卷 28, 编号 3 (2024)

The lecture focuses on pertussis, an infection managed by specific preventive measures, which continues to threaten both child and maternal health, as well as overall healthcare system.

Despite high vaccination rates, pertussis remains an “under-controlled” infection and a significant contributor to childhood morbidity and mortality. Moreover, in many countries, the incidence of pertussis is clearly rising among both children and adults, with a notable proportion of cases occurring in vaccinated individuals.

This increase may be associated with changes in the antigenic structure of the pathogen, the limited duration of post-vaccination immunity, reduced vaccination coverage, and the use of more sensitive laboratory diagnostic methods.

The lecture addresses modern aspects of the etiopathogenesis, epidemiology, clinical presentation, diagnosis, treatment, and prevention of pertussis. Given the rising incidence of this infection in Russia and several other countries in 2023, the information presented will be especially valuable for practitioners, particularly family doctors.

Helicobacter pylori is one of the most widespread infections, affecting approximately 50% of the global population, with the Russian Federation ranking among the regions with a relatively high prevalence. Eradication therapy remains the primary strategy, not only for the treatment and prevention of gastrointestinal diseases but also for reducing the risk of stomach cancer, highlighting the medical and social impact of this infection. A key factor contributing to the reduced effectiveness of eradication therapy is the microorganism’s primary or secondary resistance to antibacterial drugs, a problem recognized worldwide. It is widely acknowledged that national treatment regimens for Helicobacter pylori infection must be adapted based on systematic antimicrobial sensitivity testing to curb the rise of global antibiotic resistance. Despite decades of research and clinical practice, identifying the most effective, safe, and straightforward therapy remains a significant challenge for clinicians.

This review provides a comparative analysis of current treatment recommendations for Helicobacter pylori infection, as presented by various national and regional gastroenterological societies, including those relevant in the Russian Federation.

BACKGROUND: Estrogens play a crucial role in the functioning of the reproductive, cardiovascular, skeletal, and central nervous systems. However, existing literature on the correlation between estrogen levels and the risk of cardiovascular events in elderly populations is limited and contradictory.

AIM: To assess the effect of estrogen levels on the incidence of myocardial infarction and stroke in older women.

MATERIALS AND METHODS: The Crystal study was a population-based cross-sectional cohort study which included community-dwelling individuals aged 65 and older (n = 280). Key study parameters included survey responses and medical record analysis for non-communicable chronic diseases, alongside laboratory assessments for estradiol, thyroid-stimulating hormone, glycated hemoglobin, total protein, albumin, lipid panel, C-reactive protein, complete blood count, and creatinine levels.

RESULTS: A history of stroke was recorded in 18.9% (n = 54) of participants, while myocardial infarction was reported in 11.9% (n = 34). In participants with estradiol levels in the 4th quintile (>55 pmol/l), stroke incidence was 2.5 times higher (odds ratio 2.480; 95% confidence interval 1.180–5.211) and myocardial infarction incidence was 2 times higher (odds ratio 2.003; 95% confidence interval 1.088–3.687) after adjustments for age and high-density lipoprotein levels.

CONCLUSIONS: An estradiol level greater than 55 pmol/l is an independent risk factor for the development of stroke and myocardial infarction in women aged 65 years and older.

This clinical case presents a 39-year-old woman diagnosed with essential thrombocythemia, accompanied by a review of the epidemiology, clinical and diagnostic criteria, and patient management strategies. The case also includes a discussion of potential complications and prognosis associated with the condition. The importance of thorough outpatient monitoring is emphasized, which should include regular assessments of clinical symptoms, changes in blood count parameters, bone marrow trephine biopsy, and molecular genetic testing for MPL and CALR gene mutations. The report highlights gaps in the current medical examination process, suggesting that addressing these deficiencies could improve early detection of essential thrombocythemia and enable timely pathogenetic therapy with antiplatelet agents to prevent complications.