Vol 33, No 5 (2022)

Epigenetics is a modern promising field that studies the activity of genes in response to environmental and lifestyle factors. Knowledge of epigenetic mechanisms, starting from intrauterine development, can expand the possibilities of timely treatment of external genital endometriosis, early prevention of relapses and carcinogenesis. The present review considers and systematizes data on the use of epigenetic mechanisms in rehabilitation based on the analysis of modern scientific medical literature, both domestic and foreign. This study showed that epigenetic mechanisms significantly affect the formation of external genital endometriosis and endometriosis-associated ovarian cancer. Standard therapy in combination with epigenetic rehabilitation will lead to a decrease in the recurrence of the disease and stabilization of the achieved results. Thus, it is crucially important to develop pathogenetically substantiated comprehensive rehabilitation schemes that will provide a personalized approach, timely prevention, prognosis and treatment of external genital endometriosis.

Today, clinical medicine provides a variety of procedures and materials for bone structure restoration in surgery. The use of zirconium oxide and its alloys is a new and little studied method to restore bone structures. A number of issues, such as the quality and timing of integration of zirconium oxide, its biocompatibility with a living organism’s tissues and the effect on the latter, remain open in the use of zirconium dioxide. The purpose of the systematic review is to search for and analyze the studies that determine the prospects for the use of zirconium and its alloys in surgery, by taking into account the advantages and disadvantages of these materials.

With the high incidence of the novel coronavirus infection (NCI; COVID-19), the prevalence of comorbidity, HIV infection in particular, is increasing worldwide. Objective. To assess the features of the course of the comorbidity of COVID-19 and HIV infection. Material and methods. A total of 584 case histories of patients with COVID-19 and HIV co-infection were retrospectively analyzed. Randomly selected 52 case histories of patients with this co-infection, of them there were 15 fatalities, are considered in more detail. Statistical analysis was carried out using SPSS16 software; and case descriptions were also applied lest the important data are lost in the global frequency population and fall into outliers or anomalies. Results. The hospitalized patients had different HIV infection stages; there was a preponderance of patients with stage IVB disease; most of whom did not receive antiretroviral therapy (ART) and had profound CD4+ T-lymphocyte immunodeficiency and a high viral load. Some patients had also an unfavorable premorbid background. At the initial hospitalization stages, the clinical presentation of the disease in 13% of the patients could not clearly differentiate COVID-19 and opportunistic infections affecting the respiratory organs. The impact of mutual aggravation of the course of the diseases was observed in patients with severe HIV infection and COVID-19. Of particular interest was a group of 20 patients with coinfection who had received ART before their hospital admission. One third of these patients were noted to have a HIV viral load in the presence of COVID-19. Conclusion. A number of HIV-infected patients showed a favorable course of COVID-19 during ART and scheduled therapy for COVID-19. In the early stages of the disease, HIV reactivation was observed in inpatients with COVID-19 who received ART. This was regarded as a surge in HIV viremia in some cases and as virus reactivation and the possible development of antiviral drug resistance in others.

The natural sedative drug Nervo-Vit was studied for its effect on quality of life (QoL), anxiety, and social activity in 58 premenopausal patients with hypoestrogenemia. The health, activity, mood questionnaire and Short form 36 (SF-36) Health Quality Survey questionnaire were used. The Hospital Anxiety and Depression Scale (HADS) was employed to assess psychological characteristics. The stressful impact of estrogen deficiency on the social aspects of life in the examinees was measured by visual and spatial subscales (D.V. Sheehan). Therapy with Nervo-Vit has been established to have a positive impact on the psychological state, social aspects, and QoL of premenopausal women with estrogen deficiency.

Immunochemical methods play an important role in clinical and research studies. When studying the pathogenesis of age-associated vascular diseases, it often becomes necessary to investigate several analytes. Objective: to elaborate an algorithm for optimizing enzyme-linked immunosorbent assay (ELISA) studies with a parallel comprehensive assessment of several indicators determined in the investigation of age-associated and vascular diseases, atherosclerosis in particular. The materials were test systems for ELISA of a number of indicators characterizing the state of immunity, vascular wall, and metabolism. The duration of the study is one of the problems of immunochemical analysis of analyte panels. To solve this problem, the authors propose a parallel approach to conducting ELISA, which makes it possible to save about 16 hours. With this approach, the target analytes are grouped by the duration and multiplicity of incubation, the number of calibrators and other criteria. Thus, the described logistic principle that is able to substantially optimize a immunochemical study can be successfully applied in the comprehensive assessment of the causal relationships between age-associated and vascular diseases.

Objective. To analyze risk factors for recurrence and severity of an ulcerative colitis (UC) attack. Material and methods. A retrospective study that included 315 medical records of UC patients (167 and 148 Inpatient and outpatient records, respectively) was conducted. Results. Patients with recurrent UC requiring hospitalization were observe to have statistically significantly increases In the duration of the disease, in the frequency of exacerbations/exacerbations in their history and the frequency of using biological agents, a younger age at the onset of UC, alow status of current smoking and ex-smoklng as compared with those in patients In remission. Severe UC was associated with the following factors: a young age at the onset of UC; a lower body mass index, a history of biological therapy; a positive fecal occult blood test at the time of hospitalization; lower hemoglobin and albumin levels; higher erythrocyte sedimentation rate and C-reactive protein; a large extent of intestinal damage; and deep ulcerative defects in the colon mucosa. Conclusion. Analysis of risk factors for recurrence and severity of an UC attack aids In the personalization of treatment, In the prediction of therapeutic response, In the evaluation of the likelihood of adverse effects, and in the optimization of the early diagnosis of the risk of relapse In UC and Its severe attack.

Panniculitides are called a group of diseases that are dissimilar in etiology and clinical and morphological patterns, the main manifestation of which is inflammation of subcutaneous adipose tissue to form skin nodules. Diagnosis in therapeutic practice is complicated by the need for an extensive examination for differential diagnosis and exclusion of other diseases. The paper considers a clinical case of a female patient with panniculitis, the complexity of its diagnosis and differential diagnosis.

The article presents an analysis of Russian and foreign publications. The authors reflected the epidemiology, clinical characteristics of patients and risk of complications in patients with novel coronavirus infection (COVID-19). They noted correlations of selenium (Se) deficiency and severity of the course of the said disease. Se deficiency was associated with oxidative stress, hyperinflammation, complications of COVID-19. Showed the need for sufficient serum Se for proper functioning of the immune, reproductive systems, thyroid gland, brain. Recognized that the organic form of Se (selenocystin) had high bioavailability. Concluded that the severity of the course of COVID-19, along with other risk factors, may be related to the low serum Se content of patients. Additional prescription of selenium-containing drugs requires an individual approach, considering the data of complex clinical and instrumental examination, comorbid diseases existing in patients. Administration of SELENBIO for women may be recommended for complex prophylaxis of COVID-19, increasing of body adaptation potential and maintenance of healthy immune system.

The article describes the role of peptide bioregulators in maintaining the structural and functional homeostasis of the body. The features of the use of peptide complexes with high antioxidant activity, anti-inflammatory, immunostimulating and antistress effects are presented. The peptide complex PROTECTOR 3 Plus, characterized by a high safety profile, can be recommended for improving the immune and endocrine systems at any age, improving the quality of sleep and emotional state, with asthenic disorders, including postcovid syndrome; in the complex therapy of cancer patients.

There is now a lot of scientific evidence suggesting that the gut microbiome affects many human body organs, including the skin. In this connection, intensive study is being given to the possibility of including drugs that favors normalization of the composition of intestinal microflora in order to improve the skin process. These agents may include metabiotics and prebiotic complexes that contain substances that activate the growth of normal flora. There is evidence of a fairly common occurrence of dysbiosis and gastrointestinal disorders in atopic dermatitis (AD) and psoriasis. In this regard, the authors observed patients with AD and psoriasis who received combination therapy including calcium lactate and a prebiotic complex. The severity of symptoms was reduced just on days 3-5 days; whereas there was a significant clinical effect by day 14 of treatment. However, the mechanism of action of prebiotics on the course of psoriasis and AD requires further study.