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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 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.

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.

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.

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.

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.

Leonid Vasilyevich Sobolev is an outstanding pathologist, whose name definitely should occupy an honorable place in the galaxy of great scientists of Russia. However, his name was undeservedly forgotten, and the role of his work was underestimated. This Russian scientist made the most important discovery: he proved in an experiment that it is the islets of Langerhans in the pancreas that secrete a humoral regulator, "factor X", the deficiency of which leads to diabetes mellitus. This mysterious islet factor will be isolated from the pancreas of dogs in 1921 by the future Nobel laureate Frederick G. Banting and will become part of the medicine as insulin. However, there is every reason to believe that the discovery of F. G. Banting, who repeated a series of experiments by Leonid Vasilyevich Sobolev, is, in fact, secondary, which is the research subject in this paper.

Introduction: Chronic obstructive pulmonary disease (COPD), usually in advanced stages, is associated with high mortality, being the third leading cause of death worldwide. In the Netherlands, care delivery to patients with COPD has become a focus of the regional medical community, since the COPD death rates in this country are higher than the European Union average. However, between 2011 and 2021, the number of people with COPD (under follow-u by general practitioners) decreased. The experience of this country is interesting, as a large set of measures to improve the situation has been developed and implemented in this region. The purpose of the study was to analyze the experience of the Netherlands in organizing medical care for COPD in primary care settings., Material and Methods: The search for scientific literature sources was carried out using the PubMed database and Google system. The search time horizon equaled to 5 years., Results: In the Netherlands, in the system of care delivery to patients with COPD, primary care settings are heavily burdened. The article summarizes approaches to identify COPD risk factors, summarizes current clinical recommendations as of December 2022, and highlights findings of the study on medical digital platforms with the potential to organize continuous monitoring of patients. The paper exemplifies criteria for assessing the treatment quality in specialized care settings, including primary care., Discussion: It is assumed that the most effective measure to further improve efficacy of COPD treatment is the introduction of remote digital medical devices. A possible integration of the updated standards and quality indicators into digital services will further strengthen the concept of continuous automated remote monitoring of COPD patients. Evidence-based selection and introduction of effective digital solutions into current practice will improve quality of care delivery to patients.

Research in the field of public health at the global, national, regional and organizational levels continue to be relevant, attracting attention of the researchers who find new aspects of various problems and issues for consideration and analysis in this area. The paper presents results of a scientometric analytical study of the publication landscape for 2019-2021 in the field of public health, using the analytical platform SciVal, the data source for which is the international scientific database Scopus. The study shows positive dynamics and steady growth in most scientometric indicators in the subject area under consideration during the study period. A structural-functional and semantic-linguistic analysis of the top-50 keywords was also carried out, which showed that their ranking position significantly depends on the choice of one of two indicators: either by the number of publications or by relevance. Publications on public health are characterized by a polythematic distribution, providing researchers with the opportunity to make a wide choice in conducting scientific research in the branches of medical science they are interested in, taking into account scientometric indicators characterizing the publication landscape in these areas.

The article presents an overview of foreign sources devoted to the problems of population aging as a significant phenomenon that has become the most important medical and socio-demographic challenge in the world. The review provides global data on this problem and shows the need for elaborating and implementing active aging strategies, optimizing opportunities for health, participation and safety in order to improve the life quality as people age. The paper employs the method of content analysis of scientific publications retrieved in PubMed database by keywords - «aging», «population aging», «demographic trend», «longevity», and «life expectancy». Scientific publications for the period 2018-2023, WHO and UN materials, statistical data, and popular scientific publications have been studied. The purpose of the review was to analyze trends and global nature of aging based on scientific publications and open sources, and to highlight the most promising areas of the demographic policy on the older adults. In the time of rapid demographic changes, it is extremely important to use all available opportunities that maximize healthy aging with the participation of the older adults. We should remember that aging is a natural process and it is better to accept it, both psychologically and physically, rather than ignore. Healthy aging should become and has become the main principle of life, suggesting a longer healthy life of the older adults, who, in turn, should understand how to accept and implement this principle in their lives.

Performance of varies surgical manipulations (SM) is a key skill in surgery. To develop such skills simulation trainings (ST) are used, followed by a training transfer, which is the ultimate goal of ST However, this training goal is not always achievable - the share of doctors using laparoscopic intracorporal suturing after the training ranges from 43.8% to 72.2%. Therefore, to improve training transfer it is necessity to evaluate effectiveness of such training programs. Current methods evaluate training results either outside real practice or in practice but in small groups due to high cost and efforts consumed. The paper presents a new method to evaluate effectiveness of SM simulation training programs in general population of the trainees, evaluate additional effects of the training and analyze personal factors affecting the training results. The method is based on a survey of the ST program participants, and tested at the Training and Accreditation Center «Medical Simulation Center of the Botkin Hospital» within the program on laparoscopic intracorporal suturing. The rate of training transfer added up to 88.9%. The suggested method makes it possible to evaluate effectiveness of SM simulation training in general population of the trainees, analyze factors affecting the training results and use findings for improving ST programs and methods in general. The method can be recommended for a large-scale implementation in simulation training programs.

The paper examines the importance of health as a part of human capital, the role of which is that only a healthy person can work efficiently and with full potential; a healthy person can work more efficiently; a healthy person can work productively and thus contribute more to the development of the country's economy; an unhealthy person becomes a burden for both the organization and in general for the country.

The development of telemedicine and the provision of medical care using remote technologies requires appropriate competencies and skills from medical specialists, the formation of which is an important task of adapting educational systems to modern challenges and responding to requests from both medical staff and patients. Based on the analysis of foreign scientific publications, the paper considers the assessment of the need to train medical workers in remote work with patients and the prospects for the introduction of telemedicine consultations into everyday professional practice. It is concluded that having more knowledge about which aspects of medicine are best combined with telemedicine, it is important to train future medical professionals in the use of these technologies and the provision of these types of medical care. Doctors should not only be trained in the use of telemedicine, but also learn how to do it professionally, safely and on the basis of evidence.

The article discusses issues reflecting the importance of intergenerational sports as an institution influencing the formation of social values, civic identity, health-saving attitudes, etc. The paper defines the main and specific functions of sport as a social institution. Based on the author's sociological research, the results are presented reflecting the attitude of participants of intergenerational sports groups to certain types of social impact that sports activities and events held in mixed age groups have.

The phenomenon of déjà vu (DV) is of interest, occurring in 97% of healthy individuals, while DV can be a manifestation of a number of pathologies, such as Charles Bonnet syndrome, depression, schizophrenia, or temporal lobe epilepsy. Most cases of DV type epiphenomena are associated with hippocampal sclerosis, while up to 90% of patients with mesial temporal sclerosis are drug resistant. Despite the success of pharmacotherapy, the frequency of «uncontrolled» epilepsy in industrialized countries that adhere to modern standards of treatment is from 30 to 40%, and this percentage is higher among patients with symptomatic and cryptogenic forms than among patients with idiopathic epilepsy (respectively: 40% and 26%). In turn, when studying the DV phenomenon and choosing a therapy strategy, it is necessary to establish its origin, determine its clinical significance (whether it is initially pathological or not), and the need for treatment. During the analysis of exome data, a search was made for substitutions in genes associated with arteriovenous malformations, both with autosomal dominant and autosomal recessive types of inheritance. The genes KRIT1, RASA1, IL6, FAM58A, GLML, EPHB4, CCM2, and ELMO2 were analyzed especially carefully. The analysis of genetic data is of great importance in the aspect of preventing cerebrovascular accidents, at the same time, in order to obtain reliable and significant results, in addition to time and financial costs, examination of relatives is also required. Meanwhile, this fact does not mean that every patient needs to conduct a genetic study. The paper presents detailed instructions for supplementing anamnestic information, as well as the results of personalized instrumental and laboratory diagnostics, which made it possible to carry out timely correction of therapy and achieve a prolonged positive effect.

This paper analyzes the etymology of the Russian names of the organs of the urinary system (kidney, ureter, urinary bladder, urethra) and their separate parts (renal pelvis). It is shown that Russian anatomical terms originate from the root morphemes of the Indo-European language group, which convey morphological, physiological or anatomical features of this or that organ. At the moment Russian terminology is widely used in the study of anatomy and other fundamental and medical sciences in universities and clinical practice along with common Latin names and eponyms of names of these or other structures.

Congenital nephrogenic diabetes insipidus (CNDI, arginine vasopressin resistance) is a rare inherited disorder characterized by insensitivity of the kidney to the antidiuretic effect of vasopressin. NDI is clinically characterized by polyuria with hyposthenuria and nocturia and polydipsia. In the majority of cases, about 90%, nephrogenic diabetes insipidus is an X-linked recessive disorder caused by mutations in the AVP V2 receptor gene (AVPR2). In the remaining cases, about 10%, the disease is autosomal recessive or dominant and, for these patients, mutations in the aquaporin 2 gene (AQP2) have been reported. To date, the nucleotide variants registered in AQP2 were sporadic, there is no data on the presence of «frequent» mutations and the prevalence of the disease both among the global population and among individual ethnic groups. In this paper, we describe 12 cases of arginine vasopressin resistance caused by a new homozygous mutation p.R113C in AQP2 presented among the indigenous population of the Republic of Buryatia.

The success of genome editing of crops using the CRISPR/Cas system largely depends on the correct choice of target genes, for which directed changes will increase yield and improve the quality of plant raw materials and resistance to biotic and abiotic stress factors. This work systematizes and catalogs data on target genes used to improve cultivated plants. The latest systematic review examined articles indexed in the Scopus database and published before August 17, 2019. Our work covers the period from August 18, 2019 to March 15, 2022. A search according to the given algorithm allowed us to identify 2090 articles, among which only 685 contain the results of gene editing of 28 species of cultivated plants (the search was carried out for 56 crops). A significant part of these papers considered either editing of target genes, which was previously carried out in similar works, or studies related to the field of reverse genetics, and only 136 articles contain data on editing of new target genes, whose modification is aimed at improving plant traits important for breeding. In total, 287 target genes of cultivated plants were subjected to editing in order to improve properties significant for breeding over the entire period of the CRISPR/Cas system application. This review presents a detailed analysis of the editing of new target genes. The studies were most often aimed at increasing productivity and disease resistance, as well as improving the properties of plant materials. It was noted whether it was possible to obtain stable transformants at the time of publication and whether editing was applied to non-model cultivars. The range of modified cultivars of a number of crops has been significantly expanded, in particular, for wheat, rice, soybean, tomato, potato, rapeseed, grape, and maize. In the vast majority of cases, editing constructs were delivered using agrobacterium-mediated transformation, less commonly, using biolistics, protoplast transfection, and haploinducers. The desired change in traits was most often achieved by gene knockout. In some cases, knockdown and nucleotide substitutions in the target gene were carried out. To obtain nucleotide substitutions in the genes of cultivated plants, base-editing and prime-editing technologies are increasingly used. The emergence of a convenient CRISPR/Cas editing system has contributed to the development of specific molecular genetics of many crop species.

The use of CRISPR-Cas bacterial adaptive immunity system components for targeted DNA changes has opened broad prospects for programmable genome editing of higher organisms. The most widely used gene editors are based on the Cas9 effectors of the type II CRISPR-Cas systems. In complex with guide RNAs, Cas9 proteins are able to directionally introduce double-stranded breaks into DNA regions that are complementary to guide RNA sequences. Despite the wide range of characterized Cas9s, the search for new Cas9 variants remains an important task, since the available Cas9 editors have several limitations. This paper presents a workflow for the search for and subsequent characterization of new Cas9 nucleases developed in our laboratory. Detailed protocols describing the bioinformatical search, cloning, and isolation of recombinant Cas9 proteins, testing for the presence of nuclease activity in vitro, and determining the PAM sequence, which is required for recognition of DNA targets, are presented. Potential difficulties that may arise, as well as ways to overcome them, are considered.

The article describes the historical milestones in the study of Crohn's disease from the time of its original description in the 17th century, the revolution in the medical community after the landmark paper in 1932, to the present day. The history of Crohn's disease testifies to the discoveries of the past years, which open up to us the advantages of a scientific approach to the diagnosis and treatment of this disease.

Economic and social losses due to epidemics of non-communicable diseases have put prevention and control of them on the first line in the field of sustainable development of the United Nations. The tasks of combating NCDs and risk factors within the framework of the Sustainable Development Goals require targeted actions on the part of States in the field of policy and legislation and provision of health systems with appropriate resources. In the Russian Federation, such work is being implemented within the framework of the national project "Healthcare", federal programs to combat oncological and cardiovascular diseases. Each subject takes into account the peculiarities of economic development, staffing, implementation of informatization processes, etc. The rapid pace of transformation of Moscow healthcare, its unique institutional structure allowed to form the basis for the effective development of a system of proactive dispensary monitoring of patients suffering from chronic diseases. The authors describe the process of formation of preventive work and organization of dynamic dispensary observation in Moscow. The paper presents in detail the organizational, administrative and technological resources used to create a unique system of dynamic dispensary observation. In addition, the article illustrates the personalized subsystem of dynamic dispensary observation in EMIAS and the institute of "physician assistant". The introduction of a proactive dispensary monitoring system will reduce premature mortality and disability among residents of the city. Moscow through an individual monitoring program and motivation for the responsible attitude of metropolitan patients to their health.

Cases of horizontal transfer of transposable elements (TEs) between species are known for the Drosophilidae family. In the middle of the last century, the case of horizontal transfer of the P-element from the Drosophila willistoni to the D. melanogaster was described. A novel P-element invasion into the D. simulans genome from D. melanogaster occurred approximately 10 years ago. Currently, the P-element has spread across all D. melanogaster population and 30% of D. simulans populations in Europe, Africa and America. In this paper, we investigated the presence of the P-element in D. simulans lines caught in different years in three Asian populations (Tashkent, Nalchik and Sakhalin Island). We also examined the physiological characteristics (cytotype, lifespan, fecundity and locomotor activity) of D. simulans lines with and without the P-element to determine the significance of this new mobile element in the genome. The P-element was found in lines isolated from nature after 2012. The number of P-element copies per genome (two-to-three dozen according to fluorescence in situ hybridization data) was greater than in the American and comparable to the African populations. There were signs of intraspecific hybrid dysgenesis for some pairs of lines. However, in general the presence of the P-element did not adversely affect the physiological characteristics. Either adaptation to the new TE occurs very quickly, or the rate of movement of the P-element is so insignificant that its appearance in the genome remains unnoticed.

L-asparaginase (EC 3.5.1.1) is one of the most demanded enzymes used in the pharmaceutical industry as a drug and in the food industry to prevent the formation of toxic acrylamide. Researchers aimed to improve specific activity and reduce side effects to create safer and more potent enzyme products. However, protein modifications and heterologous expression remain problematic in the production of asparaginases from different species. Heterologous expression in optimized producer strains is rationally organized; therefore, modified and heterologous protein expression is enhanced, which is the main strategy in the production of asparaginase. This strategy solves several problems: incorrect protein folding, metabolic load on the producer strain and codon misreading, which affects translation and final protein domains, leading to a decrease in catalytic activity. The main approaches developed to improve the heterologous expression of L-asparaginases are considered in this paper.

The paper is based on the results of a CT study of 71 women with normal pelvic dimensions without pelvic bone or pelvic organ pathology who underwent the study in 2022-2023. All subjects consented to the study, which was performed according to the indications. The CT study consisted of determining the width, height, and thickness of the pubic symphysis in 3D reconstruction mode. The subjects were divided into three groups according to the anatomical age classification. The first group consisted of 23 first-age adults (21-35 years old); the second group included 25 elderly people (56-74 years old); the third group consisted of 23 elderly people (75-88 years old). The results obtained are the basis for further research and can be used by doctors of such clinical specialties as sports medicine, traumatology, forensics, forensic medicine, obstetrics and many others.

Postoperative pain is a pressing medical problem, as it significantly reduces the quality of life of patients after surgical treatment. Chronic postoperative pain further disables patients and impairs their functional activity. Being a widespread interdisciplinary problem, postoperative pain requires the integration of various pain management methods in complex multimodal pain management in the acute period and treatment programs for its chronicity. The paper examines the possibilities of reflexology methods for the relief of acute and treatment of chronic postoperative pain. Integration of reflex effects from the first days after surgery makes it possible to more effectively and safely solve the problems of acute and chronic postoperative pain.

Disease modifying therapy for adult patients with SMA still raises certain questions regarding its effectiveness, given the long-term chronic process with often significant neurological deficits at the time of initiation of therapy. This paper presents three clinical cases of adult sitter patients with SMA type 2, who began risdiplam therapy 16.5-41 years after the disease onset. All patients have been receiving therapy since 2020, at the time of observation for 2.5-3 years. All patients showed subjective and objective (using specialized scales) improvement during long-term therapy with risdiplam. In addition to an increase in muscle strength, mainly in the proximal and distal parts of the arms, several non-motor effects were also noted (including improved swallowing and breathing), which cannot be recorded using scales. No adverse events were recorded during therapy.

The adverse effects of microplastics (MP) found in food on the health have recently been recognized as a new source of human health risks. In order to evaluate and minimize them, it is necessary to evaluate the exposure using sensitive and specific methods. The aim of the research was the substantiation of methodological approaches to the identification and quantification of microplastics in food based on the analysis of literature data. Material and methods . Literature selection was carried out using the PubMed international reference database for the period from 2014 to 2023 using keywords corresponding to the context of the research theme. A total of 159 sources were selected, of which 94 original and review papers were included in the review according to the criteria of their relevance to the problem under consideration, scientific reliability and completeness. Results . At present, various approaches have been developed that make it possible to isolate MPs from complex bioorganic matrices (such as, for example, seafood), classify them by chemical composition, and quantify their content through the mass or number of particles. Among the most developed physic-chemical methods for the analysis of MPs are Fourier transform IR spectrometry and Raman microspectrometry, pyrolysis gas chromatography - mass spectrometry, thermogravimetric analysis, as well as approaches based on liquid chromatography, microfluorimetry, analytical scanning and transmission electron microscopy and others. Unsolved problems in the field of MP research in food include the high laboriousness and low performance of the identification technologies used, the lack of reference and standard samples of MP, the complexity of the equipment used, which makes it difficult to use it for routine hygienic control. The issue of the influence of MP aging degree on the results of its qualitative and quantitative determination has not been sufficiently studied. Some hopes in the field of development of rapid analysis of MTs are pinned on the use of aptamers. Conclusion . Existing analytical methods make it possible to determine the content of MPs in environmental objects, but further improvement and validation of these methods is required in relation to the assessment of the content of MPs in various types of food., Competing Interests: The author declares no conflicts of interest., (Copyright© GEOTAR-Media Publishing Group.)

Surgical treatment of inflammatory diseases of the frontal sinus is one of the biggest challenges of modern otorhinolaryngology. Close proximity of the frontal sinus and frontal sinus drainage pathways to the skull base, the orbit and the anterior ethmoid artery, great limitations with its visualization and instrumentation, and high risk of the frontal recess scarring cause difficulties in either endoscopic or external approaches to the frontal sinus. At the same time endoscopic approach to the frontal sinus is considered as preferred method of frontal sinusitis surgical treatment by majority of peers nowadays. The introduction of extended approaches to the frontal sinus pathology treatment with frontal sinus floor and interfrontal sinus septum drill-out as well as superior septectomy with common drainage pathway formation gave an opportunity to greatly decrease a rate of indications for external frontal sinus procedures. In this paper historical backgrounds of endonasal approaches to frontal sinuses are presented, current controversies in proper selection of extent and methods of the frontal sinus surgery are analyzed and endoscopic as well as external approaches to frontal sinuses are summarized.

The paper presents two clinical cases demonstrating the effectiveness of using surgical templates for the installation of dental implants in the areas of ectopic and impacted teeth in case of patient's disagreement on their removal or other methods of treatment.

Type 2 diabetes mellitus is a common chronic metabolic age-associated disease. Elderly patients over 65 years of age predominate among those with type 2 diabetes. 70% of patients with prediabetes develop type 2 diabetes during their lifetime. The article presents data on the prevalence of type 2 diabetes mellitus and prediabetes in the Russian Federation. It also reflects information about the impact of lifestyle and aging on the progression of carbohydrate metabolism disorders. The paper presents studies that prove the possibility of preventing the transition of prediabetes to diabetes. Various methods of preventing type 2 diabetes mellitus, including lifestyle changes, medications, and metabolic surgery in patients with prediabetes, are being considered. Particular attention is paid to the effectiveness and possibility of using these methods of prevention in the elderly in general.

The article is a systematic review of the literature data summarizes to date on the issue of COVID-19-associated anosmia. We mainly used full-text and abstract electronic databases (PubMed, Scopus and Web of Science). The paper discusses hypothetical mechanisms of development, clinical features, as well as methods of diagnosis and treatment of COVID-19-associated anosmia.

The paper presents typical complications after laser lingual frenectomy. Laser and scalpel frenectomy are comparable in terms of functional results. Laser technique has some advantages (less pain and discomfort during the procedure and in the early postoperative period, less need for local anesthesia, lower average surgery time) but the exact knowledge of laser technical features is mandatory for optimal surgery results. Laser technique methodology is described allowing to avoid the complications.

An overview of researches, mainly by foreign specialists, on current available approaches for sampling to study the traces of gunshot residue (GSR) is presented. The comparative characteristics of traditional methods of samples (use of cotton and gauze tampons, blotting paper, textile fabrics, adhesive tapes, adhesives and vacuum samplers), as well as advanced technologies, including special devices and sorbents, are given. The characteristics of samplings from hands, scalp, nostrils, clothes of examined persons as well as procedures, that allow to increase the duration of GSR detection, are described in details. The importance of GSR sustainability over time is noted. On average, the most likely detection periods of particles are less than 1 hour for samples, collected from hands, more than 1 hour for samples from clothes and 2-3 hours for face. It is possible to detect the GSR particles in hair up to 24 h., and in nasal mucus after 6 h. of shot. The methods of identification and determination for analytes of inorganic and organic nature are discussed. The most common methods for determining heavy metal particles are atomic spectrometry, namely atomic absorption with electrothermal atomization and atomic emission. The combination of scanning laser ablation and mass-spectrometry with inductively coupled plasma makes it possible to detect more than 15 analytes in a single sample. Scanning electron microscopy with X-ray detectors is effective for the examination of powder particles. The described methods of sampling complement each other increasing the possibility of evidence base for court proceedings.

The paper presents the results of a histomorphometric study of age-related changes in hyaline cartilage tissue by the example of studying cricoid cartilage from 88 corpses of males of various ages. A comparative assessment of the parameters between the groups was carried out and the dynamics of age-related changes in the main ones was studied. As a result of the studies, the greatest correlation with age was recorded in the following indicators: length (r=0,88) and width (r=0,89) of the ossification zone, the area of bone (r=0,87), adipose (r=0,77) and reticular tissue (r=0,86), the number of chondroblasts (r=-0,7). It was found that the transformations of cricoid cartilage occurring with age are characterized by a decrease in the area of cartilage tissue, the average number of chondrocytes and chondroblasts also tends to decrease steadily with increasing age. Age-related bone tissue transformations are characterized by an increase in the area of bone tissue and the transformation of the tissue structure itself: the number of bone beams and their dimensional characteristics (length and width) change. The results of the study allow us to evaluate the age dynamics of quantitative markers of involution processes of hyaline cartilage tissue in men by the example of studying cricoid cartilage and supplement the existing ideas about the pathogenesis of age-associated cartilage diseases.

This paper reviews the literature on the role of optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) in the diagnosis of glaucoma and considers the significance of evaluating retinal nerve fiber layer and ganglion cell complex in assessment of glaucoma progression, variability and reproducibility of the method, as well as the influence of age-related retinal changes on the results, analyzes the role of OCTA in glaucoma monitoring. Optical coherence tomography is a modern standard for glaucoma diagnosis and monitoring, and OCTA shows high potential as an auxiliary diagnostic tool.

Basis of acute pharyngitis pathogenesis is an inflammatory process at the entrance gate of the infection. Therefore, local immunity study proves to be the most informative. Difficulty in making that type of assessment is lack of generally accepted reference values and biological sampling techniques., Objective: Validation of biological sampling techniques to study the parameters of local mucosal immunity in oropharynx acute inflammatory diseases., Material and Methods: 30 people with acute catarrhal pharyngitis with intoxication syndrome were examined. The sampling was carried out in 7 different ways. 1. Collect saliva samples using the passive drool collection method. 2. Collect saliva, using cotton swabs placed into the mouth for 3 minutes. 3. Cotton swabs wrapped around a metal probe was placed on palatine tonsils and lateral walls of the oropharynx. 4. Instead of a cotton swab, a disc of laboratory filter paper with a diameter of 0.7 cm was used. 5. Scrape by the mucous membrane of the palatine tonsils and lateral walls of the oropharynx were made with a cytobrush. 6. Using a cytobrush, scrapings were made from the mucous membrane of only the posterior pharyngeal wall, excluding the region of the palatine tonsils. 7. Using a cytobrush to make scrapings from the only palatine tonsils mucous membrane. RT-PCR was used to determine IL-1β mRNA., Results: Minimal IL-1β mRNA values were detected in saliva collected by passive flow (0.095 [0; 3.45] units) and on a cotton swab (0.21 [0.1; 3.82] units). IL-1β mRNA in the material collected by methods No. 3 and No. 4 on a cotton swab and a paper disk did not differ significantly from each other. Its level was higher than in saliva and lower than in scrapings. The maximum result was revealed with method No. 5 when simultaneously taking scrapings from the palatine tonsils and posterior pharyngeal wall mucous membrane (4.76 [0.92; 8.13] units). The expression of IL-1β mRNA in the material obtained by methods No. 6 and No. 7 did not differ significantly from each other., Conclusion: Separated scrapings collecting from the palatine tonsils or posterior pharyngeal wall mucous membrane will allow assessing the inflammatory response autonomously in the lymphoid tissue and separately on the mucosa of the posterior pharyngeal wall. The mucosal scraping technique was the most effective for assessing cytokines in the oropharyngeal mucosal membrane.

Acute pain syndromes caused by discogenic lumbosacral radiculopathy and lumboischialgia are not uncommon in clinical practice and characterized by a high risk of becoming chronic. The pathogenetic aspects, features of the clinical picture, existing approaches to conservative treatment of these conditions are analyzed in this paper. Data on the efficacy and safety of a fixed combination of diclofenac and orphenadrine (Neodolpasse) use in the treatment of vertebrogenic pain syndromes based on the NEODOLEX study results are presented, and the authors' own clinical observations are given. Possible reasons for the high efficacy of Neodolpasse in patients with discogenic radiculopathies and nonspecific back and neck pain are discussed.

Rhonchopathy is a major problem of both a medical and social nature, it is detected in about 33% of the adult population. It should be noted that snoring is often accompanied by a more formidable disease - obstructive sleep apnea (OSA) syndrome, which, in turn, is considered a life-threatening condition. It is known that in severe forms of OSA syndrome, up to 400-500 respiratory stops per night with a total duration of up to 3-4 hours can occur, which leads to acute and chronic lack of oxygen during sleep. In turn, chronic obstructive pulmonary disease (COPD) is one of the most common diseases and one of the leading causes of death worldwide. The association of OSA syndrome and COPD, which is designated by the term overlap syndrome, is characterized by the summation of the negative effect of these pathological conditions on the parameters of blood oxygen saturation during night sleep. Diagnosis, treatment and prognosis in patients with overlap syndrome should be based on an interdisciplinary approach, including the use of modern and highly informative methods of functional diagnosis. To date, many methods of treatment (conservative, surgical, combined) of rhonchopathy and OSA syndrome are known. In most cases, preference is given to minimally invasive methods, creating constant positive pressure in the respiratory tract. Tracheostomy is an absolutely effective method of treating OSA syndrome, however, it is very traumatic, but in exceptional cases it is necessary. This paper describes a clinical case of installing a T-shaped stent not only for the treatment of chronic cicatricial stenosis, but also to compensate for OSA syndrome and restore vocal function.

The paper discusses changes in the structure of the classification, criteria for the diagnosis of lymphoid neoplasms in the 5th edition of the WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues (2022). Changes are presented regarding new nosological units, renaming and abolition of some previously existing ones. The importance of molecular genetic studies in the isolation of many lymphomas and the need to apply these studies in everyday clinical practice are emphasized. Lymphoid precancerous processes and lymphoid proliferations introduced into the Classification for the first time are considered.

There is an increased prevalence of respiratory infections among dentists, which is associated with a heavily polluted breathing area in the dental office. Patients and dentists are at high risk of cross-infection due to the spread of aerosols in the form of droplets suspended in the air. The ultrasonic scaler is the largest source of aerosols and spatter in the dental office. Aerosols remain in the air for a long time even after the completion of a dental procedure and have a potential risk of inhalation., Purpose of the Study: To evaluate the spatial distribution of aerosols and splashes during a dental appointment during ultrasonic dental treatment., Material and Methods: The study was conducted on a mannequin equipped with phantom jaws, where dental plaque removal was simulated using an ultrasonic scaler filled with fluorescein. The amount of contamination was measured using a transparent grid with a square marking of 1 cm 2 . The grid was placed on top of a disk of filter paper and the area of contamination was measured by counting the number of soiled squares. If a square had at least 1 yellow area, then it was considered polluted., Results: Aerosols and splashes were distributed up to 60 cm from the head restraint. Aerosols can spread over more than 1 m., Conclusions: The study showed the spread of aerosols and splashes during dental appointments. The risk of infection can be minimized by following simple protective measures.

Surgical treatment of inflammatory diseases of the frontal sinus is one of the biggest challenges of modern otorhinolaryngology. Close proximity of the frontal sinus and frontal sinus drainage pathways to the skull base, the orbit and the anterior ethmoid artery, great limitations with its visualization and instrumentation, and high risk of the frontal recess scarring cause difficulties in either endoscopic or external approaches to the frontal sinus. At the same time endoscopic approach to the frontal sinus is considered as preferred method of frontal sinusitis surgical treatment by majority of peers nowadays. The introduction of extended approaches to the frontal sinus pathology treatment with frontal sinus floor and interfrontal sinus septum drill-out as well as superior septectomy with common drainage pathway formation gave an opportunity to greatly decrease a rate of indications for external frontal sinus procedures. In this paper historical backgrounds of endonasal approaches to frontal sinuses are presented, current controversies in proper selection of extent and methods of the frontal sinus surgery are analyzed and endoscopic as well as external approaches to frontal sinuses are summarized.

The review article analyzes scientific publications devoted to the actual problem of modern society - the syndrome of falls in elderly and senile people. The multifactorial nature of falls is demonstrated, which must be taken into account when carrying out diagnostic and therapeutic measures. The information obtained made it possible to identify the most significant conditions and diseases leading to an increase in the frequency of falls. The paper systematizes information about the causes of falls and the prevention of falls, diagnosis and complex treatment of elderly and senile patients. Attention is drawn to the victims of elderly and senile age with traumatic injuries.

Application of new materials and methods in the diagnosis and treatment of eye diseases is one of the promising research areas in modern ophthalmology. Significant progress has been made in understanding the pathogenesis, diagnosis and treatment of eye diseases using nanotechnologies and nanomaterials. This paper presents the main achievements and results of original research on this issue. It has been shown that nanoparticles are able to overcome biological barriers, deliver drugs to the target site, and provide the required drug release rate. Modern nanotechnological approaches in tissue engineering are also being actively introduced into ophthalmology, making it possible to create nanoframeworks for growing three-dimensional cellular structures, including arrays of pigment epithelium cells and retinal ganglion cells for the treatment of retinal damage caused by degenerative diseases, injuries and infections.

The purpose of the study presented in this paper is to consider the attitude of senior citizens (aged 65 years and older) to telemedicine technologies and their readiness to use them.Telemedicine has become widespread in recent years, and its use will expand in the near future. Telemedicine technologies have proved to be an effective tool for solving a number of problems: providing access to medical consultations, prompt response of medical workers to patient requests, monitoring of health indicators, etc. However, the prevalence of the use of these technologies is differentiated in different age groups. Due to the fact that elderly citizens are not active users of digital gadgets, the introduction of telemedicine technologies into their daily practice of taking care of their own health is in many ways difficult.

Violation of the interconnected system of institutions for assessing the qualifications of medical specialists can be associated with two main circumstances. The first circumstance is the emergence of new institutions with duplicate tasks and organizational forms, and the second is the withdrawal from the system of an institution that performs the necessary system function. Two relatively new institutions, namely the independent assessment of qualifications (IAQ) and certification for the title of «Moscow Doctor», are considered from the point of view of these circumstances. The paper reveals that there is a convergence of the rules of the Institute of accreditation with the Institution of IAQ of qualifications, which can result in significant duplication of their activities. Therefore, it is necessary to resolve the issue of its possible unification with the Institution of accreditation while the IAQ is at the experimental stage and has not been put into practice. A certain similarity of the principles of activity can be traced in such institutions as certification for the qualification category and certification for the title of «Moscow doctor». Both of these institutions identify and rank the qualifications of specialists exceeding the basic level. The fundamental innovation of certification for the status of «Moscow Doctor» is that this institution actually introduces a qualification category that is higher than the current highest category. At the same time, this institution shows the importance of the institution of certification for a category whose existence is being questioned.

The paper presents the results of a scientometric analytical research on the study of the publication landscape formed by research institutes and scientific-practical centers subordinate to the Moscow Healthcare Department. The study was conducted using the analytical platform SciVal, the data source for which is the database Scopus, the time period was 5 years - from 2017 to 2021. The results obtained in the course of the study indicate a steady growth and positive dynamics of changes in the selected scientometric indicators, as well as a significant contribution of Moscow research institutes and scientific-practical centers to the publication flow of the Moscow Healthcare Department. For the publishing landscape of Moscow medical science, there is a wide variety of subject areas in which its publications are distributed, a significant part of which belongs to highly relevant topic clusters.

The paper analyzes a set of equations that adequately predict the IC50 value for SARS-CoV-2 main protease inhibitors. The training set was obtained using filtering by criteria independent of prediction of target value. It included 76 compounds, and the test set included nine compounds. We used the values of energy contributions obtained in the calculation of the change of the free energy of complex by MMGBSA method and a number of characteristics of the physical and chemical properties of the inhibitors as independent variables. It is sufficient to use only seven independent variables without loss of prediction quality (Q² = 0.79; R²prediction = 0.89). The maximum error in this case does not exceed 0.92 lg(IC50) units with a full range of observed values from 1.26 to 4.95.

The clinical examples of the use of modern endoscopic minimally invasive technologies in patients with urinary tract anomalies and in complex clinical cases are presented in the article. The techniques and features of percutaneous nephrolithotomy, retrograde intrarenal surgery (RIRS), antegrade ureteroscopy using f lexible scope in this category of patients are discussed. The paper confirms the efficiency and necessity of further development of endourological methods for the treatment of urolithiasis.