Multiple sclerosis (MS) is a chronic immune-mediated disease of the central nervous system, which is based on inflammatory demyelination and neurodegeneration. Over the course of the COVID-19 pandemic, there has been a perception that the virus has an effect on the course of immune processes. The questions of whether the frequency of autoimmune diseases, including the nervous system, and their course has changed have been discussed. Aim of the study was to assess the clinical and epidemiological characteristics of MS during the COVID-19 pandemic from 01.01.2020 to 01.01.2023 in Novosibirsk. In the course of our work, we studied the incidence of MS and the features of the clinical picture of the debut of MS associated with COVID-19 infection.
Material and methods. The study included 628 patients with MS living in Novosibirsk with the onset of the disease in the period before the pandemic from 01.01.2017 to 12/31/2019 (341 patients) and during the pandemic from 01.01.2020 to 01.1.2023 (287 patients).
Results. The incidence rates of MS in Novosibirsk were calculated, it was 7.1 7.6 6.4 7.38 6.92 and 3.2 per 100 thousand population in 2017, 2018, 2019, 2020, 2021 and 2020, respectively. The average incidence of MS in the study period before the pandemic was 7.03 per 100 thousand population, during the pandemic – 5.83 per 100 thousand population (critical value of the Student’s t-test = 1.972, with a significance level of a = 0.05). When analyzing the association of clinical manifestations of the onset of MS with COVID-19, it was found that coordination disorders were observed in patients with moderate infection more often than in patients with mild infection (p < 0.05; odds ratio 0.410, 95% confidence interval 0.162–1.035). No statistically significant correlation of clinical manifestations with the severity of infection was shown for patients with primary progressive MS, however, the predominance of the multi-focal nature of disease after a more severe course of COVID-19 was noted (40 %). After the first clinical demyelinating episode in the group of patients with relapsing-remitting MS, the chances of complete recovery in patients with mild infection are 2.8 times higher than in patients with moderate infection (p < 0.05).
Conclusions. Thus, as a result of the conducted study, the effect of COVID-19 on the change in the incidence of MS was not revealed. In the process of analyzing the clinical features of MS during the pandemic, it was found that COVID-19 infection can contribute to an unfavorable course of MS with worse recovery of neurological deficits after episodes of exacerbations, which leads to the accumulation of disability of patients.

Aim of the study was to compare the results of mathematical modelling of the dependence between brain ventricle size and capillary pressure for humans and animals based on the equations of multicomponent poroelastic filtration for brain parenchyma.
Material and methods. The study included two groups of animals - 4 male mice of each inbred line C57Bl/6 and BALB/C at the age of 12 weeks – and 4 healthy volunteers. The brain and cerebrospinal fluid system images of mice were obtained using an 11.7 T horizontal MR scanner, group of humans were examined using the Ingenia 3.0 T MRI scanner. An axial section at the level of –0.5 mm from bregma in the mouse groups and a frontal slice at the level of the middle of the bodies of the lateral and third ventricles, posterior to the foramen of Monroe in the human group were chosen as the geometry for mathematical modelling. Mathematical modelling is based on the stationary mathematical model of multicomponent poroelastic filtration. Multiple linear regression of mean ventricular wall displacement on fluid media interaction parameters was constructed to compare results obtained. Regression coefficients were compared using nonparametric analysis of variance based on the Kraskell–Wallis criterion and post-hoc Dunn’s criterion with Hill’s correction
Results. A qualitative coincidence in the behavior of capillary pressure and mean ventricular wall displacement was demonstrated for the human and mouse groups. No significant differences were found between the two animal lines. For the animals characterized by small ventricular size (BALB/c), greater similarity to humans is observed than for the genetic line with hypertrophied ventricles (C57Bl/6). A significant difference between humans and mice is observed only for capillary-venous interaction.
Conclusions. The low variance within groups and insignificant discrepancy between groups indicate the possibility of further accumulation of empirical data to establish correction coefficients of the animal model, which will bring it more in line with the model for humans. Thus, the analyzed models are sufficiently comparable with each other.

Coronary artery disease is a widespread cause of death and disability in the population. Angioplasty of the coronary arteries is one of the most common methods of eliminating the cause of ischemia – stenosis of the coronary arteries. As a result of stent installation, a change in the angle of vascular bifurcation occurs usually, as well as a redistribution of volumetric blood flow in the coronary artery system. Considering the high variability of the branching angioarchitecture of these arteries, as well as the structure of their environment, the problem of predicting the specific redistribution of blood flow in these arteries remains unsolved; the main ways of its implementation are computational and experimental hemodynamics.
Material and methods. This paper uses an experimental approach to explore the effect of stent placement in a model of coronary artery stenosis, and also provides an analysis of the current level of awareness of the scientific community on this issue.
Results and discussion. The experiment showed that the throughput of the model increases by 14 % compared to the model with stenosis, and the redistribution of flows in the model depends not on diameters but on the anatomy of a particular vascular network. The data of the performed mathematical modeling are generally consistent with the results of the experiment before stent installation, when the coronary tree consists of several load-bearing branches, but have quantitative differences for the distal branches of the coronary artery model in the presence of an installed stent.
Conclusions. The results of the work can be used to accumulate an experimental data array on the restructuring of blood flow during angioplasty, and can also be used to verify the numerical hemodynamics of the coronary arteries during the virtual installation of a stent in them to resolve stenosis. 

The study is devoted to considering the effectiveness of modern approaches to the development of diagnostic technology for analyzing MRI images in neuro-oncology, based on artificial intelligence (AI) and computer vision. Such approaches are necessary for rapid and diagnostically effective analysis to implement the principle of individualized medicine. Material and methods. An analysis of the effectiveness of the choice of AI technologies for the formation of processes of segmentation and classification of neuro-oncological MRI images has been presented. AI was trained on its own annotated database (SBT Dataset), containing about 1000 clinical cases based on archival data from preoperative MRI studies at the Federal Neurosurgical Center (Novosibirsk, Russian Federation), in patients with astrocytoma, glioblastoma, meningioma, neuroma, and with metastases of somatic tumors, with histological and histochemical postoperative confirmation. Results and discussion. The effectiveness and efficiency of the developed technologies was tested during the international BraTS competition, in which it was proposed to segment and classify cases from a dataset of neuro-oncological patients prepared by the competition organizers. Conclusions. The methodological approaches proposed in the article in the development of diagnostic systems based on AI and the principles of computer vision have shown high efficiency at the level of dozens of world leaders and can be used to develop software and hardware systems for diagnostic neuroradiology with the functions of a “doctor’s assistant.”

Multiple sclerosis (MS) is one of the most common causes of disability in young people of working age. The prevalence of this disease has increased significantly in recent years and today amounts to more than 2 900 000 people worldwide. The transition from relapsing-remitting MS to secondary progressive MS is observed in 25 % of cases within 10 years the disease duration, and with further time the proportion of patients with secondary progressive MS increases. Despite the importance of preventing patient disability, today the diagnosis of secondary progressive MS is established retrospectively, which makes the issue of identifying early markers of disease progression extremely relevant. The most promising diagnostic markers allow the differentiation of progressive MS with a sensitivity of up to 87 % and a specificity of up to 90 %. This review will consider the most promising clinical, instrumental and biological signs of early progression of MS.

Introduction. Beside the excretion of metabolic wastes, the lymphatic system in CNS play a crucial role in the regulation of intracranial pressure that is vital for the organism. One of the possible pathways of cerebrospinal fluid (CSF) drainage is its flow through the foramen of the cribriform plate (CP) into the nasal cavity. Despite the significant contribution of the nasal tract to the overall dynamics of the liquor, not much is known about the mechanisms of this process and how it is regulated. Due to its influence on the tone of blood vessels and peristalsis of lymphatic vessels, nitric oxide (NO) is a powerful modulator of liquor outflow, but its effects on nasal CSF outflow have not been studied yet. Aim and Methods. Using diffusion-weighted magnetic resonance imaging (DW MRI), we characterized the changes in CSF outflow through the CP of C57Bl/6 mice influenced by intranasal application of NO synthesis modulators. Results. In our study, using DW MRI and computer tomography (CT) mapping of the CP, we detected significant CSF outflow through its large dorsal and ventral foramen located along the nasal septum. At the same time, the CSF flow rate through the dorsal orifices of the CP was the highest. In addition, we showed that intranasal introduction of NO donor after 30 min leads to a significant decrease of water diffusion through the CP whereas application of a nonspecific NO synthase inhibitor into the nasal cavity enhances nasal outflow. The effects of the NO modulators did not have any significant spatial patterns; CSF outflow was significantly altered across all CP orifices regardless of their size or localization. Conclusion. The obtained results demonstrate the potential possibility of noninvasive local regulation of liquor dynamics, which may be used in the development of new approaches to the therapy of intracranial hypertension of various etiologies and methods of CNS detoxification.

The aim of the study was to compare hemodynamic parameters, the sequence of remodeling of the jugular and extrajugular outflow tracts of cerebral venous circulation in extrinsic stenosis and hypoplasia of the internal jugular vein (IJV). Material and methods. Groups with external compression and IJV stenosis (n = 50), with IJV hypoplasia (n = 27), and after IJV ligation/resection (n = 6) as a model of IJV occlusion with a minimal cerebral venous insufficiency and venous encephalopathy and control group (n = 31) were compared. All patients underwent a neurological examination, ultrasound duplex scanning of the IJV (J2 and at the level of stenosis), common carotid and vertebral artery (V2), 2DToF or 3DToF magnetic resonance venography of the neck veins. The degree of stenosis of the IJV, the crosssectional area and the time average blood flow velocity, the calculated indicator of the venous-arterial balance (VAB) were determined according to the modified formula. Results and discussion. In the group of external compression of the IJV, stenosis averaged 64.52 %. The area of the IJV at the site of stenosis was 6 times, and at the standard place (J2) – 3 times less than the area of the opposite IJV. The hypoplastic IJV throughout its entire length (from J1 to J3) had the same area (0.21 ± 0.12 cm² ), smooth contours, without local expansions or narrowings. A very low blood flow velocity (10.2 ± 11.67 cm/s) is characteristic for stenosis, in contrast to the normal velocity in the hypoplastic vein and in the control group. The blood flow velocity in the contralateral IJV with external stenosis does not differ from normal, but it is increased with hypoplasia (34.62 ± 12.23 cm/s). With MR venography, it is possible to detect a stenosing factor, symptoms of a filling defect, a decrease or loss of a blood flow signal, and an assessment of the overall picture of remodeling of the venous network of the neck. A decrease in the IJV area on the side of the lesion/anomaly corresponds to negative remodeling, while an expansion of the opposite IJV corresponds to positive remodeling. If the obstruction persists, the homolateral, then the contralateral external jugular vein expands, then the vertebral veins and plexuses, spinal epidural veins, anterior jugular and posterior cervical veins expand too. The magnitude of the IJV on the side of the anomaly/pathology with hypoplasia did not differ from the value with stenosis (9 %), but was slightly less than on the opposite IJV (53.39 ± 13.40 and 67.24 ± 18.02 %, respectively, p < 0.06) and significantly less compared to the control (24.16 ± 8.06 % on the left and 33.15 ± 8.27 % on the right, p < 0.0001), which makes this indicator a good additional criterion for outflow abnormality according to the IJV of one side.

The growing number of studies on cerebral venous circulation disorders associated with extrinsic stenosis of the internal jugular veins, as well as attempts to surgically influence the restoration of blood flow, are an indicator of the importance of this problem. Studies show that extracranial outflow disorders are associated with a wide range of neurological clinical manifestations and may contribute to the development of congestive intracranial hypertension. Anatomical variants of the development of the extracranial venous system, constitutional insufficiency and stenosis often play similar roles in the development of disorders of the cerebral venous outflow, but differ parametrically. There are no standard diagnostic criteria for differential diagnosis, normal and pathological parameters are contradictory, and the diagnosis largely depends on the combined use of imaging techniques. The history of attempts to study disorders of the cerebral venous circulation is quite long, associated with the technical innovations in every period of time. The most non-invasive, accessible and safe tools for diagnosing non-thrombotic lesions and anomalies of the internal jugular veins are currently recognized as ultrasound scanning and MR venography in tandem. Researchers note both local hemodynamic disturbances at the level of stenosis and changes in the overall picture of the venous vascular network of the neck with certain patterns of its remodeling. The pathological significance of the compensatory expansion of nonjugular outflow tracts (vertebral, paraspinal collateral, spinal epidural veins, etc.) is still a controversial issue. MRI and ultrasound combined show a high degree of agreement between the results, which should stimulate further research into the pathophysiology and differentiation of various causes and severity of non-thrombotic lesions of the jugular veins.

Modern methods of neuroimaging make it possible to develop approaches for assessing intracranial pressure as a replacement for the “gold standard” of invasive monitoring. Aim of the study was to investigate the possibility of using magnetic resonance (MR) characteristics to assess the increase in intracranial pressure in patients with secondary intracranial hypertension. Material and methods. Group 1 – 40 patients with brain tumors, group 2 – 15 patients with communicating hydrocephalus, control group – 36 individuals. The patients underwent MRI with measurement and evaluation of the optic nerve sheath diameter (ONSD), the optochiasmal cistern and the pituitary gland vertical sizes, and tortuosity of the ON. Patients of the 2nd group underwent a phase-contrast MRI with an assessment of the velocity and volumetric characteristics of blood and cerebrospinal fluid flows with the calculation of the intracranial compliance index (ICC). Using the FreeSurfer program, the brain volumes were estimated. Results and discussion. A statistically significant increase in ONSD was found in the groups of patients compared with the control group (by 24 %, p < 0.05), decrease in the vertical size of the pituitary gland and an increase in the vertical size of the optochiasmal cistern (p < 0.05), as well as ICC lowering in group 2 (by 1.7 times, p < 0.05). Tortuosity of ON in group 1 was observed more often than in other groups. A statistically significant positive correlation between ONSD and brain volumes in group 1 (r = 0.55, p < 0.05) and a negative correlation between brain volumes and ICC in group 2 (r = –0.86, p < 0.05) has been found. Conclusions. Based on the presented results, we believe that the combined use of qualitative and quantitative MRI criteria can expand the diagnostic capabilities of non-invasive assessment of increased intracranial pressure.

Current research in the field of neuroimaging is focused on the possibilities of using data from various diffusion MR models: diffusion tensor visualization (DTI), diffusion-curtosis visualization (DKI), diffusion-spectral visualization (DSI), generalized q-sample visualization (GQI), Q-ball visualization (QBI) in the assessment reorganization of the brain. The purpose of this study is to compare the results of dynamic observation of post–stroke brain reorganization by diffusion MR models (DTI, DKI). Material and methods. Dynamic MR examination of the brain of 129 patients was performed on a Ingenia 3.0 T (Philips, Netherlands) on 1–3 days, 7–10 days, 3–4 months after the manifestation of stroke according to a routine protocol (DWI-EPI, FLAIR-SPIR, T2-WI, T1W-TFE) with DTI method. The stroke was verified and DTI, GQI, and DKI maps were built. Results and discussion It was showed that the fractional anisotropy (FA) of DTI significantly changed from 1–3 days to 7–10 days in the stroke area; the mean, axial and radial diffusions increased in the affected area over the three studies. For DKI model – the curtosis FA significantly changed in the lesion area by 3–4 months; the mean curtosis decreased by the second observation in the stroke area, axial curtosis decreased in the same area throughout all studies; radial kurtosis significantly increased in the affected area throughout the study. The results confirm the world data and also indicate that diffusion metrics can interpret the neuroplasticity of the brain in various diseases, however, this requires further study. The applied diffusion models indicated the reorganization of the ischemic area and the intact contralateral area. The use of diffusion models for the dynamic assessment is a promising direction in the study of the neuroplasticity mechanisms.

The research was aimed at analyzing modern algorithms for diagnosing lesions in multiple sclerosis on MRI images. Multiple sclerosis is a severe disease of the central nervous system and ranks first among the causes of disability in patients of young working age. In connection with the development of computer vision and machine learning technologies, the relevance of using these technologies for medical diagnostics is growing. Such approaches are necessary for the effective development and implementation of diagnostic systems using artificial intelligence. Modern algorithms and models for lesion segmentation were selected and implemented. Material and methods. The paper presents CV features of diagnosing multiple sclerosis on MRI images, existing data sets: ISBI-2015, MSSEG-2016, MSSEG-2021; existing algorithms and models for lesion segmentation: U-Net, nnU-Net, TransUnet, TransBTS, UNETR, Swin UNETR. Results and discussion. The architectures and models of nnU-Net, UNETR, Swin UNETR were trained and compared at ISBI2015 with various parameters and loss functions. Four MRI sequences were used: T2-WI, T2-FLAIR, PD, MPRAGE. Lesion segmentation was approved by certified experienced neuroradiologists. Conclusions. The approaches described in the paper including data processing, model training, and results analysis, focused on the selection and development of high-quality computer vision algorithms for identifying multiple sclerosis lesions in MRI images. Identification and segmentation of demyelination foci is a necessary step for diagnosing the disease, as well as for calculating and interpreting more meaningful indicators of disease severity and progression.

Aim: To adapt a mathematical model describing the interaction between fluid media and brain matter for the purpose of definition of the dependence between brain ventricle size and capillary pressure in laboratory animals of two genotypes, BALB/c and C57BL/6. Material and methods. The study included 4 male mice of each inbred strain C57BL/6 and BALB/c at the age of 12 weeks. The brain and cerebrospinal fluid system images were obtained using an 11.7 T horizontal MR scanner (Bruker, BioSpec 117/16 USR, Germany). An axial section at the level of -0.5 mm from bregma was chosen as the geometry for mathematical modelling. To describe the data obtained, the mathematical model was adapted by selecting a scale factor based on the known values of the cerebrospinal fluid formation rate for humans and mice. Results and discussion. The same qualitative pattern of relationship between capillary pressure and mean ventricular wall displacement was observed for all animals considered. Although the selected genetic strains of BALB/c and C57Bl mice differ significantly in terms of cerebral ventricle size, these differences in animal genotype did not affect the nature of this relationship. Changing the parameters of the fluid media interaction in the area of compression or moderate ventricular dilation almost does not lead to an exit from the physiologically acceptable capillary pressure value. In this case, the size of the ventricles changes significantly. In the area of large ventricular dilation, in contrast, there is little change in ventricular size, and this is accompanied by a dramatic increase in capillary pressure far beyond physiologic limits. Thus, the change in ventricular size is an adaptive process associated with pressure fluctuations caused by changes in intracranial fluid flow. The mere fact that some of the values reach the zone of physiologically unacceptable pressures associated, in fact, with death, provided that there is practically no change in ventricular size indicates that such a situation is rarely realized and is possible in case of violation of intracranial fluid media flows associated with the fact that the increase in ventricular size limits adaptive capabilities. Conclusions. The presented animal model will further increase the understanding of the pattern we have established and allow us to move on to attempts at prediction.

This literature review was compiled according to the data of search engines PubMed, eLIBRARY.RU, Google Scholar using key words influenza, cytokines, children. The article highlights the participation of pro-inflammatory and antiinflammatory cytokines in the pathogenesis of influenza, compares the cytokine profile in different strains of the virus, with concomitant pathology, as well as attempts to find an answer to the question: “Why are young children more susceptible to this infection?” The article contains information about the creation of express systems for diagnosing cytokine storm in patients with influenza and other acute respiratory viral infections, taking into account a complex of clinical and laboratory data that comes to the aid of a practicing physician. It should be noted that there are different opinions among authors regarding the early markers of severe and complicated influenza in childhood. This information makes the topic of studying the significance of cytokines in influenza in children relevant, but it requires continuation and clarification of knowledge on this issue.

Pregnancy in the uterus rudimentary horn (PURH) is a rare form of ectopic pregnancy that develops in women suffering from abnormalities in the development of growth and fusion of the Mullerian paramesonephral ducts. A literature search was conducted in the Web of Science, eLIBRARY.ru, Scopus, PubMed/MEDLINE databases using key words “ectopic pregnancy”, “anomaly”, “complication”, “rudimentary uterine horn”, “diagnosis”, “management”. We selected articles published from 2014 to 2022. A methodological filter was not used to exclude the omission of suitable articles. The study included full-text papers and literary reviews on the subject under study, articles that are not directly related to the topic of PURH were excluded. In order to avoid the inclusion of duplicate publications in the literature review, if two papers by the same authors were found, the study period of each author was studied, and if the dates coincided, the most recent publication was selected. Usually, the PURH is overlooked and can lead to such a formidable complication as hemoperitoneum. Diagnosis and treatment of PURH remains a difficult task. Many women with rudimentary uterine horn have an acute rupture of the uterus during pregnancy. Early diagnosis is the key to successful treatment. Clinicians of various specialties should maintain a high degree of vigilance to prevent morbidity associated with this life-threatening condition.

In modern medicine, the relevance of the problem associated with the aging of the female body is undeniable. Due to the decrease in the intensity of secretion of sex steroids, the addition of metabolic syndrome is accompanied by processes which can worsen women quality of life. Under conditions of hypoestrogenemia, their physical condition suffers, which directly depends on the structure of the connective tissue that forms the basis of the skin, blood vessels, kidneys, bones, joints and ligaments. This literature review presents current data on reversible and irreversible clinical manifestations of climacteric syndrome. Reversible processes are based on changes that can be corrected: vasomotor, psycho-emotional, urogenital, sexual and musculoskeletal. Late manifestations of menopause on the part of metabolic disorders in the connective tissue determine the greatest severity of the course, and therefore represent a serious public health and health problem. The literature review shows in detail the features of the immune regulation of collagen metabolism, the characteristics of changes in bone modeling markers under conditions of estrogen deficiency. Clinically proven efficacy of phytoestrogens in menopausal disorders and metabolic disorders in women. This review shows the mechanism for reducing vasomotor symptoms, slowing down the process of bone tissue destruction in patients under the influence of this group of drugs. In addition, phytoestrogens provide the correction of lipid metabolism, thereby depressing atherogenesis and promoting prevention of cardiovascular complications. It is necessary to develop a strategy to normalize the vital functions of perimenopausal patients with symptoms of menopause with the introduction into clinical practice of measures to maintain the quality of life of women.

Due to the rapid growth in the number of patients with diabetes in a complicated epidemiological picture, the question of the possibility of exposure of a substance to several targets becomes more important. It is noted that the most common infectious diseases in patients with diabetes mellitus are infections of the respiratory and urinary tract, skin and soft tissues, diabetic foot ulcers, otitis media and periodontal infections. Antimicrobial agents can have both direct and indirect hypoglycemic effects. Quinazolinones belonging to the group of heterocyclic derivatives exhibit a wide range of pharmacological activity. The use of the PASS program for the purpose of computer prediction of pharmacological activity showed a high probability of the hypoglycemic effect of new derivatives. The obtained results motivated the authors to search for the relationship between antimicrobial action and hypoglycemic effect within the general direction of studying the multi-targeting of drug ligands. Analysis of the literature data, as well as own studies of new quinazolinone derivative pharmacological activity make it possible to divide all ligands into functional groups that cause additional binding to the target molecule. The quinazolinone fragment, characterized by the uniqueness of its structure, can be reasonably attributed to multi-target ligands. The triazole cycle and the sulfonamide group can also purposefully bind to the target molecule. A carbamide residue, a fragment of sulfonylurea and an acetamide group, depending on the structure of the substance they are part of, can function both as a specific ligand and as a functional group involved in the stabilization of the intermediate transition state. The results obtained by the authors, as well as other researchers, allow us to formulate an assumption about the relationship between the mechanisms of antimicrobial and hyperglycemic activity.

Aim of the study was to investigate the prevalence of problematic smartphone use, the characteristics of the content consumed and associations with other forms of online behavior among Russian and foreign medical students. Material and methods. 296 medical students were examined using the online survey method: 219 Russians (main group) and 77 foreigners (comparison group); 107 (36.2 %) boys and 189 (63.8 %) girls; age 20 [18; 21] years (median [lower quartile; upper quartile]). The structure of online behavior was assessed: adaptive, non-adaptive, and pathological (PIU) Internet use; specific forms of PIU: problematic use of computer games and social networks, mixed and undifferentiated form of PIU. The values of the total score of the scales of the applied psychometric questionnaires were determined. The indicators were compared in the general group of subjects, in groups of Russians and foreigners, including gender. Results. Problematic smartphone use is typical for 14.2 % of all surveyed. The share of smartphone addicts is higher among foreigners than among Russians (27.3 and 8.0 %, respectively), both boys and girls. PIU prevailed among foreigners (16.1 and 7.4 %), they are more often dependent on social networks (34.5 and 2.4 %). Foreign women were distinguished by a high incidence of problematic use of computer games (20.0 and 3.6 %) and social networks (25.0 and 3.1 %), as well as a mixed form of PIU (20.0 and 2.5 %). The content consumed by Russians (boys + girls) was dominated by being on social networks (77.6 Russians and 46.7 % foreigners) and listening to music (50.7 and 31.2 %, respectively). Gender differences in content included more frequent use of social networks by Russian students, both boys (81.1 and 48.1 %) and girls (76.5 and 43.5 %); more frequent listening to music by Russian males in comparison with foreign males (66.0 and 29.6 %) and Russian females (66.0 and 45.8 %). Foreign boys use smartphones for games more often than foreign girls, the preoccupation with smartphone games is higher among Russian women as well. Conclusions. The prevalence of problematic smartphone use, the characteristics of the content consumed and associations with other forms of PIU among Russian and foreign students were established. In our opinion, it is necessary to carry out further research aimed at solving an urgent medical and social problem of timely diagnosis of smartphonedependent behavior and prevention of somatic and neuropsychic health disorders associated with it in young people. The current range of indicators to be studied in people with problematic smartphone use should include an analysis of comorbid psychosomatic disorders (recurrent pain: headaches, abdominal pain, back pain) and features of psychosocial characteristics, taking into account age, sex and ethnic differences of electronic gadget users. 

The inflammatory process accompanies most of the pathologies and requires pharmacological correction. In spite of significant achievements of scientists in the field of medicine and pharmacology, existing steroid and nonsteroidal antiinflammatory drugs have a number of undesirable reactions. To date, one of the most urgent directions is the search for new effective and safe drugs with anti-inflammatory activity. The aim of the study was to investigate the anti-exudative properties of new 3-cyano-1,4-dihydropyridines, cyanothioacetamide derivatives in the classical test of acute formalin edema. Material and methods. The study was conducted on 88 white rats weighing 210–250 g. The effectiveness of compounds was determined in a model of acute formalin edema, which was induced by subplantar injection of 0.1 ml of 2 % formalin solution into the right hind limb of the animals. The severity of exudation was evaluated oncometrically in comparison with reference drugs – ibuprofen, indomethacin, meloxicam and metamizole sodium. The studied substances were administered intragastrically at a dose of 5 mg/kg 1.5 hours before the induction of inflammation. Results. It was found that some compounds exhibit anti-exudative activity, more pronounced or similar to the activity of reference drugs. The laboratory sample with code mar-137 was the leading sample and outperformed the comparators; 24 hours after the modeling of edema, it exceeded ibuprofen (by 2.39 %), metamizole sodium (by 4.77 %) in anti-exudative efficacy and had an anti-inflammatory effect similar to the activity of indomethacin and meloxicam. Conclusions. Newly synthesized laboratory samples of 3-cyano-1,4-dihydropyridines, cyanothioacetamide derivatives, were found to exhibit pronounced anti-exudative activity and are of interest for further research as a new class of anti-inflammatory drugs.

The experimental study is devoted to the identification of possible psychomodulatory and anxiolytic effects of ACTH(4- 7)-Pro-Gly-Pro and ACTH(6-9)-Pro-Gly-Pro under conditions of thyroid hyperfunction. Material and methods. The experiment was performed on white male rats, which were divided into groups: I – control; II – rats with hyperthyroidism model, III and IV – animals receiving ACTH(4-7)-Pro-Gly-Pro (Semax) and ACTH(6-9)-Pro-Gly-Pro at doses of 174 and 178 μg/kg/day, respectively, for 21 days against the background of hyperthyroidism. The development of experimental hyperthyroidism in animals was induced by administration of an aqueous solution of potassium iodide at a dose of 75 µg/kg by intragastric gavage, daily for 3 weeks. Behavioural activity was assessed using psychopharmacological tests “Lattice” and “Light-Dark box” in standard modification. Results and discussion. Under conditions of experimental hyperthyroidism in the “Lattice” test, changes in psychomotor behaviour of animals were observed in the form of suppression of orienteering and exploratory activity, namely, a decrease in the number of stands and exploratory “peeks” downwards. In the test “Light-Dark box” against the background of thyroid hyperfunction, an increase in the level of anxiety was observed, manifested in a decrease in the time spent in the light compartment, the number of transitions between compartments and racks, as well as an increase in the number of assessments of “risk” – “looking out” of the compartment. The studied substances ACTH(4-7)-Pro-Gly-Pro and ACTH(6-9)-Pro-Gly-Pro in conditions of experimental hyperthyroidism promoted the correction of the above-mentioned behavioural disorders, eliminating the anxiety-depressive state of laboratory animals. Conclusions. When studying the effect of ACTH(4-7)-Pro-Gly-Pro and ACTH(6-9)-Pro-Gly-Pro substances under conditions of experimental hyperthyroidism on behavioural activity of white rats in the tests “Lattice” and “Light-Dark box” it was revealed that the studied peptide compounds exhibit psychomodulatory and anxiolytic effects, correcting behavioural reactions.

Aim of the study was to investigate susceptibility to pulmonary tuberculosis in men and women depending on polymorphism of genes of xenobiotic biotransformation enzymes NAT2 (590G> A (rs1799930)), CYP2E1 (9896C> G (rs2070676)), ABCB1 (3435T> C (rs1045642)), GSTM1 (E/D) and GSTT1 (E/D). Material and methods. The study included 335 patients with pulmonary tuberculosis aged 18 to 65 years (212 patients with newly diagnosed pulmonary tuberculosis and 123 people with chronic pulmonary tuberculosis receiving intensive phase of chemotherapy). Statistical data processing was carried out on a personal computer using IBM SPSS Statistics 26 and MS Excel 2013 software packages. The control group consisted of relatively healthy individuals without chronic diseases. Genotyping of polymorphisms NAT2 (590G>A (rs1799930)), CYP2E1 (9896C>G (rs2070676)), ABCB1 (3435T>C (rs1045642)) and extended deletions GSTM1 (E/D), GSTT1 (E/D) was performed using real time PCR. Results. It has been established that the genotype EЕ of GSTT1 gene identified in 89.1 % men was statistically significantly associated with increased susceptibility to pulmonary tuberculosis, while the genotype DD of the GSTT1 gene (10.9 % cases) was associated with reduced susceptibility. A similar trend is observed in women: the greatest susceptibility to pulmonary tuberculosis is characteristic for the genotype ЕЕ GSTT1 gene (87.2 %), the least (12.8 %) – for the DD genotype. Conclusions. It is advisable to introduce genotyping of genes of xenobiotic biotransformation enzymes into the practice of a phthisiologist in order to develop measures to improve the effectiveness of prevention and treatment of patients with pulmonary tuberculosis.

Aim of the study was to develop recommendations for improving procedures and unifying the content of risk management of the healthcare system to preserve public health based on an analysis of the opinions of doctors, organizers and experts of the healthcare system. Material and methods. As part of a quantitative online survey conducted from September to December, 2022, 104 respondents working in the healthcare system of the Russian Federation were interviewed. Additionally, 6 in-depth interviews were conducted with the organizers and experts of the healthcare sector as part of a qualitative sociological study. Desk research included analysis of scientific literature, and the regulatory framework related to the introduction of a risk-based approach to healthcare. Results and discussion. The article presents an analysis the perception of risks in healthcare by doctors, organizers and experts at the level of a medical organization, of the healthcare system and of public health (macro level), with the identification and classification of the main risk groups, on the basis of which risk-management’ measures can be built. The results of the study testify to the insufficiently deep introduction of risk management into the management system of medical organizations. The half of the respondents noted the low and extremely low level of risk management principles’ usage in their own organizations (50 % of respondents) and in Russian medical organizations in general (58.6 % of respondents). At the same time, from a third to a half of the participants found that it was difficult to answer about risk management implementation in their organizations, due to the lack of a unified methodology, imperfection of standards and quality control system of this set of measures, lack of specialists who could manage risks, lack of educational activities. To introduce a systematic approach to the unification of risk management processes, it is necessary to develop and approve the methodology of best practices, as well as take care of the training of specialists. Conclusions. In order to implement a systematic approach to the unification of risk management processes, it is necessary to develop and approve a methodology of best practices, as well as to take care of the training of specialists. It is imperative that hospital managers and staff focus on improving the organizational culture of patient safety management as the basis for their mission to preserve public health. It is necessary to continue further research in this direction in order to develop a strategy for countering risks at the level of public health as a medical and social resource of society.