Generalized anxiety disorder is characterized by persistent, poorly controlled anxiety and fears for various reasons. Thoughts are dominated by the themes of danger. Nonspecific symptoms include tension, restlessness, fatigue, poor concentration, irritability and dysautonomia. In the long run, the risk of depression and alcoholism is increased, comorbidity with affective, addictive and other disorders is often encountered. The article provides a brief overview of psychotherapy methods for this disorder. The cognitive behavioral psychotherapy appears to be most effective. One of the main goals of the therapy is training of realistic and objective thinking. Using self-observation, the patient becomes aware of his tendency to seek out and exaggerate threats. The problem-solving training can be used to improve social competence and coping skills. Various relaxation methods and other varieties of psychotherapy are applied. The schema therapy is an integrative approach including elements of different methods. Internet counseling can be used in isolation or as an adjunct to conventional psychotherapy. Anxiety disorders were diagnosed relatively rarely in Russia, and the number of psychotherapists was smaller than in other developed countries. Today, the situation is changing thanks to success of psychotherapy and development of individual rehabilitation regimes.

The prevalence of multiple sclerosis (MS) is steadily increasing not only due to rising incidence, but also due to improvements in diagnosis and treatment. Accordingly, there is growing interest in improving the quality of life (QL) of chronic patients, for the assessment of which general scales are used, as well as scales developed specifically for MS. In this work, we analyzed publications devoted to assessing the quality of life of MS patients using the nonspecific SF-36 scale for the period from 2018 to 2023. Data were assessed on all eight scales: physical functioning, role functioning, bodily pain, general health, vitality, social functioning, emotional state and mental health. The usefulness of the SF-36 questionnaire has been shown in the management of patients with MS by a general practitioner for a comprehensive assessment of QL dynamics during treatment and in planning of further treatment and rehabilitation measures. However, the ambiguity of numerous QL studies results in MS obtained using the SF-36 questionnaire requires continued research and improvement of the instrument itself.

In the structure of total mortality, cardiovascular diseases are in the first place in the world. The main and most common reason for this is the incidence of myocardial infarction (MI). The basis of the pathogenesis of MI with ST elevation is persistent and complete thrombotic occlusion of the large epicardial branch of the coronary artery, leading to extensive necrosis of the heart muscle with the development of life-threatening complications, including death, the frequency of which is 8–10 %. The prognosis for MI is influenced by the presence of risk factors, complications, hemodynamic status, polymorbidity, as well as tactics for restoring coronary blood flow. To eliminate acute coronary artery occlusion, conservative treatment is used – thrombolytic therapy, surgical – primary percutaneous intervention, thromboextraction, coronary bypass surgery, as well as their combination. Today, there are scattered and isolated studies characterizing the approach to treatment in patients with MI with ST elevation in various diseases and with polymorbid pathology, the relationship with risk factors and laboratory and instrumental data has not been established, among which predictors of rapid response and death in patients with polymorbid pathology for emergency physicians have not been determined. It can be assumed that the chosen optimal patient management tactics in a specific clinical situation, taking into account the above-mentioned factors, will reduce the development of complications and increase the survival rate of patients with MI.

The review presents contradictory results from numerous clinical and epidemiological studies, giving reason to doubt the indisputability of ideas about the primary role of low-density lipoprotein (LP) cholesterol in atherogenesis and the efficacy of lipid-lowering therapy. The latter clearly demonstrates the absence of the expected clinical effect in reducing cholesterol levels after surgical correction of lipid metabolism (ileal bypass surgery) or a very modest effect when using drugs devoid of pleiotropic properties. This circumstance finds an explanation in the fact that, according to modern concepts, only modified LP are the molecular substrate of the pathophysiological process at all stages of atherosclerosis development. Native (intact) LP, the concentration of which in the blood does not correlate with the level of modified forms, are not included in the pathogenesis of atherosclerosis. Consequently, the presence of native LP in the blood does not give a true picture of the activity of the atherosclerotic process. Based on the above, in the treatment of atherosclerosis, it should be considered justified not so much to further improve methods of lipid-lowering effects on the body, which do not have a sufficiently reliable evidence base of clinical effect, but to search for means that prevent the generation of atherogenic, modified LP. In this regard, taking into account the important role of systemic inflammation in the pathogenesis of atherosclerosis, the synthesis and clinical use of safe anti-inflammatory drugs, as well as the development and implementation of methods aimed at eliminating the causes of systemic inflammation, should be considered promising.

Chronic diseases of the bronchopulmonary system have reached epidemic levels worldwide, and the situation is deteriorating as the degree of urbanization increases. Elecampane is called Russian ginseng, because the active ingredients of its roots have a multifaceted effect on the body. In diseases of the bronchopulmonary system, they promote expectoration of sputum, stimulate blood circulation and saturate the blood with oxygen, have an immunomodulatory effect, which helps to fight viral and bacterial infections of the lungs. Especially relevant is the use of elecampane preparations for the treatment of pulmonary tuberculosis, mycoplasma respiratory infection and viral infections such as COVID-19, herpesviruses, which can provoke serious lung changes, including pneumatic fibrosis and pneumosclerosis, which are formed within three months or more, and the resulting fibrosis foci are not subject to involution. Meanwhile at the stage of development of the process, fibrous changes can be minimized by both drug and phytotherapy treatment. The antiviral effect of elecampane preparations may play a role in modifying or slowing the progression of pulmonary fibrosis, especially when used at an early stage. In bronchial asthma, elecampane preparations can weaken the immuneinflammatory response.

The impact of the new coronavirus COVID-19 infection on the course of pregnancy, maternal and child health is largely unclear and controversial. The presented literature review analyzes changes in the immune, cardiovascular, and endocrine systems in women in physiological pregnancy. The peculiarities of the course of infection caused by SARS-CoV-2 virus in pregnancy, depending on the virus variant, are presented, the issues of infection pathways into immune and non-immune cells, including placental cells, as well as the issues of transplacental transfer of the virus – the key moment of infection of the embryo or fetus, on which the outcome of pregnancy also largely depends, are considered. Promising approaches to COVID-19 therapy are presented: use of inhibitors of transmembrane serine protease 2 (TMPRSS2), furin, angiotensin-converting enzyme (ACE2) and RNA-dependent RNA polymerase, amnion epithelial cells and their exosomes. At the same time, the potential use of mesenchymal stem cells in patients with severe COVID-19 pneumonia is reviewed. Difficulties and questions regarding the use of the above therapeutic methods in pregnant women are highlighted. Aspects of the use of surfactant preparations in newborns at risk of new coronavirus infection are considered.

An important section of spinal biomechanics is the analysis of various types of movements in spinal segments, which are difficult to observe, and setting up experiments is quite complex. There are few articles devoted to this topic, and the methodological approaches outlined in these studies are so heterogeneous that they do not allow for a comparative analysis. In this situation, the abstract language of mathematics allows us to objectively answer the questions that arise. Aim of the study was to develop a mathematical model of a spinal segment to calculate the combination of rotation angles and lateral inclination of the vertebra, as well as to identify factors influencing these parameters. Material and methods. The developed mathematical model of the motion segment of the spine was used as the main tool for the study. The initial data for this model were the coordinates of the reference points of the vertebrae, which makes it possible to determine a number of parameters describing their complex structure. Using this model, the parameters of the combination of vertebral movement in the frontal and horizontal planes were calculated. Results and discussion. The developed model of the combination of movements in the spinal segment is adequate to the ideas about the nature of movements in the spinal segments. The coefficient of combination of lateral tilt and rotation of the vertebra for the cervical vertebrae is from 0.5 to 0.7, for the thoracic vertebrae from 0.3 to 0.5, and for the lumbar vertebrae from 0.0 to 0.1. Fluctuations in the value of this coefficient depend on the angle of inclination of the upper articular surfaces of the underlying vertebra. Reducing the size of the articular surfaces leads to a decrease in the magnitude of the angular movements of the vertebra, and their convergence leads to an increase in mobility in the spinal segments. A negative angle of inclination of the articular surfaces causes opposite rotation of the vertebra.

The aim of the study is to assess the seasonal supply of vitamin D and biogenic amines to practically healthy women of working age living in Arkhangelsk. Material and methods. The study sample included 20 practically healthy women aged 22–44 years, permanently residing in Arkhangelsk. The study was conducted over 4 seasons: during the period of increasing (March), maximum (June), decreasing (September) and minimum daylight hours (December). The concentration of 25-hydroxyvitamin D, serotonin, dopamine, adrenaline and noradrenaline in the blood were determined. Results. The annual dynamics of 25-hydroxyvitamin D level in the blood was established with its minimum content in the winter (December), followed by an increase in the vitamin concentration in the spring, the highest level during the period of maximum daylight hours (June) and a further decrease in the fall (September). During the period of minimum day length, the smallest proportion of people (15 %) with optimal 25-hydroxyvitamin D concentration is observed, while more than half of women have insufficient level, and a quarter have vitamin D deficiency. Serotonin level decreased from spring to winter. The peak of dopamine concentration was recorded in the summer; the minimum content was recorded in the autumn. The minimum concentration of adrenaline and noradrenaline is noted in the spring; the maximum levels are in the winter. Conclusions. The most critical season for 25-hydroxyvitamin D content in women blood is the minimum duration of daylight hours’ period (December), while the more favorable season can be attributed to the maximum duration period (June) and a decrease in the duration of daylight hours (September). The annual 25-hydroxyvitamin D dynamics and serotonin levels have similar features, and seasonal changes in the adrenaline and noradrenaline concentration are in the opposite direction.

Aim of the study was to evaluate the effect of lithium- and melatonin-containing sorbent based on aluminum oxide and polydimethylsiloxane on changes in the number of platelets during hemosorption modeling and on the features of the hemostatic response during dosed contact of the sorbent with blood in an in vitro experiment. Material and methods. An analysis of the effect of the porous sorbent modified with melatonin (MT, 0.15 %) and lithium (0.5 %) based on aluminum oxide and polydimethylsiloxane (Al₂O₃@PDMS/MT-Li) was carried out in comparison with sorbent without modifiers (Al₂O₃@PDMS) and modified with MT (Al₂O₃@PDMS/MT) on a number of donor blood clotting parameters under in vitro hemosorption conditions. Studies of the hemostatic system included assessment of platelet count, chronometric parameters, fibrinogen concentration, antithrombin activity and plasminogen content. For integral assessment, calibrated thrombography and computer thromboelastometry were used. Results and discussion. Contact of all studied sorbents with blood causes a moderate decrease in the number of platelets (by 5.3–10.1 % from initial). Comparison sorbents reduce fibrinogen concentration by 7.1–7.7 %, Al₂O₃@PDMS/MT-Li – by 2.6 times, which is likely due to the methodology for determining this protein against the background of the independent anticoagulant activity of lithium ions. Al₂O₃@PDMS and Al₂O₃@PDMS/MT cause the development of a hypercoagulable shift, as evidenced by a shortening of kaolin time (by 27.5 and 22.1 %, respectively) and of activated partial thromboplastin time (APTT) by 7.1 % for both sorbents. At the same time, when lithium was included in the sorbent, not only did the hypercoagulation shift not occur, but blood clotting was also inhibited, as evidenced by an increase in kaolin time and APTT by 1.2 and 1.6 times, respectively, as well as in silicone time. Conclusions. Modifying sorbents with biologically active substances, lithium and MT, makes it possible to obtain an original hemosorbent with new properties. The presented results demonstrated the absence of a hypercoagulable shift in donor blood after contact with a lithium-, MTcontaining sorbent in vitro and indicate the potential for its using as a basis for the development of safe drugs.

This study aimed to determine the association of vitamin D serum blood levels and vitamin D gene polymorphism with the severity of coronary lesions in patients with stable coronary artery disease (CAD). Material and methods. 260 patients with stable CAD (average age was 58 years) were examined in the presented research. All patients were divided into two groups according to the SYNTAX score: low-risk patients with SYNTAX score ≤ 31 (n = 224) and high-risk patients with SYNTAX score > 31 (n = 36). For enzyme-linked immunosorbent assay and genetic analysis, peripheral blood was collected from the cubital vein into vacuum tubes containing coagulation activator and K3-EDTA, respectively. Serum blood level of 25-hydroxyvitamin D (DiaSource Diagnostics, Belgium) and 1,25-dihydroxyvitamin D (Immunodiagnostic Systems, Great Britain) were determined by enzyme-linked immunosorbent assay according to the manufacturers’ protocols. Genomic DNA was isolated by phenol-chloroform extraction method from whole blood. The quality and quantity of isolated DNA were assessed using NanoDrop spectrophotometer (Thermo Fisher Scientific, USA). Five polymorphic variants in the VDR (rs2228570 and rs73123) and GC (rs7041, rs1155563 and rs2298849) genes were selected for analysis. Genotyping was performed by real-time PCR in a 96-well plate with fluorescently labeled TaqMan probes. The quality of PCR was controlled by repeated genotyping of 10 % of the analyzed samples. Results. We found no statistically significant differences in serum blood level of the studied markers in patients from low-risk and high-risk groups. One polymorphic variant in the GC gene associated with the multiple coronary lesions (rs2298849) (odds ratio 2.26, 95 % confidence interval 1.28–3.99, p = 0.006) according to an additive inheritance model was identified. In addition, we determined the association between low serum blood level of 1,25-dihydroxyvitamin D in patients with CAD with multiple lesions of the coronary vascular system with A/A – A/G genotypes of the rs2228570 polymorphism in the VDR gene, A/A genotype of the rs7041 polymorphism and A/A genotype of the rs2298849 polymorphism in the GC gene. Conclusions. Allelic variants in the vitamin D metabolism genes are associated with the degree of coronary artery lesions assessed by the SYNTAX score in patients with stable CAD. Also, serum blood level of the active form of vitamin D (1,25-dihydroxyvitamin D) is less in carriers of homozygous genotypes for the major alleles of the VDR and GC genes.

Uterine cancer (UC) is the third most common cancer in women in Russia. Knowledge of age-specific features of the fibrinolytic system in patients with UC can be useful in terms of improving its pathogenetic therapy. Aim of the study was to investigate the peculiarities of the content and activity of some components of the fibrinolytic system in the blood of UC patients of different age groups. Material and methods. 30 healthy women (donors) and 56 patients with uterine cancer T1a-2N0M0, adenocarcinoma G1–G3 were divided into subgroups according to age: reproductive, perimenopause and menopause. ELISA of urokinase (u-PA), its receptor (u-PAR) and its inhibitor (PAI-1), tissue-type plasminogen activator (t-PA) content were performed in blood collected before treatment. Results. In reproductive UC patients, inhibitor u-PA (PAI-1) activity increased 14-fold (hereinafter the difference is statistically significant, p < 0.05) and content increased 2.9-fold, while receptor u-PA (u-PAR) level decreased 1.7-fold compared to reproductive donors. Perimenopausal UC patients showed a 3.3-fold increase in PAI-1 content and a 6.3-fold increase in PAI-1 activity compared to perimenopausal donors, t-PA concentration decreased 1.3-fold relative to donors and was 1.9-fold lower than in reproductive UC patients. In menopausal patients with UC, the activity and content of PAI-1 enhanced 5.5-fold and 4.5-fold, respectively, compared to donors. Additionally, they were 2.1-fold and 1.2-fold lower than in reproductive UC patients. The activity of u-PA increased 2.6-fold, reaching the values of reproductive UC patients. The activity of t-PA was 1.3-fold higher than in donors, but did not differ from the activity in other RTM patients, while the level of t-PA occupied an intermediate position between the corresponding indices in young UC patients (it was 1.4-fold lower) and perimenopausal UC patients (it was 1.4-fold higher). Conclusions. The development of UC is accompanied by an imbalance of components of the fibrinolytic system in the blood, depending on the age of women, with a minimum spectrum of changes in the indicators in reproductive patients and maximum - in menopause patients, which indicates the pathognomonicity of these factors in PTM and requires an individual approach to the management of such patients.

Currently, the issues of studying the quantitative assessment of the isolated effects of physical and chemical occupational factors of low intensity, severity and intensity of the labor process on the telomere relative length (TRL) are relevant in order to establish the mechanisms of development of premature aging. The aim is to evaluate the effect of isolated exposure to low–intensity physical and chemical occupational factors on the relative length of telomeres in an animal experiment. Material and methods. ICR mice (n = 65) are distributed in equal numbers into 3 test groups (exposure to vibration, noise, chemical exposure) and 1 control group (contained in comfortable conditions and not exposed to these factors). The duration of the experiment was 90 days, samples for DNA isolation from the striated muscle tissue of ICR mice thigh were taken on days 0, 30, 60 and 90. TRL was measured using real time PCR. Results and discussion. The results of the study indicate a significant shortening of TRL on the 90th day in the control group compared to the initial indicators, which may indicate the general processes of aging of animals. A long (90-day) stay of ICR mice in conditions simulating the isolated influence of various occupational hazard factors (vibration, noise, chemicals) operating at a level of 1.5 MAC, MPL, was accompanied by unidirectional dynamics of TRL. The chemical factor has the greatest impact on TDC (a decrease in TDT relative to the value of the control group is noted on the 30th, 60th and 90th days of the experiment), the physical factor causes a shortening of TDT after 60 and 90 days. Conclusions. Further study of the isolated influence of occupational factors on the TRL change in model organisms will contribute to the establishment of mechanisms that prevent the development of pathological processes in workers under conditions of production hazards.

The intestinal microbiota, having enormous metabolic potential, makes a significant contribution to the physiological and pathological processes of humans and animals and is currently considered as an important factor in the pathogenesis of cancer. The aim of this study is to determine changes in the quantitative and qualitative composition of the intestinal microbiota in Wistar rats during chemical induction of breast cancer (BC). Material and methods. The work was performed on female Wistar rats (n = 40) aged 3 months, weighing 200–210 g, using cultural methods for studying fecal microbiota in intact rats (1 group) on the 1st, 14th, 35th days and in rats with induction of breast cancer and and in rats, whereby N-methyl-N-nitrosourea was administered to induce breast cancer (2 group) on the 1st (before injection of N-methyl-N-nitrosourea), 14th, 35th days after injection of N-methyl-N-nitrosourea. Results and discussion. In all experimental animals, representatives characteristic of the intestinal normobiota of warm-blooded animals predominated, namely: Bifidobacterium spp., Lactobacillus spp., Escherichia coli with pronounced enzymatic properties, Enterococcus spp., Clostridium spp. In addition, Staphylococcus spp., yeast-like fungi of the genus Candida and mold. Escherichia coli with reduced enzymatic activity was also detected. It was established that the isolated bacteria belonged to 3 types, 4 classes, 5 orders, 6 families, 6 genera of the bacterial domain. Also, 2 genera of fungi belonging to the order Saccharomycetales were isolated. The most significant changes in the composition of the intestinal microbiota were noted in rats with chemically induced breast cancer on the 35th day tumor induction: the appearance of pathogenic microflora in the intestine was revealed.

Aim of the study was to identify the incidence of arterial stiffness in normotensive patients with ankylosing spondylitis (AS) in the Trans-Baikal region, to study polymorphism of genes for some cytokines and prognostic factors for increased arterial stiffness in this disease. Material and methods. We examined 100 patients with AS, natives of the Transbaikal region, HLA-В27 positive and 100 healthy controls, HLA-B27 negative; all included in the study were Caucasian. Arterial hypertension was an exclusion criterion. Determination of single nucleotide polymorphisms of the genes IL1B (‒31T/C, rs1143627), IL10 (‒592C/A, rs1800872), IL10 (‒819C/T, rs1800871), TNF (‒308G/A, rs1800629) was carried out in all patients with AS and healthy individuals. 74 patients with AS and 40 patients in the control group underwent applanation tonometry using SphygmoCor (AtCor Medical, Australia). Results. Pulse wave velocity on the carotid-femoral segment in patients with AS was 6.5 [4.1; 11.7] m/s, in the control group – 5.2 [3.9; 7.0] m/s (p = 0.0001). In 18 patients with AS (24.32 %) it was more than the age norm, these patients made up the group with elevated arterial stiffness. In patients with AS, carriage of the homozygous AA genotype of the IL10 gene (rs1800872, ‒592C/A) was 2.18 times more common, the homozygous GG genotype of the TNF gene (rs1800629, ‒308G/A) was 1.23 times more common, and the heterozygous ST genotype of the IL10 gene (rs1800871, ‒819C/T) was 1.5 times more common than in the control group. Prognostic factors for increased arterial stiffness in patients with AS were carriage of the IL10 rs1800871 polymorphism, age, and the radiological stage of changes in the sacroiliac joints. Conclusions. Increased arterial stiffness was detected in 24.3 % of normotensive patients with AS. The CT genotype of the IL10 gene (rs1800871, ‒819C/T), AA genotype of the of the IL10 gene (rs1800872, ‒592C/A), the G allele and the GG genotype of the TNF gene (rs1800629, позиция ‒308G/A) are associated with the development of AS in Caucasians. Multivariate regression analysis identified clinical and genetic factors that predict an increase in arterial stiffness in patients with AS, natives of the Trans-Baikal Territory.

In men from infertile couples the serum level of total testosterone (tT) has been shown to vary widely. Is it possible to expect that there is an association of tT content with spermogram disorders in men from infertile couples? Aim of the study was to investigate the patterns of changes in the spermiological status of men from infertile couples depending on tT level in blood serum. Material and methods. Design – observational, retrospective, one-stage study. The analysis of medical histories of 358 men with infertility in marriage was carried out. The sample was divided into comparison groups according to tT level: group 1 – less than 12.1, group 2 – from 12.1 to 20.9, group 3 – 21.0 nmol/l or more. Results. From group 1 to group 3, tT content increases more than twice, as well as concentration of indicators related to the level of T – sex hormone binding globulin (SHBG) and free testosterone (fT). There are no significant differences in luteinizing hormone (LH) and follicle stimulating hormone (FSH) level, although there is a tendency to its increase from group 1 to group 3. From group 1 of men with androgen deficiency to group 3, not only body weight and body mass index (BMI), but also waist circumference (WC) and hip circumference (HC), as well as the WC/HC index, characterizing the degree of abdominal obesity, decrease. The groups examined did not differ in the values of all studied ejaculate parameters. In group 1, a pronounced correlation between the content of tT and fT was found, in groups 2 and 3 – statistically significant inverse relationships between the level of Tob and the values of anthropometric indicators (body weight, BMI, WC and HC), as well as direct ones - with the concentration of SHBG, tT, LH and estradiol, in group 3 – with FSH levels. There were no correlations between tT content and spermogram indicators in any group of examined men. Conclusions. The results obtained suggest that only at high-normal level of testosterone in the blood it can have a stimulating effect on spermatogenesis. As a result of the accumulation of cases of androgenic deficiency in the population, the direct positive effect of serum testosterone on spermatogenesis is becomes insufficient for normal regulation, and the negative effect of testosterone deficiency on spermatogenesis, mediated through the accumulation of overweight and obesity comes to the fore.

COVID-19 is characterized by various adverse consequences and complications, the prevention of which affects the outcome of the disease. Aim of the study was to investigate the thrombohemorrhagic events of COVID-19 infection. Material and methods. This study involved 403 patients with novel coronavirus infection; the patients were divided into 2 groups: 75 with COVID-19 complications and 328 patients without complications. Metabolic disorders, features of lung damage, comorbidity, signs of inflammation and coagulation, treatment outcomes, peculiarities of thrombotic events and hemorrhages development were studied. Results and its discussion. Thrombohemorrhagic complications of COVID-19 occurred mostly in patients with angina pectoris, coronary artery sclerosis and chronic heart failure of functional class II–III, as well as decompensated diabetes mellitus and obesity. These coronavirus infection effects are often accompanied by an increase in content of inflammatory markers such as CRP and ferritin, as well as of hypercoagulability (D-dimers). Conclusions. Manifestations of inflammatory coagulopathy in patients infected by COVID-19 increases risk of thrombohemorrhagic complications.

The aim of the study was to conduct a comparative analysis of serum lysozyme activity and study its innovativeness in predicting bacterial complications after kidney transplantation. Material and methods. Lysozyme activity was studied in 99 patients after kidney transplantation and 81 practically healthy volunteers. Patients depending on period after surgery were divided into five groups: group 1 – 1st day after kidney transplantation (n = 6); group 2 – 1–5 months (n = 10); group 3 – 6–12 months (n = 21); group 4 – 2–5 years (n = 30); group 5 – 6–10 years (n = 32). An analysis of the correlation between serum lysozyme level, absolute leukocyte count and creatinine content was performed. Lysozyme activity was assessed in bacterial complications, transplant dysfunction and organ rejection. Results and discussion. On the 1st day after kidney transplantation lysozyme activity was minimal – 117.95 [60.80–133.51] µg/ ml (median [lower quartile – upper quartile]) (in healthy volunteers it was 243.80 [190.76–305.69] µg/ml, p < 0,001). One month after surgery, it returned to normal (292.08 [311.66–218.48] μg/ml) and did not differ from the value of the group of practically healthy volunteers for 5 months (p = 0,17). Lysozyme activity in serum of patients after kidney transplantation had inverse moderate correlation with creatinine content (r = –0,32, p < 0,05). The threshold value for the probability of bacterial infections for serum lysozyme was > 321,4 μg/ml (p = 0,003). Creatinine level > 0,11 mmol/l predicts graft dysfunction. Conclusions. On the first day after transplantation a low level of lysozyme indicates high risk of bacterial infection. One month after surgery lysozyme returned to normal which indicates restoration of humoral component of nonspecific immune resistance. Relationship between creatinine content and lysozyme activity as well as an increase in the latter in comparison with healthy group allows to use lysozyme as an additional diagnostic criterion for acute bacterial infection and creatinine – for prognosis of graft dysfunction.

Surgery of meningiomas of the posterior cranial fossa, due to its small volume and close anatomical relationship of neoplasms with the brain stem, cranial nerves, main arteries and venous collectors, remains one of the urgent problems of neurooncology. Despite the improvement of microsurgical techniques and neurophysiological control, maintaining a high level of quality of life after radical removal of meningiomas is still far from desired. Purpose of the study. Retrospective analysis and generalization of clinical results of surgical treatment of patients with meningiomas of the posterior cranial fossa. Material and methods. The paper analyzes the results of surgical treatment of 101 patient with meningiomas of the posterior cranial fossa of various localization (80 women (79.2 %) and 21 men (20.7 %), age 58.26 ± 1.00 years). According to the localization of meningiomas, they were distributed as follows: convexital – 49 (48.5 %), cerebellopontine angle – 22 (21.8 %), jugular foramen – 4 (4 %), petroclival – 16 (15.8 %), foramen magnum – 10 (9.9 %). Results. All patients underwent surgical removal of the formation. In 99 (98 %) one-stage and in 2 (1.9 %) cases of additional surgical intervention, in the form of external drainage according to Arendt and ventriculoperitoneal shunting, due to frolicking liquorodynamic disorders. Radical removal of meningioma (grade I according to Simpson scale) was achieved in 72 (71.3 %) of cases, tumor resection with coagulation of the tumor matrix zone (Simpson II) – in 21 (20.8 %), removal without resection and coagulation of the matrix, or leaving the extradural component of meningiomas (Simpson III) – in 8 (7.9 %). Conclusions. The results obtained on the basis of the complex use of modern neuroimaging diagnostic tools, microneurosurgery, optimal surgical approaches in combination with the mandatory intraoperative physiological control of the function of the brain stem and cranial nerves in the early postoperative period indicate an improvement in the functional state, and sometimes complete regression of the neurological symptoms in 58 (57.4 %) of operated patients. Complete regression of symptoms and restoration of the functional state was achieved in 30 (29.7 %) of cases, deterioration was noted in 17 (16.8 %) of the operated patients, mortality was 4.95 % (n = 5).

Currently, many countries around the world, including Russia, are experiencing an increase in measles morbidity. One of the reasons for this rise is a decrease in the number of vaccinated persons and violation of vaccination schemes. Aim of the study was to investigate of epidemiologic and clinical features of the disease during the measles outbreak in Penza Oblast in 2023. Material and Methods. A retrospective analysis of 73 medical records of patients during the outbreak of the disease in the village of Srednaya Elyuzan, Penza region, in 2023 was performed. The diagnosis was confirmed by detection of specific marker (IgM) in the blood by ELISA. Results and discussion. There were 67 children and 6 adults among those who fell ill. Outpatient treatment was provided to 36 persons, and 37 children were hospitalized. Among the children who contracted measles, 63 children were not immunized against measles, 59 of them due to parents’ refusal to immunize them. In all patients, measles was characterized by typical clinical manifestations. Moderate forms of the disease were detected in 43 children and 6 adults (67.1 %), mild – in 24 (32.9 %) children. Conclusions. A characteristic feature of this disease was the presence of more pronounced symptoms and a longer catarrhal period in older children. Thanks to timely preventive and anti-epidemiological measures, the outbreak was localized and further spread of the infection was prevented. Given the repeated possibility of outbreaks, it is necessary to improve vaccine prevention.

Aim of the study was to identify the features of susceptibility to a new coronavirus infection СOVID-19 depending on gender, age, social factors and polymorbidity. Material and methods. An analysis of the structural features of gender, age, and social factors in 620 patients who underwent examination and treatment at the Federal Research Center of Fundamental and Translational Medicine clinic (Novosibirsk) was carried out. The patients were divided into 2 groups: the main group (group 2, age 56.4 ± 0.7 years) included 272 patients who underwent a new coronavirus infection COVID-19, confirmed by a positive PCR test or antibody testing, a comparison group (group 1, age 60.7 ± 0.7 years) – 348 people who did not have COVID-19 and were undergoing examination and treatment for chronic non-communicable diseases. Results. An analysis of the incidence of COVID-19 depending on gender showed that disease was more common, by 22 %, in women than in men. Patients who had COVID-19 were statistically significantly more likely (30%) to be in the second adult age period than those in the comparison group. When studying the social features of patients who underwent COVID-19, it was found that employees and employees of the administrative and managerial apparatus were significantly more likely to suffer from this infectious disease. An analysis of the structure of polymorbid pathology revealed that patients with COVID-19 had a significantly higher value of transsystemic polymorbidity.

Aim of the study was to quantify postprandial glucose levels in response to isocaloric protein load at main meals in men with different types of fat distribution. Material and methods. The study enrolled men aged 25 to 65 years. Group 1 (n = 17) consisted of obese men with subcutaneous fat distribution (SFD) type while group 2 (n = 16) was represented by obese men with abdominal type of fat distribution (AFD). Group 3 (comparators) consisted of 10 men with normal body weight (NBW). Glycemic response to standard isocaloric protein load was assessed by the results of glucose levels within 3 hours starting 5 minutes after end of food consumption on different days and mealtime. Standard protein lunch was introduced during the second day while standard protein dinner and breakfast were performed at the third and fourth days respectively. Results. It was found that protein intake leads to neither pronounced postprandial glycemic fluctuations nor decrease in glucose levels by the end of the 3rd hour of the test. Accordingly, it also doesn’t provoke hunger, unlike carbohydrate intake does. In men with NBW a more pronounced increase in glucose level after protein meal was found, both relative to the baseline levels and comparing with men from SFD and AFD groups. In NBW group at lunchtime and especially in the evening a double-humped glycemic curve was noted. Glycemic variability in men with different types of fat distribution was characterized by the fact that glycemic increment was more pronounced in men with AFD than in men with SFD whose glycemic curve was almost flat after all meals. Conclusions. Protein intake in men with NBW and different types of fat distribution does not lead to significant changes in postprandial glucose levels. Glycemic fluctuations don’t exceed 1 mmol/L within a 3-hour period after consuming of isocaloric breakfast, lunch or dinner. Protein intake results in greater postprandial glucose levels in men with AFD than in SFD men.

The aim of the study is to study the morphological changes in tissue in the laparostomy area when it is closed with a xenopericardial plate under conditions of an active purulent-inflammatory process. Material and methods. Analysis of data from patients at the Penza regional clinical hospital named after. N.N. Burdenko, with diseases of the abdominal organs, complicated by diffuse purulent peritonitis. During treatment, xenopericardial plates with perforations in a checkerboard pattern were used (hole diameter 0.5 cm). Disinfection of the material was carried out with a sterile solution of furacilin. Using the standard hematoxylin and eosin staining protocol, as well as alternative staining methods according to Van Gieson and Weigert, light-optical examination of stained sections was carried out at a magnification of 40–400 times. Results. In 8 out of 9 patients participating in the study, a favorable course of the inflammatory process was observed; on the 21st day after laparotomy, the symptoms of peritonitis were eliminated, the surgical wound was sutured. In one case, progression of local and general signs of peritonitis was observed within two weeks. After replacing the xenopericardial plate, the course of changes in the surgical wound was favorable. On day 21, the laparotomy wound was also sutured. Repeated examination of the biomaterial one year and two months after implantation of the xenopericardial plate into the anterior abdominal wall did not reveal signs of inflammation. Conclusions. The xenopericardium performed well in conditions of purulent inflammation and in most cases was not subject to melting. In the long term, biointegration of the xenopericardium into its own connective tissue occurred.

According to the expert community, the level of occupational morbidity (OM) registered in Russia in a number of sectors of the economy is underestimated, and is determined not only by working conditions, but also by the medical, demographic and socio-economic living factors of the working population. Aim of the study was to identify priority medical, demographic and socio-economic factors affecting the detection of OM in agricultural workers (AW). Material and methods. The information base of the study was the competent materials of Saratovstat and the Department of Rospotrebnadzor in the Saratov region. The dynamics of the factorial indicators of the life activity of the AW was evaluated by the time series method, their relationship with the level of OM – using multiple correlation and regression analysis. Results and discussions. From 2009 to 2019 levels detected in the region of OM agricultural workers decreased in 3.2 times with 5.0 to 1.56 per 10,000 employees in the agricultural sector. According to the results of the analysis of 4 multiple regression models describing the influence of medical-demographic and socio-economic factors on the detection of OM AW, three priority indicators were identified among 12 regressors – the number of people employed in the “Agriculture, hunting, forestry” industry (r₁ = 0.854), the number of advisory and expert visits of specialists of the center of occupational pathology to the districts of the region (r₁₀ = 0.884) and mortality in working age (r₁₂ = 0.742). Formed on the basis of these independent variables, the generalized model “OM (Y) – factorial signs of the medical and demographic situation” showed statistical reliability and determined 86.4 % of the variability of the OM detected in AW with a high closeness of the relationship (R = 0. 9296) between the level of OM and the set of regressors. Conclusions. The established medical and demographic factors that statistically significantly affect the detection of occupational morbidity of agricultural workers must be taken into account in the sanitary and hygienic monitoring of occupational pathology of the working rural population.

The aim of the study was to assess the impact of the COVID-19 pandemic on the incidence of respiratory infections of the population of Penza region in different age groups. Material and methods. The analysis of statistical reporting data (Form 12) on the number of diseases in the service area of the medical organization in Penza region was carried out. Information was sampled on respiratory diseases of infectious etiology for the period from 2015 to 2022 and on COVID-19 morbidity in the period from 2020 to 2022 among patients of different age periods. The data is presented as a calculation per 100 thousand population. Results. In 2020, compared to 2019, there was a pronounced increase in the number of respiratory diseases (p = 0.000) in adults; in 2021, the incidence decreased slightly, being higher until 2022 than in the period before the pandemic (p = 0.000). Among children and adults, there was an increase in the incidence of acute respiratory infections in 2022 compared to 2015 (p < 0.001). Peak incidence of croup and epiglottitis among children and adolescents was observed in 2020. The incidence of COVID-19 among adolescents (8339.6) and adults (7678.5) was significantly higher than the incidence among children (5949.9) (p = 0.000). Discussion. Respiratory diseases of infectious etiology have an acute course, so primary morbidity predominates. In adults, the proportion of primary morbidity is decreasing, which may be related to an increase in chronic diseases of the respiratory system. The weak impact of the pandemic on pediatric respiratory diseases incidence is supported by the low pediatric incidence of COVID-19. The increased incidence of COVID-19 among adolescents is alarming; it supports the assumption that child and young adult populations have proven to be major gateways for the spread of COVID-19 to adults. The high incidence of croup and epiglottitis in 2020 among children (p = 0.024) and adolescents could be one of the symptoms of COVID-19 characteristic of younger age. Conclusions. COVID-19 had no effect on the increase in respiratory disease among children, but children contributed to the spread of infection among adults. There is a trend towards an increase in chronic respiratory disease in adults. RBD of infectious etiology is almost impossible to predict, except for acute laryngitis and tracheitis among adults. In adolescents and children against the background of COVID-19 infection, a large number of more severe symptoms may appear.

Aim of the study was to assess the prevalence of metabolic syndrome among the working population of the Saratov region and its relationship with medical and social factors and their combination. Material and methods. To assess the prevalence of metabolic syndrome, 3077 employees (average age 46.9 ± 9.39 years) were examined within the framework of a single-stage study based on the Saratov Hygiene Medical Research Center of the Federal Scientific Center for Medical and Preventive Health Risk Management Technologies. This group consisted of 66.5 % men and of 33.4 % women (Adult Treatment Panel III program). To study the relationship of metabolic syndrome with medical and social factors, the place of residence, education, professional affiliation and physical activity (International Questionnaire on Physical Activity) of the study participants were taken into account. Results. According to Adult Treatment Panel III in 2001 and 2005, the prevalence of metabolic syndrome among the working population of the Saratov region was 18.2 % and 21.2 %, respectively. At the same time, it significantly prevailed among urban residents (22.2 %) compared with rural residents (16.3 %) (p = 0.003), among the study participants with secondary education (22.6 %) compared with the group of people with higher education (17.9 %) (p = 0.002), among employees (26.5 %) compared with workers (17.3 %) (p < 0.001), in individuals with low physical activity (29.3 %) compared with the group of individuals with normal physical activity (18.7 %) (p < 0.001). The prevalence of metabolic syndrome among urban residents was statistically significantly higher in the group of employees compared with workers (p < 0.001). There was no statistically significant difference between the corresponding groups among the rural population (p < 0.073). As a result of the logistic regression building, it was found that the following medical and social factors contribute to an increase in the developing metabolic syndrome probability: gender, age, body mass index more than 30 kg/m2 , profession (employees), living in the city. Limitation of the study. The conducted research is limited to the working population of the Saratov region. Conclusions. The results of the study indicate a high prevalence of metabolic syndrome among the working population of the Saratov region and allow us to obtain a generalized picture of its relationship with the main medical and social factors (gender, age, body mass index more than 30 kg/m2 , profession (employees), living in the city), as well as lifestyle factors (low level of physical activity, lack of sports activities).