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Purpose : to present analysis a case reports of 17 patients who had an acute transient macular edema appeared straight after uncomplicated cataract surgery. Patients and Methods . Working with literature and retrospective observational case series reviewing clinical and imaging data from 17 patients (17 eyes) with acute transient macular edema. Results . There are several cases of acute macular hole development after cataract surgery (complicated and uncomplicated). Also there are reports of macular odema development after several weeks after uncomplicated phacoemulsification due to pseudophakic cystoid macular oedema (Irvine-Gass syndrome) or due to vitreomacular traction syndrome. We observed a series of transient macular oedema with 3.8 % incidence occurring on the first days after uncomplicated phacoemulsification with IOL implantation that had no signs of vitreomacular traction or aqute inflammation. Men suffer frequently than women (14:3). Systemic hypertension prevailed among these patients (15 from 17). Optical coherence tomography (OCT) was made in patients complaining on blure vision and who had signs of macular edema by ophthalmoscopy. By OCT high neuroepithelium detachment was observed at the first day after uneventful cataract phacoemulsification with intraocular lens implantation in 17 patients with quiet postoperative condition of the eye. The edema resolved on the 3–6-th day by standard phaco accompanying pharmacological treatment. In most cases posterior vitreous cortex was adjacent to the retina except 3 patients with posterior vitreous detachment (PVD) in macular area. We found a paper by Costen M.T.J. et al. (2007) about the same striking appearance of maculopathy called by authors “A-sign” maculopathy because of A-shaped pattern on OCT images in 3 patients after routine cataract surgery. Yaman A (2008) and Panagiotidis D (2010) also reported same findings after uncomplicated cataract surgery. We compared our findings with 3 papers mentioned above, as well as with typical pseudophakic cystoid macular edema (CME or Irvine-Gass syndrome) and vitreomacular traction syndrome. We also discussed possible ethiopathogenesis of thеse cases in terms of morphology of the macula region. Conclusion . This article could improve our understanding of mechanisms of the interstitial fluid flow in the eye tissues.

Recurrent cervical cancer is a difficult challenge for gynecological oncologist. In this paper we review papers concerning incidence and surgical treatment of pelvic recurrences. A point of interest is studies evaluating completion surgery after radiotherapy/chemoradiotherapy. Surgery after definitive radiotherapy is associated with high morbidity and should be performed only in patients with residual tumor. Magnetic resonance imaging in special regimen can be useful in detecting residual disease.

Typhoid fever is an acute infectious disease caused by Salmonella enterica subsp. enterica serovar Typhi (S. Typhi), which is still extremely common in endemic low- and middle-income countries of Asia and Africa. Industrialised countries may also be affected by typhoid fever outbreaks due to booming international tourism, and natural disasters. Given S. Typhi progressive resistance to antibiotics, high epidemiological burden, and lack of adequate sanitation and hygiene in a number of regions, the introduction of new treatment protocols and the improvement of preventive vaccination are critical tasks in global healthcare. The aim of the study was to highlight the main historical aspects of the typhoid vaccine development, to summarise data on the licensed vaccines and promising approaches to the development of new typhoid vaccines. The paper describes the current epidemiological situation of typhoid fever globally and in the Russian Federation. It dwells upon the global experience in typhoid vaccine development from the production of an inactivated vaccine to the development of conjugated vaccines. The paper summarises data on Russian and foreign-made typhoid fever vaccines currently available in the global pharmaceutical market. It outlines the main trends in the development of vaccines against the disease caused by S. Typhi. The paper demonstrates the need for improving the efficacy of existing vaccines and development of new typhoid combination vaccines.

Osteoarthritis is the second most common disorder after heart disease. This progressive degenerative disease affects the knee joint more than any others. The exact etiology of knee osteoarthritis is not clear, however, there are many predisposing factors such as obesity, age, gender, etc., that can increase the incidence and prevalence of this disease. Early diagnosis in knee osteoarthritis is very important. Despite the variety of diagnostic methods, lack of a valid and reliable diagnostic approach to detect the disorder in early stages has always been a challenge for researchers. Establishing an efficient therapeutic protocol for these patients is another crucial challenge. Recently, in addition to conventional treatments, which are surgical and non-surgical, tissue engineering and regenerative medicine as novel therapeutic modalities have received remarkable attention. In this paper, current diagnostic and therapeutic methods for knee osteoarthritis are discussed and potential biomarkers for early diagnosis and monitoring the clinical condition are discussed.

The paper analyzes the literature data on the peculiarities of nutrition of students studying in higher educational institutions of various regions of Russia, and the risks of developing food-related diseases. They are largely associated with the adaptation of students to study at a university, the lack of self-organization skills and a lack of knowledge in matters of rational nutrition. The actual nutrition of students, on the one hand, is characterized by a lack of macronutrients and micronutrients intake, on the other hand, by excessive consumption of substances that contribute to the development of obesity. The results of numerous studies show a general pattern of unbalanced nutrition of students in terms of the ratio of saturated and polyunsaturated fatty acids, insufficient consumption of dietary fiber, full-fledged proteins, and excessive intake of simple carbohydrates. Dietary fiber deficiency can lead to changes in the composition of the microbiocenosis of the digestive tract, a deficiency of omega-3 fatty acids, and consequently, the imbalance of fatty acid composition of the blood cell membrane. 20–40 % of Russian students show signs of severe hypovitaminosis, especially calciferol, which is caused not only by its deficiency in the diet, but also by physical, geographical, climatic and seasonal factors. The analysis of the content of the main minerals in students shows a sufficient content of calcium in the body, an excess of sodium and a lack of magnesium, potassium and iron, which is due to both the composition of the food consumed and the peculiarities of the accumulation and excretion of these ions. An analysis of the actual nutrition of students shows the need for counseling young people, especially in the first years of study. The introduction of an educational program on optimal nutrition is possible through the practice of curatorial work during the adaptation of the first-year students to student’s life.

The eradication of smallpox has become one of the greatest successes of modern health science. This great achievement was made possible thanks to the widespread vaccination of the population. The last case of human infection with smallpox virus occurred in 1977. In 1980, at the 33rd session of the World Health Assembly, routine vaccination against that infection was recommended to be discontinued due to severe post-vaccination complications. However, humanity remains vulnerable to other orthopoxvirus infections closely related to smallpox virus. Recently, the cases of human infection with ortopoxviruses such as monkeypox virus, cowpox virus, vaccinia virus have become more frequent. Also, cases of infection of people with previously unknown orthopoxvirus species are recorded. Zoonotic orthopoxviruses pathogenic for humans, circulating in nature, require a detailed study and monitoring of the emergence of new strains. Their occurrence against the background of the cessation of planned vaccination of the population against smallpox virus can lead to the emergence of new highly pathogenic viruses. This review contains information on cases of human infection with orthopoxviruses around the world for the period 2008–2018. It also describes epidemiological anamnesis and the relations between cases of human infection in different countries due to the spread of viruses over a wide area, the movement of people between countries, population contacts with domestic and wild animals. Also, this paper provides information on the infection of people with previously unknown strains of orthopoxviruses.

The paper provides information on the construction, development and functioning of a hospital network for the detection and treatment of patients with dangerous infectious diseases in the Republic of Guinea. With the support of UC RUSAL and with the assistance of the Ministry of Health of Guinea, hospitals have been established to provide medical care to patients suspected of COVID-19. Sick persons are admitted from regional hospitals from all over country. The majority of the hospitalized persons are patients with mild and moderate forms of the disease. Diagnostic studies using RT-PCR to detect SARS-CoV-2 virus RNA are carried out at the premises of stationary (Kindia) and mobile (Fria) laboratories. Testing of the received samples is carried out using diagnostic preparations of domestic and foreign production. This stage of work is performed by employees of the Rospotrebnadzor institutions (the Russian Federation) working on the territory of the Republic of Guinea. In total, since the beginning of the epidemic, more than 630 patients have received treatment in the stated hospitals; more than 20 thousand tests of clinical material samples have been conducted to detect the RNA of the SARS-CoV-2 virus. In addition to residents of Guinea, medical assistance was provided to citizens of Russia, Ukraine, Belarus, Kazakhstan, China, India, Sierra Leone, and the Comoros. The organization of the network of hospitals and their inclusion into the national system for counteracting the spread of new coronavirus infection allowed us to begin active work on the identifcation and treatment of COVID-19 patients in the territory of the Republic of Guinea and make a signifcant contribution to the fght against the epidemic.

Purpose of the study: to present up-to-date data on molecular genetic studies aimed to identify the risks of developing prostate cancer in representatives of various ethnic groups. Material and Methods. Literary sources were searched in databases such as PubMed, Medline, Google Scholar. We had analyzed 60 sources on the risks of developing prostate cancer. The epidemiological data on the prostate cancer incidence and risk factors depending on age characteristics, hormonal status and hereditary predisposition were shown. Results. The pathogenetic features of prostate cancer depending on ethnicity were described. The paper presents data from both European and Asian ethnic groups. In a number of studies, significant genetic differences in single nucleotide polymorphisms associated with the development of prostate cancer were identified. Conclusion. Research in the field of determining the risks of developing prostate cancer becomes more and more relevant due to the emergence of new molecular genetic markers, as well as the influence of various ethnic characteristics. Nevertheless, many questions of modern diagnosis of prostate cancer are still open, therefore, research in this area remains promising.

Review based on the analysis of more than 40 scientific papers published in the Pubmed and Medline databases from 1984 to 2019, dedicated to intraoperative hemostasis of the percutaneous tract and its tightness during nephrostomyfree percutaneous nephrolithotomy (PCNL). The article aimed to summarize scientific data on this issue. We presented information about the history and development of percutaneous surgery in the treatment of urolithiasis. In our review, we have been demonstrated various methods of surgical and intraoperative hemostasis during nephrostomy-free PCNL.

Although successes in antiretroviral therapy (ART) turned AIDS from lethal illness into sluggishly progressing disease, its prevention and treatment remain one of the most socially significant concerns. The increase in the number of patients infected with human immunodeficiency virus (HIV), especially in the USA, South America and Europe, determines the need in creating a vaccine against this disease. Existing vaccination practice has demonstrated efficiency of priming/boosting scheme for the development of immune responses. As anti-vector immunity of priming vector can constrain the response to boosting immunization with the same vaccine, heterologous priming/boosting vector constructs are used. An ideal AIDS vaccine would prevent virus dissemination and control viral replication, but it also must be safe for HIV-infected contingent. The vaccination of HIV-infected individuals is used for enhancing immune-mediated elimination of persistently HIV-infected CD4+ Т-cells during long-term ART in order to purge the latently infected viral reservoirs. The paper considers the results of clinical trials of DNA-anti-HIV/AIDS vaccines and recombinant MVA strain of vaccinia virus, expressing different combination of HIV genes, which demonstrated the safety and tolerability both, in HIV-infected and non-HIV-infected volunteers. All implemented schedules of vaccination induced cell-mediated and humoral immune responses in all volunteers. And though there are no data on acquiring AIDS by HIV-uninfected volunteers from groups at low risk of HIV-infection, there are no grounds to conclude the sufficiency of induced protection for the prevention of possible HIV infection.

Introduction. The paper presents modern literature and clinical research data on the efficacy and safety of dietary therapeutic and prophylactic foods in the complex therapy of diseases associated with Helicobacter pylori. Aim. To assess the efficacy and safety of the use of dietary therapeutic and prophylactic food products in the complex therapy of diseases of the gastrointestinal tract associated with Helicobacter pylori. Materials and methods. To evaluate the efficacy of dietary therapeutic and prophylactic food products such as Vegetable Puree Soup with Herbs and Oatmeal, Oatmeal Porridge with Herbs and Flax Seed, Protein-Sea Buckthorn Cocktail (LEOVIT Nutrio LLC), the main group of patients with gastrointestinal diseases (n = 41) was formed, which was further divided into four subgroups. Each of three subgroups received one specialty food product, and the fourth subgroup received all three products. Changes in complete blood count were evaluated using Sysmex XT-2000i analyzer, those in proteinograms – using SAS1, SAS2 protein fraction analyser and those in metabolic liver disorders, lipid profile and glucose level – using Konelab PRIME 30i (Thermo Fisher Scientific) analyzer. All parameters were studied three times: before use, 14 and 60 days after use of the products. Results and discussion. After 14 days, complaints of lack of appetite decreased in the main group, discomfort in the epigastrium, feeling of heaviness and nausea decreased. After 60 days, 100% of patients reported no heartburn, belching, nausea, pain, rumbling in the abdomen, appetite and stool returned to normal. There was a marked significant (p < 0.05) decrease in the level of alpha-1 globulin against the background of an increase in albumin, a decrease in the concentration of CRP and ESR, the levels of leukocytes and neutrophils in all subgroups of the main group after 60 days. Conclusions. The investigated products are safe, no adverse reactions were noted, including the phenomena of intolerance and allergies, and are recommended for use in dis[1]eases of the gastrointestinal tract associated with Helicobacter pylori.

The paper summarizes the information currently available in the literature on the etiology, life cycle, epidemiology, pathogenesis, pathomorphology, clinical manifestations, diagnosis, etiotropic therapy and prevention of paragonimiasis.

The pandemic of the new coronavirus (COVID-19) disease that began in December 2019 in China is still having a huge impact on all spheres of human life. The herd immunity, which is the most effective tool for preventing the spread of the disease, is formed in two ways: the passive way (i.e., the formation of a population not susceptible to re-infection due to the natural spread of the disease) and the active way (mass immunisation). High rates of COVID-19 vaccination were achieved thanks to the development and mass production of new vaccines. The selection of the most promising vaccine platforms is one of the key aspects of successful mass immunisation. The aim of the study was to compare the characteristics of COVID-19 vaccines used for mass immunisation. The paper analyses the vaccine technology platforms, efficacy of different types of vaccines based on clinical trial results, safety of vaccines for different population groups, and potential for scaling up vaccine production in order to ensure the necessary vaccination coverage. The vaccines currently used for mass immunisation are: BNT162b2 (Pfizer/BioNTech), mRNA1273 (Moderna), Gam-COVID-Vac (N.F. Gamaleya National Research Center for Epidemiology and Microbiology), Ad26.COV2.S (Johnson & Johnson), ChAdOx1-S (AZD1222) (AstraZeneca), BBIBP-CorV (Sinopharm), CoronaVac (Sinovac Biotech), and NVX-CoV2373 (Novavax). The comparison of the main characteristics of the vaccines demonstrated that the most promising types of vaccines for COVID-19 specific prophylaxis are RNA vaccines and recombinant adenovirus vector-based vaccines.

Health status of the younger generation in Russia is of particular relevance, since it is this period that forms the development potential of future generations.Objective. To study and analyze regional features of the incidence rates of the adolescent population in Russia.Material and methods. The authors have used various literature sources, statistical reports; the method of studying and generalizing experience. For the statistical analysis of the morbidity dynamics they used the indicators of absolute and relative growth, they assessed the chain and basic growth rates. Also the authors generalized the characteristic of the incidence dynamics by means of regression analysis.Results. The paper provides a detailed analysis of the incidence of the adolescent population in the Russian Federation in 2012–2018. It describes the dynamics and structure of both primary and general morbidity, identifies classes of diseases with a stable trend of growth, and compares with similar indicators in other countries; the authors analyze the regional characteristics of the incidence of adolescents; compare the level of morbidity in the Russian Federation for all classes of diseases.Conclusion. The authors revealed classes of diseases, characterized by a stable increase in indicators of both primary and general morbidity: neoplasms, endocrine diseases (obesity), eye diseases, injuries. Thus, the article identifies the directions for the health care system that require special attention and development of specific measures to reduce the level of these diseases. The results of the study demonstrate a low medical activity of adolescents, which should be taken into account when developing a set of measures aimed at increasing the coverage of adolescents with medical examinations.

Professor Semyon Semyonovich Girgolav was born on February 2 (14), 1881 in Tiflis (Tbilisi) in a large family of the hereditary honorary citizen of St. Petersburg Semyon Gavrilovich Girgolav. In 1899, he graduated from the Second St. Petersburg Classical Gymnasium with a silver medal and immediately entered the Imperial Military Medical Academy, from which he graduated with honors in 1904. Under the guidance of M. S. Subbotin, S. S. Girgolav prepared and in 1907 successfully defended his doctoral dissertation «Experimental data on the use of an isolated omentum in abdominal surgery». In 1912, Semyon Semyonovich was elected by the Conference of the Academy as a privatdozent of the general surgery clinic, and in 1914, he was confirmed as a senior assistant of the clinic. In the 1920/21 academic year, S. S. Girgolav introduced mandatory practical classes in general surgery for the first time in our country, where students studied and mastered the methods of asepsis and antiseptics, mastered the methods of examining patients with surgical diseases, methods of applying various bandages and transportation splints, techniques for temporary hemostasis, etc. In 1932, Semyon Semyonovich was appointed Deputy Director for the scientific part of the Leningrad Research Institute of Traumatology and Orthopedics (now the Russian Research Institute of Traumatology and Orthopedics named after R. R. Vreden). In the pre-war years, the main direction of scientific research of S. S. Girgolav and his staff in the hospital surgery clinic was the study of the regularities of the wound process and wound healing in surgical pathology. S. S. Girgolav applied much efforts and energy to the problems of traumatology. He developed the technique of a number of original surgical operations for acute fractures of long bones, the habitual dislocation of the shoulder joint. Semyon Semyonovich’s scientific heritage is great and multifaceted. He has published more than 140 scientific papers on general, military and thoracic surgery, traumatology, neurosurgery, surgical endocrinology and oncology, combustiology, pathology and therapy of frostbites and burns. Under the supervision of S. S. Girgolav, more than 20 doctoral and 45 candidate theses were prepared and defended. For outstanding services to the Motherland in peace and war, S. S. Girgolav was awarded two Orders of Lenin, three Orders of the Red Banner, the Order of the Red Banner of Labor, the Order of the Red Star, many medals and badges of honour. Academician Semyon Semyonovich Girgolav died on January 25, 1957 in Leningrad and was buried at the Bogoslovskoe Cemetery.

The paper evaluates the effectiveness of the use of therapeutic laser exposure (photobiomodulation therapy – PBMT) to minimize acute pain in the early postoperative period in patients after septoplasty. The study included two groups of patients. Patients of the first group (31 patients) underwent septoplasty with standard management in the postoperative period. Patients of the second group (31 patients) also underwent septoplasty, and then added PBMT to the standard measures of the postoperative period at 3, 6 and 24 h after septoplasty (λ = 0.890 μm, P = 10 W, 2 min) and then intranasally 48 h after septoplasty (λ = 0.630 μm, P = 8 W, 2 min). In patients of both groups, heart rate variability and pain were assessed using a visual analog scale within 48 hours after septoplasty. In patients of the second group, after the use of PBMT, the indicators of heart rate variability had a significantly lower total power, compared with patients of the first group. So, after PBMT, the ultra-low-frequency component of the spectral analysis of heart rate variability in the first group was 18580 ± 2067 ms2, which is significantly higher than in the second group (8086 ± 3003 ms2) (p 2) compared to the second (1095 ± 190 ms2) (p

Background. Pancreatic pseudocysts stand among current challenges in modern medicine. Their treatment uses variant instrumental techniques and implies a multispecialty approach. Trials in surgery and gastroenterology have aimed to identify an optimal strategy to tackle pancreatic pseudocysts for reducing complications and the recurrence rate, suggesting ultrasound-guided percutaneous, laparoscopic and flexible endoscopic drainage as promising treatment choices.Objectives. A summarising review of diagnostic and therapeutic methods for pancreatic pseudocyst treatment and comparison of ultrasound-guided percutaneous vs. surgical and endoscopic drainage techniques.Methods. The review examines the classification, epidemiology and methods for diagnosis and treatment of pancreatic pseudocysts. Only comparative full-text studies published within 2014–2021, as well as selected impactive publications within 2002–2013, have been included. The eLibrary, Elsevier and PubMed resources were queried for the article or journal title fields against the keywords (separate or combined) “pancreatic pseudocyst” [псевдокиста поджелудочной железы], “pseudocyst drainage” [дренирование псевдокисты], “surgical drainage” [хирургическое дренирование], “endoscopic drainage” [эндоскопическое дренирование], cystogastrostomy [цистогастростомия], gastrojejunostomy [гастроеюностомия], “duodenal-cystic anastomosis” [цистодуоденоанастомоз], “transpapillary drainage” [транспапиллярное дренирование], “transmural drainage and esophagogastroduodenoscopy” [трансмуральное дренирование и эзофагогастродуоденоскопия]. Records have been selected for topic-related scientific value.Results. The review systematically surveys 68 scientific papers in the focus area and summarises the most common surgical methods for pancreatic pseudocyst treatment. Based on the main principle, the methods are classified into three categories, ultrasound-guided percutaneous drainage, surgical drainage and flexible endoscopic drainage. The major classifications and treatment techniques are highlighted for their advantages and disadvantages.Conclusion. There exist no generally adopted strategy for pancreatic pseudocyst treatment in current clinical practice and no evidence on a particular method application in a large patient cohort. The publication survey identifies the techniques of percutaneous, surgical and endoscopic drainage with ultrasound control as highly effective overall among other surgical treatments.

Deep wound infection of the anterior chest wall tissues in patients after transsternal cardiac surgery despite intensive developments in surgical techniques and improvement of antibacterial chemotherapy, remains a genuine concern worldwide [1]. The incidence of this complication in the general population ranges from 0.5 to 4% [2, 3]. Despite developed approaches in the treatment of cardiac surgery patients, the treatment of deep sternal wound infection and surrounding tissues following a heart transplantation still remains a rather serious and pressing challenge. This paper presents a clinical observation of a heart transplant recipient, complicated by deep postoperative wound infection. The strategy of staged surgical treatment of sternal osteomyelitis consisted of surgical wound debridement, local wound debridement with vacuum dressings, and reconstructive surgery at the final stage (sternal reosteosynthesis, plasty of the anterior chest wall wound with displaced skin and fascial flaps).

Car accidents are the main cause of trauma during pregnancy. Even a non-severe accident is associated with a high risk of injury and unfavorable outcome for the fetus, especially in the event of placental abruption. Major agents leading to a trauma could also include safety belt and safety airbags. Blunt abdominal trauma during a car accident is associated with such type of intrauterine injury as fetal skull fractures and various intracranial hemorrhages. Despite a common viewpoint on relatively high death rates in this population, it is not infrequent that fetal trauma has a favorable outcome without any clinically significant neurological deficiency.The paper presents an analysis of the main outcomes of intrauterine brain injury and associated factors. As an illustration, we describe a case of a car accident related brain injury to a fetus at 38 week of gestation, with skull fracture, brain contusion, and subarachnoidal, epidural and subdural, parenchymal and intraventricular hemorrhages induced by the safety belt, with the mother being virtually uninjured. After treatment, the patient was discharged from the hospital in a satisfactory state, without clinically significant neurological symptoms and signs. A 8-months follow-up of the infant showed some delay in brain maturation manifesting as benign epileptiform discharges of childhood and magnetic resonance imaging patterns.It is highly likely, that the leading factors ensuring a favorable outcome of a intrauterine severe brain trauma (without fatal trauma to the mother and fetus) are as follows: correct obstetric strategy, late gestational age and absence of a massive parenchymal and/or intraventricular bleeding. After the short-term clinical recovery from a severe intrauterine brain trauma and in addition to it, proper follow-up of the child is essential because of a high risk of long-term cerebral and functional abnormalities, mostly paroxysmal, behavioral and cognitive.

Diabetes is a serious public health problem and one of the major chronic noncommunicable diseases. A lengthy stepwise treatment, and the need for an individualised approach to antidiabetic therapy, pose serious challenges for medicine developers. For all new hypoglycaemic medicines, there has been a centralised authorisation procedure in the European Union (EU) since 2005, which ensures a unified approach to efficacy and safety assessment. The aim of the study was to analyse current requirements for planning clinical trials of hypoglycaemic medicines containing new active substances (except for insulin products). The recommendations for diagnosis and treatment of type 2 diabetes, prepared by the European Association for the Study of Diabetes (EASD) and the American Diabetes Association (ADA) in 2019, suggest a step-by-step approach to intensification of treatment to maintain glycaemic targets, which takes account of concomitant cardiovascular or other diseases, and clinical characteristics of patients. The analysis of EASD/ADA documents and scientific literature helped to develop recommendations on the basic principles of planning and conducting clinical trials at the final stages of hypoglycaemic medicine development. The paper describes new approaches to clinical trials, which allow for a more reliable assessment of the treatment effectiveness. The strategy for the assessment of therapeutic effect should be carefully planned, justified, and reflected in variables of interest, clinical trial design, and statistical analysis of the trial results. The main efficacy criterion in confirmatory clinical trials of hypoglycaemic medicines should be the demonstration of benefits in improving glycaemic control. The medicine’s effect on the body weight may be considered as a secondary endpoint. An essential requirement is confirmation of the medicines’ cardiovascular safety, while potential additional benefits are reduction or prevention of risks of cardiovascular disease development. The clinical trial protocol should provide definitions for intercurrent events and hypoglycaemia. A comprehensive safety study of a new hypoglycaemic medicine should involve identification of anticipated or known side effects characteristic of a particular pharmacological class. The provided recommendations may be helpful for medicine developers, and for experts who perform assessment of clinical trial programmes and regulatory submissions for hypoglycaemic medicines.

Introduction. Skin cancer is one of the most common malignancies, however melanoma accounts for only 1.8 % of all skin cancers. Melanoma is rare but aggressive tumor. Early detection and appropriate treatment of the tumor are critical and result in improved overall and recurrence-free survival rates. Histopathological reporting plays a critical role in guiding the surgical oncologist’s treatment plan for melanocytic lesions. The experience and knowledge of the pathomorphologist are decisive in the future fate of the patient.Case description. We report a case of a 36-year-old female patient who presented with a pigmented lesion on the skin of the trunk. In the regional cancer center at her place of residence, she underwent surgical removal of this lesion with a surgical margin of about 1 cm. The histological diagnosis was reported as melanoma. Diagnosis of melanoma was also confirmed in another medical center that did not specialize in the treatment of patients with skin tumors, but the tumor thickness was changed to a smaller one. However, in the federal cancer center that specialized in the treatment of patients with skin melanoma, the diagnosis of melanoma was not confirmed. The patient was diagnosed with nevus. The paper discusses in detail the reasons for the erroneous diagnosis of a malignant neoplasm, indicating the stages of differential diagnosis.Conclusion. This clinical case demonstrates that a reference analysis of borderline melanocytic lesions under conditions of specialized cancer centers with experienced pathologists is required. We have described objective difficulties in pathomorphological diagnosis, which can additionally be aggravated by the absence of important clinical and instrumental information, artifacts during excision biopsy, macroscopic examination, and orientation of tissue fragments in the embedding paraffin block.

With multimodal visualization of the chorioretinal complex structures using modern research methods, it was possible to isolatea mixed, or combined, phenotype of the late stage of age-related macular degeneration (AMD). Early detection of this AMD form is of vital importance not only for accurate diagnosis, but for choosing optimal management tactics for patients. The paper presents two clinical cases with different variants of the development of the mixed phenotype of the late AMD stage. In one case, the long-lasting “geographic atrophy” (GA) was complicated by the development of choroidal neovascularization, while in the other case GA appeared during the treatment of wetAMD.

The paper presents the results of a clinical-psychopathological and experimental psychological study carried out on 91 women with breast cancer (aged 35—65, mean age 55.8±11.08 years). The sample was divided into two groups, 51 women with a diagnosed posttraumatic stress disorder (PTSD) developed as a result of their illness and 40 stress-resistant women. The author’s semi-structured anamnestic interview was used to study the clinical and socio-psychological characteristics of patients. Methods: Trauma Screening Questionnaire (Brewin et al., 2002), Impact of Event Scale (Tarabrina, 2001), Type of Attitude to the Disease measure (Vasserman et al., 2014), G. Ammon’s Ego Structure Test (Tupitsyn et al., 1998), Mental Health Assessment measure (Bocharov, Tupitsyn, 1999), The Personal Views Survey III- R (Leontiev, Rasskazova, 2006), Experiences in Close Relationships (Kazantseva, 2008). Results: In patients with PTSD, low parameters of resilience, the dominance of maladaptive types of attitude to the disease, and deficient and destructive personality structures (aggression, anxiety, deficient external and internal boundaries of the self, and destructive narcissism and sexuality) were revealed.

Allergic rhinitis remains one of the most pressing problems of modern otorhinolaryngology. Allergic rhinitis is an allergic inflammation of the nasal mucosa characterised by the following symptoms (one or more): stuffiness, rhinorrhoea, nasal itching, sneezing. In recent years the incidence of allergic rhinitis in the economically developed countries has been shown to be close to 40–50%. Allergic rhinitis is now characterised by an early onset, often continuously relapsing course and resistance to antiallergic therapy. Allergic rhinitis has a negative impact on a person’s social and daily activities, mental well-being and general health, regardless of age. Allergic rhinitis significantly reduces job performance, physical and mental activity, communication skills, causes snoring, anxiety, depression, sleep disorders and erectile dysfunction. Studying the mechanisms of the disease provides the basis for a rational therapy that addresses the complex inflammatory response rather than just the symptoms of allergy. Treatment is either in outpatient settings or inpatient – in specialised departments. A recent priority of pharmacotherapy is the use of intranasal corticosteroids, both as basic therapy for allergic rhinitis and as part of a combined regimen. The use of intranasal corticosteroids is considered to be the therapy of choice in allergic rhinitis. The paper demonstrates the efficacy and safety of topical corticosteroids for use in clinical practice. Intranasal corticosteroids have a wide range of reported indications, an extensive evidence base and can be recommended for the treatment of allergic rhinitis. For best result intranasal corticosteroids should be used at first signs of allergic rhinitis onset.

The current literature review covers the role of sympathetic nervous system activation (SNS) and the significance of a new biomarker catestatin (CST), which is a chromogranin A-derived peptide, for assessing prognosis of patients with heart failure (HF). This review details the works devoted to CST metabolism and its role in clinical conditions with excessive catecholamine production, including the ability to counterbalance the adverse effects of SNS on cardiovascular system. The paper also presents the central results of studies on HF patients and shows the correlation of the CST level with HF functional class and stage. In addition, particular attention is paid on the possibilities and potential benefits of assessing the CST in addition to conventional management of patients hospitalized due to acute decompensated heart failure.

Regardless of the fact that arterial hypertension is the focus of modern cardiology, resistance to therapy is still an important public health problem with adverse medical, social, and economic consequences. Aim of study: systematizing the available results of studies of the effectiveness of renal denervation in the treatment of patients with resistant AH. Search within databases (PubMed, Cochrane Library) was performed for randomized controlled studies of second-generation catheterassisted renal denervation and sham-controlled studies. We have used PRISMA protocol for preparing our paper. The neutral results of the SYMPLICITY HTN-3 study significantly weakened the interest of practical cardiology in this procedure, however recently published data from the EnligHTNed IDE, SPYRAL HTN OFF MED, and SPYRAL HTN-ON MED studies confirmed the effectiveness and safety of the technique. As the result the second-generation catheters (multielectrode catheters) used for renal denervation confirmed the effectiveness and safety of the procedure, and also expanded the technique usage beyond resistant hypertension. However, the question of the reliability of long-term effects of the procedure still remains, as well as establishing mechanisms to identify predictors of planned intervention responsiveness.

A.A.Fil'1, E.L. Sorokin1,2, O.V. Kolenko1,3 1Khabarovsk Branch of the S.N.Fedorov NMRC “MNTK “Eye Microsurgery”, Khabarovsk, Russian Federation 2Far Eastern State Medical University, Khabarovsk, Russian Federation 3Institute of Advanced Training of Healthcare Specialists, Khabarovsk, Russian Federation This review article summarizes current data on the pathogenesis of macular edema after retinal vein occlusions (RVOs) and patterns ofmacular morphometry and chorioretinal hemodynamics. RVOs account for 60% of acute vascular eye diseases. The major cause of vision loss in RVOs is macular edema which results from subclinical inflammation characterized by leukostasis and enhanced expression of adhesion molecules and production of cytokines increasing retinal capillary permeability. The association between the severity of macular edema and vitreous levels of pro-inflammatory mediators (IL-1β, IL-6, TNF-α, MCP-1, and VEGF) is established. Cystic lesions and detachment of the neuroepithelium (75%) are typical for macular edema after RVOs. Impaired chorioretinal hemodynamics (as demonstrated by a significant reduction of vascular density in the superficial and deep vascular plexus, significant decrease in peak diastolic flow velocity, and increase in resistivity index in the ophthalmic artery and short posterior ciliary arteries) is also reported. The paper addresses etiological factors of RVOs and pathogenesis of macular edema, technical tools for vital assessment of the retina, and choroidal/retinal hemodynamics. This provides great opportunities for a complex in-depth study of the development and course of macular edema to identify potential predictors ofits development and persistence. Keywords: retinal vein occlusions, macular edema, morphometry, chorioretinal hemodynamics. For citation: Fil' A.A., Sorokin E.L., Kolenko O.V. Macular edema after retinal vein occlusions. Macular morphometry and chorioretinal hemodynamics. Russian Journal of Clinical Ophthalmology. 2021;21(3):164–168 (in Russ.). DOI: 10.32364/2311-7729-2021-21-3-164-168.

D.V. Pechkurov, A.A. Tyazheva Samara State Medical University, Samara, Russian Federation Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders in adults, children, and adolescents. This paper reviews the etiology and pathogenesis of IBS, particularly one of its subtypes, postinfectious IBS, associated with a prior acute intestinal infection. The authors discuss risk factors, diagnosis, and treatment for postinfectious IBS and describe diagnostic search and therapeutic algorithm in a child. Treatment for IBS involves changes in diet and lifestyle, pharmacotherapy, and psychotherapy.This case report is interesting for clinicians since only attempts are made to systematize guidelines on the diagnosis and treatment for postinfectious IBS. However, specific management strategies for this condition are scarce, making the diagnosis difficult and resulting in treatment delay. Keywords: irritable bowel syndrome, functional gastrointestinal disorders, prokinetic agent, synbiotic, Maxilac. For citation: Pechkurov D.V., Tyazheva A.A. Postinfectious irritable bowel syndrome in children. Russian Journal of Woman and Child Health. 2021;4(3):292–297 (in Russ.). DOI: 10.32364/2618-8430-2021-4-3-292-297.

E.V. Gol’tsman1, O.A. Kuchma1, E.N. Bondarenko1, D.A. Maiseenko2 1I.S. Berzon Krasnoyarsk Interregional Clinical Hospital, Krasnoyarsk, Russian Federation 2Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russian Federation The rate of congenital malformations of the larynx is challenging to assess. This is probably accounted for by the fact that these diseases occur more commonly than they are diagnosed. This paper describes a case report of congenital laryngeal stenosis, which was a diagnosis of exclusion since this congenital malformation is very rare in neonatal and pediatric practice. After a preliminary diagnosis in the maternity hospital, a newborn was transferred to Krasnoyarsk’s large pediatric hospital for examinations and treatment. Clinical diagnosis was verified by laryngotracheoscopy and CT scan of the larynx and trachea. The newborn’s condition was severe for 28 days. He stayed in the intensive care unit and was on a ventilator and oxygen. Tracheal intubation followed by extubation (performed three times) has no effect due to the increase in respiratory failure. Newborn’s condition improved only after palliative tracheostomy. The child was discharged in satisfactory condition with recommendations on tracheostoma care. Management decision on the surgical technique to address this malformation will be taken later. Keywords: primary congenital tracheal stenosis, children, clinical presentations, diagnosis. For citation: Gol’tsman E.V., Kuchma O.A., Bondarenko E.N., Maiseenko D.A. Congenital tracheal stenosis: case report. Russian Journal of Woman and Child Health. 2021;4(3):298–301 (in Russ.). DOI: 10.32364/2618-8430-2021-4-3-298-301.

O.N. Komarova Yu.E. Vel’tishchev Institute of Pediatrics of the Pirogov Russian National Research Medical University, Moscow, Russian Federation This paper addresses the primary aspects of developing gut microbiota and the immune system and the role of gut microbiocenosis in this process. Optimal gut colonization and adequate immune response are critical factors in developing tolerance to commensal microbes and anti-infectious protection. The authors highlight various prenatal, neonatal, and postnatal factors which prevent normal colonization of gastrointestinal mucosa. One of the methods to restore the qualitative and quantitative composition of gut microbiota are probiotics. Probiotics demonstrating antagonistic activity for pathogens compete with these pathogens for the adhesion to mucosal epithelium and nutrients, thereby inhibiting the production of bacterial toxins, modulating the functions of the immune system, improving gut microbiocenosis, maintaining the integrity of the gastrointestinal mucosal barrier, and controlling gut inflammation. Probiotics are a heterogeneous group of living bacteria with species- and strain-specific properties. For example, Lactobacillus reuteri is an effective probiotic commonly prescribed in premature babies, children with acute gastroenteritis, and infantile colic. Keywords: gut microbiota, microbiocenosis, premature, C-section, probiotics, bacteria, immune system, infantile colic, Lactobacillusreuteri. For citation: Komarova O.N. Efficacy of Lactobacillusreuteri in clinical practice. Russian Journal of Woman and Child Health. 2021;4(3):277–283 (in Russ.). DOI: 10.32364/2618-8430-2021-4-3-277-283.

The expert consensus of the Russian communities discusses the issues of comprehensive medical rehabilitation of patients with coronavirus disease 2019 (COVID-19). COVID-19 is a contagious infectious disease that can cause pulmonary, cardiac, motor, metabolic, neurocognitive and mental disorders, that is, multiple organ dysfunction. COVID-19 survivors, especially after a severe clinical course, face serious psychological and physical problems, posttraumatic stress, cognitive dysfunction, nutritional deficiencies and exacerbation of concomitant chronic diseases. Some patients, regardless of the COVID-19 severity, have a long clinical course of the disease (“chronic-COVID”, “long COVID”). There is evidence of post-acute COVID-19 syndrome. In this regard, patients after COVID-19 will need rehabilitation measures. The expert consensus of the Russian communities presents general principles, stages and aspects of medical rehabilitation after COVID-19, indications and contraindications for rehabilitation interventions. The paper includes recommendations on comprehensive cardiac and pulmonary rehabilitation, as well as specifics of rehabilitation care for different COVID-19 courses within the national three-stage rehabilitation system.

There is currently no approved list of vascular cognitive impairment biomarkers. The main problem for the practitioner in identifying cognitive impairment in patients is the differential diagnosis of Alzheimer's disease, vascular cognitive impairment, and other diseases, which are much less common. Vascular cognitive impairment includes post-stroke dementia, cognitive dysfunction in cardio-and cerebrovascular diseases. Without etiology identification, it is impossible to prescribe adequate treatment. Another challenge is identifying cognitive impairment before dementia develops. This literature review is devoted to the search and critical analysis of candidates for biomarkers of vascular cognitive impairment and the establishment of markers of moderate cognitive dysfunction. The papers were searched for in the Web of Science and PubMed databases. A list of cerebrospinal fluid, plasma, serum and genetic biomarkers was made, allowing for differential diagnosis between vascular impairment and Alzheimer's disease. The markers of moderate cognitive dysfunction, which make it possible to identify cognitive impairment at the pre-dementia stage, were also identified.