology of the digestive system, pharmacokinetic properties of traditional dosage forms of PPI. Persistence of GERD symptoms is particularly explained by the fact that the use of conventional single release PPI does not allow to fully control the cyrcadian rhythm of gastric secretion and should be taken twice a day before a meal, which has a negative effect on adherence. Thanks to dual delayed-release and longer presence in blood, dexlansoprazole MR showed high efficacy in the treatment and maintaining remission of various forms of GERD, as well as greater adherence to treatment.

A complex of clinical symptoms which develop as a result of motor and tonic dysfunction of gallbladder (GB), bile duct and sphincter, is called "functional disorder of the biliary tract".

Proton pump inhibitors (PPI) are currently the most effective class of antisecretory drugs widely used in the treatment of non-ulcer dyspepsia, reflux esophagitis and GERD, peptic ulcer disease and H. pilory infection, as well as NSAID-associated gastric lesions. Despite the common mechanism of action and pharmacological effects of this class of drugs, there is clinical inter-individual variability of their effect on acid production determined by pharmacokinetic and pharmacogenetic factors. As a result, the clinical efficacy of treatment of acid-base disorders and eradication of H. pilory is decreased.

At present, penile erection is defined as a neurovascular event associated with hormonal control and arterial dilatation, that depends upon relaxation of trabecular smooth muscle and activation of corporal veno-occlusive mechanism. There is a growing understanding that ED should not be regarded as a disease but a symptom of vascular trouble. ED factors are similar to those for cardiovascular diseases. ED may be an early manifestation of coronary artery or peripheral vascular disease, and should be regarded as a marker of cardiovascular pathology. Thus, men with mild ED should be examined for the risk of cardiovascular disease. The article describes three lines of ED treatment. Causes of failure of PDE-5 are considered. The new sildenafil generic Erexesil® is noted for high efficacy (fully bioequivalent to the original drug), European quality and low cost.

Pathology of bone homeostasis in diabetes mellitus (DM) is a significant problem that must be considered when selecting anti-diabetic therapy. Many anti-diabetic drugs have a specific effect on bone homeostasis which should be taken into account when selecting treatment for type 2 diabetes, especially in patients at high risk of osteoporosis. This review discusses mechanisms of impact on bone metabolism and fracture risks of DM and various groups of antidiabetic drugs, focusing on new groups of drugs included in the Russian algorithms over the past decade (GLP-1 receptor agonists, DPP-4 inhibitors, sodium-glucose cotransporter 2 inhibitors). It can be useful to both researchers and clinicians who are striving to offer the therapy of choice to their patients today.

The study of the prevalence of different types of diabetes mellitus (DM) is essential for choosing the right treatment for this group of patients. Among 56 patients presented with diabetes, 16% were diagnosed with diabetes type 1, 37.5% with diabetes type 2, 18% with diabetes against a background of chronic pancreatitis, and 28.5% with gestational DM. The characteristic features of diabetes type 1 and 2, pancreatogenic diabetes and relevant risk factor for gestational diabetes were identified. At the onset, the majority of patients demonstrated classic signs of the disease. Patients with diabetes mellitus type 1 differed by more significant changes in carbohydrate metabolism both according to HbA1c testing and individual measurement of glucose level with the help of modern, high-quality and easy-to-handle glucose meters. For most patients, the onset of any type of diabetes was characterized by a lipid metabolism disorder. Abdominal obesity and blood glucose levels in diagnosing diabetes mellitus are closely related to the level of C-peptide.

Deficiencies of micronutrient status during pregnancy may result in disruption in fetal development, malformations, premature birth, low birth weight, as well as a higher incidence of alimentary-dependent diseases in infants. Timely detection and management of micronutrient deficiencies when planning and throughout pregnancy are key for the successful course of pregnancy, adequate fetal development and postnatal growth of the infant. The authors discuss indications and methods for managing vitamin and mineral deficiencies in pregnant and lactating women, composition and benefits of various drugs and specialty foods.

High incidence of recurring aerobic/nonspecific vaginitis is associated with the formation of stable pathological biofilm. The increasing antibiotic resistance does not allow to eliminate associations of conditionally pathogenic microorganisms and inhibits the growth of lactobacilli. Vaginal use of bacteriophages is a targeted antibiotic therapy. The study showed that multivalent bacteriophage (Sextaphage®) used as vaginal monotherapy is comparable with antibiotic in terms of treatment efficacy of aerobic vaginitis, does not reduce the level of lactobacilli and has a high compliance.

The article tells about the results of the most challenging studies and prospects for LNG-IUS in gynecology. The quality of life of women using LNG-IUS is evaluated. The use of LNG-IUS increases both physical and psychological well-being of women.

The article tells about a four-year experience of performing venous ultrasound to evaluate blood flow in 12,394 hospitalized and ambulatory patients with acute venous pathology at the Central Clinical Hospital of the Russian Academy of Sciences. Sufficient clinical data provides the basis for the methodology of primary and dynamic ultrasound studies in patients undergoing conservative treatment of venous thrombosis and different types of surgical prevention of pulmonary embolism. Particular attention is paid to the interpretation of ultrasound results in terms of the probability of pulmonary embolism. The results of the application of the proposed methodology were evaluated in practice at the multidisciplinary emergency care hospital and at the medical and diagnostic center.

There is data on the pathogenetic links between iron deficiency and systemic inflammation associated with obesity. In chronic inflammation in obese patients, a mechanism of iron sequestration becomes activated primarily by macrophage and adipose tissue cells. The efficiency of iron absorption from food, its uptake by erythroid cells and heme synthesis are decreased. Excessive accumulation of iron in fat cells induces oxidative and endoplasmic stress and production of proinflammatory cytokines, thus affecting the key pathogenetic links of obesity and exacerbating the condition. There is clinical evidence suggesting better iron metabolism parameters and decreased serum hepcidin in patients who lost weight after bariatric surgery. The findings related to the incidence and pathogenic form of anemia (iron deficiency or anemia of chronic disease) after bariatric surgery are heterogenous.

Cervical intraepithelial neoplasia (CIN) is atypical transformation of squamos epithelium without stromal invasion predictive of cervical cancer. According to the World Health Organization (2014), there is mild cervical epithelial neoplasia (CIN I; mild dysplasia; flat warts; koilocytosis; koilocytic atypia) and moderate and severe cervical epithelial neoplasia (CIN II-III; moderate and severe dysplasia, epithelial carcinoma in situ). [45].