Surgical and natural menopause is often associated with depression symptoms. Along with the postpartum period, perimenopause is a “window of vulnerability” for depression development, because decline in estrogen level accounts for extinction of reproductive function, emotional disorders, genitourinary menopausal syndrome, which are combined with non-endocrine risk factors, such as decreasing income levels, low social support, and stress. Although a direct relationship between blood estrogens level and depression has not been demonstrated, the relation between menopause symptoms and depression has been proven, i.e., the symptoms of menopause can be considered as risk factors. Here, we summarizes the current view on the correct counseling and routing of menopausal women with depression symptoms in primary health care facilities, the principles of managing patients with risk factors, including genitourinary menopausal syndrome, as well as methods of rehabilitation and informational support. This will aid to improve the quality of medical care for such patients.

In this review we summarize current data on prevalence, etiology and pathogenesis resulting in premature ovarian insufficiency (POI). In particular, genetic, autoimmune, metabolic, iatrogenic disorders as well as unfavorable impact of environmental factors represent key pathogenetic mechanisms underlying POI development. Clinical picture of this disease is mainly manifested by oligo- and amenorrhea as well as genitourinary menopausal syndrome (GUMS). Special attention is paid to a link between such clinical signs and psychosocial discomfort not being a life-threatening condition but still able to markedly lower quality of woman’s life and considered as a comorbidity with type 2 diabetes mellitus, osteoporosis and cardiovascular diseases. Hormone replacement therapy (HRT) serves as the first-line therapeutic approach for treating POI, which is performed according to the principles similar to those used to perform menopausal hormone therapy (MHT) in case of natural menopause that should be continued until reaching at least the average age for the onset of menopause. Topical estriol therapy eliminates GUMS symptoms, which in turn positively affects sexual function and woman’s psychosocial status and contributes to improved quality of life. The data from recent studies examining topical estriol therapy in POI demonstrated high efficacy and safety. Finally, we also discuss diverse strategies to support reproductive function in women with POI.

Introduction. Despite the high prevalence of functional dyspepsia (FD), the question of effective treatment of this pathology remains open. This underlines the relevance of new approaches in the treatment of FD and the introduction of the drug Dyspevict® (acotiamide), a prokinetic with a new mechanism of action, into clinical practice to alleviate symptoms and improve the quality of life of patients with FD.Aim. Evaluate the efficacy and safety of the use of acotiamide in patients with FD with postprandial distress syndrome (PDS).Materials and methods. 389 patients were randomized in a 1:1 ratio into two groups. Patients of the first group took acotiamide, patients of the second group – placebo. Study drugs were taken orally for 4 weeks. The main criterion for the effectiveness of treatment was the “response to therapy”, assessed by patients on a 7-point Likert scale. Secondary efficacy criteria were: complete regression or relief of symptoms of FD with PDS, improvement in the quality of life of patients, which was assessed on the basis of the Nepean short dyspepsia index.Results and discussion. After 4 weeks, “response to therapy” was observed in 143/193 (74.1%) patients in the acotiamide group compared with 98/189 (51.9%) patients in the placebo group (p < 0.001). Therapy with Acotiamide, in contrast to placebo, showed a complete regression and relief of some symptoms of FD with PDS. Also, after the use of acotiamide, there was an improvement in well-being and quality of life in 172/194 (88.7%) patients compared with 131/189 (69.3%) patients in the placebo group (p < 0.001).Conclusion. The results of the conducted clinical study allow us to conclude that acotiamide is an effective treatment for FD with PDS in adults. The safety profile of the drug is comparable to placebo.

Introduction. Gastroesophageal reflux disease (GERD) is extremely common in the structure of gastroenterological diseases. Aim. To conduct a prospective observational post-marketing study of rabeprazole (Razo®) 20 mg taking once daily in patients with non-erosive reflux disease (NERD) after 2 and 4 weeks of therapy and esophagitis stage A and B after 4 weeks of therapy (GERBERA).Materials and methods. 75 patients with GERD were included in the study (36 men and 39 women, mean age 41.7 ± 1.5 years). Clinical examination with the completion of standard questionnaires, assessment of the quality of life of patients were performed at three visits: before the start of the treatment, after 2 and 4 weeks of therapy. Fibroesophagogastroduodenoscopy was performed in all patients before treatment and in patients with esophagitis after 4 weeks of therapy. All patients received rabeprazole (Razo®) at a dose of 20 mg once a day for the treatment of GERD. The diagnosis of heartburn and sour eructation was carried out according to the recommendations of the Montreal Consensus, the diagnosis of esophagitis was performed based on the Los Angeles classification.Results and discussion. Among patients with NERD, 74.1% of patients responded to Razo® therapy after 2 weeks of treatment, after 4 weeks the proportion of responders increased to 94.4% (p = 0.008). Healing of erosions after 4 weeks was observed in 90.5% of patients with esophagitis. Razo® therapy was accompanied by a pronounced improvement in GERD patients in all parameters of quality of life and patient satisfaction with the results of Razo® treatment.Conclusion. Based on the results of our study, we obtained high efficacy of Razo® at a dose of 20 mg once a day for the treatment of patients with NERD and erosive esophagitis.

The prevalence of GERD in most European countries and the Russian Federation is at the level of 15–20%. Hydrochloric acid plays a significant and sometimes major role in damage to the mucosa of the upper gastrointestinal tract (GIT) in patients with various acid-related diseases. Despite the presence of various classes of drugs that reduce the damaging effect of hydro-chloric acid on the mucous membrane of the upper gastrointestinal tract, acid-related diseases continues to be an urgent medical problem. The review article discusses the issues of pharmacological treatment of acid-related diseases. Such classes of drugs as antacids, H2-histamine blockers, gastroprotectors, potassium-competitive blockers of hydrochloric acid secretion are described in detail. Particular attention is paid to the group of proton pump inhibitors (PPIs). The paper evaluates the merits of each class of drugs, their significance in the treatment of acid-related diseases. One of the most popular PPIs in the Russian Federation is omeprazole. The effectiveness of the drug is determined by pharmacokinetic parameters, in particular bioavailability. The bioavailability of omeprazole of various trade names varies widely. To increase the rate and completeness of dissolution, and hence the bioavailability of poorly soluble molecules in the modern pharmaceutical industry, various disintegrants are used as excipients. The addition of sodium superdisintegrant carboxymethyl starch to the new Omez® dosage form with MiniCaps technology promotes an accelerated and more complete intake of omeprazole into the systemic circulation, helping to increase bioavailability. In addition, the innovative dosage form has a volume that is 30% smaller than the classic capsule, which improves ease of use and adherence to treatment.

The aim of the study was to evaluate the timeliness and eff ectiveness of the diagnosis of precancerous diseases and early forms of gastric cancer in primary health care. Materials and methods. A multicenter retrospective descriptive study was conducted with an analysis of the medical records of 426 patients who were diagnosed with malignant neoplasm of the stomach at the time of going to outpatient facilities. We used data from 125 outpatient facilities in 7 centers for the period from 2009 to 2019. Results. The average age of patients with a fi rst established diagnosis of malignant neoplasia was 61,7 (95% CI 58.6 ÷ 64.8) years. The prevailing form of malignant neoplastic disease was the option “Adenocarcinoma, intestinal cancer” — 77,7%, diff use type cancer — 12,7%, other histological types — 9,6%. The diagnosis of malignant neoplastic disease at the III and IV stages of the disease was fi rst established in 67,4% of patients. The number of years lived by patients with a diagnosis of gastric gastric cancer was 2,0 years. Over a 10-year follow-up, 75% of patients died. Risk factors for gastric cancer were identifi ed in 41% of respondents. Signs of dyspepsia syndrome were observed in 31,5% of patients, and they appeared on average 4,6 (95% CI 4,4 ÷ 4,8) years before the diagnosis of gastric malignancy. Among people with gastric cancer, dyspepsia symptoms occur every day in every third patient. The features of the manifestations of dyspepsia in the observed patients were: daily manifestations of symptoms (33,3%), symptoms at night — 9,4%, an increase in the intensity of dyspepsia (21,3%), the lack of a clinical response to the therapy (proton pump inhibitors, prokinetics, eradication of Helicobacter pylori infection) in 58% of cases. Anxiety symptoms were recorded 2,4 years before a diagnosis of stomach cancer.