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The article is devoted to the peculiarities of organizing a parent club for families raising children with disabilities. Based on practical experience, the authors identify the conditions necessary for the effective functioning of the parent club. Based on the results of the study of the social potential, psychological characteristics and relevance of this form of work for parents, a program of classes was compiled and the main directions of the club's work were determined.

Objective: To study the frequency and conditions for the emergence of atrial fibrillation paroxysms (AFP) in elderly and late-life patients in the postcovid period on the background of comorbid pathology. Design and method: 2 months after SARS-Cov-2-pneumonia, 124 people were examined, 66 of them (41 men and 25 women) aged 68±5.9 years (group 1) and 58 (33 men and 25 women) aged 81±4.3 years (group 2). According to computed tomography (CT) performed during SARS-CoV-2-pneumonia, in group 1, 12 patients (18.2%) had lung lesion volume < 25% (CT1); 34 patients (51.5%) 25-49% (CT2); 18 patients (27.3%) 50-74% (CT3); 2 patients (3%) > 75% (CT4). In group 2, 14 patients (24.1%) had CT1; 18 patients (31.1%) CT2; 21 patients (36.2%) CT3; 5 patients (8.6%) CT4. All patients had arterial hypertension (AH) and coronary heart disease (CHD) on the background of atherogenic dyslipidemia; 59 had type 2 diabetes mellitus (DM), 13 had chronic kidney disease (CKD). Holter monitoring (HM) was performed for all. The content of ferritin, D-dimer, and CRP in the blood plasma was measured for all. Results: According to the HM, in 13 of 66 (19.7%) group 1 patients, AFP were registered, of which 7 patients had 30-40 minutes seizures, 3 patients – about 2 minutes seizures. 3 patients were hospitalized, their sinus rhythm was restored by cardioversion. In 16 of 58 (27.6%) group 2 patients, HM revealed AFP, 2 of them were hospitalized due to the deterioration of their condition, the sinus rhythm was restored by cardioversion. In 7 patients, AFP did not exceed 30 minutes; in another 7 patients, AFP were short, no more than 2-3 minutes. Blood ferritin in group 1 was 175±66.2 ng/ml; in group 2 212±40.2 ng/ml (p = 0.012); D-dimer 501±50.3 ng/ml and 835±53.8 ng/ml, respectively (p = 0.0002); CRP 4.3±2.1 mg/l and 8±3.3 mg/l, respectively (p = 0.0009). Conclusions: 2 months after SARS-CoV-2-pneumonia with a large area of lung damage, elderly and late-life patients with a very high cardiovascular risk have signs of inflammation, and a tendency to increased thrombosis, which probably causes the AFP emergence.

Objective: To study the incidence of coronary atherosclerosis in young and middle-aged diabetic (DM) patients with acute coronary syndrome (ACS) against the background of arterial hypertension (AH). Design and method: Seventy-six DM patients admitted with a diagnosis of ACS (59 men,17 women) were included, ages from 36 to 59 years (mean 55.5 years). History of DM less than 1 year in 16 patients; 1-5 years in 24 patients and 5-12 years in 36 patients. The mean of HbA1c was 8.1% (6.2-10.9%). Diagnosed the grade 1 of AH was in 32 (42%) patients; grades 2-3 in 44 (58%) patients. All patients underwent coronary angiography (CAG) with stent implantation in criminal artery. Blood tests for low-density lipoprotein (LDL-C) and high-density lipoprotein (HDL-C), NT-proBNP, renin, aldosterone, creatinine were performed. As a control group 115 patients (101 men, 14 women) with ACS without diabetes mellitus included, mean age was 54.5 years (37-59 years). Mean of HbA1c was 5.4% (4.9-5.8%). Grade 1 of AH was diagnosed in 72 (62.6%) patients; grade 2-3 in 43 (37.4%) patients. Results: According to CAG, lesions in one vessel of coronary artery (CA) was found in 18 (23.7%) diabetic and in 64 (55.7%) without diabetes patients; lesions in 2 vessels of CA - in 40 (52.6%) diabetic and in 35 (30.4%) without diabetes patients. Lesions in 3 vessels of CA was found in 18 (23.7%) diabetic and in 16 (13.9%) without diabetes patients. The incidence of multivessel CA lesions in diabetic was 76.3% and 44.3% without diabetes patients. LDL-C was 4.14 ± 1.45 mmol/l in diabetes and 3.66 ± 1.26 mmol/l without diabetes (p = 0.0334); HDL-C was 1.30 ± 0.42 mmol/l in diabetes and 1.15 ± 0.32 mmol/l without diabetes (p = 0.0046). In 67.1% diabetic patients and in 52.1% without diabetes renin and aldosterone levels exceeded the norm. NT-proBNP was 880 pg/ml (397-2530 pg/ml) in diabetes had significantly higher than 739 pg/ml (272-1576 pg/ml) without diabetes (p = 0.0001). Conclusions: In young and middle-aged DM patients, arterial hypertension and atherogenic dyslipidemia are the leading risk factors for atherosclerotic CA lesions.

Objective:To evaluate the 24-hour blood pressure (BP) control and the effect of the triple fixed combination (TFC) amlodipine / indapamide / perindopril on the arterial stiffness parameters according to 24-hour blood pressure monitoring (ABPM) data in patients with uncontrolled hypertension (HTN).Design and method:The study involved 78 patients with insufficient BP control, against the background of previous combination therapy. All patients received TFC amlodipine / indapamide / perindopril. The patient’s condition was assessed during 4 observation visits: visit 1- inclusion, visit 2 - 4 weeks, visit 3 -12 weeks, visit 4 - 24 weeks observation. At each visit, the achievement of the target BP level < 130/80 mm Hg was assessed, as well as the effect of therapy on the parameters of arterial stiffness (pulse wave velocity (PWVao), pulse pressure (PP), agumentation index (Aix), arterial stiffness index (ASI)) and central aortic pressure parameters (systolic aortic pressure (SBPao), diastolic pressure in the aorta (DBPao), central pulse pressure (PPao)) according to ABPMResults:In subjects with HTN with ineffective antihypertensive therapythe initial office BP was 160.8 ± 10.3 / 91.5 ± 8.1 mm Hg. After 24 weeks of therapy with a TFC there was a significant decrease in blood pressure to 121.3 ± 3.5 / 73.6 ± 4.2 mm Hg (p < 0.001). According to ABPM data, mean values of daily BP significantly (p < 0.001) decreased from 153.9 ± 9.04 / 8.38 ± 9.18 to 120.3 ± 4.7 / 73.4 ± 4.7 mm Hg. Data analysis showed a decrease PWVao (11.39 ± 1.32 m/s vs 9.98 ± 0.91 m/s, p < 0,05) as well as ASI (174 (138, 253) vs 139 (107.196) mmHg; p < 0.001) and Aix -29,9 (-41,12) vs - 33,7 (-53, 9) p < 0,05. There was a statistically significant decrease in the parameters the central pressure in the aorta (Fig.1)Conclusions:In patients with HTN and previous uneffective antihypertensive therapy the FTC amlodipine / indapamide / perindopril provided high antihypertensive effectiveness. Parameters of vascular stiffness can serve as criteria for quality control of blood pressure and can be used to assess the effectiveness of antihypertensive therapy.