The aim: To analyze the dynamics of daily monitoring of blood pressure, intracardiac (according to echocardiography), peripheral hemodynamics (according to ultrasound of the vessels of the lower extremity), the thickness of the intima-media complex (according to carotid sonography) in patients with hypertension the effect of treatment with a combination of lisinopril and amlodipine. Materials and methods: The study included 40 patients with hypertension with 2 (29 patients) and 3 (11 patients) degrees of hypertension in combination with AOLE with I-III stages of chronic insufficiency of the lower extremity, which revealed hyperkinetic, eukinetic, and hypokinetic types of hypertension with a predominance of the sympathetic nervous system. The groups are comparable in age, sex, duration of hypertension, and medications received in the previous stages. For antihypertensive therapy, the most common drugs for use were selected – lisinopril + amplodipine in fixed doses of 10 and 5 mg, respectively. If after 2 weeks we did not reduce the mean level of SBP and DBP by 10% or more from baseline, we doubled the dose of lisinopril without changing the dose of amlodipine. Results: After 6 months of treatment, in particular, an increase in the pulse index – by 24.8%, a decrease in the resistance index – by 21.1%, an increase in linear and volumetric blood velocity – by 25.6% and 27.4%, respectively, while achieving the target blood pressure. Conclusions: It is proved that in the absence of individual contraindications the combination of lisinopril and amlodipine is optimal and universal for effective treatment of patients with hypertension in combination with AOLE in all types of central hemodynamics.

Introduction: The prevalence and incidence of cardiovascular diseases have been attracting considerable attention in recent decades. This is partly due to the fact that myocardial fibrosis is the major consequence of the most nosological units of cardiovascular diseases. We believe that early pathogenic therapy of myocardial fibrosis should be taken into consideration as a solution to this issue. The change of the connective tissue metabolism in myocardium is the central chain in pathogenesis of diffuse ischemic necrotic cardiosclerosis (DINC) occurs after repeated epinephrine injury of myocardial tissues. The aim: The present study establishes that use of metabolic therapy by trimetazidine (TM) has a protective effect on myocardium repeatedly damaged by epinephrine in hight concentration during the development of DINC in rats with different resistance to hypoxia. Materials and methods: Using the method of hypobaric hypoxia, male albino rats were divided into three groups due to their different resistance to hypoxia. Each group was divided into four equal subgroups: control group, DINC group (2 times repeated injections of epinephrine hydrotartrate (0,5 mg/kg body weight) and calcium gluconate (5 mg/ kg body weight), control group introdused with trimetazidine dihydrochloride (10 mg/kg body weight), DINC treated with TM group (2 times repeated injections of epinephrine hydrotartrate (0,5 mg/kg body weight) and calcium gluconate (5 mg/kg body weight) group introduced with TM (10 mg/kg body weight) for all period of observation. The concentration of protein-bound oxyproline in homogenate of myocardium was determined at 7, 14 and 30 days after the modelling pathology and the histological examination of Masson trichrome staining of myocardium was performed. Results: Experimental modeling of DINC increased the concentration of protein-bound oxyproline in homogenate of myocardium at 7, 14 and 30 days after the modelling pathology, as well as accompanied by metabolic imbalances in diffuse connective tissue elements, which are rich in collagens. Experimental modeling of DINC+TM increased the concentration of protein-bound oxyproline in blood serum significantly less intensive. Conclusions: The intensity of metabolic imbalances in diffuse connective tissue elements of myocardium is the highest in the low resistant animals to hypoxia. Those results are confirmed by histological examination of the myocardium of rats with different resistance to hypoxia. Fibrotic regions in myocardium are rich in collagens. It has been revealed that the most pronounced therapeutic effect of TM is observed in animals with low resistance to hypoxia, slightly less – in animals with medium resistance to hypoxia, and the lowest – in animals with high resistance to hypoxia.

48-78 % of patients admitted to surgical hospitals with ventral hernias are obese, which has a significant impact on the course of the disease and the postoperative period, and little is reported in the literature. Obesity, on the one hand, contributes to the formation of hernia, on the otherprogresses with its appearance. Despite the large number of surgical procedures to correct the abdominal wall, the results of surgical treatment of primary and postoperative ventral hernias, especially in morbid obesity are unsatisfactory, due to errors in choosing the optimal method of surgery indicated by the high number of complications and high recurrence. Recurrences after surgical treatment of primary and postoperative ventral hernias occur in 10-60 % of cases, which indicates that the problem of surgical restoration of the abdominal wall is still far from being solved. Objective. Conduct a retrospective analysis of the results of surgical treatment of patients with ventral and postoperative ventral hernia to determine the main risk factors for complications in patients with morbid obesity. Materials and methods. The results of surgical treatment of 183 patients operated on for primary and postoperative ventral hernia with concomitant morbid obesity in 2015-2020 combination with dermatolipectomy and liposuction. A total of 46 (25.14 %) were performed. Dermatolipectomies were performed by Kuster, Jolly, Thorek and Castansres-Goethel. Pulmonary artery thromboembolism (PE) was diagnosed in 2 (1.09 %) surgically operated: 1 (1.31 %) patient with degree I of obesity and 1 (1.72%) with degree II respectively. Abdominal compartment syndrome (ACS) was diagnosed in 4 (2.19 %) surgically operated: among them with obesity degree IIin 2 (3.45 %) patients and degree IIIin 2 (4.08 %) patients. Significantly higher frequency of wound complications was observed in patients with obesity degree II-15 (26.17 %) and degree III-16 (31.41 %). Hernia recurrence occurred in 10 (12.58 %) surgically operated with obesity degree I, in 6 (9.33 %) with degree II, and in 6 (11.82 %) with degree III. Conclusions. Performance of laparoscopic and non-tension implantation methods of hernioplasty should be a priority, especially in groups of patients with pre-existing morbid obesity degree II-III. In obese patients with degree III there is a significantly higher incidence 191 of abdominal compartment syndrome, and the simultaneous dermatolipectomy or liposuction significantly reduces the incidence of local complications and recurrences.