[The agreed experts' position of the Eurasian Association of Therapists on tactics of management of patients with comorbid pathology infected with SARS-Cov-2].

The agreement of experts of the Eurasian Association of Therapists (EAT) discusses pathogenesis and treatment of COVID-19. Modern data on the characteristics of cardiovascular, kidney, respiratory damage in SARS-infected CoV-2 are presented. The tactics of managing patients initially having cardiovascular diseases, diabetes mellitus, chronic obstructive pulmonary disease, bronchial asthma, chronic kidney disease are discussed in detail. The article presents data on drug interaction of drugs.

[Pyo-necrotic injuries in case of the neuro-ischemic form of diabetic foot syndrome].

It was analyzed the results of examination and treatment of 217 patients with neuro-ischemic form of the diabetic foot syndrome. Diabetic macroangiopathy with critical limb ischemia (TASC II) was diagnosed in all patients. Tissue foot damage of grade 3 (Wagner) was observed in 100 (46.1%) patients, grade 4 - in 117 (53.9%) patients. The developed strategy of surgical treatment includes the revascularization of an affected limb, surgical management of a pyo-necrotic focus and the plastic reconstruction of the foot after rapid relief of ischemia symptoms. An application of such treatment strategy led to preserve a foot or a stump of the foot in 205 (94.5%) patients.

[Single-step endovascular revascularization of the kidney, lower limb and endovascular reconstruction of abdominal aortic aneurysm in a patient with type 2 diabetic mellitus].

Presented in the article is a clinical example of surgical treatment of a patient with a severe course of type 2 diabetes mellitus, multiple lesions of coronary arteries, lower-limb arteries with the development of lower-limb ischaemia, bilateral lesions of renal arteries and chronic renal insufficiency, the presence of an aneurysm of the infrarenal portion of the aorta. The unique nature of the case report consists in joint work of endocrinologists, cardiologists, specialists in purulent surgery and reoentgenovascular surgeons, also in carrying out simultaneous endovascular reconstructive operation on various vascular basins: stenting of the right renal artery, balloon angioplasty and stenting of the left leg arteries and endovascular prosthetic repair of the abdominal aortic aneurysm. The comprehensive treatment of the patient resulted in safe performance of the endovascular intervention, saving the supporting function of the limb, improvement of glycemic control, decreasing the risk of sudden death on the background of abdominal aortic aneurysm rupture, decreased rate of progression of renal insufficiency, better control of symptoms of angina pectoris and cardiac failure. Also the article reflects importance of rendering medical care for patients with multifocal atherosclerosis and diabetes mellitus, also showing the necessity of creating multi-modality medical centres and working out of algorithms for treatment of this patient cohort.

[Analysis of the quality of primary therapeutic-preventive care rendered to patients with type I diabetes mellitus]. / Analiz kachestva pervichnoi lechebno-profilakticheskoi pomoshchi bol'nym sakharnym diabetom I tipa.

A prospective follow-up of a random sample of patients with insulin-dependent diabetes mellitus revealed a marked decompensation of carbohydrate metabolism in 98% of the examinees, a high incidence of diabetic ketoacidosis, a long duration of temporary invalidity, and poor adherence of patients to medical recommendations. Assessment of primary health care rendered to patients with type I diabetes at district outpatient clinics of Moscow demonstrated its poor efficacy and a necessity to improve the level of specialized diabetologic care.

[Effectiveness of an intensive treatment and training program for patients with type I diabetes mellitus]. / Effektivnost' programmy intensivnogo lecheniia i obucheniia bol'nykh sakharnym diabetom I tipa.

The authors analyze the results of comprehensive, prospective, controlled investigation of the program for intensive care and training of 121 patients with insulin-dependent diabetes mellitus (IDDM). The basic principles of the program are training on a team's basis, intensive insulin therapy, auto-monitoring of metabolism, and liberal diet. The results demonstrate that glycemia level approaching the normal may be attained and maintained in the majority of patients without increasing the risk of grave hypoglycemia, cases with severe diabetic ketoacidosis may be eliminated, and periods of temporary invalidity of patients reduced by 7-10 times. The selected training program was equally effective for patients of various age groups and levels of education, as well as for patients with "labile" diabetes. Results of treatment did not depend on the type of insulin preparations used. The authors come to a conclusion on a higher efficacy of new strategy of IDDM treatment in comparison with the traditional approaches.

[Age-related features of neurohumoral regulation of somatotropic hormone secretion]. / Vozrastnye osobennosti neirogumoral'noi reguliatsii sekretsii somatotropnogo gormona.

Experiments with primary cultures demonstrated a stimulating effect of TRF on somatotropic hormone (STH) secretion by hypophyseocytes of neonatal but not adult rats and a reduced reactivity of neonatal somatotrophs to the inhibitory effect of somatostatin during short-term incubation. No noticeable serotonin effect on STH release from hypophyseal cells of animals of various ages was observed. During prolonged (24 h) incubation a weak inhibitory effect of bromocriptine and melatonin on STH secretion by pituitary cells of neonatal but not adult rats was observed. These results permit us propose a similarity of the functional characteristics of neonatal pituitary somatotrophs to somatomammotroph properties.