Endometriosis is one of the most common and understudied diseases in women all over the world. The more than a century-old history of endometriosis research does not currently provide unambiguous answers about the causes, risk factors, etiology and methods of its treatment. Chronic pelvic pain as one of the main symptoms of endometriosis is the cause of not only physical suffering, but also a negative change in the mental status of women, deterioration of their quality of life. Body-oriented methods of treating the disease often turn out to be ineffective. The relationship between psychosomatic components (depression, anxiety, neuroticism) and chronic pelvic pain, despite the evidence, remains underestimated and is not always considered in medical theory and practice. This review article reflects the main epidemiological characteristics of chronic pain syndrome in genital endometriosis in women, from an epidemiological point of view, the main approaches of modern medical science to determining risk factors for its occurrence and development are considered. The promising role of an interdisciplinary (biopsychosocial) approach in the diagnosis and treatment of such patients, the need for further research and practical application of complex methods of treatment of chronic pain syndrome in genital endometriosis are shown.

Adaptogens are a category of herbal medicinal products that enhance the adaptive reserves of the body, resistance to extreme factors and survival under stress. Adaptogenic properties have been revealed in dozens of plants, in particular, preparations based on raw materials from the Lady’s Mantle (Alchemilla vulgaris L.), a perennial herbaceous plant from the family Rosaceae, have a wide range of biological activity, including antioxidant, antiinflammatory, neuroprotective, anticancer and other, which allows them to be used for prevention and supportive therapy in the treatment of many pathological processes. The results of the authors’ own research and a number of literature data substantiate the presence of adaptogenic properties in this plant. The review analyzes the information in the scientific literature on the chemical composition of compounds included in preparations based on A. vulgaris raw materials, the modern interpretation of the concept of “adaptogen” and criteria for evaluating the adaptogenic properties of plants, and discusses possible molecular and cellular mechanisms that ensure the presence of such properties in the Lady’s Mantle.

The surgical anatomy of the dorsal pancreatic artery is of paramount importance in the work of a pancreatic surgeon, transplant surgeon, and oncologist. This artery supplies blood to the pancreatic neck region, the area where, in the vast majority of cases, pancreatodigestive anastomosis is performed. Material and methods. A systematic literature review was conducted using the PubMed, Embase, CyberLeninka, and GoogleScholar bibliographic databases. The following keywords and their combinations were used: «cranial trunk», «superior mesenteric artery», «splenic artery», «common hepatic artery», «dorsal pancreatic artery», «pancreatic body and tail arteries», «pancreatic isthmus blood supply», «pancreatic anatomical segment arteries», «anatomy», «variants», «arterial anastomoses» and «anomalies». Results and discussion. Frequency of dorsal pancreatic artery was 79–100 % according to the data of anatomical investigations; radiological ones – 64.4–100 %. Its main sources were the splenic artery – from 22.22 to 80 % according to anatomists, from 13.5 to 100 % according to radiologists; the cranial trunk – 3–33.3 and 8–27.75 % respectively; the superior mesenteric artery – 1.8–25 and 3.8 % respectively; the common hepatic artery – 12–24 % regardless of the research methods. The course of the dorsal pancreatic artery and its division into the terminal branches (prepancreatic and inferior pancreatic arteries) was characterized by relative constancy. Conclusions. This review summarizes world literature data devoted to the topographic anatomy of the splenic artery and its pancreatic branches involved in the blood supply of the body and tail of the pancreas. The search for dorsal pancreatic artery in anatomical and radiological material should start from the main trunk and the area of its division into terminal branches, and then move to its source.

Quantitative characteristics of the impact of factors of the production environment (physical, chemical, biological), the severity and intensity of the labor process, their contribution to the deterioration of the health of the working contingent and the development of mechanisms of premature aging can hardly be overestimated. Occupational factors play a leading role among the health risk factors of the labor contingent in the workplace. Their effect on the organism of people engaged in work with harmful and (or) dangerous working conditions can have cumulative effect on the health of workers and cause premature aging of the body, exert an adverse effect on the central nervous, cardiovascular, endocrine, reproductive, digestive, excretory, blood, musculoskeletal system, causing psychosomatic, acute and chronic occupational diseases, and poisoning. Long-term chronic “occupational” and domestic stress prevails among the mechanisms that reveal premature aging at the level of the hypothalamic-pituitary-adrenal axis. The article analyzes (according to literature sources) the most probable risk factors and mechanisms that trigger the processes of premature aging.

Often premature birth is accompanied by preterm premature rupture of membranes (PPROM). PPROM is a complication of the course of pregnancy in 2–3 % cases and is the most common in premature birth. As a rule, the protocols for the management of such patients vary greatly and are mainly individual. In practical obstetrics, there is an urgent need to decide whether the risk of complications resulting from previous PPROM exceeds the risk of intrauterine infection. Of course, the need for further research in this area is necessary, which will help to choose the tactics of the maximum allowable period that would be optimal for reducing perinatal morbidity and mortality, as well as to identify factors that improve the prognosis for the mother and fetus. The review analyzes and summarizes the results of studies on PRPO in premature pregnancy complicated by chorioamnionitis. The advantages and disadvantages of various approaches in the management of such patients are considered. The modern medical literature presented in eLibrary and CyberLeninka electronic libraries, PubMed database of medical and biological publications has been studied.

The activity of thyroid hormones is one of the key elements in the regulation of the organism’s adaptive reactions. The article presents an analysis of thyroid hormones’s action mechanism as the organism’s response to environmental stress. The purpose of the study is to specify the role of iodothyronines in the formation of the organism adaptive reactions. Material and methods. The literature analysis was performed using the PubMed, SpringerLink, eLibrary, GoogleScholar databases for relevant publications for the period 2015–2023. Results and discussion. The development of both hypo- and hyperthyroidism negatively affects the functioning of a number of organs and systems of the organism. The consequences of changes in the level of thyroid hormones in the form of hypo- and hyperthyroidism for the adaptive capabilities of the organism are characterized, and the possibilities of correcting adaptive reactions by regulating their level are analyzed. Conclusions. To date, it has been proven that thyroid hormones are actively involved in the expression of more than 100 genes, maintaining redox balance, as well as in many metabolic reactions, which affects the adaptive potential of the organism. At the same time, the development of both hypo- and hyperthyroidism negatively affects the functioning of a number of organs and systems of the organism. Therefore, for a person to successfully adapt to stressful environmental factors, it is advisable to correct the content of iodothyronines in the organism. Actively used hormonal support, despite proven effectiveness, has nevertheless a number of limitations regarding the potential harm of such therapy, as a result of which approaches to correcting the content of iodothyronines are currently being analyzed, in particular, through the nutritional intake of a number of vitamins and microelements, as well as through dosed physical activity.

Normal anatomy of the left atrial appendage (LAA) of human fetus is of a great importance for fetal cardiac surgery and heart bioprinting. Aim of the study was to clarify the mesoscopic anatomy and histotopography of different parts of the LAA walls in normal human fetuses of 16–22 gestation weeks. Material and methods. We prepared serial histotopograms of the left atrial appendages from 10 normal human fetal hearts stained by Masson trichrome, orcein and fast green. We studied slides by means Olympus CX microscope, TOUPCAM U31S digital camera, and ADF-Image program for measuring. Using a Carl Zeiss EVO LS 10 scanning electron microscope at a magnification of 15–5000 times, three samples were examined using the freeze-chip method. Results. Having measured the outer walls of the LAA intertrabecular spaces, we found that at the level of the middle third of the left atrium, their thickness is minimal in the posterior wall (80 [61–97] μm) (median [lower quartile; upper quartile]), thickness in the anterior wall is 142.9 ± 33.2 μm (mean ± standard deviation) (101 [79–192] μm). At the level of the coronary sulcus, the same parameters were 143.7 ± 23.6 µm (147.5 [90–180] µm) and 137.4 ± 33.9 µm (101 [68–195] µm), respectively. Downward, LAA posterior wall increased about 1.8 in thickness, whereas the thickness of the anterior wall was the same. The endocardium showed the same thickness in all locations. Microanatomically, the LAA myocardium never discovered to build from distinct layers but “anatomical syncytium” or seldom bundles. Collagen and elastic layers were common for endocardium, rare for epicardium. Endocardial elastic fibers interweaved in the underlying collagen so the distinct boundary lacks there. Conclusions. Mesoscopic and microanatomical features of LAA walls in human fetus consist of variable thickness at different levels, unlayered but “syncytial” myocardium, muscleless areas, elastic and collagen layers of the endocardium.

The aim of the study is to determine the morphometric features of splenic vasculature structural components (biounits, BU) of various kinds in individuals of different sex and age. Material and methods. The paper is based on the results of morphometric study of corrosion casts of splenic venous vasculature of 64 people (32 men, 32 women) at the age of 21 to 60 years (32 first period of adulthood, 32 second period of adulthood), deceased from sudden death and accidental causes. The study was conducted in compliance with ethical principles, including the World Medical Association’s Declaration of Helsinki. The diameters (D) and lengths (L) of the venous segments constituting BU were measured. Splenic venous vasculature was represented as a system consisting of three types of BU: 1 BU – the proximal segment diameter (D) is less than the sum of the diameters of distal segments (d_max and d_min) associated with it, D < d_max + d_min; 0 BU – D = d_max + d_min; 2 BU – D > d_max + d_min. Results. All three kinds of BUs were identified; there was a significant relationship between the relative number of BUs of different kinds, sex and age group; the sizes of all three kinds of BUs were determined; 1 BU was the largest and 0 BU was the smallest; 0 BU was the most symmetrical and 2 BU was the most asymmetrical; the relative number of 1 BU decreased, 0 BU increased, and 2 BU practically did not change in the direction from proximal to distal parts of the channel. BUs of the 1st kind have the largest diameter of proximal segments, while 2 BUs occupy the middle position in the range of values of the investigated parameters. The smallest diameter belongs to 0 BU. As for the length of segments L, the maximum values are typical for 1 BU, the minimum – for 2 BU, and the middle position in the series is occupied by 0 BU. Conclusions. The results obtained can serve as a foundation for the creation of a morphometric standard of splenic venous vasculature, and should be considered in its numerical modelling.

Aim of the study was to evaluate the features of the anatomy of the deep vein of the femur according to CT-phlebography data. Material and methods. The data of CT-phlebography of 100 limbs of 50 patients (27 women, 23 men, mean age 39 years, age range 28–46 years) obtained in 2021–2023 were used as the basis of the work. The study was performed according to the original technique (patent of the Russian Federation N 2799023) on a 128-slice multispiral computed tomography scanner, with slice thickness of 0.5 mm, intravenous injection of contrast agent. The diameter of the femoral deep vein at different levels, the presence of additional trunks and its anastomoses with other segments of deep and superficial veins were evaluated. Results. True doubling of the femoral deep vein occurs with a frequency of 6 %, anastomoses of the femoral deep vein with the femoral-pubic segment of deep veins in 62 % cases. Variant anatomy with direct transition of the femoral or popliteal vein into the femoral deep vein occurs in 13 % of observations. Conclusions. The data on variant anatomy of the deep vein and its tributaries may be of practical importance when it is necessary to diagnose or choose the technique of surgical intervention in patients with venous diseases of the lower extremities.

Determining the physical development of the population of the regions is quite convenient within the framework of identifying the level of public health, while it is very important to track changes in the physical health of adolescents entering the reproductive phase of life, depending on the periods of development of the country. The aim of this study was to identify significant changes in the morphological profile of adolescents in Penza and Penza region over 15 years. Material and methods. The object of the study were 492 people of both sexes, 16 to 21 years of age, born and permanently residing in Penza and settlements of Penza region, divided into two groups according to the year of birth (group 1 – born in 1986–1990, 2 group – born in 1999–2004). Anthropometry and somatometry were carried out by the method of V.V. Bunak with subsequent comparative analysis of statistical indicators. For a comparative assessment of the level of physical development and identification of significant differences between the two groups, the following index methods were used: body mass, Rohrer, Erisman, Pignet, Rees-Eysenck, Tanner. Results and discussion. Based on the results of the study, it was concluded that Penza residents of 1999–2004 birth, compared with predecessors, there was a significant increase in the studied absolute anthropometric parameters with a simultaneous shortening of the hand and shin length. Among the representatives of the modern youth of the region, when compared with the group of 1986– 1990 birth, the number of people with mesomorphy increased by 2.2 times, the number of people with overweight – by 1.5 times, the number of individuals with a narrow chest – by 1.3 times, the number of cases of a low degree of physical development, hypersthenic type (according to the results of calculating the Rees-Eysenck index) – by 1.2 times, at the same time the number of normosthenics increased by 1.1 times (according to the results of calculating the Pignet index). Conclusions. Comparative analysis showed significant changes in the constitution of the autochthons of Penza region of adolescents over 15 years.

Adolescence is one of the most difficult period in the person’s life. Adolescent behavior is influenced by many factors, including the social environment, internal attitudes and hormonal levels. One of the important hormones that can change behavior is oxytocin – an extremely important prosocial neuropeptide that influences social bonding from an early age. The effect of oxytocin on the psycho-emotional state is quite individual and may depend on age, gender, ethnocultural factors, social environment, the presence of stress factors, and personality traits. The results of the studies indicate the relationship between the increased concentration of oxytocin and the presence of developed social contacts. The aim of this work was to identify an association between psychosocial characteristics in adolescent of different gender and rs53576 polymorphism of the oxytocin receptor gene. Material and methods. Psychological and genetic testing of adolescents aged 11–18 living in the territory of the Angara-Yenisei macroregion was carried out. Mental health assessment was carried out using the Russian version of the questionnaire “Strengths and difficulties” by R. Goodman. Results and discussion. The rs53576 OXTR AA genotype is more frequent in boys than in girls (20.8 % vs. 14.3 %, p = 0.03). The association of the rs53576 OXTR A allele with social behavior disorders and depression was previously shown. Boys carrying the AA genotype have significantly higher scores (borderline values) on the scales of “Emotional symptoms” and “Problems communicating with peers” compared with carriers of the GA and GG genotypes. Conclusions. Evidences of differing individual psychosocial consequences of high activity of the oxytocinergic system, depending on the context of the social environment, allowed us to formulate the “hypothesis of the social significance of oxytocin”. Problems in communication with peers in adolescents with pronounced social empathy and altruistic personal characteristics can be successfully overcome. Both the general orientation of the pedagogical process towards the approval of prosocial behavior, and socially significant personalities, whom adolescents can perceive as an example to follow, can help in many ways.

The aim of study was to investigate the indicators of cardiovascular and autonomic adaptation of cadets of the Institute of Civil Aviation to different types of locomotor motion activity. Material and methods. Heart rate, blood pressure, cardiovascular indices were assessed in 96 healthy cadets divided into four groups according to the type of their locomotor motion activity. The study also analyzed Baevsky’s indices. Results and its discussion. The analysis of cardiovascular indicators and indicators of heart rate variability both in the background state and in response to an active orthostatic test revealed an increase in the adaptive reserve and heart rate variability in the series «not engaged» – «self-exercising» – «game sports» – «cyclical sports». It has been established that cadets involved in cyclic sports have greater parasympathetic activity and its influence on the heart rate both at rest and in response to orthostatic load, which reflects a deeper degree of their adaptation to physical and educational load, based on structural changes in cells of the cardiovascular, nervous and endocrine systems. Apparently, the data obtained indicate the manifestation of a general strategy of structural and functional restructuring of the body’s regulatory systems, aimed at the formation of optimal compensatory and adaptive changes in hemodynamics.

The aim of the study is to analyze the prevalence of functional and structural disorders of the musculoskeletal apparatus (MSA) and postural balance in adolescents in the Saratov region. Material and methods. The condition of the musculoskeletal system in adolescents of the Saratov region (n = 555) was studied as part of a one-stage study. The prevalence of pain complaints in various structures of the musculoskeletal system, body type, posture, shape of the pelvis and feet, the presence of trigger points, the function of the hip and shoulder joints, the volume of movement in various parts of the spine were analyzed. To assess the postural balance, the indicators of the statokinesiogram were studied. Results. A high prevalence of complaints of pain in the structures of the musculoskeletal system has been established. The most common structural changes are: scoliotic posture disorder, the shape of the shoulders, chest, shoulder blades, pelvis, feet. Among the functional disorders – limited mobility in the hip and shoulder joints, in the thoracic and lumbar spine. Trigger points were found mainly in the trapezius, pectoralis minor, scalenus, quadratus lumborum, sternocleidomastoid muscles. Statistically significant correlations were found between the parameters of the statokinesiogram and complaints of pain in the spine, structural and functional disorders of the musculoskeletal system. Conclusions. The results of the study indicate the need for an interdepartmental integrated approach to the prevention of diseases of the musculoskeletal system in adolescents. An important condition is the quality of preventive medical examinations, a personalized approach to physical education, optimization of the ergonomics of classrooms in schools, training the population in movement hygiene, and increasing commitment to a healthy lifestyle.

Nowadays, the palm of superiority in elective surgery belongs to the problem of hernias. According to the literature worldwide, more than 20 million patients undergo surgical treatment for hernia of the anterior abdominal wall every year, most of whom undergo alloplasty using various kinds of nets. The study of the influence of methods for fixing implants and the emerging local inflammatory response of tissues on the frequency of relapses after allognioplasty is devoted to isolated works. Aim of the study was to investigate in an experiment the characteristics of the reaction of local tissues when implanting a rigid monofilament mesh polypropylene implant with a shape memory effect, and a classic mesh endoprosthesis made of monofilament polypropylene (PP) with various methods of fixing implants. Material and methods. An experimental study on 60 white male Wistar rats was performed to identify tissue reaction features around the PP mesh. Group 1 animals (n = 30) were implanted with a rigid mesh monofilament PP implant (Herniamesh, Italy) with shape memory effect, group 2 animals (n = 30) – with a classic mesh endoprosthesis made of monofilament PP for soft tissue repair ESFIL® standard (Lintex, Russia). Biopsies were examined at 1, 2, 3 months after implantation of the PP mesh. Results. A morphological study showed that 1 month after the implantation of a rigid mesh monofilament PP implant, the inflammatory reaction is less obvious than when implanting a classical PP endoprosthesis. This reaction contributed to the earlier germination of collagen fibers around the rigid implant monofilaments. At 2 and 3 months after the implantation of PP nets in both groups of animals, there were no advantages as the regenerate formed. Conclusions. When introducing PP mesh with suture fixation and rigid monofilament PP mesh without fixation, there is a natural response to the integration of the endoprosthesis, which is characterized by aseptic inflammation followed by pronounced fibrosis around the implant. Such processes, occurring in response to the implantation of synthetic polypropylene nets, increase local mechanical tissue resistance, and can create additional strength against recurrence of inguinal hernias.

Pulmonary hypertension is a condition characterized by a progressive increase in pressure in the pulmonary circulation. The simplest and most common experimental model of pulmonary hypertension is the monocrotaline model. It is based on the process of transformation of monocrotaline in the liver by cytochrome P450 into endothelial toxic monocrotaline pyrrole, which in turn, damaging the endothelium of the pulmonary vessels, leads to circulatory disorders in the pulmonary circulation and the formation of pulmonary hypertension. Thus, additional prestimulation of cytochrome P450 may increase the stability and representativeness of the monocrotaline model. The purpose of this work was to determine differences in morphological changes in the myocardium and pulmonary vessels of rats in which pulmonary hypertension was modeled using monocrotaline with and without additional stimulation of liver enzymes. Material and methods. The study was conducted on 24 mature male Wistar rats. The animals were divided into 4 groups of 6 rats. Group 1 was represented by intact animals. In groups 2, 3 and 4, modeling of pulmonary hypertension in rats was carried out with a single subcutaneous injection of an aqueous-alcohol solution of monocrotaline at a dose of 60 mg/kg. In order to induce cytochrome P450 in groups 3 and 4, animals were intragastrically administered phenobarbital for one and three days, respectively. Results and discussion. The area of cardiomyocyte nuclei in the groups with one- and three-day preliminary stimulation of liver enzymes was 22.78 ± 3.4 and 23.63 ± 3.72 µm2 , respectively, significantly different from the corresponding values of the control group and group 2. Similar results were revealed when determining the index of the thickness of the medial membrane of small-caliber pulmonary arteries – 58.32 ± 10.02 and 76.44 ± 18.55 % in the groups with one- and three-day preliminary stimulation, respectively. In addition to quantitative changes, qualitative changes were also noted: with additional activation of cytochrome P450, interstitial fibrosis and myocarditis more intensively formed in the myocardium, and signs of “monocrotaline syndrome” more rapidly arose and progressed in the lungs. Conclusions. Based on the data obtained, it can be assumed that preliminary cytochrome P450 causes an increase in the stability, reproducibility and severity of morphological changes in the monocrotaline model of pulmonary hypertension.

Osteoporosis is a disease associated with a decrease of bone density and quality. Bone tissue is especially sensitive to changes in trace element content in the body. Deficiency of macro- and microelements (silicon, calcium, manganese, etc.) can lead to the development of osteoporosis. The aim of the research was to study the effect of NaBiKat phytoextract on the viability and functional activity of fibroblasts, mesenchymal stem cells (MSCs), osteoblasts and osteoclasts, involved in bone metabolism in osteoporosis. Material and methods. An aqueous solution of the NaBiKat phytocomplex consisting of rice husks and germ film, green tea was used in the work; its content of basic chemical elements was measured using atomic immersion spectral analysis. The cytotoxicity of the phytoextract was evaluated on fibroblasts, MSCs, and osteoblasts of humans using the MTT test. The activity of mitochondria in cells was assessed by staining with a fluorescent dye TMRM. The production of intracellular proteins in osteoblasts and osteoclasts was determined using flow cytometry. Results and discussion. In an aqueous solution of phytoextract, a large amount of sodium, potassium, silicon, manganese, magnesium and a small amount of calcium, iron are found. The phytoextract did not have a cytotoxic effect on fibroblasts and stimulated proliferation of MSCs and osteoblasts up to 112–128 % and up to 130 %, respectively. At maximum concentration, the phytocomplex reduced osteoblast proliferation. Phytocomplex enhanced mitochondria activity in MSCs and osteoblasts, reduced in fibroblasts and osteoclasts. Under its influence, an increase in RANKL synthesis was observed in osteoblasts, the amount of type 1 collagen did not change, and cathepsin K production decreased in osteoclasts, while it did not significantly affect MMP-9 content. Conclusions. The results obtained indicate that an aqueous phytoextract based on rice husk and germ film, green tea leaves is safe for MSCs, fibroblasts, osteoblasts, and osteoclasts in humans and is able to stimulate the functional activity of osteoblasts, as well as reduce the activity of osteoclasts due to the high content of macro- and microelements.

The continuing interest in the problem of vibration disease (VD), especially when combined with arterial hypertension (AH), is due to the steady development of industrial sectors associated with vibration acceleration and the tendency towards the early development of AH. Aim of the study was to investigate the features of clinical, nutritional and anthropometric indicators and frequency of occurrence of Ala16Val (rs4880) polymorphic locus of the manganese superoxide dismutase (MnSOD) gene in VD combined with AH. Material and methods. 431 people were examined, among them 104 patients with VD stage I, 101 – with VD stage I in combination with AH I–II stage, 107 – with AH I–II stage, without contact with vibration, and 119 people working at the same enterprise without contact with vibration, without signs of hypertension. A complex of clinical, anthropometric, laboratory, functional and genetic studies has been carried out. Results. In case of VD comorbid with AH, the frequency of complaints, both general and specific, significantly increases compared to other groups. Body mass index, waist circumference / hip circumference (WC/HC) ratio, fat mass increase, extracellular fluid content with a decrease in active cell mass, musculoskeletal mass and phase angle compared with the control group. An imbalance of nutrition in terms of macro- and micronutrients, an increased content of the fat component in the diet with a deficiency in the diet of omega-3 polyunsaturated fatty acids has been established. In persons with VD and AH, the C/C genotype, which is more common in healthy people, is registered in only 16% of cases, while the polymorphic variant T/T is in 29 %, which exceeds the corresponding value in the control and isolated AH groups by 1.9 and 1.5 times, respectively. Discussion. The common pathogenetic features of VD and AH lead to the development of adipose tissue dysfunction and trophological insufficiency. There is no doubt that hypertension is associated with increased body weight, obesity, and adipocytokine serum concentration. An indicator of a high risk of developing cardiovascular pathology, including heart attack, stroke, is an increase in the WC/HC index. The role of the Ala16Val polymorphism of the MnSOD gene in the formation of AH and some variants of occupational diseases has been shown in a number of studies. Conclusions. The variant of VD, comorbid with AH, is characterized by a significant increase in the frequency of detection of the T/T genotype in the polymorphic locus Ala16Val (rs4880) of the MnSOD gene in combination with an altered nutritional and anthropometric status of such patients. The presence of this polymorphism may be associated with an increased risk of developing concomitant vascular pathologies in VD, however, in combination with malnutrition and associated changes in anthropometric parameters, this risk increases many times over. Thus, early diagnosis of the risk of developing comorbid vascular pathology in VD can be aimed at identifying the genotype, and prevention can be aimed at modifying nutrition.

The aim of the study is to identify social and economic factors associated with the development of coronary and cerebral ischemic events in urban residents based on the results of a three-year follow-up. Material and methods. The prospective non-interventional observational study included 431 patients. Data on the coronary and cerebral ischemic events in history, and social, economic and demographic data were collected at the baseline. Follow-up appointments were scheduled 3 years later to assess new cases of coronary and cerebral ischemic events. Taking into account the presence or absence of the adverse events in history at the baseline and follow-up visit, four groups of patients were formed. There were 350 (81.2 %) people without a coronary history (group 1), and 81 (18.8 %) with it (group 2). Respondents without a coronary history were divided into a subgroup with the absence of new ischemic (coronary and cerebral) events at the repeat stage, numbering 246 (57.1 %) people (1a), as well as a subgroup with their development – 104 (24.1 %) (1b). Similarly, respondents with a coronary history were divided into a subgroup with the absence of adverse events at the second stage, which included 35 (8.1 %) people (2a), as well as a subgroup with their occurrence – 46 (10.7 %) (2b). Results. At the baseline, only 18.8 % out of 431 patients had coronary events in history. At the follow-up visit, 150 (34.8 %) patients presented with new coronary or cerebral ischemic events: 10.7 % of those cases were fatal, 1.9 % – new cases of myocardial infarction, 3.5 % – cases of stroke, 13.5 % – new cases of angina pectoris, and 5.3 % – other diseases associated with coronary artery disease. One third out of 350 patients without coronary events in history and half of patients with coronary events in history presented with newly developed adverse events. Young respondents (35–49 years old) with no coronary history were 3 times more likely to have coronary and cerebral ischemic events over 3 years than people of the same age, but with previous diseases of the cardiovascular system. During the 3-year followup period, the risk of coronary and cerebral ischemic events in patients with coronary events in history was associated unemployment odds ratio (OR) 2.74 (95 % confidence interval (CI) 1.33; 5.66, p = 0.006), widowhood OR 2.98 (95 % CI 1.32; 6.74, p = 0.008), living in a rural area OR 2.30 (95 % CI 1.16; 4.55, p = 0.017) and female gender OR 2.63 (95 % CI 1.28; 5.43, p = 0.008). Conclusions. The risk of coronary and cerebral ischemic events during the 3-year follow-up period in the population of urban residents is associated with social and economic determinants such as female gender, unemployment, living in a rural area, and widowhood in the presence of a coronary history. 35–49-year-old men without a coronary history should also be considered as a group of special attention for the prevention of adverse events.

Immune relationships involved in a wide range of immunopathological conditions, including ankylosing spondylitis (AS), are formed due to the characteristics of the subset composition of follicular T helper cells (Tfh) and B lymphocytes. Expression of the HLA-B27 antigen can change the reactivity of cells of the immune system and, accordingly, their interaction and participation in the immunopathogenesis of AS. The aim of this study was to investigate the characteristics of the subset composition of Tfh and B cells in HLA-B27-positive and negative patients with AS. Material and methods. 66 patients (17 women and 49 men) aged 20–58 years with a diagnosis of AS were examined. Molecular genetic research on HLA-B27 expression was carried out using the quantitative PCR method with real-time detection. The subset composition of Tfh and B cells was studied using flow cytometry. Results. An increase in the amount of Tfh2 in the blood is observed in all patients with AS. The number of Tfh1 was reduced in HLA-B27-positive AS patients, but Tfh17 cell content was increased. Changes in the subset composition of B lymphocytes, which were found only in patients with an HLA-B27-positive form of the disease, manifest themselves primarily as an imbalance in the distribution of B cell memory. Only negative correlations of Tfh1 and Tfh17 content with “double-negative” B cell and plasmablast precursors percentage are detected in HLA-B27-negative AS patients. Tfh1 cell number correlate negatively with naïve and activated naïve B cell content in HLA-B27-positive disease, Tfh2 cell percentage – with memory B cell fraction number. CCR6+ Tfh and Tfh17 have positive regulatory effects on plasmablast precursors. Conclusions. The subset composition of Tfh characterizes the dominance in the immunopathogenesis of AS of the direction of the regulatory influence of follicular T helper cells on B lymphocytes regardless of the carriage of the HLA-B27 gene in AS patients. High levels of Tfh type 17 are also detected in HLA-B27-positive patients. The relationships between the subsets of Tfh and B cells in HLA-B27-negative AS patients characterize the presence of processes aimed at inhibiting B cells. The influence of Tfh1 is aimed at suppression of B-cell immunity in HLA-B27-positive AS while Tfh2 and Tfh17 stimulate B-cell mechanisms.

This study demonstrates the relationship between IgG titer to cytomegalovirus (CMV) and the proinflammatory cytokine TNF-α and IL-1β concentration, the prognosis after hospitalization of patients due to decompensation of chronic heart failure (CHF) during 24 months of observation. Material and methods. We examined 132 patients with CHF of ischemic etiology (age 59.0 [54.0; 63.5] year, median [lower quartile; upper quartile]), hospitalized for CHF decompensation. Patients were included in the study after stabilization of CHF decompensation before discharge from the hospital. Subsequently, patients were prospectively monitored for 24 months. Upon inclusion in the study, TNF-α, IL-1β plasma concentration was determined, before discharge from the hospital and after 24 months – the titer of IgG antibodies to CMV. Results. The titer of IgG to CMV in the cohort of patients was 1356 [835; 1931] units/ml. Patients were divided into tertiles 1, 2 and 3 with an antibody titer of less than 923, from 923 to 1811 and more than 1811 units/ml, respectively (44 persons in each group). Individuals from the tertile 3 group were more likely to have IV functional class CHF (p = 0.025), and also had a higher content of pro-inflammatory cytokines (p = 0.001 for TNF-α and p = 0.019 for IL-1β), and the number of hospitalizations due to decompensation of CHF, worsening functional class of CHF and deaths during 24 months of observation than in patients of tertile 1. Conclusions. With an increased level of IgG to CMV in patients with CHF, there is an increase in the concentration of pro-inflammatory cytokines and the risk of adverse cardiovascular events within 24 months after an episode of CHF decompensation compared to patients with lower antibody levels. The activity of the inflammatory process, which is influenced by CMV infection, on the background of immunosuppression in patients with CHF, is likely an important trigger for the progression of cardiovascular pathology and mortality.

Aim of the study was to analyze the frequency and dynamics of schizophrenia, schizotypal disorder and autism in children and adolescents in Moscow and in the Kabardino-Balkarian Republic (KBR) for 2021–2022 to determine the need for appropriate support measures for this population group. Material and methods. The dynamics of primary and general morbidity of mental diseases, including children and adolescents, as well as primary and general morbidity of schizophrenia (F20), schizotypal disorder (F21) and autism among children and adolescents in Moscow and in the KBR for 2021–2022, corresponding to the ICD-10 codes, are considered. Results and discussion. There is an increase in the overall incidence of mental illness in 2021 and 2022 both in Moscow (an increase of 8.4 %) and in the KBR (an increase of 0.3 %), of which among the child population (10.9 and 2.2 %, respectively). An enhancement of the primary incidence of mental illness in Moscow was revealed with an increase of 23.7 %, in the KBR with an increase of 1.1 %, among the child population corresponding values were 29.4 and 10.6 %. The overall incidence of schizophrenia decreased by 1.1 % in Moscow and by 0.5 % in the KBR, among the child population – by 1.3 and 21.3 %, respectively. The overall incidence of schizotypal disorder enhanced by 9.1 % in Moscow, by 8.1 % in the KBR, among the child population – by 7.9 and 0 %, respectively. A decrease in the primary incidence of schizophrenia was revealed by 0.1 % in Moscow, by 91 % in the KBR. Among the child population it increased by 25.6 % in Moscow and decreased by 100 % in the KBR, as well as number of newly diagnosed cases of schizophrenia. The primary incidence of schizotypal disorder rose by 34.1 % in Moscow, by 16.7 % in the KBR, among the child population it decreased by 1 % and hasn’t changed, respectively. It is possible to note an increase in the total incidence of autism in 2021–2022 both in Moscow (by 21.1 %) and in the KBR (by 9.4 %), while the number of newly diagnosed cases of autism in Moscow increased by 26.3 %, then in the CBD it decreased by 66.8 %. Conclusions. A diagnostic bias was revealed – a decrease in the number of patients diagnosed with schizophrenia (F20) and a significant increase in the number of patients diagnosed with schizotypal disorder (F21). The statistical data obtained mainly indicate an improvement in the diagnosis of autism in childhood in Moscow and a decrease in the incidence of autism in the KBR.

Age-associated diseases (AAD) remain an urgent issue for individuals of different age groups. In the context of the recently completed COVID-19 pandemic, there is an acceleration of aging processes. From a clinical point of view, the early manifestation of AAD corresponds to accelerated aging. The study of AAD epidemiological characteristics in the aspect of different age groups seems very relevant. Aim of the study was to investigate the epidemiological characteristics of AAD (on the example of hypertensive diseases and type 2 diabetes mellitus) at the federal, district and regional levels. Material and methods. The materials were the statistical collections of the Ministry of Health of Russia for 2011–2021. An assessment of the incidence rate, trend, rate of increase/decrease in incidence, the ratio of the incidence rate among people over working age to the incidence rate of the adult population (age-specific incidence index, ASII) was carried out. Units of observation: hypertensive diseases; type II diabetes mellitus. Results and discussion. In 2011–2021, an unfavorable upward trend in morbidity was observed at the federal (Russian Federation), district (the North-West Federal District) and regional (Saint-Petersburg) level. However, in terms of the rate of increase in morbidity and ASII, specific features were found for the considered nosologies: hypertensive diseases were characterized by an increase in ASII, and for type 2 diabetes, on the contrary, a decrease in VID (“rejuvenation” of AAD).