The article is a detailed review of current views on the incidence, causes and role of exacerbations in the progression of COPD, and the role of bacterial infection in exacerbations of the disease. Primary and secondary preventive actions are described. Antibacterial treatment approaches in patients with acute exacerbations of COPD are analyzed.

The incidence of influenza and other acute respiratory infections in the Russian Federation remains high. Meanwhile, the economic burden of seasonal flu reaches 100 billion roubles per year, which is about 85% of the cost of all infectious diseases. In most cases, the progression of flu is favourable ending in 2-5 days with a good outcome. The most dangerous complications that threaten the life of patient are primarily various respiratory disorders and systemic inflammatory response syndrome. Flu therapy should take into account possible worsening of symptoms, risk of complications and serious disorders in the vital organs. The main objectives of pathogenetic therapy of influenza in the early stages of the disease are: 1) recovery of the enzymatic activity of proteins and consequently of all physiological processes which became impaired by excessive temperature rise; 2) limitation of the local inflammatory response through timely intake of anti-inflammatory drugs; 3) antioxidant protection against reactive oxygen intermediates produced in large quantities in the area of inflammation.

Interview with PhD in medicine, assistant professor of the department of medical and social assessment and polyclinical therapy of the First Moscow State Medical University named after I.M. Sechenov N.I. Lapidus, MD, professor of otorhinolaryngology of the Russian Medical Academy of Postgraduate Education E.V. Nosulya, and PhD in medicine, senior researcher at the Laboratory of functional and ultrasonic research methods of the Scientific Research Institute of Pulmonology, Federal Medical and Biological Agency of Russia, S.Y. Chikin

Community-acquired pneumonia is one of the most common infectious diseases in developed countries. Chronic heart failure is an independent risk factor for unfavorable course and prognosis of community-acquired pneumonia. Objective challenges of clinical, radiological, laboratory and microbiological diagnosis of community-acquired pneumonia in elderly patients with chronic heart failure dictate the need for a greater number of physicians to routinely examine for serum biomarkers of inflammation. Systemic antibiotic therapy for the category of patients is carried out in accordance with the standard guidelines and should be based on certain peculiarities of the etiology, impact of concomitant functional impairment of the organ systems and additional medication therapy on the pharmacokinetics of antimicrobial agents, and take into account the risk of potentiation of adverse reactions as a result of administration of drugs.

Administration of β-blockers in patients with cardiovascular pathology combined with obstructive bronchial or pulmonary disease (bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD)) is associated with a risk of bronchospasm in a number of patients. No test has been developed so far to identify such patients. We recommend to carry out a 4-hour bronchial provocation test with a small dose of beta 1 selective β-blocker bisoprolol. The study included 31 patients with BA and COPD with concomitant cardiovascular disease requiring administration of β-blockers. Results of six consecutive spirometry tests, which continued for 4 hours to assess the effect of bisoprolol on airway function, are demonstrated. The maximum reduction in FEV1 after administration of the β-blocker was identified. Spirometry test results were compared in patients with BA and COPD.

Obesity is considered to be a major factor for non-alcoholic fatty liver disease. Approaches for the treatment of obesity are discussed, in particular, the effectiveness of biologically active food supplement Hepaguard Active, a complex containing L-carnitine, is evaluated.

Acid-base disorders today represent a serious problem not only for the population in general, but for every single patient. The term acid-base disorders is used to denote pathological conditions resulting from aggressive action of hydrochloric acid on the mucosa of the upper gastrointestinal tract. Gastroesophageal reflux disease is undoubtedly the leading pathology in this group.

Obesity today is one of the most relevant interdisciplinary problems in healthcare and one of the key reasons for blood pressure increase. Thus, according to the Framingham Heart Study,78% of hypertension in men and 65% in women can be directly attributed to obesity [10]. Fat cells play an important role in the development of hypertension, i.e. they generate a variety of biologically active substances some of which have pressor and proinflammatory effects. Leptin is one of key substances which contributes to the increase of AP through the activation of the sympathetic nervous system and direct effect on kidneys (increased sodium reabsorption). Furthermore, obesity itself adversely affects the structure of renal tissue and increases the risk of progression of renal failure and hypertension. In addition, fatty tissue has its own renin-angiotensin system and may actively produce angiotensin.

Pulmonary hypertension is a group of diseases characterized by progressive increase in pulmonary vascular resistance leading to right ventricular failure and premature mortality. According to various sources, the prevalence of pulmonary hypertension may reach up to 50 per 1,000,000 population. Young females aged 20 to 40 years are the most likely candidates for idiopathic pulmonary hypertension. In men, the disease is less common. The disease has received considerable attention recently: timely and effective diagnosis and treatment of pulmonary hypertension is a relevant issue.

Interview with MD, leading researcher at clinical lipidology laboratory of the atherosclerosis unit, Russian Cardiology Research and Production Complex of the Ministry of Health of the Russian Federation, member of EAS/IAS/NLA/HEARTUK/ACC/AHA//CGAB/IAS Lipid Guidelines Committee/WCCL Advisory Board А.V. Susekov

Angiotensin II receptor blockers (ARBs), or sartans, are a group of pharmaceuticals that modulate the renin-angiotensin-aldosterone system (RAAS). They are more successful in blocking the effects of AT II compared to ACE inhibitors, and are characterized by higher tolerability. Large comparative studies with ARA II were completed lately, including studies on long-term efficacy and impact on prognosis. The obtained evidence base contributed to the expansion of indications for clinical use of sartans in the treatment of arterial hypertension (AH) and comorbid conditions. The action produced by ARBs is not age-dependent, not characterized by escape phenomenon in the context of long-term use; ARBs have implicit organ-protective and pleiotropic properties, and are metabolically neutral compared to other antihypertensive drugs. The available medications belonging to the ARB class have very specific pharmacological and pharmacokinetic properties that determine some of their clinical effects.

Sleep disorder is one of the most common conditions that accompanies functional and organic impairments in humans. According to a number of studies, the overall duration of night's sleep has decreased. For example, in 2005, the length of a night's sleep in 40% of American adults was less than 7 hours, whereas in 1960 the percentage was not higher than 15% [1, 2].

The article tells about current approaches to diagnosis and treatment of the most common causes of vertigo: vertebrobasilar insufficiency, benign paroxysmal positional vertigo, phobic postural vertigo.

The article is devoted to the choice of an effective antiepileptic drug. The most common manifestations of epilepsy are discussed. The authors describe a clinical case of successful treatment of cryptogenic focal epilepsy with complex partial seizures with the help of a classic antiepileptic drug.

Diabetic neuropathy is the most common complication of diabetes mellitus. Among the large number of drugs used as symptomatic therapy to reduce its manifestations, alpha-lipoic acid medications are specific for providing pathogenic effect on many mechanisms of diabetic neuropathy. The article provides an overview of studies on the use of alpha-lipoic acid in the treatment of diabetic neuropathy.

Currently, the use of drugs which can modify metabolic processes in the cartilage attracts increasing attention, primarily because of their high safety profile. The article presents data on the use of combined drugs Theraflex and Theraflex Advance in the treatment of patients with degenerative-dystrophic diseases of the joints and spine.

Self-monitoring of blood glucose is the main tool in the management of diabetes mellitus (DM) utilized by both doctor and patient. On the one hand, self-monitoring of blood glucose is necessary to achieve and maintain adequate glycemic control; on the other hand, it is an invasive and stressful procedure. In order to make self-monitoring of glucose effective, both doctor and patient need to be aware of its relevance, while blood glucose meters should be highly accurate and reproducible, as well as pain-minimizing and user-friendly.

The role of vitamins and minerals during pregnancy is undoubtedly relevant. Treatment of hypovitaminosis during pregnancy significantly improves women's health, reduces signs of toxicosis and incidence of congenital malformations of the fetus. Administration of multivitamin complexes safeguards against anemia, decreases the risk of pregnancy failure and prevents abortion.

Hirsutism, acne, seborrhea and alopecia in women, according to general opinion, are directly attributed to androgenic metabolic disorders. However, androgen-dependent skin lesions represent a heterogeneous group of diseases and include symptoms of various origin associated with various diseases and conditions, not always consisting in the excess production or action of male hormones in the female body. Whatever the cause of androgen-dependent dermopathy, presence of an obvious cosmetic defect causes trauma to the patient. That is why androgen-dependent dermopathy is a relevant issue. The other facet of its relevance lies in the fact that androgen-dependent symptoms may become the first sign of a serious illness, so they need to be considered by all specialists, not only dermatologists. In fact, the problem of androgen-dependent dermopathy is interdisciplinary and a matter of interest for dermatologists, gynecologists, endocrinologists, psychiatrists and general practitioners.

Bacterial vaginosis is an infectious non-inflammatory syndrome characterized by replacement of normal microflora with polymicrobial associations of anaerobes and Gardnerella vaginalis. These microorganisms have the ability to grow on the mucosa, the so-called biofilm. Metrogyl vaginal gel is proposed as a potential remedy for the treatment of bacterial vaginosis.

Contact lenses are a widely used alternative to glasses. However, wearing contact lenses, especially in violation of directions for use, often results in corneal injury. The article tells about the authors' results of use of a new keratoprotector in patients wearing contact lenses and suffering from corneal lesions.

Under the conditions of the current unfavorable demographic situation in Russia, birth of a healthy child becomes one of the most pressing problems. Factors contributing to population decline are quite significant and deeply rooted in the Russian soil.

CIN is most common in women of reproductive age. The current treatment standards for CIN I and/or CIN II are invasive and aggressive, which sometimes leads to a disruption of reproductive function. At the same time, long-term follow-up and non-intervention can result in further progression of the process. Therefore the search for conservative treatment of CIN I-II remains a challenging task. We conducted a multicenter, randomized, placebo-controlled, double-blind, parallel group study which showed that administration of Cervicon-DIM vaginal suppositories for 90 days at a dose of 200 mg/day or 100 mg/day is associated with improved histological condition of CIN I-II and even leads to cure.