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The article is devoted to the work of Mahmud Kashani (d. 735/1334-35), who was a sheikh of the Suhravardiya Sufi order and the author of several significant works. The object of analysis was one of the parts of his most famous work — the prose treatise “The lamp that indicates the true path, and the key to a sufficient amount [of mystical knowledge]”. The article deals with the religious views and scientific heritage of Mahmud Kashani. A commented translation of part of the first section “On Love” from the tenth chapter “Explanation of mystical states” of the specified work is proposed. Since Mahmud Kashani is also credited with the poem “Treasures of Secrets and Symbols of the Righteous”, dedicated to the psychological aspects of mystical love, we have also translated one of its chapters. Comparison of fragments of these works shows significant discrepancies in the explanation of love, which may be due to the fact that the author expounds the concept of love of ascetic Sufism in the first essay, and Sufism “based on love” in the second. The second direction goes back to the composition of the “Revelation of Love” by the Persian mystical philosopher Ahmad Ghazali. It is also possible that ‘Izz ad-Din Mahmud is not the author of the poem “Treasures of Secrets…”.

Background: Diabetes mellitus (DM) is a disease characterized by chronic hyperglycemia and a cascade of pathological vascular alterations leading to diabetic retinopathy (DR) and diabetic macular edema (DME). Purpose: To compare clinical characteristics in patients treated with aflibercept only and in those treated with aflibercept plus hyperbaric oxygen (HBO) therapy for DME. Material and Methods: This open-label case-control study involved 91 type 2 diabetic (DM2) patients with non-proliferative DR and DME. Patients of the aflibercept-only group received a monthly intravitreous aflibercept at a dose of 2 mg for 5 months. Patients of the aflibercept-plus-HBO group received a monthly intravitreous aflibercept at a dose of 2 mg for 3 months. In addition, the latter patients received ten HBO sessions in the period between the first and the third injections. All patients underwent a routine general clinical and eye examination. Results: At 3 months and 6 months, patients in the aflibercept-plus-HBO group showed improvements in visual acuity by 28.81% and 7.14%, respectively (р < 0.05), and retinal sensitivity to light by 24.44% and 19.5%, respectively (р < 0.05), with a reduction in the number of patients with DME by 84.56% and 51.13%, respectively (p < 0.05). Conclusion: Intravitreal aflibercept with adjunctive HBO provides improved efficacy of treatment for DME in patients with DM2, with reductions in (a) the number and risk of intravitreal injections, (b) drug load on the patient, and (c) treatment duration.

The developers of Clinical Practice Guidelines for Acute Kidney Injury titled The Initiative to Improve Global Kidney Disease Outcomes (KDIGO) point at the need of new biomarkers for diagnosis acute kidney injury (AKI).The objective: to study and evaluate the diagnostic significance of the levels of neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) in patients with AKI in the early postoperative period when antibiotic therapy is used.Subjects and Methods. AKI frequency was assessed in 276 patients during the early postoperative period after the antibacterial drugs had been prescribed. Serum levels of KIM-1 and NGAL, glomerular filtration rate (GFR), creatinine, protein in urine were tested before the start of antibiotic therapy, in 24–48 hours, and in patients with AKI – additionally in 72–96 hours. The normal initial renal excretory function was registered only in 36 patients (13.04%). The majority of patients (242 patients, 86.96%) were diagnosed with chronic kidney disease of various stages.Results. NGAL and KIM-1 levels were higher in the group of patients with AKI before start of antibiotic therapy versus the group of patients with preserved renal function. However, a statistically significant increase in the level of KIM-1 and NGAL was found only in the group of patients with stages 3A and 3B of CKD versus the groups of patients with stages 1 and 2 of CKD. The second important observation is that a comorbid pathology in patients led to a high AKI incidence when antibiotic therapy was used – 35.86% (30–42%; 95%CI).Conclusion. The relationship of NGAL and KIM-1 levels with glomerular filtration rate (GFR) and KIM-1 level with the presence of proteinuria as indicators of impaired renal filtration function suggests that NGAL and KIM-1 levels reflect the state of renal filtration function. Based on this observation, it should be accepted that NGAL and KIM-1 levels can be used as markers for the diagnosis of AKI in patients receiving antibiotic therapy. The prescription of antibiotic therapy in the postoperative period in patients with surgical pathology and renal dysfunction leads to a high AKI incidence. Elevated KIM-1 and NGAL levels in AKI during the antibiotic therapy suggests their involvement in the reparation process.

Introduction. In the context of a pandemic, it is necessary to quickly and accurately stratify patients into groups based on the severity of their condition and prognostic risk. For these purposes, some available biomarkers, such as proadrenomedullin, can be used. Objective. To determine the prognostic value of regional mean proadrenomedullin (pro-ADM) in comparison with routine clinical and laboratory parameters in patients with a new coronavirus infection COVID-19. Materials and methods. The study included 140 patients who were hospitalized with a diagnosis of community-acquired pneumonia on the background of COVID-19. The level of pro-ADM was determined on the first and third days of hospitalization by ELISA. In accordance with the outcome of the disease, patients were divided into two groups: those discharged with recovery or improvement (n = 110, 78, 6%) and those who died during their stay in the hospital (n = 30, 21, 4%). Results. Pro-ADM had the highest prognostic value as a predictor of adverse outcome on day 1 AUC ROC 0.72 95% CI (0.57–0.84) sensitivity 79.2%, specificity 62.9% and on day 3 AUC ROC 0.98 95% CI (0.86–1.0) sensitivity 100%, specificity 95.6%. ROC analysis results for C-reactive protein AUC ROC 0.55 95% CI (0.41–0.77), sensitivity 73.3%, specificity 45.6%; procalcitonin AUC ROC 0.62 95% CI (0.49–0.73), sensitivity 80%, specificity 48.2%. The relative risk of a poor outcome for a proADM level > 500 pmol/L is 2.3 95% CI (1.23–4.32), and for a proADM level > 700 it is 8.5 95% CI (4.83–14.94) p < 0.001. Conclusions. Compared to C-reactive protein and procalcitonin, regional mean proadrenomedullin has the highest predictive value as a predictor of death in patients with COVID-19.

Introduction. The diagnosis of alcohol-related liver disease is limited by the lack of a tool to reliably identify whether the present deterioration in the patient’s condition is due to alcohol consumption or other causes.Purpose. to conduct a comparative assessment of the clinical and diagnostic significance of liver function biochemical indicators (AST, ALT, GGT, ALP) and their calculated derivatives (AST/ALT, GGT/ALP, GGT/GGTn, ALP/ALPn) as markers of alcohol consumption in patients with alcoholic liver cirrhosis.Material and methods. The observational study included 112 men over 18 years of age with alcohol-related liver cirrhosis. The patients were assessed the severity of liver cirrhosis according to the Child-Pugh scale, performed general and biochemical blood tests, coagulation test, assessment of the fact of alcohol consumption by the level of phosphatidylethanol. An analysis was made of the relationship between alcohol consumption and changes in laboratory parameters of liver function, with the determination of their sensitivity and specificity.Results. Patients with Child-Pugh B cirrhosis who consumed alcohol on phosphatidylethanol had higher levels of plasma albumin, GGT, and lower values of creatinine, direct and total bilirubin, urea, and aPTT compared with patients who did not drink alcohol (p < 0.05). Alcohol-drinking patients with class C cirrhosis have higher ALT levels compared with abstinent patients with the same severity of cirrhosis (p < 0.05). The relationship between the fact of alcohol consumption, determined by the level of phosphatidylethanol, and the ratio of GGT of patients to the normal GGT value, as well as between the ratio of GGT to alkaline phosphatase and the degree of increase in GGT, turned out to be statistically significant. To assess the fact of alcohol consumption, the level of serum GGT > 65 IU/ l (75.5%) has the highest sensitivity, the highest specificity is the ratio of the patient’s GGT to the normal value of GGT > 2 (82.9%).Conclusion. Compared with the known 100% sensitivity and > 92% specificity of Peth as a alcohol biomarker, among the biochemical indicators of liver function and their calculated derivatives, GGT > 65 IU/l have the greatest sensitivity or specificity (respectively, 75.5% and 65%) and GGTnorm. > 2 (37.7% and 82.9%, respectively), which makes it possible to use the totality of these parameters as an indicator of the continued impact on the patient of the main etiological factor of alcohol-related liver cirrhosis in the routine practice of most medical organizations of the Russian Federation.

Background: Diabetic macular edema (DME) can be seen in both types of diabetic retinopathy (DR), and is a major cause of vision loss. Purpose: To evaluate the efficacy of the combination treatment for DME in type 2 diabetic patients with non-proliferative diabetic retinopathy (NPDR). Material and Methods: An open-label, controlled study included 45 type 2 diabetic patients with both NPDR and DME. Patients of the aflibercept-plus-hyperbaric oxygen (HBO) group and those of the aflibercept-only (control) group received a monthly intravitreous aflibercept at a dose of 2 mg (50 µL) for 3 months. In addition, the former patients received an adjunctive treatment with ten sessions of HBO in the period between the first and the third injections. Changes in clinical and biochemical characteristics were assessed at 3 months after initiation of treatment. Results: At 3 months, patients of the aflibercept-plus-HBO group showed a statistically significant improvement in visual acuity, improvement in retinal light sensitivity, reduction in manifestations of DME, and statistically significant reductions in blood glucose and glycated hemoglobin levels. At 3 months, the changes in the activities of antioxidant enzymes were more substantial in this group, and these improvements were statistically significant compared to baseline and compared to controls. Particularly, superoxide dismutase (SOD) activity, catalase (CAT) activity, and glutathione reductase (GSR) activity decreased by 33.9%, 22.4% and 17.7%, respectively, compared to baseline, and 34.78%, 28.9%, and 25.3%, respectively, compared to controls. Conclusion: Treatment for DME with the use of aflibercept and adjunctive HBO caused a substantial reduction in the frequency of DME and improvements in visual acuity and retinal light sensitivity in type 2 diabetic patients NPDR. Under these conditions, a decrease in the activity of CAT was larger than that of GSR but smaller than that of SOD, likely indicating an improvement in antioxidant protection.

Chronic pancreatitis is a multifactorial disease in which repeated episodes of inflammation of the pancreas contribute to the development of fibrous tissue, leading to chronic pain, as well as exocrine and endocrine insufficiency. The incidence and prevalence of chronic pancreatitis in the world are growing, as evidenced by current statistics. In addition, the annual costs associated with the treatment of exocrine and endocrine insufficiency are also increasing. In the United States alone, the annual cost of treating these complications is $ 75.1 million. Exocrine insufficiency is one of the most frequent complications, which is characterized by a deficiency of pancreatic enzymes, leading to the development of malabsorption syndrome (impaired absorption of nutrients, vitamins and minerals). Due to the increased incidence and deterioration of the quality of life associated with this condition, the goal of treatment is to compensate for the deficiency of exocrine enzymes with oral pancreatic enzyme replacement therapy. The core of this therapy is to deliver activated, unbroken enzymes directly to the small intestine during a meal. Many studies have shown that prescribing enzyme replacement therapy improves symptoms associated with exocrine insufficiency, reduces the progression of osteopenia, and improves survival in such patients. The use of pancreatin contributes to the correction of exocrine insufficiency in patients with chronic pancreatitis. The data presented in the article indicate that the drug is a safe and effective agent, meets all modern standards and requirements, and can be used to correct enzymatic pancreatic insufficiency.

Currently, lactulose is known to most as a laxative that has a hyperosmotic effect, stimulating intestinal peristalsis. The drug has long established itself as a safe and effective medicine. Lactulose is one of the few drugs that is approved for use in pregnant women and children under 6 months of age with functional constipation. The prebiotic properties of lactulose were discovered in 1957. After research, it was found that it promotes the growth of beneficial bacteria, such as bifidobacteria and lactobacilli. In addition to being used as an effective weak and prebiotic agent, lactulose has been successfully used since 1966 for the treatment of hepatic encephalopathy. The mechanism of action of the drug is that it prevents the absorption of excess ammonia, which is formed in the large intestine, through the hydrolysis of protein and urea by the intestinal microflora. Lactulose, which has a wide range of effects on nitrogen metabolism by the intestinal microflora, affects not only ammonia, but also other bacterial toxins as a result of the studies that have demonstrated the reliable effectiveness of the drug, the world’s leading professional communities have included lactulose in their recommendations as the drug of choice for the treatment of patients with hepatic encephalopathy at any stage of the disease. The article presents current data on the effectiveness and safety of the use of lactulose in various diseases. In addition, attention is paid to such a concept as microbiota. Its functions and influence on the human body are described.

Introduction. IBS is a functional bowel disorder that has a significant impact on patients and society, especially in terms of quality of life and medical costs.Pathogenesis. It is believed that the pathogenesis of IBS consists of several mechanisms: the syndrome of intersection of functional disorders (gut-brain), stress, visceral hypersensitivity and changes in motor skills.Visceral hypersensitivity. Changes in visceral sensitivity in IBS are characterized by central abnormalities in areas of the cerebral cortex. Motility impairment in IBS manifests itself as abnormal myoelectric activity in the colon, resulting in repetitive contractions of the small intestine and colon, which appear to cause pain.Intestinal microflora. FODMAPs are found in high amounts in some fruits, artificial sweeteners, legumes, and green vegetables and are poorly absorbed by all people. FODMAPs have enzymatic and osmotic effects that may contribute to the onset of symptoms in some patients.The principles of IBS therapy. Treatment for IBS should be based on the type and severity of symptoms. For the treatment of IBS, drugs of various pharmacological groups are used, depending on the prevailing symptoms. These include opioid receptor agonists, bile acid sequestrants, guanylate cyclase agonists, chlorine channel activators, as well as antibiotics, probiotics, antidepressants, 5-HT3 receptor antagonists, and antispasmodics.Myotropic antispasmodics. Drugs with antispasmodic activity are used to treat functional and organic diseases of the gastrointestinal tract as a basic therapy or «on demand». Mebeverine quickly and effectively relieves spasm, pain and the entire complex of intestinal symptoms, in addition, the drug reduces visceral hypersensitivity due to a local anesthetic effect. The drug has a high safety profile and has a number of advantages over drugs of the same pharmacological group.Conclusion. Myotropic antispasmodics have been shown to be highly effective in the treatment of IBS. Mebeverine occupies a special place among myotropic antispasmodics. Its combined action provides a pronounced antispasmodic activity along with a high safety profile.

TNF-α has been known since 1985. It is a multifunctional proinflammatory cytokine, synthesized mainly by monocytes and macrophages. Since its discovery, many studies have been conducted that have proven that it provides homeostatic function and regulates many biological processes in the body. Violation of its regulation in humans is associated with the development of many autoimmune diseases. The intensive studies that led to the understanding of its polyfunctionality and its role in the immunopathogenesis of a number of diseases served as the basis for the development of anti-cytokine therapy with monoclonal antibodies. In 1975, a technique for producing such antibodies was developed. The first antibodies against TNF-α obtained were chimeric, consisting of 30% mouse protein. Because of this feature, drugs based on chimeric antibodies had immunogenicity, which was manifested in the formation of antibodies to the drug, which led to a decrease in their effectiveness. To reduce immunogenicity, scientists in 1990 created the first fully human monoclonal antibody based on a technology called phage display. This is how adalimumab was born, the first fully human multi-clonal antibody to TNF-α. Humira® (adalimumab) is currently considered a widely studied drug from the group of TNF-α inhibitors, with a good safety and efficacy profile. The article presents current data that demonstrate that the drug significantly improves the course of diseases such as rheumatoid and psoriatic arthritis, and will allow for long-term remission in Crohn’s disease.

Severe bronchial asthma in children remains a serious problem, which is caused by high mortality, side effects from therapy with high doses of glucocorticosteroids and a significant consumption of health resources. According to statistics from the Monitoring, Analysis and Strategic Health Development Department of the Ministry of Health of the Russian Federation, 1028.6 BA cases per 100,000 children under 14 years of age were registered in Russia in 2017. The article presents modern data on the pathogenesis of bronchial asthma, causes of therapy-resistant asthma, participation of interleukin-5 (IL-5) in the development of eosinophilic inflammation. Research data demonstrate the safety and effectiveness of anti-IL-5 therapy as a supplement to standard treatment for severe eosinophilic bronchial asthma and its poor control. Mepolizumab is the most widely researched anti-IL-5-monoclonal drug. It statistically significantly reduces the level of eosinophils in sputum, reduces the frequency of exacerbations and hospitalizations helps reduce maintenance therapy with glucocorticosteroids. As a result of randomized, placebo-controlled trials mepolizumab has been shown effective and safe in children 6 years of age and older, experts of leading world organizations approved its use for the treatment of severe eosinophilic asthma in children, what makes this drug the only one currently approved for use in patients in this age profile. However, further studies are needed to determine the optimal duration and long-term therapeutic efficacy in children.

Main groups of antisecretory drugs used in the treatment of acid-dependent diseases, including gastroesophageal reflux disease (GERD), are described in a review. Mechanisms of activation, degradation and inactive metabolites formation of proton pump inhibitors (PPIs) – final elements of acid production blockage – are considered in detail. Special attention is paid to the presence of PPIs’ derivatives with different functional activity: inactive derivatives, active and inactive metabolites. Topographic description of these derivatives, their significance in terms of an effect on bioavailability, clinical effectiveness and a potential of PPIs interactions with other administered drugs. The combined decision-making algorithm in the presence of gastroesophageal reflux disease symptoms is presented, compiled on the basis of the most authoritative current recommendations. This algorithm provides for the use of PPIs in standard doses once a day for 4–8 weeks with a possible dose escalation in a case of ineffectiveness. If treatment with high doses of PPIs is ineffective, a set of measures is needed to identify the causes of this inefficiency and to choose additional medical strategy. Depending on the clinical situation, after erosions epithelization the treatment can be stopped, used on demand, prolonged in the intermittent or supportive forms. Particular attention is paid to the Panum® drug, which has proven its effectiveness in patients with different degrees of reflux esophagitis. The availability of dosage forms for prescription and over-the-counter leave allows ensuring its comfortable and unhindered purchase by patients and eliminating excessive burden on the healthcare system.

Combination of amoxicillin/clavulanate firstly occurred on a pharmacological market in 1977 and it is still has been used successfully for treatment of infections in children and adults. Clavulanic acid provides an opportunity to fight microorganisms that produce specific enzymes – beta-lactamases. Despite the global antibiotic resistance problem, amoxicillin/clavulanate is still active against different infections in children. The level of susceptibility to amoxicillin/clavulanate of St. pneumonia is high for a period of 40 years. Based on the multicenter study of the antimicrobial resistance of pneumococci, haemophilus, group A streptococci, moraxella PeGAS I-III findings, susceptibility to amoxicillin/clavulanate of St. Pneumoniae in Russian Federation has been changed slightly from 100% to 99.6% over a period of 1993 – 2009 y. The systematic review with meta-analysis published in 2019 showed that the sensitivity of hemophilic bacillus and moraxella to amoxicillin/clavulanate in the treatment of acute otitis media accounted for 98% each. The article presents data on clavulanic acid action mechanism, spectrum of amoxicillin/clavulanate activity on the ground of clinical trials and meta-analyses, priority of suspension usage in pediatric practice is explained. Possibilities of using in pediatric practice were also viewed.

Intestinal microflora in terms of the integral body of knowledge about its importance for the human body is now considered as an additional “virtual” organ, producing many biologically active compounds that affect the various properties and functions of the macroorganism: fermentation of non-digestible food polysaccharides, maintenance of the optimal values of the intra-lumen pH and “intestinal barrier”, the activity of the immune system, vitamin status, energy homeostasis, angiogenesis. Saccharomyces boulardii is not a representative of the natural microflora of the human intestine, but, used as a probiotic, interacts with it, restoring the balance of short-chain fatty acids, reducing the levels of bacterial toxins, acting as a surrogate normal microflora until it is restored and replaced by natural representatives. S. boulardii has immunostimulating and anti-inflammatory activity. The results of clinical studies have demonstrated the effectiveness of S. boulardii in correcting pathological conditions associated with Helicobacter pylori, Clostridium difficile, Candida albicans, Salmonella typhimurum, Yersinia enterocolitium, protozoa Entamoeba and in treating irritable bowel syndrome and antibiotic-associated diarrhea. The efficacy of a drug containing S. boulardii has been demonstrated in the article by clinical studies and a clinical example. This drug has proven to be a highly effective and safe probiotic agent for the prevention and treatment of a number of diseases of the gastrointestinal tract with physiologically optimized pharmacodynamic effect that simulates the protective properties of normal human intestinal microflora. When using a drug containing S. boulardii, both adults and children do not have serious side effects, which increases the possibility of its safe use in clinical practice.

Nonsteroidal anti-inflammatory drug is one of the most commonly prescribed drugs for the treatment of inflammatory and pain syndromes in the clinical practice of doctors of various specialties. The popularity of this pharmacological group is increasing due to over-the-counter dispensing condition, but at the same time, the significance of issues of likelihood, prevention and treatment of severe adverse drug reactions during intake that is controlled and uncontrolled by medical personnel is increasing. This review is devoted to the issue of non-steroidal anti-inflammatory drug-induced damage to the gastrointestinal tract and to the current possibilities to prevent and manage such damage. The drugs that can increase the production of prostaglandins and mucus in the digestive tract and have a general anti-inflammatory effect raise significant hopes. Rebamipide draws particular attention due to numerous pleiotropic effects, including stimulation of secretion of newly formed prostaglandins and glycoproteins in the mucous membranes, inhibition of synthesis of oxidative stress products, inflammatory cytokines and chemokines by intestinal epithelial cells. The authors considered the effectiveness of prophylactic use of rebamipide in comparison with other strategies for the use of drugs to prevent the development of stomach ulcers, duodenal ulcers and distal small bowel ulcers. They described the mechanisms of prophylactic action and its debatable aspects for proton pump inhibitors, H2-histamine receptor blockers, misoprostol. The clinical efficacy of rebamipide is illustrated by a clinical example. The absence of effects on cytochrome P450 enzyme activity, which minimizes the risks of drug interactions and changes in bioavailability, biotransformation and excretion of the drug itself during its course use is an additional advantage of rebamipide.

The follow-up group of «frequently ill children» is formed on the basis of criteria formulated by domestic pediatricians A.A. Baranov and V.Yu. Al’bitskiy, due to the high relevance of medical, social and economic problems caused by the increased morbidity in this category of patients especially with acute respiratory infections, with likely development of severe complications or the manifestation of chronic respiratory diseases. In general, the state of the immune system in frequently ill children is characterized by decreased local immunity and increased stress of systemic immunity, and the features of the functional immunity activity in this category of patients determine the various possibilities to affect immunity during the prevention and treatment of acute respiratory infections. This article discusses the features of the functional activity of the immune system in frequently ill children, as well as the possibilities of drug management of its disorders and the benefits of using inosine pranobex to prevent and treat respiratory infections in this category of patients. According to the international classification of drugs maintained by the World Health Organization, the drug belongs to the groups of immunomodulators (L) and antimicrobial antiviral drugs (J) for systemic use. It is proved that inosine pranobex effectively increases cellular and humoral immunity, and reduces non-specifically the viral replication capacity. During clinical trials, the drug proved to be a highly effective and safe component of the complex treatment of acute respiratory infections in frequently ill children. The use of inosine pranobex reduces the duration and intensity of symptoms of infectious respiratory tract diseases. The drug can be recommended for children with concomitant chronic respiratory tract diseases.

The frequency of infective endocarditis (IE) has increased 3 times over the past 30 years. The incidence of IE morbidity is recorded in all countries of the world and in the Russian Federation more than 40 people per 1 million population get sick. One of the most frequent causative agents of infective endocarditis is Enterococcus faecalis (E. faecalis), which takes the third place in the structure of the frequency of IE pathogens. Enterococcal IE remains a disease with high mortality, despite the emergence of new groups of antibacterial drugs. This review includes the results of studies of the efficacy and safety of various antimicrobial regimens of IE caused by E. faecalis. The analysis of data from foreign and native studies of antimicrobial treatment in patients with infective endocarditis, accompanied by enterococcal bacteremia is presented in the review. The search for literature performed by using medical databases: MEDLINE, EMBASE, eLIBRARY. The current review included studies of the efficacy and safety of antimicrobial treatment. The main antibiotic therapy regimens of IE caused by E. faecalis include 2 beta-lactam antibiotics or a combination of ampicillin and gentamicin, according to the results of 5 found studies. Found antimicrobial regimens significantly did not affect mortality. Data from international registries testify to the efficacy and safety of daptomycin monotherapy for enterococcal endocarditis. Linezolid and daptomycin are the main drugs of treating infective endocarditis caused by vancomycin-resistant enterococci. Native studies report of a high level of resistance of enterococcal strains to beta-lactam antibacterial drugs. The duration of fever, the frequency of surgical heart valves interventions, the duration of bacteremia are not fully represented in each of the studies, and it is difficult to evaluate these factors. Ampicillin+ceftriaxone and ampicillin+gentamicin are the main antimicrobial treatment regimens of enterococcal endocarditis. Efficacy of these regimens is not significantly different. Treatment of IE should be carried out taking into the epidemiological situation and the strain resistance.

One of the serious problems during the treatment of osteoarthritis (OA) is the developing of adverse drug events during therapy. Nonsteroidal anti - inflammatory drugs (NSAIDs) are the first drugs with the high incidence and severity of adverse events. This article describes OA treatment strategies approaches for OA are presented using the complex drug Alflutop, which has a composition similar to the human hyaline cartilage. The drug has anti - inflammatory and analgesic effects, normalizes the function of the affected joints, improves the quality of patients’ life, also has a structure - modifying effect. Such therapy is safe, well tolerable for patients, and can be used used as a starting complex OA treatment.

Constipation, which is currently one of the global problems of mankind, requires modern approaches to its pharmacological correction. Constipation that occurs in the absence of organic digestive pathology is in most cases considered a symptom of functional constipation or irritable bowel syndrome, the diagnosis of which is based on the compliance of the patient’s complaints and anamnestic data with the Rome IV criteria for the diagnosis of these functional disorders. Regulax Picosulphate, an intravenous droplet, is a modern laxative drug with a possibility of precise and easy dosing that does not have a local irritant effect on the gastric and duodenal mucous membranes; the efficacy and safety of this drug has been proven in controlled clinical trials.

Onset of fever and pain syndrome in children is one of the most frequent reasons parents take their children to a paediatrician. Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used to relieve such symptoms. The mechanism of action of NSAIDs is to inhibit the activity of the enzyme called cyclooxygenase (COX). Paracetamol, one of the drugs that inhibit COX, exerts its pharmacodynamic effect in the central nervous system, thereby providing antipyretic and analgesic effects, but it is ineffective in stopping inflammation. Such common conditions in children as fever and pain syndrome of mild to medium intensity are among the indications for use of Efferalgan containing paracetamol as an active ingredient. Solution and rectal suppositories are the most commonly used dosage forms of Efferalgan in children, as these dosage forms can be used, when the child reaches 1 and 3 months of age, respectively. The correct dose of paracetamol for a child depends on their weight. It should be remembered that the relief of a fever or pain syndrome is a symptomatic treatment. Therefore, if they appear, you should visit a doctor to identify carefully the possible cause and select the appropriate therapy.

Immediacy of the problem of combination therapy of respiratory diseases in paediatric practice is caused by their multifactorial pathogenesis in children and the need to achieve a high clinical effect in the use of drugs at relatively low doses and with minimum risks of serious adverse effects and drug interactions. The fixed-dose combination of salbutamol, bromhexine and guaifenesin produced in the form of tablets and syrup fully meets these requirements, which makes it possible to use it in children and adults with acute, chronic infectious (ARVI, bacterial pneumonia, respiratory tuberculosis, etc.) and non-infectious (bronchial asthma, pulmonary cystic fibrosis, primary ciliary dyskinesia, etc.) diseases.

Aim. To determine celiac disease detection rate in patients with digestive disease. Subjects and methods. A total of 318 gastroenterological patients admitted to be treated at the Central Research Institute of Gastroenterology in September to October 2012 were examined. The patients’ age was 18 to 74 years (mean 51.5±16.4 years). Immunoglobulin A (IgA) and immunoglobulin G (IgG) anti-gliadin antibodies (AGA), IgA anti-tissue transglutaminase (anti-tTG) antibodies and IgG anti-tTG antibodies were determined. When the antibodies were elevated, esophagogastroduodenoscopy with duodenal biopsy was performed. Results. Forty-one of the 318 patients were found to have higher AGA (12.9%); out of them IgA AGA were in 17 (5.35%) patients and IgG AGA were also in 17 (5.35%). Elevated levels of both antibodies (IgA AGA and IgG AGA) were seen in 7 (2.2%) patients. Overall, the detection rate of increased AGA levels was 12.9%. The antibodies were more commonly higher in patients with liver diseases (21.8%) and in those with inflammatory bowel diseases (21.6%). Both IgA anti-tTG, IgG anti-tTG and IgA AGA, IgG AGA were detected in 6 (1.9%) of the 318 patients. The diagnosis of celiac disease was verified by duodenal histological examination in 3 (0.94%) of the 318 patients. Conclusion. The celiac disease detection rate in gastroenterological patients was 0.94%.

Data about efficacy and safety of acetylsalicylic acid usage as antiplatelet drug and for cancer prevention are presented.

Subject of research. Control system of a four-mass object (twin telescope) with dual motor drive is considered. Method. The reducing ability of an object model to the third order is used for simplification of control system. The synthesis of a discrete controller algorithm is completed based on the reduced model of the object. Characteristics of the system which consists of four-mass object with dual motor drive and obtained regulator are investigated. Control synthesis based on the modified design method of an optimal control with guaranteed degree of stability is used. Reduced-order observer is used in the control system since only one parameter of the plant can be measured — angular velocity of one lumped inertia. System robustness is verified by changing the nominal parameters of the plant in 10% range. Main results. In case of using a single motor drive a regulator can be built only on the basis of the model of object slow motions. System performance (bandwidth) should be enough low not to excite elastic vibrations. Control rate then is limited by the lowest resonating frequency of the plant. Numerical simulation reveals that transition time of the system with single motor drive significantly exceeds transition time of the system with dual motor drive. Both systems maintain the properties of robustness with changing parameter Practical relevance. The results can be used in the control systems design of the complex electromechanical mechanisms with elastic couplings such as telescope main drive axis.

Improved design method of optimal control system for the linear object with elastic coupling is considered. Standard optimal control system design implies the selection of state and input penalty matrix for the quadratic functional. Moreover the system performance quality depends greatly on the specific penalty matrix. Instead of the state and input penalty matrix selection procedure the selection of desired stability degree is proposed. The proposed method of optimal control system design is based on the idea of new state matrix utilization. The new state matrix has its eigenvalues at the specified distance to the right from the eigenvalues of the original state matrix. Thereupon we can assign the closed loop state feedback system matrix eigenvalues at that specified distance to the left from imaginary axis of the complex plane, in the other words, we can achieve the desired stability degree of the system. The proposed method of control algorithm design is demonstrated for a control system of an electric drive with two-mass mechanism (object). Object characteristic was evaluated by amplitudefrequency response obtained during identification experiment. Unavailable or immeasurable variables of the control object state were estimated by reduced-order observer while optimal control system design.

According to current standards, treatment of peptic ulcer disease in a majority of patients requires eradication of Helicobacter pylori. Latest antibiotics can achieve a high degree of eradication; however, clinical efficacy of treatment is determined not only by the effectiveness of eradication, epithelization of the ulcer, elimination of other symptoms of the disease, and the prognosis, but also by absence of side effects of the treatment.