Objective. On the example of a clinical case, the difficulties of timely diagnosis of acute pancreatitis are considered. Main points. Acute pancreatitis is an actual problem of modern medicine due to its wide prevalence and high mortality rates. A clinical observation of a 48-year-old patient with dyspeptic complaints and intestinal manifestations is presented. Conclusion. The presented clinical case illustrates not only the difficulty of timely diagnosis of acute pancreatitis, but also confirms that patients with existing pain, dyspeptic and asthenovegetative syndromes after a viral intestinal infection require special attention and are at risk of developing acute pancreatitis.

Aim. To study the prognostic relationship between heart failure (HF) and osteoporosis, as well to search for modern principles and approaches to the management of patients.Material and methods. A search was conducted in the PubMed, RSCI databases from 2012 to 2022 using keywords. The studies were selected according to the PRISMA algorithm.Results. Based on the results, 124 papers were received, and 9 articles were eventually selected. The age of the patients was at least 49 years (mainly elderly patients). The median follow-up ranged from 12 months to 10,5 years. The larger percentage were females.Conclusion. Osteoporosis was associated with the HF risk, and patients with heart failure had a higher risk of accidental fracture due to accelerated bone turnover. The foregoing makes it possible to consider patients with HF as a group of increased risk of osteoporosis and associated fractures, and impaired mineral metabolism as a possible additional cardiovascular risk factor.

The demographic aging of the population causes an increase in the number of patients with both heart failure (HF) and osteoporosis. This is due to the strengthening of disease-preventive measures, multimorbidity, and presence of comorbid conditions such as senile asthenia. As a result, these pathological conditions can cause serious consequences such as loss of functional and social activity, disability, and high rates of hospitalization and mortality. The article considers the common risk factors of HF and osteoporosis and the leading pathophysiological mechanisms underlying these conditions. Modern ideas about the causes of bone metabolism disorders and their features in patients with HF are discussed. Data on the contribution of systemic and immune inflammation, rennin-angiotensin-aldosterone system activation in the pathogenesis, and progression of HF and osteoporosis are presented. The relationship between low bone mineral density and hemodynamic disorders in patients with HF is also shown. All this is considered in the prospect of distinguishing patients with HF as a risk group for osteoporosis and patients with decreased bone mineral density as having a high cardiovascular risk.