Vol 21, No 2 (2024)

Anemia of chronic diseases (ACD) is a pathological process that develops in patients with systemic inflammation in a wide range of diseases of both infectious and non-infectious origin. ACD is the second most common disease in the world after iron deficiency anemia (IDA) and is a factor that aggravates the course of the underlying disease and increases mortality. Pathophysiologically, ACD is a complex multifactorial process and includes 3 main development mechanisms: an increase in the production of hepcidin, a decrease in the formation of erythropoietin and inhibition of normal erythropoiesis in the bone marrow. These processes are triggered by pro-inflammatory cytokines. Special attention in the article is paid to the universal humoral regulator of iron metabolism – hepcidin. For a doctor of any specialty it is important to identify ACD, conduct a differential diagnosis that allows one to distinguish ACD from other types of anemia (including iron deficiency), establish a possible combination of IDA and ACD, since different types of anemia require their own therapeutic approaches. The patient’s prognosis will depend on the correct treatment. In order to verify ACD a thorough search for the underlying disease is carried out, СBC indicators and iron metabolism indicators are assessed. The basis of the therapeutic approach to the treatment of ACD is the treatment of the underlying disease. Therapy for this type of anemia includes the use of iron preparations, erythropoietin and replacement therapy with blood components.

The goal: To analyze the topical problems in the use of the newest antibiotics in abdominal surgical interventions and approaches to their solution. Material and methods: The large-scale (as a rule) publications mostly of 2019–2023 on the issue were analyzed. The searching had been executed according to keywords in Pubmed (ncbi.nlm.nih.gov). Findings: Modern protected cephalosporins and carbapenems, as well as eravacycline, appear to be valuable tools in the treatment of surgical intra-abdominal infection, caused in particular by resistant microflora, especially when taking into account local data. The value of tigecycline in this nosology seems less obvious.

The aim of the work was to study the features of autonomic regulation of heart rhythm (HR) in women in the peri- and postmenopausal periods, depending on morphofunctional asymmetries of the female body. A total of 417 women aged 35–60 were examined. According to the lateral behavioral profile of asymmetries of the female body (Annette’s test), the nature of vegetative regulation at rest and orthostasis was determined according to the data of cardiac intervalography using the Varicard 2.51 complex and the Eskim-6 program. As a result, it was found that in the reproductive period in women with the right lateral phenotype, the autonomous circuit of HR variability regulation prevailed, and in ambidextrous women, the central one dominated. Ambidextrous and right-handers were characterized by egalitarian modulation, while left-handers were characterized by a respiratory typology of autonomic regulation of HR. In perimenopause, a moderate tension of regulatory mechanisms was formed in the lateral subgroups, and a high tension was formed in the postmenopausal subgroups. In ambidextrous and left-handers, discoordination of HR regulation prevailed. Thus, women with the polarity of the lateral phenotype in the late reproductive period were distinguished by the stability and economy of the mechanisms of autonomic regulation of HR. Ambidextrous had the most energy-consuming mechanisms in the postmenopausal period, which is a risk of cardiovascular disease pathology.

In healthy volunteers, physical performance was assessed according to PWC₁₇₀ tests, maximum oxygen consumption and microcirculation status by laser Doppler flowmetry (LDF) using a computerized LAKK-02 analyzer. The performance indicators corresponded to the norms of the age group, while significant correlations were revealed with the indicators obtained during the LDF, which confirms the informativeness of the method.

Fuchs endothelial corneal dystrophy (FECD) – multigenic bilateral disorder, characterized by dysfunction of corneal endothelium cells (CECs) that eventually results in loss of transparency. Purpose: To evaluate the pathogenesis of FECD with histological and immunohistochemical methods, immunofluorescence, scanning electron microscopy (SEM). Methods: Endothelium–Descemet membrane (EDM) complexes, corneal buttons were obtained from 76 patients (85 eyes) with FECD during keratoplasty and divided into 1A, 2A, 3A groups, 15 EDMs (donor tisuue) – 1B, 2B, 3B groups (control). Morphological (hematoxylin/eosin staining) and immunohistochemical (primary antibodies to cytokeratin AE1/AE3 and vimentin) studies (1A, 1B groups), phase-contrast microscopy and immunofluorescence analysis of tight junction protein ZO-1 (2A, 2B groups), SEM (3A, 3B groups) were performed. Results: FECD is characterized by decline of CECs, cell and nuclear enlargement. Nuclear-cytoplasmic ratio of CECs is relative to control. CECs expression ZO-1 is decreased in the area of guttae ingrowth. Coexpression of cytokeratin AE1/AE3 and vimentin is found. Morphological and immunohistochemical studies show DM’ thickening, stromal and epithelial edema and local fibrosis, vimentin (stromal cells) and cytokeratin AE1/AE3 (epithelium) expression in FECD. Conclusion: Pathogenesis of FECD include CECs’ epithelial-mesenchymal transition, followed by guttae formation – the excrescences, which destroy cytosketon and lead to progressive loss of CECs. Changes in permeability of endothelium cause edema and fibrosis of stroma and epithelial layer.

The incidence of malignant neoplasms in Russia and the world is growing, and among the many malignant tumors of the main localizations, there are rare forms of cancer, mentioned in the literature as a description of single cases. Such diseases include a malignant neuroepithelial tumor arising from the olfactory neuroepithelium of the nasal cavity – esthesioneuroblastoma (ENB), which accounts for only 3 to 6% of cases of malignant neoplasms of the nasal cavity and paranasal sinuses. In due to the rarity of this disease, there are certain difficulties in the clinical and morphological diagnosis of ENB, there is no coding of it in the ICD, and there are no uniform standards of treatment. The article presents the results of a retrospective analysis of the features of clinical and morphological diagnosis of esthesioneuroblastoma. The study was conducted using the database of the Volgograd Regional Clinical Oncology Dispensary from 2003 to 2023. At the initial histological examination, the diagnosis of esthesioneuroblastoma was established only in 6 patients (66.6 %), in three patients (33.4 %) other forms of the malignant process were diagnosed, which did not correspond to clinical manifestations. Immunohistochemical (IHC) data confirm the greatest correspondence of the immunophenotype to olfactory neuroblastoma, G3 (according to Hyams) M9522/33. The study showed that the use of IHC for differential diagnosis is mandatory and allows for more accurate identification of esthesioneuroblastoma.

The article presents the results of a study of hemodynamic parameters in conditionally healthy middle-aged and elderly people in comparison with those of people with hypertension of middle and elderly age. Anthropometric data and hemodynamic parameters were determined and recorded in men and women, statistical processing of the obtained data was carried out using the analytical software IBM SPSS Statistics, 22.0. In the course of the study, a more significant inclusion of compensatory mechanisms for normalization of stroke volume, minute volume and peripheral vascular resistance was found in the group of conditionally healthy elderly people in comparison with a similar age group with arterial hypertension.

The purpose of the study: The purpose of this work was to study the prevalence of bronchial asthma and chronic bronchitis in adolescents, depending on the factors of the ecosystem and climatic zones in the Republic of Dagestan according to the data of the incidence and morbidity. Material and methods of research: We analyzed statistical data on the incidence and incidence of bronchial asthma and chronic bronchitis among adolescents aged 14–18 years for 5 years (2018–2022) in the lowland, mountainous and foothill zones of the Republic of Dagestan according to the Ministry of Health of the Republic of Dagestan. Previously, similar studies have not been conducted in this age group. Results and their discussion: From these data it can be seen that, firstly, in the republic as a whole, the increase in the incidence of bronchial astma in adolescents amounted to 124.4 % (from 0.86 to 1.93 per 1000 population); secondly, a steady increase in the incidence of bronchial astma is observed in rural areas (228 % vs. 53.8 % in cities), thirdly, the incidence has its own characteristics depending on the height of residence above sea level (mountains – more than 1000 m, foothills – 500–1000 m, plain – less than 500 m). A comparative assessment of the data on the prevalence of asthma in cities and rural areas revealed the following patterns: in general, adolescents in villages are almost 2 times less likely to suffer from bronchial asthma than in the city (summary figures for 5 years per 1000 population – in rural areas – 0.96, in urban areas – 1.78). Although the increase in the number of adolescents with bronchial asthma was also noted among urban residents (by 53.8 %), but among rural adolescents the increase in 5 years exceeded 4 times and amounted to 228 % (0.57 in 2018 and 1.86 in 2022). The heterogeneity of the incidence of chronic bronchitis by year was noted in all climatic zones. In the mountainous climatic zone, the incidence in 2018 was 14.7 per 1000, in 2019 there was a slight decrease (10.5), and in subsequent years there was a gradual increase and by 2022 it reached 19.3 per 1000 population. There were no large differences in morbidity in the foothill zone, although in 2022 it decreased to 3.2 compared to other years (6.4 in 2018, 7.2 in 2019, 5.3 in 2020 and 7.0 in 2021). The same situation was observed in the lowland zone, although in general, the incidence rate in this climatic zone increased from 5.5 in 2018 to 7.3 in 2022, with insignificant differences in 2019 (8,6) and 2020 (4,4). Conclusions: Bronchial asthma is a common disease among adolescents in the Republic of Dagestan and there is its close dependence on both climatic zones and ecosystem factors. When comparing the data on the prevalence of bronchial asthma in urban and rural areas, the following patterns were revealed: in general, adolescents in villages are almost 2 times less likely to suffer from bronchial asthma than in the city. Although the increase in the number of adolescents with AD was also noted among urban residents (by 53.8 %), but among rural adolescents the increase in 5 years exceeded 4 times and amounted to 228 %. Regarding chronic bronchitis, heterogeneity of morbidity by year was noted in all climatic zones. In the mountainous and lowland zones, there was an uneven increase in the incidence of chronic bronchitis over the years, and in the foothill zone there was a downward trend. Such differences in morbidity rates can only be explained by the lack of a unified approach to the nomenclature and diagnosis of chronic bronchitis in various medical institutions of the republic.

The study is devoted to the topical issue of physiological justification for the use of various methods for relaxation of masticatory muscles in a state of hypertension in individuals engaged in strength training. Data are presented on a comparative analysis of the effectiveness of the effects of the following deprogramming devices on the masticatory muscles: “Aquasplint”, muscle relaxation mouthguard and transcutaneous electrical neurostimulation, according to electromyography of the masticatory muscles and Dopplerography of the superficial temporal arteries. The predominant physiological effectiveness of using a stabilizing mouthguard and transcutaneous electrical neurostimulation as a method of targeted impact on the tone of the masticatory muscles has been established.

Single-nucleatide substitutions in genes encoding proteins of the hemostasis system and platelet receptors are one of the causes of hereditary predisposition to hypercoagulation and increased thrombosis. The aim is to assess the prevalence of individual allelic variants of hemostasis genes in the population of the Arkhangelsk region. Materials and methods: The study included two groups of participants from the Arkhangelsk region: patients of the Regional Center for Antithrombotic Therapy (RCATT) (n = 2354) and healthy volunteers (n = 195). The molecular genetic study of the polymorphism of the genes of the hemostasis system was carried out by PCR. The results of the study: According to the results of the study, there was no statistically significant difference in the distribution of unfavorable allelic variants of \hemostasis genes between the two groups of participants. Probably, in order to realize the hereditary tendency to increased thrombosis, it is necessary to combine the polymorphism of the studied genes with other

Introduction: Radiation-induced hepatitis develops both with direct irradiation of malignant neoplasms of the liver and abdominal organs. An important task of modern radiobiology is the development of methods for the prevention of acute and chronic post-radiation complications, for example, the injections of protectors. Materials and methods: Wistar rats (n = 40) were divided into groups: I – control (n = 10); II (n = 10) – electron irradiation; III (n = 10) – injection of ascorbic acid before electron irradiation; IV (n = 10) – injection of ascorbic acid. A biochemical blood test, oxidative status analysis, morphological, morphometric and statistical studies were carried out. Results: In group III, a less pronounced change in the main morphological and morphometric parameters was noted compared to group II; indicators of biochemical analysis and oxidative status approached control values. Conclusions: According to the results of the study, it was revealed that local irradiation with electrons after a week leads to disruption of the histoarchitecture of the liver, and the injection of ascorbic acid reduces the depth and range of radiation-induced hepatitis.

Graft resorption can be an obstacle to achieving good functional results during Latarge surgery. One of the factors influencing the possible development of osteolysis is the size of the defect of the articular process of the scapula. This article presents an analysis of the relationship between the preoperative magnitude of the glenoid defect and subsequent osseointegration of the graft after Latarge surgery.

The severity of pain in patients with external genital endometriosis (EGE) associated with pelvic pain syndrome was assessed using a visual analogue scale (VAS) and the McGill pain questionnaire, and the effectiveness of surgical treatment of patients with EGE was assessed. Predicting the IV and I degrees of endometriosis prevalence will allow the obstetrician-gynecologist to choose treatment tactics for patients, diagnose and the ability to prevent the progression of the disease in the early stages.

Nowadays, cardiac surgery is highly safe in terms of protecting internal organs from ischemia and cardioplegia. This allows for radical interventions even in weakened patients with risk factors for perioperative mortality. At the same time, classical heart valve replacement operations are suboptimal and invalidate the patient. The purpose of the study is a critical analysis of the current state of the problem of prosthetics of heart valves, evaluation of alternative methods of prosthetics. To replace the atrioventricular valve, the most suitable bioprosthesis may be a human mitral allograft, which allows you to fully replace the complex structures of the AV valve due to the identity of the anatomy, can work cooperatively with all functional structures of the left ventricle, has the potential to repopulate the patient’s tissues, sufficient strength and a relatively simple and permanent anatomy (compared with tricuspid allograft), while it is safe in terms of rejection. Currently, there is a large set of alternative options for prosthetics of heart valves. Many of them are characterized by greater physiology, anatomicity, and safety in terms of prosthesis-dependent complications compared to classic skeleton prostheses.

At the moment, a number of studies have been carried out that have proven that omentin has a sensitizing effect on insulin, has anti-inflammatory and anti-atherosclerotic effects. Plasma levels of omentin are known to be significantly reduced in obese patients with insulin resistance. Decreased levels of omentin have also been reported to be associated with inflammatory and autoimmune diseases, including atherosclerosis and psoriasis.

The article presents research data that allow to identify changes in the level of omentin in chronic inflammatory rheumatic diseases, as well as to suggest its effect on the risk of development and course of cardiovascular complications.