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A novel coronavirus infection SARS-CoV-2 (COVID19) is especially dangerous for elderly and senile patients. Preventive measures for elderly people should cover three areas: 1) direct prevention of the viral infection, 2) preservation of the functional status and prevention of geriatric syndromes, including the use of social support measures, 3) control of comorbidities. The clinical pattern of COVID-19 in older patients may be atypical, while the mildness of symptoms (no fever, cough, shortness of breath) may not correspond to the severity of the prognosis. Delirium may be the first manifestation of COVID-19, which requires special care in its screening. Management of elderly and senile patients with COVID19 should include measures for delirium prevention, the detection and improvement of nutrition. The risk of malnutrition with sarcopenia increases with hospitalization of a patient, especially when using artificial ventilation, is associated with an unfavorable prognosis during hospitalization, accelerates the progression of senile asthenia and reduces the quality of life. Geriatric assessment is the cornerstone of determining the management of an elderly patient.

The predictive value of vascular biomarkers such as pulse wave velocity (PWV), central arterial pressure (CAP), and augmentation index (AIx), obtained through pulse wave analysis (PWA) in resting conditions, has been documented in a variety of patient groups and populations. There are appropriate recommendations on their clinical use in clinical practice guidelines of various scientific societies. Operator-independent methods are currently available for estimating vascular biomarkers also in ambulatory conditions. The acceptable accuracy and reproducibility of ambulatory PWA makes it be a promising tool for evaluating vascular biomarkers in daily-life conditions. This approach may provide an opportunity to further improve the early cardiovascular screening in subjects at risk. However, there is no sufficient evidence to support the routine clinical use of PWA in ambulatory conditions at the moment. In particular, long-term outcome studies are needed to show the predictive value of ambulatory PWV, CAP and AIx values.

The Task Force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology (ESC).

Castrate-resistant prostate cancer (CRPC) is one of the most complex and currently completely unsolved problems of oncourology. Possible novel treatment of CRPC is administration of Octreotide Long, long-acting somatostatin analogue. In this paper we have shown an experience of treatment with Octreotide Long 30 mg and dexamethasone in 69 CRPC patients from February 2014 to March 2016. We have assessed an efficacy and safety of the therapy. Age of patients ranged from 56 to 89 years, all patients had continued androgen deprivation. Response to the treatment was assessed clinically by the following factors: change in the level of prostate specific antigen (PSA) in serum, dynamics of indicators of general and biochemical blood tests, the level of pain syndrome and improvement in the patient’s quality of life. Total response to reduction and stabilization of PSA level was achieved in 70.9 % of patients. In general, the best results were observed in the group of patients treated with Octreotide Long before first-line chemotherapy with docetaxel. Tolerability of Octreotide Long in combination with dexamethasone in all cases was good. No significant side effects – neither hematological, nor clinical were noted. We also did not register any cases of drug discontinuation due to its intolerance.

Abiraterone acetate (ABI) is associated not only with a significant survival advantage in both chemotherapy-naive and -treated patients with metastatic castration-resistant prostate cancer (mCRPC), but also with a delay in time to development of Skeletal Related Events and in radiological skeletal progression. These bone benefits may be related to a direct effect on prostate cancer cells in bone or to a specific mechanism directed to bone microenvironment. To test this hypothesis we designed an in vitro study aimed to evaluate a potential direct effect of ABI on human primary osteoclasts/osteoblasts (OCLs/OBLs). We also assessed changes in bone turnover markers, serum carboxy-terminal collagen crosslinks (CTX) and alkaline phosphatase (ALP), in 49 mCRPC patients treated with ABI.Our results showed that non-cytotoxic doses of ABI have a statistically significant inhibitory effect on OCL differentiation and activity inducing a down-modulation of OCL marker genes TRAP, cathepsin K and metalloproteinase-9. Furthermore ABI promoted OBL differentiation and bone matrix deposition up-regulating OBL specific genes, ALP and osteocalcin. Finally, we observed a significant decrease of serum CTX values and an increase of ALP in ABI-treated patients.These findings suggest a novel biological mechanism of action of ABI consisting in a direct bone anabolic and anti-resorptive activity., info:eu-repo/semantics/published

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.

During the care of patients with novel coronavirus infection at the Lomonosov MSU Medical Research and Education Center from April 21 to June 13, 2020, we observed cases of spontaneous mediastinal emphysema (spontaneous pneumomediastinum) as a manifestation or a probable complication of COVID-19.The aim of the paper. To provide clinical case descriptions and approaches to the management of patients with spontaneous pneumomediastinum in COVID-19 associated pneumonia, as they are not addressed in the current clinical guidelines, and therefore are worthy of special attention.Among 224 patients with laboratory-confirmed diagnosis of the novel coronavirus infection COVID-19, five cases of pneumomediastinum without pneumothorax were identified. Of these, in two cases the pneumomediastinum developed during noninvasive lung ventilation (NLV) (one case) and invasive lung ventilation (one case). In three cases, spontaneous mediastinal emphysema was not associated with lung ventilation. By the time of publication, one case of pneumomediastinum was completed, and four patients remained hospitalized. All five patients were males aged from 52 to 84 years.This paper presents in depth the description of two cases of mediastinal and subcutaneous emphysema in patients with COVID-19.

Objective: to analyze the roles of undifferentiated connective tissue dysplasia (UCTD) in the development of cartilage and ligamentous apparatus diseases.Material and methods. This paper presents the results of analyzing the literature on fundamental and clinical studies of relationships between chondroitin sulfate (CS) and connective tissue (CT) disease. A total of 922 publications on the relationship between CT dysplasia and CS and 2249 publications on CS receptor molecules were analyzed. These arrays of publications were analyzed using topological and metric approaches to data analysis.Results and discussion. The genetic predisposition to UCTD is substantially aggravated by inadequate nutrition that leads to deficiency of certain micronutrients that support CT reconstructive processes. The paper presents the results of a systematic analysis of prospects for the use of drugs based on standardized CS substances in patients with UCTD. CS is a material for CT reconstruction. CS increases the activity of growth factors and reduces CT inflammatory destruction (inhibition of the secretion of histamine, pro-inflammatory chemokines, Toll-like receptors, and the NF-κB cascade through exposure to the CD44 receptor).Conclusion. The pharmacological effects of CS indicate the importance of using standardized CS forms in the treatment of patients with UCTD.

The paper is devoted to frontotemporal dementia (FTD), one of the most common forms of frontotemporal degeneration. The main symptoms of the disease include disinhibition, lack of empathy, obsessive-compulsive symptoms, apathy, cognitive impairment, appetite changes, and progressive changes in social behavior. In parallel, there are personality changes that are characterized by lower levels of self-awareness and by progressive psychological and social maladaptation of patients in society.The paper describes a clinical case of FTD in a female patient with marked behavioral changes and personality disorder. A 52-year-old woman was admitted to the alcoholism treatment department for alcohol intoxication and symptoms of mental confusion. According to her relatives, drinking too much alcohol every day, she was found to become rude, indifferent to others and her own duties, sharply limited the range of her activities and communication, and showed a decline in memory for current events. Psychopathological examination determined a distinct motivational-volitional decrease, the patient’s inability to mobilize mental activity, non-critical thinking, and indifference. X-ray diagnosis revealed the changes characteristic of frontotemporal neurodegeneration (atrophy of the frontal and temporal lobes prevails). The described case confirms that alcohol abuse can mask organic disorders that develop in systemic cerebral atrophy.

One of priority issues of the present-day healthcare system is development of new vaccines and improvement of existing ones due to decreasing immunocompetence of the population, emergence of new infections and reemergence of old ones which were previously thought to be under control. Adjuvants have proven to be integral and important components of modern vaccines, as they enhance immune response to the vaccine antigen. However, despite a lot of effort put into their development, only a small number of adjuvants are currently used in clinical practice.The aim of the study was to systematise literature data on the adjuvants’ mechanisms of action, their specific structure, composition, and stimulation effects that mediate their immunoadjuvant properties. The paper summarises data on adjuvants used as components in licensed vaccines, describes their characteristics, analyses molecular mechanisms of their action in order to establish correlation between their structure and activity, which is important for the development of more efficacious and safe adjuvants. The paper cites advanced developments aimed at enhancing stimulation effects of existing adjuvants. It concludes by stating that the key research area aimed at improving vaccination efficacy is the study of mechanisms that contribute to the development of effective protection against infectious agents, as well as analysis of how to use adjuvants to stimulate the body’s defensive mechanisms, primarily by impacting the innate immunity.

Chronic pain (CP) is still one of the urgent problems of modern medicine. The paper provides a review of the main pharmacotherapeutic approaches from the standpoint of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) guidelines. When preparing this material, the authors have analyzed the publications available in the resources: PubMed, EMBASE, Cochrane, and еLIBRARY. The paper presents the main pathogenetic mechanisms of pain syndrome development in osteoarthritis (OA), including synovial inflammation and associated immune disorders. It considers the types of development of pain syndrome and the main prognostic outcomes according the mechanism of pain, providing a rationale for the use of nonsteroidal anti-inflammatory drugs (NSAIDs) and/or chondroprotectors (CPs). In accordance with the ESCEO guidelines, it is noted that when starting OA therapy, CPs should be considered as the first step (in their long-term prescription and pharmaceutical quality), then NSAIDs should be added (topically), then (if ineffective) orally, by excluding patients with hip OA. It is known that the intramuscular administration of CPs (chondroitin sulfate (CS) in particular) can increase their bioavailability. The use of glucosamine sulfate (GS) is recommended for patients over 60 years of age. According to the recommendations of the 2019 ESCEO experts, CS and GS should be used as a disease-modifying OA drug from the first step and at all subsequent stages.

Herbal medicines make up a large part of all medicinal products in the Russian market. Complex combinations of biologically active substances that are used as components in herbal medicines not only determine their therapeutic efficacy, but can also cause adverse reactions. The aim of this review was to analyse data on adverse effects of herbal medicines, and reasons and mechanisms behind their development. Special attention should be given to hepatotoxic and nephrotoxic effects of biologically active substances that are used as components in herbal medicines, because liver and kidney failure may lead to life-threatening conditions. The paper addresses hepatic adverse effects, including sinusoidal obstruction syndrome, caused by toxic biologically active substances of the pyrrolizidine alkaloids group. The paper summarises data on herbal medicines and toxic biologically active substances causing acute kidney injury and chronic kidney disease. It analyses potential clinically significant interactions that may occur during co-use of herbal and other types of medicines due to their pharmacokinetic and pharmacodynamic interactions. Further research involving collection, systematisation, and analysis of adverse effects of herbal medicines used alone or in combination with other medicinal products is needed to improve the safety of pharmacotherapy.

The paper presents the current etiopathogenetic classification of chronic cerebrovascular diseases (CVD) and discusses the role of hypertension, cerebral amyloid angiopathy, and genetically determined syndromes in the development of this pathological condition. It gives recommendations for the neuroradiological diagnosis of chronic CVD in accordance with the international standards. The paper discusses the clinical manifestations of chronic CVD, primarily vascular cognitive impairment. It discusses international guidelines for the examination and treatment of patients with chronic CVD, as well as the rules for stroke prevention in this patient cohort. The possibilities of pathogenetically based therapy in decreasing the severity of vascular cognitive impairment in the presence of chronic CVD are also highlighted.

The paper deals with the actual problem of managing patients with drug-induced headache (DIH) in patients with primary headaches. It describes a clinical case of extremely severe DIH in a patient with chronic tension headache (TH). The paper analyzes the typical and atypical manifestations of DIH and discusses the role of prolonged stress in the development of TH. Special attention is paid to the problems with therapy and compliance during a long-term follow-up of the patient. Based on the clinical features of pain syndrome in the described patient, the authors suggest for the first time that the use of extremely high number of daily doses of combined narcotic analgesics for many years can result in recurrent DIH statuses. The paper discusses whether it is expedient to introduce the concept “DIH severity” and whether an additional clinical parameter “the number of doses of painkillers per month” can be of informative value, which has not been proposed yet in the literature. All the issues given in the paper are conjectural and are raised by the authors for further investigation of the DIH problem.

The article provides an overview of the most influential papers on the topic of “male infertility”. The selection criteria were the practical significance of the article and the impact factor of the journal in which it was published, according to SCImago Journal Rank (SJR). As a result, we created the list of 10 papers published in the I quarter (January – March) of 2020. The review included articles on the following issues: the effectiveness and safety of antioxidants, zinc and folic acid in the treatment of male infertility; the effect of obesity on sperm DNA-fragmentation; the possibility of obtaining of spermatogonia in children and adolescents with Kleinfelter syndrome; comparison of intracytoplasmic sperm injection (ICSI) and intracytoplasmic morphologically selected spermatozoa injection (IMSI); the reaction of the female reproductive system to the seminal fluid; viral profile in seminal fluid of men receiving the antiretroviral therapy, the effect of sleep duration on fertility and the risk of diabetes mellitus in children, conceived using assisted reproductive technologies.

This paper highlights published hypotheses on the possibility of coronavirus SARS-CoV-2 entry into the bloodstream, its interaction with vascular endothelium, red blood cells, hemoglobin and its fragments. As a result of such interaction, iron ions may be released into the bloodstream and, subsequently, a cytokine storm may occur. In this context, it is important to find a cytoprotective agent capable of blocking such processes. The perfluorocarbon emulsion could be a candidate for this role.The aim of the paper is to show the feasibility of biophysical methods to study the molecular mechanisms of action of SARS-CoV-2 on human red blood cells and hemoglobin as well as the restorative and cytoprotective effect of the perfluorocarbon emulsion during Fe2+ oxidation in heme.Materials and methods. High resolution spectroscopy, atomic force microscopy, atomic force spectroscopy, electroporation were used. Blood was exposed to oxidizing agents of different nature. Perfluorocarbon emulsion was added in various concentrations and its effect at various incubation times was studied. Concentration of hemoglobin derivatives was calculated considering multicollinearity, and statistical analysis of the results was performed.Results. The perfluorocarbon emulsion was shown to have an effective restorative and cytoprotective action in iron ion oxidation in the heme: Fe3+ was restored to Fe2+. The degree of MetHb reduction to HbO2 and Hb depended on the concentration of the oxidizing agent and incubation time. We observed a change in MetHb content from 80-90% to 5-12%. The perfluorocarbon emulsion in clinical concentrations helped eliminate local membrane defects and restored normal erythrocyte morphology.Conclusion. In the light of the studied hypotheses, the use of perfluorocarbon emulsion can become an effective method for blocking the consequences of coronavirus effect on the blood cells and restoring a normal gas exchange.

Accumulation of knowledge on Crohn’s disease, and development of biological products intended for the treatment of its underlying cause formed the basis for the development of objective methods for assessing the intensity of the pathological process, which in turn affected scientific approaches to the planning of clinical trials in this field. To date, many international recommendations related to planning, conduct of clinical trials, and analysis of their results, have been updated. Considerable experience has been gained with clinical trials of medicines intended for the treatment of Crohn’s disease. Therefore, the methodological approach to the planning of pivotal clinical studies needs to be reviewed. The aim of the study was to develop requirements for planning and expert evaluation of clinical trials conducted with the aim of obtaining marketing authorisation for medicinal products for the treatment of Crohn’s disease. The paper analyses regulations, recommendations, and scientific literature on the treatment of Crohn’s disease and describes the methodology for planning clinical trials. It describes the evolution of approaches to clinical research planning since biological medicines appeared. The authors substantiate the need for an integrated concept of clinical research, which covers goals, estimated therapeutic effect, design, and choice of the statistical analysis method. They also provide scientific arguments in favour of a combined primary endpoint including endoscopic remission and the assessment of treatment results by the patient. The paper lists patient eligibility criteria in terms of “inducing and/or maintaining remission of the disease”. The authors analyse the main intercurrent events, their influence on the therapeutic effect, and propose approaches to the planning of endpoints, including assessment of intercurrent events. The paper highlights the fact that the principles of planning and conducting Phase III clinical trials need to be consistent with the evidence-based strategies of reducing the risk of incorrect assessment of efficacy and safety of new medicines, and that the obtained results have to meet the requirements of the regulatory authorities at the stage of marketing authorisation.

The paper discusses specific features of acute respiratory infections (ARI) progression in patients with comorbidity. The relevance of this study is accounted for by severe progression of ARIs in this group of patients, as well as by specific considerations of combining causal treatment of infections with life-long treatment of chronic diseases.The aim of the study was to use a clinical case to substantiate an optimal treatment strategy for influenza and associated complications in a comorbid patient.Results: the analysis of the clinical case showed that an unfavourable course of ARI in the patient was due to the lack of timely antiviral therapy, adverse effects of paracetamol during statin therapy, exposure to pneumonia pathogen degradation products, general intoxication, and immune response. The compromised medical history contributed to the development of severe complications. The paper proposes a strategy for selecting the most eff ective and safe approach to the treatment of ARIs in a comorbid patient.Conclusions: ARIs in patients with chronic diseases entail increased risks of complications that may arise both due to specific characteristics of the infection and unfavourable combination of drugs. Treatment regimens for infl uenza and other ARIs in comorbid patients should be eff ective and timely. Early antiviral treatment is especially important in patients with comorbidity. When choosing a treatment regimen, it is necessary to assess potential benefi ts of pharmacotherapy as well as associated risks, including those related to previously prescribed medicines.

The paper provides a review of the data available in the literature on the relationship of pain to the risk of OA progression. Network analyses and numerous studies, including those conducted at the V.A. Nasonova Research Institute of Rheumatology, have confirmed that pain syndrome is one of the significant predictors of knee OA progression. The major class of medications for OA pain includes nonsteroidal anti-inflammatory drugs. The paper gives data on the efficacy of meloxicam in OA patients, which is widely used in both Russia and other countries of the world. Meloxicam is characterized by a good safety profile in the gastrointestinal tract, cardiovascular and renal systems. It is the drug of choice in patients with musculoskeletal diseases, in particular OA. Good results in severe pain syndrome have been shown by a step-by-step regimen of meloxicam when the injection formulation of the drug is used in the first days of treatment, and then, to consolidate what has been gained from therapy, its oral dosage form is administered in terms of concomitant diseases.

The paper reviews Russian and foreign literature on atypical depression (AtD). It sets forth the historical aspects of identifying AtD among other depressive disorders: the authors have traced the path from depression with individual atypical manifestations to a syndrome with a clearly defined pattern and inclusion criteria in the international DSM-4 and DSM-5 classifications. The paper gives epidemiological indicators and shows their diversity due to various approaches to the determination and clinical assessment of AtD. It analyzes the results of studying AtD in the presence of various affective disorders, such as recurrent depressive disorder, bipolar affective disorder, and psychogenic depression, and notes their heterogeneity in both symptoms and genesis. The authors present approaches to treating AtD and the results of investigating drug (antidepressant) and non-drug (cognitive-behavioral psychotherapy, increased physical activity therapy) treatments.

The paper systematizes the history of studying the neurochemical activity of mianserin and mirtazapine. The concept of the development of the antidepressant effect of these drugs, by stimulating the release of norepinephrine into the synaptic cleft, is shown to have gained unanimously acceptance. The data on manifestation of their thymoleptic effect due to stimulation of the release of serotonin into the synaptic cleft have been disputed. Other neurochemical theories of the development of the antidepressant activity of mianserin and mirtazapine have been unproven or rejected. The history of identifying the position of mianserin and mirtazapine in the classification of antidepressants has been generalized. The paper shows the ambiguity of approaches to this issue. As turned out, the legality of using the term «noradrenalinergic and specific serotonergic antidepressant» has been criticized. Analysis of historical facts has identified that it is rational to assign mianserin and mirtazapine to one neurochemical group and its designation by the term «norepinephrine and (presumably) serotonin release stimulators – α 2 -adrenergic receptor and serotonin 5-HT2 receptor blockers».

The review is devoted to specific aspects of the development of post-vaccination immunity following immunisation with different types of antiviral vaccines, as well as to ways of increasing immunogenicity of vaccines and effectiveness of preventive vaccination. Vaccines containing highly purified and recombinant antigens obtained using modern technologies have lower reactogenicity and a higher safety profile, but are less immunogenic compared to live vaccines. Effective vaccines have not been developed for many viral infections yet. Therefore, it is critical to search for ways to enhance immunogenic properties of vaccines in order to increase the efficiency of vaccination, and to develop new vaccine formulations that provide reliable protection of the body against infection. The aim of the paper was to analyse specific aspects of immune response development following immunisation with antiviral vaccines, and approaches to increasing their immunogenicity using adjuvants. It reviews different types of antiviral vaccines, as well as specific aspects of immune response development depending on the nature of a specific antigen. The paper substantiates the use of adjuvants to enhance and regulate the induced immune response. It analyses mechanisms that determine the stimulating effect of adjuvants and summarises data on the adjuvants used in the licensed vaccines for human use. The authors highlight the need for further research to increase the efficiency of vaccination and suggest that one of potential solutions is the use of adjuvants based on recombinant human cytokines.

The paper presents data on the coronavirus disease COVID-2019 caused by the SARS-CoV-2 coronavirus, which was temporarily named 2019-nCoV (2019 novel coronavirus) until 11 February 2020. An outbreak of pneumonia of unknown etiology in Wuhan ( Hubei province of China ) which was first described in an official publication of the Chinese Office of the World Health Organization on December 31, 2019, attracted attention of both dedicated experts and the entire international community. On January 30, 2019 it was recognised as a public health emergency of international concern. The first cases were reported on December 12, 2019 in China, and on January 31, 2020 Russia reported its first two cases of the infection in two Chinese citizens staying in Russia. The causative agent is the new SARS-CoV-2 coronavirus. It had not been detected before, and was first identified by Chinese researchers on January 7, 2020 under the temporary name 2019-nCoV. The aim of the study was to summarise information about coronavirus disease COVID-2019 beginning from the onset of the epidemic until early March 2020. The paper provides general information about coronaviruses, developments of the COVID-2019 epidemic caused by the SARS-CoV-2 coronavirus, and gives an assessment of the global epidemiological situation. It cites the recommendations of national regulatory authorities and the World Health Organization on the treatment of various forms of coronavirus infection and septic shock caused by SARS-CoV-2, including target values of systemic hemodynamics, a list of recommended medicines, methods of their use, and limitations of pharmacotherapy.

Pulmonary artery thromboembolia (PATE) is not a clinical entity as such, but a complication of different diseases and conditions leading to deep thrombosis in the low tension circulation system, right cardiac chambers or causing local thrombosis in the pulmonary artery system. PATE is characterized by complex pathogenesis of respiratory failure of varying severity, which makes it difficult to choose a respiratory support technique.Purpose of the overview: to show advantages of different respiratory support techniques and prospects of high-flux oxygen therapy with regard to PATE pathophysiology.82 sources were selected based on the principle of combining clinical and experimental data from papers published over the recent 5 years and earlier that are still relevant for medical practice.The overview presents the structure of main causes and prevalence of PATE and considers thrombogenesis stages and predominant manifestations of respiratory failure during PATE occurring due to inconsistency between pulmonary ventilation and perfusion. Review discusses five methods of respiratory therapy in PATE patients: low-flux and high-flux oxygen therapy, non-invasive and invasive artificial lung ventilation, extracorporeal blood oxygenation. Finally, the paper shows the efficacy and limitations of these methods.Conclusion. High-flux oxygen therapy seems to be the most effective and promising technique in PATE patients thanks to absence of adverse cardiohemodynamic consequences, subjective comfort for patients, and relation to minimal risks of secondary infectious complications.Nevertheless, the clinical experience accumulated is insufficient to make an absolute choice of one particular technique for respiratory support during PATE. It is necessary to continue investigating the clinical efficacy of high-flux oxygen therapy in the specific population of patients who experienced PATE.

One of the major obstacles to effective translational medicine is the challenge of translating animal research results into clinical studies. Scientific literature mainly addresses the selection of the drug dose at initiation of clinical trials (Phase 1). Appropriate selection of doses is also essential for preclinical toxicology and pharmacology studies. Some basic principles that are used when translating dosages from animal models to humans are applicable to selection and justification of doses when planning and conducting preclinical studies. The paper provides an overview of the main methods that can be used for selection and justification of animal doses in preclinical studies, e.g. cross-species dose conversion using body surface area scaling. It summarises situations when doses may be directly converted based on body weight. The paper gives special attention to cross-species dose translation according to pharmacokinetic data. There is no one-size-fits-all approach to cross-species translation; dose conversion must be scientifically justified taking into consideration all information available on the test drug, i.e. its chemical structure, intended route of administration, pharmacokinetic parameters, preclinical and clinical data on pharmacodynamics, and inter-species differences in pharmacokinetics and pharmacodynamics.

Cancer remains one of the leading causes of death. Conventional treatment methods, including radiation and chemotherapy, have limited effectiveness. Therefore, the development of novel approaches to cancer treatment is an urgent challenge. Biomedical cell products (BMCPs) which include adoptive cell therapy (ACT) and dendritic cells vaccines (DCVs) are considered a promising area of research. The aim of the study was to review current ideas about the principles of BMCP therapy, as well as clinical experience with cell-based products used for cancer treatment. The paper summarises the results of clinical use of tumor-infiltrating lymphocytes (TIL-therapy), genetically modified T-cells that express tumour antigen-specific receptors (TCR/CAR T-therapy), as well as DCVs. The use of human immune cells genetically modified ex vivo is a novel and promising approach to cancer treatment. The main analysed ACT approaches which are based on the use of genetically modified T-lymphocytes have some benefits and drawbacks. The paper discusses the methods of BMCP production, provides data on the effectiveness of ACT and DCVs. It pays special attention to safety concerns associated with each treatment method, as well as to other factors limiting their clinical use. It is expected that the main areas of further research will be aimed at increasing BMCP efficacy and reducing adverse reactions.

The aim of this research was to study the most important problems in diagnosing a socially significant problem - osteochondrosis of the cervical spine. According to some authors, in the structure of disability and disability associated with pathology of the spine, diseases of the cervical spine occupy one of the leading positions. The paper analyzes data from 41 sources of literature on the pathogenesis and diagnosis of osteochondrosis of the cervical spine. Due to the complexity and ambiguity of the approaches to the diagnosis of osteochondrosis of the cervical spine, this paper analyzes the most important research methods in the diagnosis of this pathology. Attention is focused on the main pathogenetic prerequisites for the occurrence of pain. According to literature data, the main attention in the diagnosis of osteochondrosis of the cervical spine is given to the basic methods: clinical and neurological examination, where the severity of the disorders is determined using scales that include not only an assessment of the intensity of the pain syndrome, but also the determination of a number of neurological disorders. The authors propose the use of a DN4 questionnaire, LANSS scales, neurological impairment scales (N1S); radiation research methods, such as survey spondylography of the cervical spine in direct and lateral projections, functional spondylography of the cervical spine in the position of maximum flexion and extension, multispiral computed tomography, magnetic resonance imaging data, and neurophysiological studies. Radiation research methods can determine pathological changes in the bone tissue itself. Magnetic resonance imaging indices make it possible to assess the degree of pathological changes in the soft tissue anatomical structures of the spinal canal and intervertebral discs. According to the literature, much attention is paid to functional research methods, in particular, electroneuromyography, which allows to assess the level and degree of damage to nerve fiber, the dynamics of the pathological process. Attention is paid to the allocation of marker indicators. All methods are significant, evidence-based, objective and modern and do not exclude the possibility of using data from other research methods. The analysis of the presented literature once again convinces clinicians of the ambiguity and heterogeneity of approaches to the issues of pathogenesis and diagnosis of the cervical spine, which requires further improvement of the proposed methods for clarifying and objectifying the pathological process. An important andjustified is a pathogeneti-cally grounded approach to their study.

Epilepsy affects more than 70 million people worldwide. From 30 to 40% of the patients are resistant to existing medication. This paper describes the current state of the treatment of epilepsy and proposes a future approach to preventative treatment at earlier stages of epileptogenesis. For preventative treatment biomarkers are needed that predict the development of epilepsy at its earlier stages. Pathological high frequency oscillations are the only acceptable biomarker of epileptogenesis. However, the main limitation of this biomarker is the necessity of implanting of recording electrodes. The search for noninvasive biomarkers of epileptogenesis is one of the hot topics in epilepsy research. There are two potentially interesting directions in this area: search for inflammatory biomarkers in the peripheral blood and analysis of different parameters of imaging methods. In this paper we present approaches for identification of potential epileptogenesis biomarkers by magnetic resonance imaging. Some of magnetic resonance imaging parameters correlate with the existence of pathological high frequency oscillations, may indirectly reflect ongoing inflammation process in the brain and be potential biomarkers of epileptogenesis.

The widespread use of statins in clinical practice necessitates a systematic approach to the risk and safety assessment. The aim of the study was to analyze information about adverse reactions to statins and their specific causes in patients with hypercholesterolemia accompanied by diabetes and hypothyroidism. The paper compares statin products (simvastatin, atorvastatin, pravastatin, rosuvastatin, and fluvastatin) in terms of the frequency of the most significant adverse reactions—statin-induced myopathy, liver damage, secondary hyperglycemia. It dis­cusses specific causes of adverse reactions to statins in patients with hypothyroidism and dia­betes. It was demonstrated that the use of statins in patients with compensated hypothyroid­ism, who have CC and TC allelic variants of the SLCO1B1*5 gene ( c.521T>C ), is associated with a higher risk of developing statin-induced myopathies. The adjustment of statin doses, especially in patients with hypothyroidism and diabetes, should be made based on the results of pharmaco­genetic testing for SLCO1B1*5 ( c.521T>C ) allelic variants. The results of dynamic clinical and laboratory control of the hepatic transaminase level, as well as the levels of glucose, glycated hemoglobin, and thyroid-stimulating hormone should be the key factors to be taken into account when adjusting treatment plans in this group of patients. The paper analyses polymorphisms of genes which are associated with resistance to statin therapy in patients with diabetes. Thus, the use of statins for primary prevention and treatment of cardiovascular diseases in patients with hypercholesterolemia accompanied by diabetes and/or hypothyroidism, requires a comprehen­sive assessment of the risk/benefit ratio.

Using the study of cognitive functioning in patients with cardiovascular diseases paper discusses problems of changes in brain activity in patients with somatic diseases related to a main pathology and resulting from surgical treatment. Analysis of the current state of research in this area provided. Based on this analysis, promising areas for further research, such as development of methods for predicting an occurrence and development of cognitive impairment, organization of timely diagnosis of changes in cognitive activity, development of preventive and therapeutic measures, exploring the value of cognitive functioning for treatment adherence. In addition, paper discusses the methodological approaches and main organizational aspects of conducting such studies and indicates the most relevant methods for studying cognitive functioning in a cardiac surgery clinic.

The paper is devoted to the safe use of hormonal contraception in women with migraine, an urgent interdisciplinary problem daily faced by gynecologists, neurologists, and specialists in headache diagnosis and treatment. It gives information on the prevalence of migraine, the risk of ischemic stroke and other cardiovascular disorders in women with different types of migraine, including those receiving contraception and hormone replacement therapy. The paper presents the main provisions of the new interdisciplinary consensus «Hormonal contraceptives and the risk of ischemic stroke in women who have migraine», which are recommended to be taken into account by specialists of any profile when prescribing hormonal therapy to women with migraine in order to avoid cardiovascular events.

The problem of alcohol abuse and its social and medical consequences has remained relevant for many years. Damage to the nervous system is one of the most common manifestations of alcoholic disease. The effect of ethanol and its metabolites results in damage to all parts of the nervous system and skeletal muscles. The paper provides a brief overview of Russian and foreign literature on the neurological manifestations of chronic alcohol intoxication. It considers modern ideas about the pathogenesis of alcoholic neuropathy (APN). It also discusses differences in the clinical presentation, course, and developmental mechanisms of the main (chronic toxic and acute/subacute) forms of APN associated with thiamine deficiency. The paper notes difficulties in diagnosing peripheral nerve damage, especially in the early stages of the disease and describes modern methods for objectifying damage to thin nerve fibers in chronic APN. It presents approaches to treating alcohol-induced damage to the peripheral nervous system, by taking into account the leading mechanisms of pathogenesis. Special attention is paid to B-complex vitamins and alpha-lipoic acid preparations frequently used in this disease, to the mechanisms of their therapeutic action, and to the evaluation of their efficacy in APN.

Nonsuicidal self-injuries (autotomy, self-inflicted destruction, self-mutilation) is a variant of autoaggression in a patient without the intent to take his/her own life. Patients with the consequences of self-injuries receive help from physicians of various specialties, who often cannot determine their motivation for autoaggressive actions, since it is associated with mental disorders. The paper presents data on phenomenology, some classifications and motivation of nonsuicidal self-injuries. Various mental disorders are noted to be the most common cause of autoaggressive behavior. The paper describes a clinical case of a female patient who has mutilated her face for a long time, hiding the cause of her autoaggressive action. A detailed clinical and psychopathological analysis of her medical history and mental status allowed for classifying hypochondriacal delirium within schizophrenia as a cause of self-mutilating actions. The motivation for this behavior was to fight against a pseudotumor, for which the patient suffered pain and prolonged suppurative processes on the skin of the face, without visiting physicians.

Modern food culture and ecological environment lead to metabolic failures. Cardiovascular and digestive diseases, as well as obesity and diabetes, are becoming younger and younger. The present research featured the development of medical science by promoting the scientific platform of ‘preventive environment’. The priority of the platform is to assess the impact of individual bioactive nutrients on morbidity. The paper starts with a brief overview of the main directions in dietetics. Imbalanced nutrition leads to metabolic syndrome, which results in weight gain and cardiovascular diseases. Scientists associate metabolic disorders with hereditary predisposition, i.e. the presence of polymorphism of certain genes, and with the effect of environment and diet. Modern science knows few medical options for obesity treatment, which means that both pharmaceutical and nutraceutical methods of weight-reducing treatment remain understudied. Functional foods with a modified carbohydrate profile can improve the chemical composition of the diet. The study involved ranking of dairy products according to the obesity risk. The paper describes the effect of various biologically active substances of plant origin on metabolism of an obesity-affected organism. Thypakoids were found to affect satiety and fullness of the gastrointestinal tract through hormones of appetite. They also affect the microbial composition of the gastrointestinal tract without causing side effects, such as steatorrhea. The research results indicate that thylakoids are a new means of natural origin for the prevention and treatment of obesity. A single dose of black tea containing flavonoids was found to reduce peripheral blood flow in the upper and lower extremities after glucose loading, which was accompanied by a lower reaction to insulin. A mixture of curcumin and piperine can increase fat loss and suppress inflammation caused by high fat content. The paper also features the phenomenon of oxidative stress: antioxidant ingredients, such as vitamins, trace elements, and minor biologically active components are mandatory for a balanced diet. The analysis of scientific data made it possible to create a formula for a preventive product – an oat milk with a modified carbohydrate composition and various fruit, berry, and vegetable fillers.

In the 1960s, following the Thalidomide Disaster, the World Health Organization (WHO) initiated the development of an international drug safety monitoring programme. The objectives of this WHO programme are to improve the quality and safety of pharmaceuticals, and to support public health programmes by providing information for effective assessment of the risk-benefit ratio of medicinal products. The paper outlines the main focus areas of the programme and the mechanism of interaction between the countries involved. It summarises the functions of the WHO Collaborating Centre for International Drug Monitoring located in Uppsala, namely, accumulation and assessment of data on efficacy, inefficacy and risks of medicinal products, which are communicated by the participating countries, and provision of reliable and coherent data to specialists. The paper provides a review of online resources and methods used by VigiBase — global database of adverse drug reactions — that make it possible to search and analyse the data statistically. It describes the functions of the national monitoring centres located in different regions, and their interaction with the WHO. The dissemination of objective and reliable medical information throughout the world, promotion of pharmacovigilance as a science, creation of international partnerships and pooling of expertise from different countries allow for a significant improvement in the safety of pharmacotherapy.

Spontaneous preterm birth is one of the most pressing issues in obstetrics, as it remains one of the leading causes of newborn morbidity and mortality. Pending issues of aetiology, pathogenesis, and absence of medicinal products indicated for the treatment of spontaneous preterm labour pose a challenge for rational pharmacotherapy. The paper presents the results of a scientific literature review on the problem of rational pharmacotherapy of spontaneous preterm labour using tocolytic drugs — calcium channel blockers, cyclooxygenase inhibitors. The paper summarises specific pharmacokinetic parameters of these drugs during pregnancy. It discusses pharmacogenetic aspects of using tocolytic drugs in pregnant women and their potential clinical effects. It was demonstrated that women with threatened miscarriage had high interindividual variability in nifedipine plasma concentrations depending onCYP3A5genotype. It was shown that certain genetic polymorphisms ofCYP2C9may lead to an increased metabolic rate and an increase in indomethacin clearance resulting in the reduction of its efficacy. Yet, there is minimal research regarding this issue. Therefore, further research is needed to assess the impact ofCYP3A5andCYP2C9genotypes on the efficacy and safety of nifedipine and indomethacin used as tocolytic drugs in obstetrics.

O.I.Letyaeva, O.R.Ziganshin South Ural State Medical University, Chelyabinsk, Russian Federation This paper discusses one of the important gynecological issues, inflammatory diseases of the urogenital tract caused by opportunistic microbes. The treatment and long-term control over these conditions are challenging and depend on their occurrence and high risk of complications. Impaired local anti-infectious protection is one of the risk factors of chronic inflammation. Since the disease may recur even after successful treatment, domestic and foreign authors increasingly focus on immunotherapy as a part of complex strategy and isolated entity. Local immunotherapy may prevent recurrences and activate host defense. This paper describes the management of two women with mixed infections. The first woman with chronic recurrent inflammation (cervicitis caused by U. urealyticum, vulvovaginal candidiasis, and aerobic vaginitis) in whom prior etiological therapy was ineffective received immunotherapy which resulted in long-term remission. The second woman with coexistent papillomavirus infection (genital warts) and bacterial vaginosis received immunotherapy and topical etiological treatment. As a result, clinical symptoms, the size and number of genital warts reduced which greatly facilitated their chemical destruction. Keywords: genital tract, urogenital infections, papillomavirus infection, bacterial vaginosis, local immunity, biofilms. For citation: Letyaeva O.I., Ziganshin O.R. Pathogenic treatment of the inflammatory diseases of the urogenital tract in women of reproductive age. Russian Journal of Woman and Child Health. 2021;4(1):59–64. DOI: 10.32364/2618-8430-2021-4-1-59-64.

The paper describes a clinical case of the rare status epilepticus syndrome FIRES (febrile infection responsive encephalopathy) + NORSE (new-onset refractory status epilepticus). The difficulty of diagnosing this condition is due to the fact that it occurs extremely rarely and the laboratory and instrumental findings are nonspecific. The disease is characterized by acute onset, fever, and subsequent development of status epilepticus, cognitive impairment, and pharmacotherapy-resistant epilepsy. The paper describes a 19-year-old male patient who was observed to have a favorable course of FIRES + NORSE syndrome without pharmacotherapy-resistant epilepsy, motor deficiency, and with the preservation of self-care skills.

The need to strengthen the post-approval regulation of biological products stems from their increasing role in the treatment of serious human diseases. Until recently, there were open questions on the classification of changes and supporting data necessary to confirm the comparability of a biological medicinal product before and after any changes, as well as on the procedures and deadlines for the submission and approval of variations. In October 2017 the WHO Expert Committee on Biological Standardisation developed and published the «Guidelines on procedures and data requirements for changes to approved biotherapeutic products». The WHO recommendations are primarily aimed at resolving the complexities and current problems in the global life cycle management of biotherapeutic products. Guidelines suggest approaches that ensure continued quality, efficacy, and safety of this group of products, as well as continuity in supply and access. The purpose of this paper was to analyse the WHO recommendations on post-approval changes to biotherapeutic products in order to develop harmonised approaches to the assessment of post-approval changes to biological medicinal products in the Russian Federation. The categories of quality changes, supporting data, conditions to be fulfilled, procedures and deadlines set forth in this paper can serve as a basis for further improvement of the national regulatory and methodological framework.

In order to expand the range of balanced, high-quality, and safe dairy products, constant work is required to create new technologies, control the quality, as well as to develop new methods for the identification of plant additives. The paper presents some results of the development and quality assessment of cottage cheese mousse with pumpkin puree using physicochemical methods and molecular genetic analysis. An analysis of organoleptic and physicochemical methods revealed that the quality and safety of Adagio pumpkin (S. rero.) corresponds with the State Standard 7975-2013 and Sanitary Regulations 2.3.2.1078-01. The authors introduce a new method for pumpkin puree production. An experiment demonstrated that pumpkin puree meets organoleptic and physico-chemical indicators stated in the requirements of State Standard 32742-2014. The composition of biologically active nutrients was determined as follows: the content of pectin substances was 2.27 g/100 g, fiber – 1.5 g/100 g, and β-carotene – 2.97 mg/100 g. The paper describes a scientifically-based formula and a new technology for the production of a high nutritional value product, i.e. curd mousse with pumpkin puree. The research also included a quality and safety assessment of the developed mousse. A molecular genetic analysis was used to identify pumpkin in the semi-finished product and dairy product. Based on the GenBank NCBI database, the matK chloroplast genome gene was chosen as the target gene. With the help of various software packages based on the matK gene, universal primers were developed and designed. Optimal parameters for amplifying fragments of species-specific pumpkin DNA were defined experimentally. Electrophoregrams were made to visualize the presence of pumpkin in the puree and cottage cheese mousse. As a result, the classical polimerase chaim reaction (PCR) method was recommended to identify pumpkin in food products with the determination of amplification products in agarose gel using primers developed on the basis of the matK gene of the chloroplast genome.

The paper considers insulin’s specific action on the patient’s body, types of insulin preparations and insulin analogues which are used for the treatment of diabetes, as well as applicable requirements for these products. It was demonstrated that determination of biological activity is one of the key quality parameters of this type of medicines. The paper summarises the methods used for evaluation of insulin and its analogues, which are based both on the hormone’s general action on the body (in vivo: double crossing, euglycemic clamp, etc.), and on certain aspects of the hormone’s interaction with the body systems (in vitro: receptor-binding assay, phosphorylation, metabolic methods). Due to the appearance of insulin biosimilars on the pharmaceutical market, the article raises the issue that the «Biological potency» parameter tested in animals should be kept as part of the product specification. The analysis of the in vivo and in vitro methods of biological activity determination convincingly demonstrates that animal models can not be replaced with the modern analytical methods based on cell cultures. Consequently, animal models are still necessary, as they allow for an adequate assessment of the quality of insulins in terms of «Biological potency». Taking into account the global trend towards reduction of animal testing, the authors point out the need to develop modern methods, the results of which will be comparable to the results of in vivo determination of the biological activity.

For the first time, the paper presents in detail the prevalence of osteoarthritis (OA) and considers the predictors of disease development and progression. The clinical classification of OA and its place in the ICD-10 are described. The clinical presentation of the disease is characterized in detail according to the localization of the process. It is noted that there is a change in the understanding of OA as a classic model of nociceptive pain. The paper depicts clinical, laboratory, and instrumental methods for diagnosing the disease, as well as classification and diagnostic criteria; much attention is paid to the current principles of OA therapy according to the Russian clinical recommendations and the guidelines of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the European League Against Rheumatism (EULAR).

The paper reviews of the data available in the literature on the clinical efficacy and safety of tofacitinib (TOFA) in the treatment of psoriatic arthritis (PsA). It considers the mechanism of action of TOFA, which is mainly in the selective inhibition of signal transmission due to its effect on the activity of JAK3 and/or JAK1, the enzymes that ensure the function of turning on and turning off the signals transmitted by cytokines. TOFA is noted to directly or indirectly act on a wide range of a number of molecules that play an important role in the pathogenesis of PsA.The paper analyzes the current data on the clinical efficacy of TOFA in treating PsA, which have been obtained in the 12-month OPAL Broaden study including patients with PsA and an inadequate response to synthetic disease-modifying anti-rheumatic drugs and in the 6-month OPAL Beyond study enrolling those with PsA and an inadequate response to tumor necrosis factor-α (TNF-α) inhibitors. It is noted that the results of these studies confirmed the efficacy of the drug in treating PsA not only according to the data of objective (medical) monitoring, but also to the subjective characteristics of pain, to the global assessment of disease activity, fatigue, as well as the mental and physical components of the SF-36 quality of life questionnaire.It is concluded that the current findings allow JAK inhibitors to be recommended as a new pathogenetically sound approach to treating PsA and suggest that TOFA has benefits in managing patients unresponsive to therapy with TNF-α inhibitors.

Fracture and migration of metal implants is a well-known issue which is especially relevant for actively loaded zones with a high amplitude of physiological movements. The authors analyzed 17 publications dedicated to Kirschner wire migration into the spinal canal after fixation of acromioclavicular joint (ACJ) injury. The present paper contains literature review and own clinical case of the authors. The authors generalize the conceptions of migration causes, surgical tactics and prevention recommendations. The key reason of fracture and migration of Kirschner wires during fixation of ACJ injury is the instability of implants, trans-articular wire insertion during fixation of reduced dislocation of acromial end of the clavicle, insufficient immobilization and untimely implants removal after removal of immobilization. Implants migration into the spinal canal is the indication for their surgical removal irrespective of clinical signs. In the majority of studied publications authors described posterior approach or lateral approach aligned with the migration direction. No grafting techniques for dura mater defects were present in the studied literature. The authors of the current paper justify a surgical procedure for removal of migrated implant using a combined posterior and lateral approach on the own clinical case. The choice of procedure algorithm results from the need for prophylaxis of secondary spinal cord lesion and liquorrhea during removal of migrated implants from spinal canal.

Regulatory T cells (Tregs) is a CD4+ lymphocyte subpopulation that maintains autotolerance by suppressing the activity of autoreactive lymphocytes. There is a hypothesis that functional defects or a smaller number of Tregs underlie the pathogenesis of a number of autoimmune diseases. The paper considers the main features of the phenotype of Tregs. It discusses the number of Tregs in both peripheral blood and affected organs in systemic lupus erythematosus, as well as the time course of changes in the level and functional abilities of different subpopulations of Tregs during immunosuppressive therapy. In addition, the paper presents various approaches to using Treg lymphocytes in the therapy of autoimmune diseases.

Today, within the context of harmonisation of requirements in the international pharmaceutical market, there is a trend towards development of common standards, including in the field of preclinical studies. The reliability and reproducibility of experimental data obtained in various laboratories using animals cannot be guaranteed unless the 3Rs principles are observed (the principles of humane experimental technique) to ensure the welfare of animals. The present paper analyses Russian and foreign recommendations on different administration routes and administered volumes as applied to mice, rats, guinea pigs, and rabbits – the most frequently used laboratory animals. The paper systematises literature data on oral/intragastric, subcutaneous, intramuscular, intravenous and intraperitoneal routes of administration. It assesses potential complications of each route of administration, and negative effects on both health and well-being of laboratory animals, as well as on the results of experiments. The paper also touches upon some anatomical and physiological characteristics of laboratory animals, potential opportunities for feed and water deprivation, ways of reducing pain in animals. The results of comparison of administered volumes helped to determine optimal recommended and maximum administered volumes.

The review dwells on the analysis of anesthetic techniques for pediatric eye surgery, including the use of drugs used and methods of anesthesia. While preparing the paper, Cyberleninka (www.cyberleninka.ru), PubMed, Medline databases were used with the targeted search using the following keywords: propofol, sevoflurane, paracetamol, regional anesthesia, ophthalmology, children. The search was not restricted by the date of paper publishing; the focus was made on papers published within the last 10 years. The purpose of the review was to assess the scope of various anesthetic techniques (general anesthesia and regional blockades), anesthetics (sevoflurane, propofol, paracetamol, local anesthetics) in pediatric eye surgery.