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The article discusses long-term safety of drug-eluting stents in emergent coronary revascularization.

Examination covered 245 individuals and included characteristics of endocrine state of pulp and paper plant workers over 2011-2012, in comparison with data from 1990, as well as comparison with reference groups of male workers with no contact with chemical'industry in Arkhangelsk. Findings are both in main and reference groups general decrease in levels of cortisol, thyroxin;progesterone, testosterone, insulin, somatotropin and increased serum level of estradiol. With that, inside both groups, reliable tendencies to increased levels of cortisol, thyroxin, insulin, SSH and lower concentration of progesterone in the pulp and paper plant workers vs. the reference group members. Positive tendency was absence of abnormal concentrations of insulin, SSH and lower frequency of high cortisol levels in the pulp and paper plant workers nowadays.

At an international online expert meeting held on September 16, 2021, the results of the empagliflozin research program EMPA-REG Outcome, EMPEROR-Reduced and EMPEROR-Preserved were reviewed. We analyzed cardiovascular and renal outcomes during the treatment with empagliflozin in patients with chronic heart failure, regardless of the presence of type 2 diabetes mellitus. The positive results of the EMPEROR-Preserved study are updated and their significance for clinical practice is discussed. Several proposals have been adopted that will accelerate the introduction of empagliflozin therapy into practice in patients with heart failure and overcome clinical inertia.

On December 18, 2020, an expert council was held with the participation of members of the Russian Society of Cardiology, the Eurasian Association of Ther-apists, the National Society for Atherothrombosis, the National Society for Evi-dence-Based Pharmacotherapy, and the Russian Heart Failure Society. The event was devoted to the discussion of the correct use of research data of "real clinical practice" in decision making.

The document focuses on key issues of diuretic therapy in CHF from the standpoint of current views on the pathogenesis of edema syndrome, its diagnosis, and characteristics of using diuretics in various clinical situations.

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The paper summarizes data on laboratory and clinical assessment of Corega denture adhesive cream adhesive properties: adhesion strength and time of adhesive material fixing. Clinical assessment was based on Ulitovsky-Leontyev denture fixation index evaluated in 18 edentulous patients with full removable dentures 1 and 12 months after denture manufacturing. After one year of evaluation denture fixation in patients using Corega denture adhesive cream was 8-15% better (depending on alveolar bed anatomy) than in controls proving that Corega improves full denture adaptation to physiological atrophy of alveolar bone.

A large body of empirical research shows that psychosocial risk factors (PSRFs) such as low socio-economic status, social isolation, stress, type-D personality, depression and anxiety increase the risk of incident coronary heart disease (CHD) and also contribute to poorer health-related quality of life (HRQoL) and prognosis in patients with establishedCHD. PSRFs may also act as barriers to lifestyle changes and treatment adherence and may moderate the effects of cardiac rehabilitation (CR). Furthermore, there appears to be a bidirectional interaction between PSRFs and the cardiovascular system. Stress, anxiety and depression affect the cardiovascular system through immune, neuroendocrine and behavioural pathways. In turn, CHD and its associated treatments may lead to distress in patients, including anxiety and depression. In clinical practice, PSRFs can be assessed with single-item screening questions, standardised questionnaires, or structured clinical interviews. Psychotherapy and medication can be considered to alleviate any PSRF-related symptoms and to enhance HRQoL, but the evidence for a definite beneficial effect on cardiac endpoints is inconclusive. A multimodal behavioural intervention, integrating counselling for PSRFs and coping with illness should be included within comprehensive CR. Patients with clinically significant symptoms of distress should be referred for psychological counselling or psychologically focused interventions and/or psychopharmacological treatment. To conclude, the success of CR may critically depend on the interdependence of the body and mind and this interaction needs to be reflected through the assessment and management of PSRFs in line with robust scientific evidence, by trained staff, integrated within the core CR team.

In the Strategic Academic Leadership Program, the number of publications included in the 1% of the most cited ones in the Web of Science Core Collection database over previous 10 full years is used as an indicator of research potential of universities and scientific centers. The purpose of this study was to analyze the segment of Highly Cited Papers and Hot Papers on surgery using the Essential Science Indicators (ESI) analytical application. According to ESI data, relevant for March 2020, highly cited publications on medicine have formed 2.425 research fronts including 211 ones in surgery. We have analyzed the directions of researches in surgery characterized by the greatest number of citations.

Annually, up to 850 000 coronary aortic bypass graft operations are performed worldwide. Despite modern technical equipment ensuring a high level of safety of the procedure, currently important remains a problem related to intraoperative myocardial damage in using artificial circulation. Early detection and clinical assessment of myocardial ischaemia often present a difficult task. This article deals with clinical, instrumental and laboratory methods of diagnosis, aimed at verification of an intraoperative cardiac lesion associated with graft dysfunction in coronary artery bypass grafting. Isolated electrocardiographic and echocardiographic signs of myocardial ischaemia between the comparison groups did not differ significantly. Analysing the markers of myocardial lesions, statistically significant differences were obtained only after 48 hours which, from the point of view of saving viable myocardium, is an utterly long-term interval. Studying the findings of intraoperative flowmetry showed statistically significant dependence between velocity characteristics, pulse index of shunts and their patency on angiographic examination. Thus, only combination of diagnostic parameters makes it possible to detect myocardial damage related to shunt dysfunction. This enables early determination of indications for performing bypass angiography and selection of the required therapeutic policy. Timely coronary artery angiography makes it possible to reveal defects of shunts and to timely perform surgical correction, preventing myocardial infarction.

Currently, there are no widely used available techniques for reliable prognosis of the onset and course of peripheral artery disease. Working out of optimal test systems including genetic ones for assessment of risks for the development of the disease, its progression or development of complications in patients with peripheral atherosclerosis is an important mission of modern medicine. This article deals with a promising technique of genetic studies in patients with peripheral artery disease, i. e., study of gene expression. Also provided herein is a literature review devoted to the main techniques used for the analysis of the profile of gene expression. This is followed by evaluating the possibility of using DNA chips, as well as describing the state of the art and unsolved problems of studying gene expression in patients with peripheral artery disease.

The research included evaluation of express-diagnosis capability of immunochromatographic assay (ICA) Binax NOW (Alere, Inc., USA) for diagnosis of the rhinosinusitis caused by to detect the Streptococcus pneumoniae antigen directly in clinical samples. The unique feature of the method included obtaining samples with an electric suction machine in order to evaluate aspirate from deep parts of the nasal cavity. Diagnostic capability of the Binax NOW was determined in a comparative study using classical bacteriological method in 100 clinical samples. Pneumococcus was isolated in 16 patients (16±3,7%) via bacteriological method. ICA utilization allowed to reveal pneumococcal antigen in 20 cases (20±4,0%). ICA test sensitivity equaled 87,5%, specificity - 92,9%. Obtained results allow us to recommend ICA for identification of pneumococcal infection in patients with sinusitis for practicing physicians. The advantages of the evaluated method were fast results (for up to 15 min) and possibility of non-invasive sampling technique of clinical specimens., Competing Interests: The authors declare no conflict of interest.

Analysed herein is efficacy of hybrid intervention according to the 'frozen elephant trunk' procedure in the medium-term period of follow-up in patients operated on for aortic dissection. During the period from 2012 to 2018, a total of 44 'frozen elephant trunk' procedures were carried out for Stanford type A and B thoracic aortic dissections. All interventions were performed in conditions of moderate hypothermic circulatory arrest (25-28 °C) with unilateral cerebral perfusion through the brachiocephalic trunk. The mean diameter of the implanted stent grafts amounted to 27.7±2.8 mm (range 24-30 mm). The distal edge of the stent graft was located at the level below the Th9 in more than 65% of cases (range Th7-Th12). The stent grafts were fixed proximally at the levels Z0-Z3, predominantly in the Z3 zone (72.7%). Thirty-day mortality amounted to 6.8%, with in-hospital mortality of 15.9%. Five-year survival in acute and chronic type A aortic dissection (AD) amounted to 100 and 80%, respectively (p=0.175). In acute type B aortic dissection five-year survival amounted to 62.2%, being 25.0% for chronic AD (p=0.057). Freedom from reinterventions for acute and chronic type A aortic dissection amounted to 100 and 66.7%, respectively (p=0.286). Freedom from aortic reinterventions for acute and chronic type B aortic dissection amounted to 100% and 75%, respectively (p=0.123). Reconstructive operations performed according to the 'frozen elephant trunk' technique appear to be effective surgical treatment in patients with thoracic aortic dissection, yielding satisfactory clinical results during a medium-term follow-up period.

Despite the present-day level of the development of cardiac surgery, a low left ventricular ejection fraction (LLVEF) is an important independent predictor of high complication rates and increased in-hospital mortality related to open surgical interventions. The method of myocardial endovascular revascularization is associated with the lowest rates of both intraoperative and early postoperative complications. However, percutaneous coronary intervention (PCI) does not always make it possible to perform anatomically complete myocardial revascularization. Comparisons of the remote results of anatomically complete and incomplete revascularization of the myocardium in the world literature seem to be extremely scarce and ambiguous, with a low ejection fraction in the majority of cases being an exclusion criterion. In order to elucidate these problems we carried out a prospective, single-centre study, including a total of 151 patients suffering from ischaemic heart disease with a left ventricular ejection fraction of less than 35%, who were subjected to myocardial endovascular revascularization. The patients were divided into 2 groups: those with complete (n=87) and incomplete (n=64) revascularization, followed by comparing the alterations in the echocardiographic parameters, assessing the incidence of repeat myocardial revascularization due to a relapse of the clinical course of angina pectoris, and the survival rate in the remote period. The obtained findings were suggestive of efficacy of both complete and incomplete endovascular revascularization of the myocardium in patients with a low left ventricular ejection fraction (LLVEF), with no statistically significant differences between the patients of both groups in the examined parameters revealed.

The authors performed clinical studies based on modelling of an ascending aortic aneurysm in 37 patients and 10 apparently healthy subjects. Echocardiography was carried out in the B-mode using the Vivid E9 device (USA, GE). The linear dimensions of the aorta were assessed at three points - in the immediate vicinity of the valves, in the area of the maximum dilatation and in the area of decreased dilatation with registration of blood flow velocity in the aorta. The aortic walls were contoured with the division of equal intervals into 4 portions in order to obtain longitudinal shear deformation velocity during the cardiac cycle. We worked out a system of assessing the velocity vector fields with the help of transthoracic echocardiography in patients with an ascending aortic aneurysm, based on registration of blood flows, which made it possible to obtain the components of velocity. We also determined an optimal method of assessing turbulence in the aorta taking into account the direction of the vectors. Obtained were the numerical data of aortic wall deformation velocity in the longitudinal direction and calculation of the weighting function with the distinction between pathology and the norm. Based on the deformation, the distance between the registered points, and the movement of the vascular wall, we determined the reference values of blood flow velocity inside the aorta and immediately close to its walls.

It is proposed for preserving samples of biological fluids (blood plasma first of all) and mailing them to analytical laboratory to significantly modify a well-known technique of "dried blood spot" (DBS) at the expense of application of home-made fluoroplastic filtering material type MFFK-G as a porous carrier of fluid biological sample. The synthetic material contains no chemically active molecular fragments and it has four times greater water capacity than filter and chromatographic paper. Thus, fluoroplastic porous disc of mass of 15 mg is suitable to carrying of 70-100 mkl (instead of 15-20 mkl) of fluid. The preliminary impregnation of such a disc with solution of antioxidant - 0.5% - 0.9% 2,6-di-tret-butyl-4-methyl phenol in chloroform - permits to strongly increase stability of higher poly-saturated fatty acids in applied of dry plasma sample or erythrocytic mass on the disc. In that case, time of storage of ready-made disc with dry sample under room temperature increases up to 35-40 days and time of storage in freezer - from 50-60 days to half a year and longer. The storage of dry samples in airtight bottles of vials air-blown with technical propanebutane, also increases time of storage of samples approximately on a degree. This method permits to qualitatively determine content of individual fatty acids in the fraction of etherized and non-etherized fatty acids and also total and free cholesterol in samples of biological fluids., Competing Interests: The authors declare no conflict of interest.

This paper was designed to report the results of comparative clinical and functional studies involving 89 patients who presented with moderately severe chronic obstructive pulmonary disease and were given the combined treatment with yellow turpentine bathtubs and bronchodilators inhalations with the use of a nebulizer. The patients comprising group 1 (n=29) were treated with yellow turpentine bathtubs and bronchodilators inhalations, those making up group 2 (n=30) received monotherapy with yellow turpentine bathtubs alone, and the patients included in group 3 (n=3) served as controls treated with the use of therapeutic physical exercises and symptomatic medications analogous to those given to the patients of the two former groups. The results of the study give evidence of the advantages of the rehabilitative complex including yellow turpentine bathtubs and atrovent inhalations over two alternative therapeutic modalities attributable to its pronounced anti-inflammatory and immune-corrective activity that resulted in the generalized improvement of bronchial patency, reduction of lung hypertension, and enhancement of physical tolerance; taken together, these effects ensured the best clinical results.

This paper summarizes the results of the application of thr magnetic fields for the treatment of experimental tumours, such as sarcoma M-1, alveolar liver cancer PC-1, and Erlich's carcinoma. The evidence of the anti-tumour action of both strong (1200 mTI) and weak (5 to 100 mTI) magnetic fields has been obtained. The author describes the modulating effect of the magnetic fields on the anti-tumour potency of photodynamic therapy and chemotherapy. The data concerning the impact of ferromagnetic hyperthermal therapy on the tumour growth and the survival rate among the tumour-bearing animals are presented.

Background: Melatonin is known to modulate circadian and seasonal rhythms in metabolism, reproduction, and behavior. However, the effect of exogenous melatonin supplementation on the functioning of the thyroid and adrenal glands in species without a clear seasonality in reproduction is still unclear., Aim: Using a meta-analysis of publications, to investigate the effect of melatonin monotherapy on the concentrations of pituitary thyroid-stimulating hormone, thyroid hormones (TG), pituitary adrenocorticotropic hormone and corticosterone (CS) in rats kept under standard laboratory conditions., Materials and Methods: In our work, using the Review Manager 5.3 program, we conducted a meta-analysis of publications examining the effect of melatonin monotherapy on the functioning of the thyroid gland (22 papers) and adrenal glands (20 papers) in rats kept under standard conditions., Results: According to the results of our meta-analysis, the effects of melatonin on the levels of TG and CS depend on the dose and duration of therapy. A decrease in TG and CS was associated with therapy lasting no more than 4-5 weeks and with high doses of melatonin. An increase in CS and a trend toward increased TG levels were observed with longer therapy. However, a few studies have observed a decrease in TG with very long-term melatonin therapy (≥32 weeks). Among all TGs, total thyroxine (T4) showed maximum sensitivity to exogenous melatonin, which indicates the influence of melatonin on the secretory function of the thyroid gland. In addition, melatonin increased the relative weight of the adrenal glands. There was no convincing evidence that the effects of melatonin were influenced by the route and timing of administration, or the timing of blood sampling., Conclusion: As a result, exogenous melatonin can modulate TG and CS levels, even in species without a clear seasonality in reproductive function.

Monitoring of scientific activity is a process of systematic tracking, analysis and evaluation of the activity and results of scientific research, to identify new directions and trends in research, as well as to assess the growth, level of activity and significance of scientific activity in a particular field of knowledge. This paper summarizes and analyzes statistical data for 2023 on publication and patent activity, personnel, directions and topics of research work of participants in the Scientific Program of the Moscow Healthcare Department for 2023-2025, the functions of which are coordinated by the Research Institute for Healthcare Organization and Medical Management of Moscow Healthcare Department.

Despite the presence of various signs of cardiac amyloidosis ("red flags"), the introduction into routine practice of new non-invasive diagnostic methods (Speckle Tracking technology using echocardiography, myocardial scintigraphy with technetium pyrophosphate, genetic testing, screening for free light chains of immunoglobulins to exclude AL-amyloidosis), which have high specificity and sensitivity, transthyretinic (ATTR) cardiomyopathy is still a difficult to diagnose disease, especially in the early stages when treatment is most effective. The article presents a clinical case of ATTR-amyloidosis with predominant heart damage, manifested by severe diastolic heart failure resistant to treatment. The timing, from the moment of the first episode of decompensation of heart failure to death, is 4 months, which confirms the rapid progression of severe biventricular dysfunction of the heart. Despite the presence of cardiac and extracardial "red flags" of ATTR-amyloidosis in the patient, the diagnosis was established at autopsy. The paper analyzes possible errors of early diagnosis at the outpatient and inpatient stages of patient management.

Patients with rheumatic diseases infected with hepatitis B virus (HBV) are difficult to manage not only due to the presence of risk factors for the development and rapid progression of liver cirrhosis, but also due to the likelihood of reactivation of this infection. Despite the successes achieved in the fight against HBV, the virus cannot be completely defeated due to the presence of hidden forms of the disease, escaping the field of vision of a rheumatologist and an infectionist. Based on the results of the analysis of current publications, the paper presents the rationale for a complete immunological screening of patients with rheumatic diseases when prescribing antirheumatic therapy. The issues of the role of COVID-19 in the exacerbation of chronic viral hepatitis B, antiviral prevention and monitoring are discussed, the classification of antirheumatic drugs according to the risk of HBV reactivation is presented.

The paper presents the results of in-depth interviews and a questionnaire survey of the Russian cites administration representatives about cities resilience under the sanctions pressure and COVID-19. The survey was conducted by the Center for Territorial Changes and Urban Development of IPEI RANEPA in March-May 2023, it was attended by representatives of the administration of more than 50 cities of the Russian Federation. We found overall situation as stable: social programs are being implemented in full, unemployment is decreasing, construction of municipal facilities continues, problems with failures in the supply of spare parts, equipment and components are being solved. At the same time, the sanctions have affected the urban economy in completely different ways: while in some cities show significant negative effect, in others the impact of sanctions is insignificant. Cites face number of new challenges: disruption of supply chains, refusal to supply paid equipment, inability to find analogues of imported equipment with the necessary characteristics, rising prices for spare parts. components and construction materials, the rupture of established sales channels to unfriendly countries, a drop in municipal budget revenues, etc. The heads of the city administration work overtime to solve emerging problems, organize interaction between enterprises, establish and deepen business contacts with friendly countries, put forward proposals to improve the situation at the federal level. New tasks successfully solved, although it requires serious efforts. To respond to new challenges, we need a new, more decentralized and local-oriented style of public administration, a process of well-established feedback.

Mental disorders are a serious problem in modern society. They affect millions of people around the world and have a significant impact on the quality of life and people's ability to function in a normal environment. In this regard, the issues of ensuring the rights of citizens suffering from mental disorders do not lose their relevance and require special attention from doctors, lawyers and the scientific community. There are a number of reasons for this, including: 1) an increase in the incidence of mental disorders among the population, especially among socially vulnerable groups such as refugees, orphans, victims of hostilities and natural disasters; 2) medical care for mentally ill people can be provided forcibly, and therefore requires firmly established procedural standards; 3) mentally ill people often pose a danger to both for themselves and for society, therefore, the existence of fair law-restrictive measures is necessary; 4) persons with the status of mentally ill should have guarantees of social protection and integration into society without violating personal freedom (in the case when patients are not socially dangerous). On September 1, 2024, Federal Law No. 465-FZ dated 08/04/2023 «On Amendments to the Law of the Russian Federation «On Psychiatric Care and Guarantees of Citizens' Rights in its Provision» will enter into force. This paper analyzes the adopted amendments, how they will affect law enforcement practice, whether they will create even more grounds for restricting the rights of patients in psychiatric hospitals, or are aimed at improving the legal regulation of psychiatric care.

Enhancement of the health care system in Russia continues to be one of key directions of National development. In conditions of deficiency of personnel, systemic changes are needed to transit to qualitatively new level. The application of digital platforms permits to resolve a number of issues related to accessibility and quality of medical services. The paper characterizes current state of health care digitization and level of competitiveness of medical institutions. On the basis of analysis of corporate culture of medical institutions, conclusions are made that it contributes to successful implementation of unified medical information system and development of best corporate standards and traditions.

The paper analyses publications data related to issues of application of AI and machine learning systems in medical science and practice. The particular attention is paid to key points of AI application in health care: diagnostics, telemedicine, development of new medications, medical rehabilitation and management decision-making process. Despite broad perspectives of applying the given systems in clinical practice and pharmaceutical industry, there are a number of such unsolved problems as ensuring information security, risk of making erroneous decisions and necessity to change existing normative legal base of health care.

The main treatment option of prolactin-secreting pituitary adenomas is dopamine agonist therapy, which demonstrates prolactin level normalizing and reducing the size of an adenoma in the majority of cases. However, significant amount of patients - about 20% - poorly responds even to high doses of dopamine agonists that is explained by the resistance to therapy. The occurrence of pharmacodynamic characteristics is one of the causes responsible for the development of resistance to typical therapy. Clinical manifestations of persistent hyperprolactinemia are due to following pathological factors: hormonal hypersecretion and the mass-effect of pituitary adenoma. Prevention of irreversible changes is possible only with timely detection of resistance and determination of the optimal personalized treatment algorithm.We report a clinical case of dopamine-agonist resistant microprolactinoma. Patient's health stabilisation, normal level of prolactin and reduction in size of adenoma were achieved due to administration of combined treatment with tamoxifen and dopamine agonists. Hyperprolactinaemia occurring because of prolactin-secreting pituitary adenoma and associated adverse effects are significant problem, decreasing quality of life and demographics in general. This underlines the importance of figuring out causes and identifying predictors of the therapy resistance.The results of the study, illustrated by a clinical example, are presented in the present paper.

The article discusses the possibilities of using film therapy in working with elderly and senile people. The methodology of film therapy in individual and group form, categories of films that can be viewed with clients are discussed, examples with annotations of 21 films are given. The paper presents the results of the use of film therapy in the course of individual and group work with the elderly. 7 elderly women took part in a group consultation on the basis of the State Educational Institution of the Kirovsky district of Yekaterinburg. The result of the work was the opportunity to expand the time and life perspectives of the participants, an attempt to rethink their own views and behavioral patterns. The experience of using film therapy has shown the possibilities of its application in gerontopsychological practice, its significant potential and the breadth of application options. The results obtained can form the basis for the development of psychocorrective programs on the topic, as well as a series of studies.

Searching for third molars atraumatic removal method remains a challenge in oral surgery. Method of partial removal of impacted tooth leaving a non-extracted root in the wound becomes more popular recently. Determining medical indications for this method, as well as searching for standards for its implementation is important. The paper presents a review on latest technique of performing a coronectomy, and the long-term results of this method. However, the technique of incomplete tooth extraction is highly controversial in terms of harm to the patient's health. There are also uncertain medical indications for this method and the legal treatment consequences.

Phenylpiracetam (PP) is a nootropic drug with additional pharmacological effects, including anxiolytic, antiasthenic, antidepressant, anti-inflammatory and anticonvulsant effects. The paper presents the results of an analysis of experimental and clinical studies, which indicate the prospects for the use of PP in cerebral ischemia, neurodegenerative pathologies, epilepsy, asthenia, and mental disorders. The adaptogenic properties and mitochondrial protective effect of PP are considered, assessments of the possible effect of PP on neurotransmitter systems, regulation of carbohydrate and fat metabolism with the prospects for the use of PP in patients with metabolic syndrome.

This paper presents a unique clinical observation of 16 years of use without replacement of a domestic voice prosthesis in a patient after laryngectomy. Long-term recurrence-free survival was achieved as a result of treatment of laryngeal leiomyosarcoma.

Objective: To create a new taxonomy of schizophrenia spectrum disorders (SSD) based on the comparability of the design of SSD and borderline states., Material and Methods: The total sample consists of 205 patients with an established diagnosis of SSD (F21; F25; F22 according to ICD-10) collected from studies of the department of borderline mental pathology and psychosomatic disorders of the Federal State Budgetary Institution Mental Health Research Center and the Department of Psychiatry and Psychosomatics of Moscow State Medical University in the period 2014 to 2024. Clinical, psychometric, statistical methods were used., Results: A new two-level model of schizotypal personality disorder (STPD) has been developed: the first level is psychopathic-like disorders of the «Ferschroben» type; the second level are psychopathological disorders (positive, negative, etc.), appearing under their «mask», constituting a «tracing paper» of manifestations of schizophrenia «in miniature». The two-level psychopathological model of STPD is a complex clinical phenotype, including independent but overlapping phenotypic formations: psychopathic-like - the «Ferschroben» type; and basic - schizophreniform disorders., Conclusion: The clinical classification of schizophrenia spectrum disorders has been developed; pseudoneuroses and stress-induced disorders of the endogenous circle are considered in the aspect of the dynamics of STPD.

Sir Charles Bell (1774-1842) is Scottish physiologist, surgeon, artist, philosopher and anatomist. Throughout his professional career, Charles Bell made a number of important discoveries and published a large number of scientific papers. Bell first presented a detailed description of the clinical picture of facial palsy (later named after him) and a number of other neurological disorders, as well as important information about referred pain and reciprocal inhibition. Exploring the physical expression of emotions, Bell described the anatomical basis of facial expressions, which became the basis and incentive for Charles Darwin's work in this direction. Being a talented artist, the scientist himself illustrated his publications. Bell was one of the first to integrate scientific research in neuroanatomy with clinical practice. His most significant discoveries are collected in the book «The Nervous System of the Human Body» (1830). A number of neurological conditions and patterns were named after him.

This review is devoted to the English- and Russian-language terminology of quantitative metrics that are used in the evaluation of images obtained by optical coherence tomography angiography (OCT-A). The paper presents an analysis of the use of terms characterizing intraretinal blood flow (vascular density, perfusion density, skeletonized density, etc.), area and shape of the foveal avascular zone, and choriocapillaris blood flow. The factors causing the heterogeneity of OCT-A terminology are described, including the lack of a unified international nomenclature for OCT-A, features of their Russian translation, inconsistency of the parameters in optical coherence tomography systems of different manufacturers. The article also considers ways to standardize the terminology.

Olfactory disorders is one of the first symptoms of diseases from various departments of medicine (otorhinolaryngology, psychology, neurology, etc.). Based on international clinical recommendations, olfactory tests are the gold standard for the diagnosis of olfactory disorders. There are many different psychophysical tests: UPSIT (USA, Pennsylvania), Sniffin' Sticks test (Germany), BAST-24 (Spain), etc. Currently, there is an acute shortage of olfactory tests available for clinical practice In Russia. This problem is related to the fact that there are no olfactory tests registered as medical devices on the territory of the Russian Federation. Also, a significant limitation is the unrecognizability of odors by the population of our country, which include foreign analogues (licorice, anise, turpentine, etc.)., Objective: To develop and validate the national olfactory test on healthy volunteers., Material and Methods: The development and validation of the olfactory test included several stages. First, the development of an olfactory test was carried out, the selection of aromas to assess the threshold and identification ability of olfaction. 25 dilutions of n -butanol were used for the assessment of the threshold olfactory ability. For the stage of assessing the identification ability of the sense of smell, in our previous study, an assessment of the recognition of odor names in the territory of the Russian Federation was carried out. A total of 3.000 people from 8 federal districts of the Russian Federation were interviewed. During the development of the test, 20 names of flavors with the highest rating were used. By the 8 th , the selection of monocomponent substances was carried out. Commercially available certified food and perfume flavorings have been used for fragrances whose equivalent in the test cannot be a monocomponent substance. A group of 25 healthy volunteers selected a flavor or a monocomponent for each of the 20 positions. To carry out the identification stage of testing, a booklet was developed with answer options for each fragrance, including 80 images associated with the smell. A methodology for conducting diagnostics has been created. Next, the validation of the developed olfactory test was carried out on 150 healthy volunteers. The study included an assessment of the threshold and identification ability of the sense of smell using the developed test and conducting a comparative analysis with a set of flavors and descriptors corresponding to the Sniffin' Sticks test., Results: The developed test includes: 2 panels - panel 1 to assess the threshold ability of smell, panel 2 to assess the identification ability of smell, a booklet with 80 images and captions to them. The norms of threshold and identification olfactory abilities were also determined in the developed test. The domestic test was validated against the relative foreign Sniffin' Sticks test. Spearman's correlation between the accuracy values of the domestic test (17-20; 85.00-100.00%) and the values of the foreign test (11-16; 68.75-100.00%) did not reveal statistically significant differences ( rs =0.065, p =0.432), which confirms the equally effective assessment of olfactory ability by the domestic olfactory test in comparison with its foreign counterpart., Conclusion: In this work, a methodology for the use of Russian olfactory test was developed and validated on healthy volunteers. The features of the developed test are an assessment of the threshold and identification ability of smell, an adapted set of odors for the Russian population, the use of paper blotters when applying flavor and visual images of descriptors. Despite the wide variety of psychophysical tests, this problem requires further study and comparative analysis of olfactory tests available In Russia and foreign analogues in order to obtain a universal and effective diagnostic method for the populations of our country., This work was supported by the Russian Foundation for Basic Research (Project No. 24-25-00415).

Treatment of patients with severe chronic and recurrent forms of sinusitis, complicated by pathological stretching of the paranasal sinuses, is not a trivial task. This is especially true for those clinical cases where a pathological increase in the size of the sinus leads to widespread destruction of its walls and may be accompanied by serious complications from adjacent structures. The paper presents an analytical review of publications on the topic of pathological stretching of the paranasal sinuses. Potential factors influencing the development of this pathology, mechanisms of pathogenesis and classification options are described in detail. Modern approaches are considered in the surgical treatment of this pathology, which can be carried out in one or two stages, depending on the presence of secondary aesthetic defects.

This article, composed using literary sources and archival materials, is dedicated to the 155th anniversary of Alexander Grigoryevich Lyutkevich - a prominent Russian ophthalmologist of the late 19th and early 20th centuries (12.09.1867-18.04.1928) and one of the founders of the Voronezh Medical Institute. The paper traces the main stages of his biography, notes his work in rapid-reaction emergency care units, and pays attention to his teaching activities. The importance of Lyutkevich's doctoral dissertation on the treatment of high myopia is emphasized. The article also highlights his important role as editor of the classic textbook "Course of eye diseases" by A.A. Kryukov. In Lyutkevich's public activities, his contribution to the establishment of the Society of Ophthalmologists in Moscow is particularly noteworthy. Lyutkevich's high organizational skills are highlighted, which were clearly manifested in the Yuriev University and in the creation of the medical faculty of the Voronezh University.

The paper continues the study of the population ageing in the regions of the Northwestern Federal District. It characterized population ageing based on prospective ageing indicators that take into account remaining life expectancy. The dynamics of life expectancy (LE) at birth was analyzed. A computation and comparative analysis of the old age threshold for the regions that are part of the Northwestern Federal District have been carried out. A comparative analysis of ageing indicators - traditional and prospective (the proportion of the elderly and the share of the population above the old age threshold) was carried out. It has been found that there are no fundamental differences in the dynamics of life expectancy in older ages, as well as in the of old age threshold, between the regions considered. It is shown that for the male population in almost all regions in 2021, the value of the old age threshold is below 60 years, while for the female population the opposite inequality is observed. Thus, in 2021, the share of men over the old age threshold exceeds the proportion of the elderly in almost all regions considered, and for the female population, the share of the elderly is expected to be higher than the values of the prospective indicator.

This review highlights literature data on potential genetic markers that potentially influence the development of postoperative cognitive dysfunction, such as TOMM40, APOE, TREM2, METTL3, PGC1a, HMGB1 and ERMN. The main pathogenetic mechanisms triggered by these genes and leading to the development of cognitive impairment after anesthesia are described. The paper systematizes previously published works that provide evidence of the impact of specific genetic variants on the development of postoperative cognitive dysfunction.

Multi-omics methods for analysing postgenomic data have become firmly established in the tools of molecular gerontology only in recent years, since previously there were no comprehensive integrative approaches adequate to the task of calculating biological age. This paper provides an overview of existing papers on multi-omics integrative approaches in calculating the biological age of a human. An analysis of the most common options for integrating methylomic, transcriptomic, proteomic, microbiomic and metabolomic datasets was carried out. We defined (1) concatenation (machine learning), in which models are developed using a concatenated data matrix, formed by combining multiple omics data sets; (2) fusion model approaches that create multiple intermediate submodels for different omics data to then build a final integrated model from the various intermediate submodels; and (3) transformation methods (via artificial intelligence) that first transform each of the single omics data sets into core plots or matrices, and then combine them all into one graph before building an integral complex model. It is unlikely that multi-omics approaches will find application in anti-aging personalized medicine, but they will undoubtedly deepen and expand the understanding of the fundamental processes standing behind the phenomenon of the biological aging clocks.

The paper presents an overview of modern scientific data on the study of the effect of laser radiation on biological tissues of the mouth in the therapeutic treatment of dental diseases. The use of lasers in the treatment of dental caries and its complications, non-carious lesions of hard dental tissues, as well as the use of lasers in the treatment of periodontal diseases and aesthetic restoration of teeth is considered.

Allergic rhinitis (AR) can significantly reduce the quality of life of patients leading to increased fatigue, mood changes, cognitive impairment, and depression. In clinical practice, insufficient effectiveness of initial AR monotherapy is often noted, and a significant proportion of patients referring for medical care have moderate-severe AR. In this regard, the issues of optimization of combined pharmacological treatment of AR are becoming more and more urgent. This paper provides analysis of the opportunities of combined pharmacotherapy within the framework of current management strategy of AR. Based on the results of some studies and known pharmacological properties of medications it is being discussed the advantages of combined use of intranasal corticosteroids and leukotriene receptor antagonists, in particular mometasone furoate and montelukast, in the therapy of AR, including such comorbidities as bronchial asthma, chronic polyposis rhinosinusitis and pharyngeal tonsil hyperplasia. Some aspects of combination therapy with montelukast and second-generation systemic antihistamines as an alternative approach in case of inability to take intranasal corticosteroids, including the reasonability of using a fixed combination of montelukast and levocetirizine, are analyzed from the perspective of rational pharmacotherapy. The problem of interchangeability of brand-name and generic drugs for the treatment of AR is discussed, considering the almost complete absence of studies of their therapeutic equivalence.

Adherence to therapy largely determines the success of treatment interventions: low levels of adherence are associated with reduced treatment effectiveness. For many chronic diseases, the level of adherence to treatment is about 50% or less, which confirms the relevance of this topic and requires its research. The high costs of treatment, the need for long-term continuous use of drugs and the special socio-economic significance of a disease such as multiple sclerosis (MS) determine the importance of maintaining a high level of adherence to its treatment. An analysis of literature data on the concept of treatment adherence, methods of its definition and influencing factors was carried out, the values of the level of adherence in the treatment of MS, as well as measures to maintain it during the COVID-19 pandemic were considered. Increasing awareness of healthcare professionals about the problem of treatment adherence and ways to improve it helps to improve the efficiency of managing patients with MS. The paper considers the primary stage of the strategy to improve treatment adherence among patients with MS, namely the formation of expanded knowledge of the problem by specialists of a multidisciplinary team involved in the diagnosis and treatment of patients with MS.

Primary pulmonary myxoid sarcoma with EWSR1-CREB1 fusion is an extremely rare tumor. Its clinical manifestation is unspecific and only molecular genetic method can proof this diagnosis. This paper describes an unusual clinical presentation of primary pulmonary myxoid sarcoma in a 68-year-old patient with involvement of both lungs.

A literature search was conducted to review papers on the results of studies of clear cell renal cancer (CCRC) vascularization. Numerous data on the relationship between tumor pathogenesis and its vascularization have been revealed, which indicates the multifactorial nature of CCRC development and the significant role of angiogenesis in this process. It should be taken into account that patients with CCRC may have impaired vessel formation even before tumor development. To evaluate normal and pathologic angiogenesis, a pathohistologic study using immunohistochemistry is certainly necessary. Due to the significant role of angiogenesis in the development and course of CCRC, the use of drugs that suppress the formation of the vascular network in the tumor is relevant and advisable. To date, many drugs have been developed and introduced into clinical practice to inhibit angiogenesis. However, such drugs have not lived up to the expectations placed due to the frequent and rapidly developing drug resistance. Timely detection of pre-tumor and tumor processes, as well as effective treatment of cancer, including CCRC, is possible only with close cooperation between pathomorphologists and oncologists.

The presented literature review reveals the topic of the features of risk factors for cognitive impairment in women in the perimenopausal period (PMP), as well as the possibilities of their earliest detection and correction. The paper searches for various symptoms and predictors of the development of cognitive impairment in women in the PMP. The key features include certain difficulties in making a diagnosis at earlier stages. The relationship of metabolic disorders with factors negatively affecting the health of women in the PPP, as well as contributing to the deterioration of cognitive functions, is considered. Women are more at risk of developing cognitive impairment and represent a specific target group that requires special attention in assessing risk factors and methods for correcting cognitive disorders. To date, the relationship between gender and dementia risk still needs to be studied in more depth. Given this, menopause is an important physiological period, as it is accompanied by intense hormonal changes that may be the direct cause of cognitive decline. Many women experience mood disorders, anxiety, increased mental and/or physical fatigue, irritability, mild cognitive disorders, which requires an interdisciplinary approach by doctors to this issue. All these manifestations should be evaluated and corrected in time to avoid their progression and a decrease in the quality of life. An integrated approach to therapy, both medicinal and non-medicinal, can significantly improve the quality of life of patients in the PPP.

This study is aimed at investigating epileptic seizures, one of the consequences of traumatic brain injury (TBI). Immediate and early post-traumatic seizures, as well as late post-traumatic epileptic seizures or post-traumatic epilepsy, can have different pathogenetic bases. The following key risk factors associated with post-traumatic epilepsy are known: duration of unconsciousness, gunshot wounds, intracranial hemorrhage, diffuse axonal injury, prolonged (more than 3 days) post-traumatic amnesia, acute subdural hematoma with surgical evacuation, immediate and early post-traumatic epileptic seizures, fracture of the skull bones. The role of genetic factors in post-traumatic seizures is poorly understood due to the complexity and multiple causal mechanisms. This paper addresses the role of genetic factors in the occurrence and severity of epileptic events in patients with TBI. In particular, we investigated the role of the Cys112Arg single nucleotide polymorphism of the apolipoprotein E gene. Apolipoprotein E is known for its role in the transport and metabolism of lipids and, therefore, the development of cardiovascular diseases; it is also associated with Alzheimer's disease and has recently been studied in the context of association with epilepsy. The study shows an association between this polymorphism and the risk of immediate and early epileptic seizures in patients with severe TBI.

Radiation therapy is one of the main treatment option for prostate cancer used either independently or as a component of combined and complex treatment of the disease. Modern achievements make it possible to deliver doses of radiation that match the exact dimensions of the tumor for greater efficacy, with minimal exposure of the surrounding tissues, however, does not eliminate them. In most patients, clinical manifestations of chronic radiation proctitis occur during the first 2 years after radiation therapy. The article summarizes the current knowledge about pathophysiology, clinical manifestations, diagnostics and treatment options for this condition. In this paper, we present a case of complicated of chronic radiation proctitis.

Glucagon-like peptide-1 receptor agonists (arGLP1) are an effective treatment for patients with type 2 diabetes mellitus (T2DM), mainly due to increasing insulin secretion and suppressing glucagon release by stimulating the respective receptors. Taking into account their positive effect on major cardiovascular events, drugs in this group with proven cardioprotective effects are recommended for patients with T2DM and clinical cardiovascular diseases or multiple cardiovascular risk factors. In this paper, we present an overview of current clinical studies on the clinical efficacy and safety of arGLP1 and discuss current prospects for arGLP1 as a therapy for patients with T2DM.