[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.

[Efficacy of metformin in abdominal obesity].

AIM: To study the effect of metformin on metabolic parameters, body weight (BW), and waist circumference (WC) in patients with abdominal obesity (AO). SUBJECTS AND METHODS: The results of using metformin 2000 mg daily for 3 months in 46 patients with AO. The comparison group consisted of 50 people. BW, WC, and blood pressure (BP) were measured; lipid profile parameters and blood insulin concentrations were determined; and Homeostasis Model Assessment (HOMA) estimates were calculated. Metabolic syndrome (MS) and AO were judged by the 2005 International Diabetes Federation (IDF) criteria. RESULTS: The study and comparison groups showed were reductions in BW by 4.2 and 1.7 kg and in WC by 4.2 and 1.1 cm, respectively. Metformin used in the patients with AO contributed to a more significant improvement in the lipid profile than in those who received no medication. A decrease in the HOMA index was observed only in the metformin group. The effects of the drug were more pronounced in MS and insulin resistance. The use of metformin in the patients with AO decreased lower BW and HOMA index and improved lipid metabolism even in the absence of MS. CONCLUSION: The trial has demonstrated that the people with AO may take metformin could be used in to reduce BW and WC and to treat and prevent MS.

[Cytokines and their role in pathogenesis of diabetic retinopathy].

The role of cytokines is estimated in development of diabetic retinopathy. Titer of cytokines is compared in healthy subjects and patients with impaired glucose metabolism. Fundus examination and specific cytokines level assessment allowed us to conclude that cytokines directly take part in pathogenesis of retinopathy before clinical manifestation. It provides rational to use cytokine level as a predictor of early manifestation of diabetic retinopathy, its timely treatment and prevention of progressing till end stages.

[Mineral bone density and mineral exchange status in patients with chronic generalized periodontitis].

Chronic generalized periodontitis (CGP) development and course are closely related with somatic pathology. Systemic factors (Ca-regulating hormones level including) influence jaw bone tissue metabolism by resorptive processes reinforcing. We determined the degree of skeletal bone tissue mineralization and the level of Ca-regulating hormones in women with CGP of reproductive age and in postmenopausal period. According to our data the women with severe CGP of reproductive age had normal values of sceletal mineral bone density in cases of Ca-regulating hormones level and Ca-homeostasis changes.

[Characteristics of immune system in patients with metabolic syndrome]. / Osobennosti sostoianiia immunnoi sistemy u bol'nykh s metabolicheskim sindromom.

AIM: To characterize features of immune status in patients with metabolic syndrome (MS). MATERIAL AND METHODS: 41 MS patients entered the study (mean age 55.9 +/- 9.7 years). Blood free triiodthyronine (T3f), thyroxine (T4f), TTH, antibodies to thyroglobulin (abTG), thyroid peroxidase (AbTP) were studied with enzyme immunoassay; levels of CD3+, CD4+, CD8+, CD16+, CD72+ were studied with monoclonal antibodies; IgG, IgA, IgM were measured by radial immunodiffusion in gel by Manchini. The size and the structure of the thyroid were investigated with ultrasound. RESULTS: Thyroid pathology was in 48.8% patients with MS, chronic infectious diseases (CID)--in 51.2%. MS patients free of thyroid pathology and CID had elevated blood levels of IgG, IgA, dysimmunoglobulinemia and low relative number of CD3+ lymphocytes, close correlations of T3free with the levels of CD3+, CD4+, CD8+, T4free with CD72+ (r = -0.97 to +0.92), T4free with IgA, IgG (r = -0.96, r = -0.90), TTH and IgA (r = -0.89), weak negative correlations of uric acid with the levels of CD3+, CD4+, CD72+ and positive with CD8+, CD16+, immunoglobulins. Combination of MS with thyroid pathology and/or CID was characterized with aggravated defects in T- and B-cell immunity, fall in IgG, IgA and changed direction of correlations of thyroid and immune statuses. CONCLUSION: Immune status in MS patients was characterized by stimulation of humoral immunity, dysimmunoglobulinemia, T-cell immunity deficiency. This may be related to chronic hyperinsulinemia, dyslipidemia, antigenic stimulation with modified lipoproteins. Thyroid hormones levels positively correlate with concentrations of immunocytes and negatively--with immunoglobulins.

[Trends of physical fitness, physical performance, and blood circulation in children in response to graded exercises at a health center]. / Osobennosti dinamiki pokazateley fizicheskoi podgotovlennosti, fizicheskoi rabotosposobnosti i reaktsii krovoobrashcheniia na dozirovannuiu fizicheskuiu nagruzku u detei v usloviiakh ozdorovitel'nogo tsentra.

The article presents physiological features of the effect of summer conditioning of children on their physical performance and on circulation action of graded exercise. Physiological mechanisms of the influence which a complex of health factors have on body response to short-term physical exercise are described.

[Effect of reflex-segmental massage on central hemodynamics in healthy people]. / Vliianie reflektorno-segmentarnogo massazha na sostoianie tsentral'noi gemodinamiki u zdorovykh.

Bioimpedance tetrapolar rheopolygraphy was made in 18-22-year-old athletes in lying position and active orthostasis using computer technology Kentavr PRS (Microlux). The study group of 40 men received a 10-day course of massage including classic massage of the spine and neck, reflex-segmental massage of the left scapula, region between the left scapula and the vertebral column, left great chest muscle and sites of left attachment of the ribs to the chest. The examinations were made before the massage and after it. The results demonstrate an optimizing effect of reflex-segmental massage technologies on central hemodynamics.

[The use of highly purified Iletin-II-type porcine insulins and human insulin preparations in clinical practice]. / Primenenie vysokoochishchennykh svinykh insulinov tipa Iletin-II i preparatov insulina cheloveka v klinicheskoi praktike.

The paper presents the results of treatment with insulins of iletin-II and humulin series. Decreased insulin doses, absence of complications, stable compensation of diabetes mellitus, reduction of insulin antibodies titer suggest high clinical effectiveness of the above preparations. Because of low immunogenicity humulin insulins are preferable when compared to iletin-II ones.

[Osteocalcin in diffuse toxic goiter]. / Osteokal'tsin pri diffuzno-toksicheskom zobe.

Bone metabolism was investigated in toxic goiter. The authors obtained evidence on high levels of osteocalcin which marks bone formation. The time of the thyroid function recovery during thyrostatic therapy and indices of phosphorus-calcium metabolism disagree indicating delayed normalization of the bone tissue metabolism. There is a correlation between the thyroid function, osteocalcin and oxyproline that indirectly confirms the action of thyroid hormones on the bone matrix; between osteocalcin levels and other indices of bone metabolism (serum alkaline phosphatase activity and oxyproline excretion).

[Status of phosphorus-calcium metabolism and secretion of calcium- regulating hormones in diabetic nephropathy]. / Sostoianie fosforno-kal'tsievogo obmena i sekretsiia kal'tsii- reguliruiushchikh gormonov pri diabeticheskoi nefropatii.

The studies performed by the authors led them to the conclusion that diabetic nephropathy aggravates derangement of phosphoric--calcium metabolism in patients with diabetes mellitus. Secondary hyperparathyroidism, as a result of negative calcium balance in decompensated diabetes mellitus and renal dysfunction, contributes to development of marked alterations of the osteoarticular system.