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The article deals with the current problems of the prevalence, diagnosis and treatment of acid-related disorders in children. The administrative and legal aspects of the state regulation of measures aimed at diagnosing Helicobacter pylori infection, procurement of drugs for its treatment in the Russian Federation are discussed. The article also focuses on the standards of treatment of H. pylori infection in children with regard to age restrictions for the administration of the recommended drugs. A detailed account of the mechanisms of the developing H. pylori resistance to modern antibacterial drugs is given. The above problems necessitate the use of highly effective and safe drugs with low H. pylori resistance and approved for administration in children. The article indicates the already established and hypothesised factors of the pathogen’s low resistance to bismuth preparations. The multifactor, predominantly local, pharmacodynamic effect of bismuth tripotassium dicitrate in children ≥ 4 years of age is described. Data on the clinical effectiveness and high safety of this compound in H. pylori eradication therapy in paediatric population are also presented. Key words: acid-related disorders, Helicobacter pylori, standards for diagnosis and treatment of H. pylori in children, antibiotic resistance, bismuth tripotassium dicitrat

Current guidelines for the management of patients with dyslipidemia define low-density lipoprotein cholesterol (LDL-C) as the primary target in addressing lipid-lowering therapy. The target level of LDL-C in real clinical practice is achieved in no more than a third of patients who have undergone a coronary event and receive high-intensity lipid-lowering therapy. Achieving the goals of lipid-lowering therapy in a significant proportion of patients with atherosclerotic cardiovascular diseases (ACVD) is impossible with the use of even high doses of statins, which requires its enhancement by other drugs. The article considers the place of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors in the prevention of cardiovascular diseases in patients with ACVD in accordance with the latest Russian and international guidelines. A modern decision-making algorithm for the initiation of PCSK9 inhibitors therapy in patients with ACVD is presented. The authors provide a clear understanding about the patient populations that will benefit most from the taking of PCSK9 inhibitors. Particular attention is paid to Guidelines for the management of dyslipidemias developed by European Society of Cardiology and European Atherosclerosis Society in 2019. The issues of patients provision with PCSK9 inhibitors with reference to Russian conditions are described in details in accordance with the requirements for territorial programs of state guarantees. Further improvement in the provision of PCSK9 inhibitors to patients with indications for this therapy is necessary, considering the potential of these drugs in reducing cardiovascular morbidity and mortality in patients with ACVD.

Stroke is still the most significant problem of the modern medicine and the leading cause of mortality and morbidity. There is the great experience of neuroprotection in patients with stroke in the Russian Federation. In clinical practice it's important to follow conditions, where neuroprotection will have maximum safety and effectiveness. The clinical trials of ethylmethylhydroxypyridine succinate (mexidol) in patients with acute ischemic stroke are described in the present review. Early management (in the first 6 hours) with mexidol significantly improve recovery dynamic and stroke outcome. Therapy with mexidol increases neurological recovery, improves vital activity and quality of life of patients with stroke. Furthermore, mexidol demonstrates high safety profile.Инсульт остается одной из наиболее актуальных проблем современной медицины, являясь ведущей причиной смертности и инвалидизации населения. В РФ имеется большой опыт применения нейроцитопротекторов при ишемическом инсульте. В реальной клинической практике важно соблюдать условия, при которых нейропротекция будет максимально безопасной и эффективной. В настоящем обзоре представлен анализ результатов клинических исследований, посвященных эффективности и безопасности этилметилгидроксипиридина сукцината (Мексидол) у пациентов с острым ишемическим инсультом. Раннее (в первые 6 ч инсульта) применение препарата достоверно улучшает восстановительную динамику и улучшает исход заболевания; при использовании препарата отмечено ускорение регресса неврологических нарушений, улучшение жизнедеятельности и качества жизни пациентов. В исследованиях продемонстрирован высокий профиль безопасности этилметилгидроксипиридина сукцината.

Chronic cerebral ischemia (CCI) is a common cerebrovascular syndrome, the development of which is associated with a high risk of increasing cognitive, behavioral, and motor disorders, and the formation of a patient's dependence on others. Timely start of treatment can slow down the course of the disease, make it more favorable. The review considers the possibility of using the domestic neuroprotector mexidol in patients with CCI. The results of a series of clinical studies on the use of ethylmethylhydroxypyridine succinate (mexidol) in patients with CCI are analyzed. The effectiveness of the drug in relieving cognitive, affective and motor disorders is noted. Information about the good tolerance of mexidol is presented.Хроническая ишемия головного мозга (ХИМ) — распространенный цереброваскулярный синдром, развитие которого ассоциировано с высоким риском нарастания когнитивных, поведенческих, моторных нарушений, формированием зависимости больного от посторонней помощи. Своевременное начало лечения способно замедлить течение заболевания, сделать его более благоприятным. В обзоре представлен анализ результатов клинических исследований, посвященных эффективности этилметилгидроксипиридина сукцината (Мексидола) у пациентов с ХИМ. Отмечена эффективность препарата при купировании когнитивных, аффективных и моторных нарушений. Приведены сведения о хорошей переносимости этилметилгидроксипиридина сукцината.