[Epithelial protective therapy in comorbid diseases. Practical Guidelines for Physicians].

This document was produced with the support of the National Medical Association for the Study of Comorbidities (NASС). In 2021 the first multidisciplinary National Consensus on the pathophysiological and clinical aspects of Increased Epithelial Permeability Syndrome was published. The proposed guidelines are developed on the basis of this Consensus, by the same team of experts. Twenty-eight Practical Guidelines for Physicians statements were adopted by the Expert Council using the "delphic" method. Such main groups of epithelial protective drugs as proton pump inhibitors, bismuth drugs and probiotics are discussed in these Guidelines from the positions of evidence-based medicine. The clinical and pharmacological characteristics of such a universal epithelial protector as rebamipide, acting at the preepithelial, epithelial and subepithelial levels, throughout gastrointestinal tract, are presented in detail.

[Anxiety and Depression in Chronic Heart Failure. What Can a Cardiologist Do?]

AIM: To reveal the probability and duration of the onset of remission of anxiety-depressive symptoms in patients with CHF III-IV receiving optimal medicine treatment (OMT) or (OMT), supplemented with the education program and active outpatient monitoring (OMT + A). MATERIALS AND METHODS: A secondary analysis of the results of RCT CHANCE, which studied the impact of the training program and active outpatient control (further additional exposure (DV) plus optimal medication (OMT) on mortality and cardiovascular hospitalization in patients with CHF III-IV FC. Therapeutic training and outpatient control performed by the cardiologist after discharge from the hospital (weekly in the first month, every 2 weeks for the next 2 months, and then On the basis of the results of the telephone contact, an additional visit could be scheduled, the CHANCE study control group was made up of patients on OMT who were observed as practiced in regular health care setting. Control group had 4 visits to the cardiologist during the 1 year observation. The present analysis included patients on OMT and OMT + DV who had a clinically significant anxiety at the 0 week of the CHANCE program using the Hospital Anxiety and Depression Scale (HADS) (the sum of scores on the anxiety subscale ≥11), depression (the sum of scores on the depression subscale ≥11), or a combination of anxiety and depressive symptoms (scores on anxiety and depression subscales ≥11). Patients who did not pass HADS or SHOCK testing at 0.24 and 48 weeks were excluded from the analyses. A total of 237 patients were included. Severity of HF symptoms were assessed by "Scale of Heart failure Optimizing Clinical Status (SHOCS)" and compared it with the shares of patients who reached remission (HADS scores.

[Pain in diabetic neuropathy: psychosomatic aspects].

Diabetic neuropathy (DN) is one of the most common complications of diabetes mellitus (DM). Most clinical and population studies indicate that its prevailing form is distal symmetric, affecting about 30% of patients with diabetes. The main clinical manifestation of this form of DN is a decrease (up to a complete loss) of sensitivity, which is either not recognized by the patient or is perceived as numbness, loss of any sensations in the lower extremities. At the same time, in a relative minority of patients, the leading symptom in the DN clinical presentation is pain, which, in some cases, reaches high intensity, disrupts working ability, daily activity, and sleep.