The review presents the key provisions of the recommendations of the Russian society of cardiology and the guidelines of the European society of cardiology for the diagnosis and treatment of atrial fibrillation (AF), updated in 2020. The recommendations clearly state the requirements for atrial fibrillation diagnosis verification, and propose an approach to the formation of a complex characteristic of the disease in four positions, which is designated as 4S-AF (Stroke risk, Symptom severity, Severity of AF burden, Substrate severity). The authors analyzed the strategy "CC To ABC" (Confirm AF, Characterize AF, Treat AF: the ABC pathway) proposed by European experts, the issues of modern terminology and requirements for verifying the diagnosis of AF, complex characteristics of the disease and stratification of the risk of stroke and bleeding, a new ABC approach in the treatment of AF, where A is anticoagulant prevention of thromboembolic complications, B is the control of symptoms of the disease and C is the detection and treatment of comorbid pathology. The General principles that have changed in comparison with the previous versions of guidelines of 2016 on the initiation and tactics of anticoagulant therapy, pharmacological and non-drug cardioversion, catheter ablation in patients with AF, affecting the prognosis and outcomes in patients with AF, are outlined. It is emphasized that the pattern of atrial fibrillation (first diagnosed, paroxysmal, persistent, long-term persistent, permanent) should not determine the indications for anticoagulant prevention. The solution to this issue is determined by the level of risk according to the CHA2DS2-VASc scale. The introduction of the considered methods of diagnosis and treatment of AF into clinical practice will optimize the burden on the health care system and reduce the costs associated with the burden of AF.

Optimization of joint syndrome treatment methods, including those based on the intra- and periarticular drug administration and invasive diagnostic techniques, remains high on the agenda of modern clinical rheumatology. The implementation and quite widely spread use of ultrasonographic visualization has been an impetus to the development of this type of treatment for joint diseases. Without any doubt, the quality of intraarticular injection performance mainly depends on the professional level of the specialist and his/hers procedural skills. However, here comes a predictable question: are these conditions sufficient to enable maximal precision, safety, and efficacy of intraarticular interventions? From this perspective, it is interesting to study the possibilities to improve the results of local treatments for the joint syndrome by means of the ultrasound navigation technique. Based on data presented in the literature review, we compared a “blind” invasive treatment method to the ultrasound navigation-guided intra- and periarticular interventions in patients with skeletomuscular and connective tissue disorders. The authors of the studies published point to higher safety, efficacy, procedure precision, and diagnostic quality of the information obtained by the ultrasound navigation. Its important advantages include wider possibilities and availability of this method in outpatient settings, due to its rather low costs and patients' safety. The information from the current literature review reflects an initial stage of studies on the evaluation of the role, significance, determination of potential of the ultrasound navigation to enhance the quality of diagnosis and invasive treatment in patients with joint syndromes of various origins and to minimize adverse effects.

No abstract

Mauriac syndrome is a severe complication of type 1 diabetes mellitus, manifested by growth retardation, impaired formation of secondary sexual characteristics, lack of libido, and hepatomegaly. Currently, the presented syndrome is quite rare. This is more related to the emergence of intensive insulin therapy, which keeps the level of daily glycemia within the tolerance of type 1 for diabetes mellitus. The article describes a clinical case of the development of Mauriac syndrome in a 21-year-old patient with decompensated diabetes mellitus and multiple complications. The patient was deprived of proper control over the condition of daily glycemia and full-fledged insulin replacement therapy for a long because of unfavorable social and material conditions in the family, which contributed to the development of chronic insulin insufficiency and complications.

Артериит Такаясу, или неспецифический аортоартериит, называемый также «болезнь Такаясу», «заболевание отсутствия пульса», «средний аортальный синдром», «синдром Марторелля», «артериит молодых женщин», является заболеванием, относящимся к группе системных васкулитов, с частым поражением сосудов крупного диаметра, и служит возможной причиной развития инфаркта миокарда. Распространенность заболевания до конца не известна. По мнению А. Политано и К. Дж. Cherry (2015), неспецифический аортоартериит является второй причиной окклюзионной болезни сосудов крупного диаметра в Америке. По одним данным, в России на 1 млн населения приходится 2,6 человека, имеющих данную патологию. Соотношение мужчин и женщин в Российской Федерации колеблется от 1:2,4 до 1:1,71. Большая часть пациентов с неспецифическим аортоартериитом находятся в возрастном диапазоне от 10 до 30 лет. В статье представлено описание клинического случая заболевания неспецифическим аортоартериитом пациентки 38 лет с развитием инфаркта миокарда. Данный пример доказывает, что определение наличия артериита Такаясу представляет собой трудную задачу из-за первично-хронического течения заболевания у большей части больных, отсутствия специфичных симптомов, наличия многообразных клинических проявлений, что часто приводит к поздней постановке диагноза и возникновению осложнений. Ключевые слова: аортоартериит Такаясу, неспецифический аортоартериит, системный васкулит.