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The aim:To study the clinical course of chronic pancreatitis (CP) in patients with concomitant hypertension. Materials and methods: A thorough analysis of the results of subjective and clinical and laboratory examinations of 102 patients with CP, who were hospitalized in the therapeutic department of Khust district hospital during 2017-2018 was conducted. Results: Takingintoaccount that the initial examination of patients was carried out during the period of exacerbation of the disease, all patients presentedwith pain syndrome (100%).The overwhelming majority of patients identified pain as permanent aching discomfort in the abdominal cavity with periodic intensification (n = 41 (40,2%), 18 patients indicated burning pain (17,6%), 30 – cutting (29,4%) ), and 13 (12,7%) experienced pain of varying nature.due to the presence of hypertension (GC) 73 (71.6%) patients complained of a headache of a paroxysmal periodic pulsating character, which was most often localized in the occipital-frontal area and was accompanied by dizziness, “flickering of flies” before the eyes, noise in the ears. Also, 14 (13,7%) patients had shortness of breath at moderate physical exercise, lower extremity edema that appeared in the afternoon and disappeared by the morning.In addition, 33 (32,4%) surveyed patients indicated a periodic heartbeat.In 18 (17,7%) patients sporadic dizziness was observed. The level of blood pressure (BP), which was established in the studied patients, corresponded to arterial hypertension of grade 1-2 (154,15 ± 9,24 / 94,53 ± 9,05 mm Hg). In terms of heart rate (HR) in the examined patients, it was 80.26 ± 10.73 beats per minute. Conclusions: According to the study, the negative impact of concomitant hypertension on the clinical course of chronic pancreatitis was established, namely: hypertension in most cases causes intensification of pain syndrome; pain syndrome in comorbid patients with cronic pancreatitis and arterial hypertension is accompanied by more pronounced manifestations of asthenisation: general weakness, lethargy;dependence of the duration of pain syndrome from the height of blood pressure and the duration of arterial hypertension was found; dyspepsia syndrome is more pronounced, varied and prolonged in patients with high blood pressure; smoking (37,3%), alcohol (19,6%), psychoemotional overload (6,9%) are common etiologic factors in comorbid patients with chronic pancreatitis and arterial hypertension; BMI results indicate the dominance of excess body mass in most comorbid patients with chronic pancreatitis and arterial hypertension.

Patient P., born in 1956, was found by relatives in a state of confused consciousness, an act of involuntary urination and defecation, numbness and weakening of the strength of both lower limbs were recorded. He was taken by ambulance to the reception room of the Regional Clinical Center of Neurosurgery and Neurology. The following concomitant diseases are known from the life anamnesis: Atrial fibrillation, gout, hypertension and type II non-insulin-dependent diabetes mellitus. Objective status: general condition of medium severity, tophuses of small joints of hands and feet, knee and elbow joints. Pronounced deformity of hands and feet due to gouty lesions. Heart tones are weakened. Breath sounds are weakened. The abdomen is soft, not painful on palpation. Glasgow coma scale 14-15 points. Consciousness is confused, disoriented in time, space and own person. To clarify the diagnosis, clinical and laboratory and instrumental diagnostic methods were used. Neurological complications, in particular, acute encephalopathy, on the background of coronavirus infection, may develop in patients with the presence of such risk factors as advanced age, cardiovascular diseases, hypertension, diabetes, gout. Most of the neurological complications in COVID-19 are probably not related to the direct penetration of the virus into the CNS, but are a trigger for the development of the pathology. Neuroimaging in such cases does not reveal pathological changes or reflects non-specific disorders.

The aim: To assess the dynamics of serum levels of angiopoietin-2 and transforming growth factor-β1 in patients with chronic hepatitis C (CHC) with concomitant nonalcoholic fatty liver disease (NAFLD) after successful DAAs. Materials and methods: 82 patients with CHC were examined, of which 56 were diagnosed with NAFLD and increased body weight. Ang-2, TGF-β1, leptin, adiponectin, and the degree of liver fibrosis were determined for all participants. The patients were divided into groups: 1 gr. (n=23) – CHС + increased body weight + hepatic steatosis, 2 gr. (n=33) – СНС + increased body weight + nonalcoholic steatohepatitis, 3rd gr. (n=26) – CHC. All patients received DAAs for 12 weeks. Results: From 82 patients F3-4 had 31 people, F1-2 – 25, F0-1 – 11, F0 -15 patients. F3-4 and steatosis S2-3 (p<0.05) was more common in patients of 2 gr.. Serum Ang-2 levels were higher (p<0.05) in patients of 2 gr. with F3-4, than in patients with F0-2. Fibrosis regression occurred more often in patients with 1 and 3 gr. with F1-2 than in patients 2 gr. and F3-4 and was accompanied by a decrease in Ang-2 and TGF-β1 levels. Conclusions: High levels of Ang-2 and TGF-β1 are registered in patients with CHC+NAFLD, which correlate with the degree of liver fibrosis and significantly decrease after successful DAAs in patients with low initial stages of liver fibrosis and normal body weight.

The article presents clinical observation of a patient with cryptogenic cirrhosis of the liver, a chronic diffuse progressive liver disease, which is manifested by structural rearrange¬ment of its parenchyma. Cryptogenic cirrhosis is cirrhosis of uncertain etiology that lacks definitive clinical and histological criteria for a specific disease. Cryptogenic cirrhosis accounts for nearly 5% to 30% of cases of cirrhosis and nearly 10% of liver transplants. The problem of cirrhosis of the liver is extremely relevant, because this pathology is observed mainly in young and able-bodied people. In addition, it takes the first place among the causes of mortality from diseases of the digestive system. To clarify the diagnosis, laboratory and instrumental diagnostic methods of investigation were performed. Due to severe thrombocytopenia and minor leukopenia, myelodysplastic syndrome was suspected. Metabolic disorders that can be considered as probable in the occurrence of the above-mentioned changes in the liver parenchyma had been ruled out.