Gamma-glutamyltranspeptidase (GGTP), isolated from a variety of sources from microorganisms to mammals, including human blood and organs, has been studied sufficiently detailed, which allowed to take a fresh look at the role of this enzyme in cellular metabolism, the pathogenesis of several diseases and its application in clinical medicine. Evidences in favor of use of GGTP as reliable marker to forecast cardiovascular diseases, and complications of type 2 diabetes of a metabolic syndrome are accumulated. 

The article provides literature review on the subject: chronic obstructive pulmonary disease: pathogenesis, principles of treatment, the course of heart failure in elderly people with comorbide pathology (chronic obstructive pulmonary disease and cardio-vascular diseases). Role of NT-pro BNP as marker of heart failure in patients with chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD) was analyzed. Influence в-blockers and m-anticholinergic drug on cardiovascular system, and possibility of reception of β-blockers at people with COPD and HF was studied. 

Literature review is devoted to the pathogenesis of atherosclerosis and pathogenetic mechanisms that determine the value of peroxisome proliferator-activated receptor (PPAR) in atherogenesis. PPAR α and ϒ-2 are nuclear receptors that regulate lipid and glucose metabolism, and immune inflammation in the vascular wall and play a significant role in the pathogenesis of atherosclerosis. Thiazolidindiones, fibrates, ω-3 polyunsaturated fatty acids, statins, and aleglitezar, affecting PPAR α and ϒ-2 can prevent development and progression of atherosclerosis and may be used for primary and secondary prophylaxis of atherosclerosis.

Acquired myasthenia gravis is an autoimmune disease, based on the imbalance of humoral and cellular immunity, characterized by weakness and fatigue of skeletal muscles, and in some cases involvement of the heart muscle. In most cases, the object of the autoimmune destruction is peripheral nicotinic acetylcholine receptors of the postsynaptic membrane of the neuromuscular synapse. In myasthenia gravis there has been identified a number of other antigenic targets: muscle-specific tyrosine kinase, lowdensity lipoprotein receptor-related protein 4, titin, and ryanodine receptors skeletal muscles. Their specificity and pathogenetic role have been disclosed, but it is about 15-20% of seronegative forms that require further immunological research. Accurate diagnosis depends on the efficient detection of clinical forms of myasthenia gravis and full analysis of the autoimmune mechanisms underlying the disease.

The Pilot project «Development of medical rehabilitation system in Russian Federation» is the large Russian project which is intended to transform system of rehabilitation care for patients with stroke, heart attack, and after total hip arthroplasty. The present article is the second one in the series of publications of the Project’s protocol. The publication shows the criteria of translation from 1 to 2 stages of rehabilitation and from 2 to 3 stages for all three profiles of the project. Working peculiarities of the second phase of the project are prescribed which realizes the new model of rehabilitation with assessment according to the ICF, determination of rehabilitation diagnosis, work in multidistsiplinary team and the introduction of a new speciality – ergotherapy. 

The paper is devoted to study of peculiarities of emotional communication in families of drug addicts as well as personal characteristics of their mothers, and possible violations in receiving of social assistance. 91 families have been surveyed: 30 families of healthy individuals and 61 families of patients with drug addiction. Survey included: level of co-dependence, the intensity of psychopathological symptoms, level of anxiety and depressive experience of the mothers of drug addicts, their styles of emotional communication and level of social assistance. Study revealed the negative styles of emotional communications in the parent families of drug addicts in comparison with the styles of emotional communications in the families of healthy persons. The mothers of drug addicts differed from the mothers of healthy persons with increased level of paranoid features, suspiciousness, high hostility, anxiety, increased number of phobic fears and obsessions; they are less socially integrated, and are reluctant to seek emotional and instrumental support from others. 

The aim of this study is determination of predictors of efficiency of radiofrequency ablation (RFA) in patients with atrial fibrillation (AF) and metabolic syndrome (MS). Material and methods. 98 patients with AF (78 patients with AF and MS (IDF, 2005) and 20 patients without MS) have been examined. Comparison groups included 50 patients with MS without arrhythmia and 50 practically healthy subjects. RFA was performed with Carto 3 navigation system. Follow-up period after RFA was 12 months. Epicardial fat thickness (EFT) was measured with help of echo-cardiography. Results: patients with AF relapse had more MS components than those with effective procedure (3.21±1.18 and 1.73±1.14, accordingly, p<0.001). Initially, EFT of patients with AF relapse after RFA was larger that in patients without arrhythmia after exposure. EFT in patients with AF more than3.5 mmincreases probability of arrhythmia relapse in 1.87 times (OR: 1.87, 95 % CI 1.03 — 3.41, р = 0.04). Conclusion: determination of EFT with echo-cardiogaphy can be used in estimation of AF relapse risk after RFA.

The study included 61 patients with exudative neoplastic pleurisy of unknown primary localization. All patients underwent immunocytochemical study of pleural exudate to determine the etiology of effusion. Immunocytochemistry of 55 patients (90 %) of 61 ones was effective. The reason of exudation was both primary tumors — lung cancer (22), pleural mesothelioma (4) and pleural metastases of tumors of other localization - cancers of ovaries (9), breast (4), kidney (3), uterine body (2) , malignant lymphoma (2), colon (2), pancreas (2), thyroid gland (2), stomach (1), prostate (1), vagina (1). Immunocytochemical study of pleural effusions is the method of choice for the differential diagnosis of neoplastic pleurisies of unknown etiology.

Objective: to estimate contribution of C(-344)T version of aldosterone synthase CYP11B2 gene in risk of metabolic syndrome (MS) and atrial fibrillation (AF) for inhabitants of the Northwest region of Russia. Material and methods: 199 patients with MS, 103 from them with AF and 267 healthy persons. Identification of C-344T gene of CYP11B2 aldosterone sinthase has been performed by means of PCR method with restriction analysis. Results: in MS carriership of TT (-344) genotype met more often than in control: 33.2 % and 24.3 %, respectively (p = 0.04). Carriership of TT (-344) genotype increases risk of MS: OR = 1.54 (95 % CI 1.03-2.32) and was not associated with an increased risk of AF. Conclusion: association of TT(-344) genotype of CYP11B2 gene with risk of metabolic syndrome for inhabitants of the Northwest region ofRussia is revealed.

Based on long-term follow-up to perform comparative analysis of long-term results of surgical treatment of myasthenia. A retrospective analysis of long-term results of surgical treatment of 146 patients with myasthenia has been carried out. We used the modified Keynes classification to estimate the severity of myasthenia and to summarize the data relating to therapy volume and treatment results. In dependence on the type of thymus lesion patients were divided into two groups. Thymus hyperplasia was verified at — 106 (72.6 %) patients, tumor lesion of the thymus gland (thymoma) — at 40 (27.4 %) ones. The results were estimated in the following periods after thymectomy: 1—2 years, 3—4 years, 5—6 years, 7 — 9 years, 10—14 years, and over 15 years. Short- and longterm results of surgical treatment of myasthenia for the patients without tumor lesions of the thymus gland were significantly better. Positive effects of surgical treatment of myasthenia in patients with hyperplasia are observed after 1 year of surgery (p = 0.0023), and the best results are observed after 5 — 6 year of the disease, then after 7 — 9 year one notes some deterioration of state (p = 0.026). In the myasthenia patients with thymoma one notes the similar trends in dynamics of state, but in general, the results are significantly (p = 0.042) badly than in the group of the patients with hyperplasia. Starting from the first year after operation treatment the patients with myasthenia with thymus hyperplasia have statistically significant (p = 0.048) decrease of average doses of glucocorticoids, and anticholinesterase drugs. The statistically best treatment results were noted for the patients operated at the first year of the disease. Positive result of surgical treatment of myasthenia is noted both in the short- and long-term period and at thymomas. In the group of patients with thymoma one has noted significantly badly results in comparison with group of hyperplasia. It is necessary to perform surgical treatment in the first year of disease.

The approach to administration of balneo - mud treatment (BMT) for patients with hypertensive disease (HD) and ischemic heart disease (IHD) based on determination of severity and number of ischemic episodes in comparison with characteristic of rhythm disturbance according data of Holter monitoring, profile of circadian arterial pressure (AP) with circadian monitoring of AP has not yet received a sufficient spread in sanatorium-and-spa resorts of Crimea. This approach can be effective when choosing tactics of treatment at the spa, which leading factors are Saki lakepeloids. The correct assignment muds treatment and spa treatment in patients with hypertension can not only accelerate the achievement of target blood pressure, but also enhance the effectiveness of drug therapy. The good effect with stabilization of AD on the background of combined therapy has been obtained for 72 % of patients: in group of HD patients in 94 % cases; in IHD group with stable angina combined with HD in 51 % cases. AD patients characterized with significant decrease of activity of VNS sympathetic link, increased activity of parasympathetic ANS, decrease of the number of ischemia periods, decrease of episodes of extrasystolic arrhythmia. Use of peloids in the group of IHD patients with stable angina of 2^nd functional class (FC), combined with HD of 1-2 stages can increase speed and magnitude of the night rise of AD and activity of sympathetic link of vegetative nervous system VNS, increase insignificantly the number of episodes of morning myocardial ischemia, and have arrhythmogenic effect.

In recent years, the surgical treatment of DTG includes extirpation of the thyroid gland that can lead to the development of postoperative hypocalcemia, which causes of development are under study. Up to now, there are no clear recommendations for prophylaxis of postoperative hypocalcemia. In this connection, it is actually to carry out additional research to explore the methods of prophylaxis of postoperative hypocalcemia. The study involved 57 patients with diffuse toxic goiter, who had extirpation of the thyroid gland in period from 2010 until 2015. According to results of the performed study, it has been shown that prophylactic administration of preparations of calcium and vitamin D reduces the risk of postoperative hypocalcemia for patients with vitamin D deficiency.

This review introduces readers to the modern problems of improving the dental care of the workers of metallurgical production in the new socio-economic conditions and basic methods of prevention of dental diseases. Presented data testify about the peculiarities of the dental status and the rules of individual oral cavity hygiene in the examined population.