УДК 616–002.525.2–031.81:616.12–008(048.8)

Introduction. The prevalence and incidence of systemic lupus erythematosus (SLE) in the world is significant. In recent years, there has been a tendency of the SLE prevalence increase. Despite the undoubted progress in understanding the etiology and pathogenesis of SLE, its diagnosis and treatment, the mortality of patients, including ones at young and working age, is higher than in the general population, and circulatory system lesions are ones of
its main reasons in these cases.
The aim of the study. To analyze the literature, devoted to the modern view on the problem of systemic lupus erythematosus with and without comorbid lesions of the circulatory system, describe the clinical case.
Materials and methods. Content analysis, method of system and comparative analysis, bibliosemantic method of studying the current scientific studies on modern principles of diagnosis and treatment of patients with SLE are used. A clinical case is described.
Results. A clinical case of a 43-year-old patient S., who was hospitalized for SLE, she considers herself ill for eighteen years and she has been constantly taken outpatient and periodically inpatient treatment due to the frequent deteriorations in her general condition, clinical and laboratory parameters, is described. Based on the received results of the examinations, applying the method of determining the functional class of SLE, the patient was diagnosed
with a clinical diagnosis indicating comorbid lesions of various organs and systems (skin, joints, kidneys, vessels, heart, blood system, immune system, eyes). The generally accepted basic medical complex of the patient includes drugs, taking into account the lesions to the circulatory system. The conducted complex pathogenetic treatment gave a positive result.
Conclusions. In the described clinical case demonstrated the development of comorbid lesions of many organs and systems, including circulatory system, in a patient with systemic lupus erythematosus. Inclusion in the treatment complex in addition to basic and drugs for the treatment lesions of circulatory system has improved the general condition of the patient, stabilized clinical and laboratory parameters, as evidenced by a prospective study during
three years. The information provided in our clinical case is consistent with the results of the literature review. Systemic lupus erythematosus needs further in-depth study due to its widespread prevalence among young and people of working age, lack of accurate knowledge about the etiology and pathogenesis of the disease, comorbid lesions of many organs and systems, including circulatory system, the development of severe and often life-threatening manifestations, the lack of clear recommendations that would predict the differentiated use of drugs taking into account comorbid syntropic lesions.
Keywords: SLE, circulatory system lesions, atherosclerosis, diagnosis and treatment of SLE.

УДК 618.173-036.8-02:616.1/.7-036-08

У статті наведено основні положення та клінічні підходи до ведення жінок у періоді менопаузального переходу. Зокрема, представлено сучасну класифікацію етапів старіння репродуктивної системи, надано характеристику клімактеричних і менопаузальних порушень, викладено сучасні засади менопаузальної гормональної й альтернативної терапії.

The article presents the main provisions and clinical approaches to the management of women during the menopausal transition. In particular, the modern classification of the stages of aging of the reproductive system is presented, the characteristics of climacteric and menopausal disorders are given, and the modern principles of menopausal hormonal and alternative therapy are outlined.

The aim: To analyze the metabolic status of patients with coronary artery disease and nonalcoholic fatty liver disease depending on body mass index.
Materials and methods: The cohort of patients included 107 people with coronary artery disease (CAD), nonalcoholic fatty liver disease (NAFLD) and overweight (n=56) or obesity (n=51). In all patients glucose, insulin, HbA1c, HOMA-IR, hsCRP, transaminases, creatinine, urea, uric acid, lipid profile, anthropometric parameters and ultrasound elastography were measured. Results: During the analysis of serum lipid spectrum in patients with obesity: lower levels of HDL and higher TG concentration compared with patients who had overweight. The insulin level was almost twice as high as in patients with overweight and the HOMA-IR index was 3.49 (2.13;5.78), where as in patients with overweight it was 1.85 (1.28;3,01), p<0.01. In patients with coronary artery disease and overweight, the of hsCRP was 1.92 (1.18;2.98) mg/l and was significantly different from the hsCRP level in obese patients, which was 3.15 (2.64;3.66) mg/l, p=0,004. Conclusions: In patients with coronary artery disease, non-alcoholic fatty liver disease and obesity, the metabolic profile was characterized by a more unfavorable lipid spectrum: lower levels of HDL and higher triglicerid concentration. Carbohydrate metabolism in obese patients included disorders such us impared glucose tolerance, hyperinsulinemia and insulin resistance. There was also a correlation between body mass index with insulin and glycated hemoglobin. Higher concentration hsCRP in obese compared with patients with overweight was observed. This confirms the role of obesity in the patogenesis of coronary artery disease, non-alcoholic fatty liver disease and systemic inflammation.

Abstract.1 New 4-aryl-3-(morpholin-4-yl)-2-arylimino-2,3-dihydrothiazole derivatives 1.1-1.16 were obtained using the Hantzsch reaction by condensation of N-(morpholin-4-yl)-N'-arylthioureas with the corresponding α-bromoacetophenones in alcohols. Synthesized hydrobromides 1.1-1.8 were formed as crystalline precipitates during the boiling of the reaction mixture. Bases 1.9-1.16 were obtained by neutralizing the corresponding hydrobromides with NH4OH solution. It has been proposed a possible mechanism of the reaction that is based on the study of the structure of the synthesized compounds. The structures of the synthesized compounds were confirmed by 1H NMR spectroscopy with its special techniques (NOESY and ROESY experiments). It has been shown the formation of the isomer 4-(4'-chlorophenyl)-3-(morpholin-4-yl)-2-(4'-chlorophenylamino)-2.3-dihydrothiazole on the basis of compound 1.14. Pharmacological screening of synthesized derivatives of 4-aryl-2-arylimino-2,3-dihydrothiazole compounds revealed the analgesic effect in the model of visceral pain caused by the introduction of acetic acid to white mice. The anti-inflammatory effect of the synthesized compounds was evaluated in vivo by reducing limb edema in rats with carrageenan-induced inflammation. Thus, the synthesized compounds have analgesic and anti-inflammatory activity.