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In recent decades, the prospect of using a biomarker strategy for early personalized diagnosis of cardiovascular pathologies has been actively explored. The use of new markers appears promising, and the search for an ideal marker is actively ongoing, which will make it possible to understand various mechanisms of cardiovascular diseases. In recent years, scientists have actively focused on studying the role of neuregulin-1 as a laboratory biological marker in cardiac pathology. Neuregulins belong to a superfamily of epidermal growth factors that are synthesized by the vascular endothelium in response to ischemia, adrenergic stimulation, and oxidative stress. Several studies have shown the potentially important diagnostic and prognostic value of assessing neuregulin-1 as a biological marker. Thus, further scientific and clinical studies will demonstrate the possibility of using this marker as an additional laboratory tool for diagnosing, risk stratifying, and predicting cardiovascular events in patients with cardiovascular pathology. The therapeutic effect of recombinant neuregulin-1 on reducing morbidity and mortality in patients with cardiac disorders require more detailed assessments.

Research into new biological markers may help early diagnosis and effective therapy for cardiology patients. The use of biomarkers to evaluate patients has made a major impact in oncology, but is still in its infancy in the cardiology field. Studies on secreted frizzled-related protein 5 (SFRP5) have revealed its potential use as a marker of cardiovascular pathology. Preclinical studies have highlighted the important role this protein plays in many biological processes. It reduces the proliferation and migration of cardiac fibroblasts and suppresses the Wnt5A/JNK signaling pathway thus reducing the severity of oxidative stress and inflammation. It normalizes nitric oxide production and has several other effects. However, recent clinical studies of SFRP5 have produced conflicting data. Nevertheless, this protein shows promise as a marker for several metabolic and cardiovascular diseases. Preliminary data also suggest SFRP5 may be a therapeutic target. Further study of SFRP5 and its role in cardiovascular pathology is necessary, and will create new diagnostic and prognostic possibilities for this biological marker.

BACKGROUND: Achondroplasia and pseudoachondroplasia are hereditary systemic skeletal dysplasias characterized by a certain similarity of clinical manifestations; however, they have different etiopathogenetic mechanisms and confirmation methods for molecular genetic diagnosis. Their common phenotypic features often make differential diagnosis difficult during the clinical examination of patients, planning DNA diagnostics, and appropriate time detection of neurosurgical and orthopedic complications. AIM: This study aimed to identify differential diagnostic criteria for achondroplasia and pseudoachondroplasia and optimize the strategy for their molecular genetic diagnosis. MATERIALS AND METHODS: A comprehensive examination of 76 children from 74 unrelated families aged 1 month to 18 years with phenotypic signs of achondroplasia and pseudoachondroplasia was conducted. To clarify the diagnosis through genealogical and amnestic analysis, clinical and neurological examination data according to the standard method and radiographic data were used. Molecular genetic confirmation of diseases was conducted by searching for hotspot mutations in the FGFR3 gene, assessing the number of GAC repeats located in exon 13 of the COMP gene, and new-generation sequencing of the target panel consisting of 166 genes responsible for hereditary skeletal pathology. RESULTS: Based on a comparative analysis of the specific phenotypic characteristics, the criteria for the differential diagnosis of achondroplasia and pseudoachondroplasia were identified. The leading signs of achondroplasia are disproportionate nanism from birth, macrocrania, and facial dysmorphism, which are not specific to pseudoachondroplasia. Certain radiological features are essential in the differential diagnosis of pseudoachondroplasia, which should be considered when referring to patients for molecular genetic analysis. A deletion of the GAC repeat c.1417_1419del in the COMP gene was identified in 27% of patients with pseudoachondroplasia. Thus, the analyses of these two mutations in FGFR3 and COMP were conducted first. In the absence of target mutations, further diagnostic search should be continued with a target panel consisting of 166 genes responsible for hereditary skeletal pathology or whole-exome sequencing. CONCLUSIONS: The analysis of the clinical, radiological, and molecular genetic characteristics of patients with achondroplasia and pseudoachondroplasia, together with the literature data analysis, made it possible to clarify the differential diagnostic criteria for these diseases and optimize the algorithm for their molecular genetic diagnosis.

According to the World Health Organization, more than 38 million people are carriers of the human immunodeficiency virus (HIV). The relative risk of cardiovascular events in patients with HIV infection is 1.52 times higher than those without it. An HIV-positive status is associated with a 50% increased risk of acute myocardial infarction. The mechanisms of CVD development caused by HIV activity are not fully understood, and the contribution of traditional risk factors cannot fully explain such a high potential for coronary heart disease (CHD) in patients with HIV infection. Data suggest that HIV-associated chronic inflammation and immune system activation may lead to progressive endothelial dysfunction and vascular damage. The pathogenesis of atherosclerosis and, consequently, CHD in HIV infection is extremely versatile and poorly studied. The key mechanisms in HIV-associated CHD include the effect of HIV proteins on immunocompetent cells and vascular endothelium, immunodeficiency, translocation of microorganisms from the gut, and chronic inflammation with platelet activation. Despite considerable progress in understanding HIV-associated cardiovascular disease, many unresolved questions remain. Even with effective viral suppression, inflammation and immune dysregulation appear to increase the risk of cardiovascular complications. The lack of large-scale clinical studies on the prevention and treatment of cardiovascular disease in HIV is very important. Nevertheless, some important features should be considered in the management of patients with HIV infection.

Identification of a new significant level of regulation of gene activity using small non-coding molecules of ribonucleic acid miRNA can be confidently considered as one of the most outstanding discoveries of modern science It became clear that the suppression of gene expression caused by miRNA is an extremely important universal mechanism widely involved in most intracellular signaling pathways. Current data on the role of miRNA-122 in the development of cardiovascular diseases is included in this review. miRNA-122 is positioned as a promising biological marker in cardiovascular pathology. miRNA-122 promotes inflammation, oxidative stress, and apoptosis in cardiovascular disease. Clinical and experimental studies support the pathophysiological role of miRNA-122 in fibrosis and cardiac dysfunction. Overexpression of miRNA-122 exacerbates the loss of autophagy and enhances angiotensin II-mediated inflammation, apoptosis, fibrosis, and cardiac dysfunction. miRNA-122 should be considered not only as a promising diagnostic and prognostic tool, but also as a target for modern medicine. Inhibition of miRNA-122 results in antifibrotic, antiapoptotic, anti-inflammatory, antioxidant, and pro-autophagic effects. Further study is required to evaluate the real diagnostic and therapeutic potential of miRNA-122.

To date, the most widely used biomarkers are natriuretic peptides and cardiac troponins. Many other biomarkers have also been identified, but only a few of them have found application in actual clinical practice. This review focuses on the Klotho protein and its role in cardiovascular diseases. In 1997, a gene that slows down the aging process was identified. It was named Klotho (Greek, ώ, spinning; Latin, Clotho; English, Klotho) in honor of the goddess of ancient Greek mythology, spinning the thread of life and being the personification of the steady, calm course of fate. Mice with an insertional mutation in the region of the Klotho gene promoter were characterized by premature aging processes. Three families of Klotho are known: -Klotho, -Klotho, and -Klotho, and the most studied is -Klotho. The Klotho protein consists of a large extracellular domain and a short C-terminal intracellular region. The extracellular domain consists of two repeat sequences called KL1 and KL2. -Klotho and -Klotho contain the KL1 and KL2 domains, respectively, and -Klotho contains only the KL1 domain. The Klotho gene in humans is located on chromosome 13q12 and consists of five exons. The Klotho protein is mainly expressed in the distal convoluted tubules of the kidneys and the vascular epithelial plexus of the cerebral ventricles. At lower concentrations, the Klotho gene is also found in other organs and tissues, particularly in the heart. Many studies have demonstrated the protective role of the Klotho protein in cardiovascular pathology. The pleiotropic properties of this protein are reflected in the diversity and interaction of cardioprotective mechanisms. The regulation of the concentrations of the Klotho protein in the blood and its expression in heart cells with the help of drugs can play a significant role in cellular metabolism and represent a promising target for the treatment of heart and vascular pathologies.

Cardiovascular diseases remain the leading cause of death worldwide despite significant advances in medicine and increased life expectancy. It is very important to search for and study new cardiovascular biological markers that can help the early diagnosis of cardiovascular diseases, serve as a laboratory tool for assessing the effectiveness of treatment, be a predictive marker of possible adverse clinical outcomes, and be a significant criterion for risk stratification. This review aims to consider interleukin-13 (IL-13) as a diagnostic and prognostic biomarker in cardiovascular pathology. IL-13 is involved in the development of many cardiovascular diseases, according to variousin vitroandin vivostudies, but its role remains unclear until the end. IL-13 has a positive effect, promoting the development of the heart at an early stage and facilitating the recovery of the heart after a myocardial infarction. Due to the induction of fibrosis and adverse cardiac remodeling, long-term IL-13 synthesis appears to be a risk factor for adverse outcomes in chronic cardiovascular diseases, such as heart failure. Understanding the effect of IL-13 on cardiac metabolism will shed light on possible new pathogenetic mechanisms for the development of heart disease. As a rule, an increase in the level of IL-13 in the blood serum goes in parallel with its expression in the tissues of the heart. However, the dissociation of systemic inflammatory reactions and local expression is not excluded. The introduction of IL-13 can restore the regenerative capacity of cardiomyocytes and reduce cardiac dysfunction. IL-13 deficiency limits the proliferation of cardiomyocytes, induces compensatory hypertrophy of cardiomyocytesin vitroand deletion of IL-13, leads to cardiac dysplasia, and impairs recovery processesin vivo. Although IL-13 is associated with cardiac fibrosis, cardiomyocyte proliferation, myocardial hypertrophy, immune cell recruitment and differentiation, and chemokine secretion in the heart, it is precise signaling pathways and underlying mechanisms of action remain poorly understood.

Objective. To identify the potential epizootic and epidemiological risks arising from the development of the infrastructure of Platov Airport in the territory adjacent to the airport for the development, if necessary, of a set of anti-epidemic and preventive measures. Materials and methods. Epizootological monitoring was carried out in the vicinity of Platov airport, as well as on the territory of the complex itself for three seasons (20192021). The capture of small mammals was carried out according to the standard method of trap-lines with Hero crushers; 1200 trap-days were accumulated. Route records of bats with the determination of their species were carried out. The species belonging of blood-sucking arthropods was determined using determinants. Regulatory support for the above monitoring was formed in accordance with the current normative and methodological documents: SanPiN 3.3686-21 "Sanitary and Epidemiological Requirements for the Prevention of Infectious Diseases"; MP 3.1.0211-20 "Trapping, Accounting and Forecasting the Number of Small Mammals and Birds in Natural Foci of Infectious Diseases"; MU 3.1.3012-12 "Collection, Accounting and Preparation for Laboratory Examination of Blood-sucking Arthropods in Natural Foci of Dangerous Infectious Diseases". Laboratory studies of samples of extracted biomaterial for the search of markers of pathogens of natural focal infections were carried out taking into account the requirements of current regulatory documents. Samples for laboratory testing were formed in compliance with the principle of "one point of collection of material, one time of collection of material, one type of material". Results. The results of epizootological monitoring of the territory of the Platov airport (Rostov-on-Don) are presented, according to which a real possibility of the development of epizootics of dangerous infectious diseases among small mammals living in the adjacent territory to the Platov airport has been established. In order to eliminate potential risks that can lead to complications of the epidemiological situation, it is necessary to carry out planned deratization and acaricide treatments on the territory of Platov airport. The continuation of regular epizootological monitoring of the airport territories and adjacent territories remains very relevant. Conclusions. The results of epizootological monitoring of the territory of the Platov International Airport (Rostov-on-Don) revealed the presence of mouse-like rodents penetrating from the surrounding fields, including those belonging to groups I and II of infectious sensitivity to tularemia, which form potential epizootological risks. A comprehensive laboratory study of biological material obtained from mouse-like rodents captured during epizootological monitoring did not reveal markers of pathogens of natural focal infections. At the same time, systematic regular epizootological monitoring of the airport territory is necessary due to the presence in the territories surrounding the airport complex of natural foci of particularly dangerous infections common to humans and animals, where mouse-like rodents live and reproduce, including house mice and rats, capable of migrating and inhabiting residential and warehouse premises and in case of activation of epizootic process to introduce infection into the territory of the airport complex, especially in autumn and winter.

Cardiovascular disease is a serious problem of modern healthcare, which is one of the leading causes of general mortality, reduction and loss of ability to work, as well as disability. The search and the study of new cardiovascular biological markers can allow the optimization of the diagnosis of cardiovascular diseases, development of laboratory tools for assessing the effectiveness of a treatment, and improving the prediction of possible adverse clinical outcomes. The purpose of this review was to promote the consideration of interleukin-18 (IL-18) as a diagnostic and prognostic marker in cardiovascular pathology. For the first time, K. Nakamura et al. in 1989, described IL-18 and interferon-gamma (IFN--inducing factor, IFN--inducing factor, IGIF) as a new, previously unknown factor that induces the production of IFN-. Data obtained from rodent models and clinical studies have demonstrated that IL-18 is involved in the pathogenesis of several diseases, immune-inflammatory rheumatic conditions, systemic vasculitis, cardiovascular diseases, malignancy, central nervous system pathologies, inflammatory bowel disease, psoriasis, and diseases of the kidneys and lungs. In animal models of acute myocardial infarction, pressure overload, and left ventricular dysfunction, IL-18 has been demonstrated to increase cardiomyocyte hypertrophy, induce cardiac contractile dysfunction, and extracellular matrix remodeling. It is therefore expected that further scientific and clinical studies can demonstrate the possibility of using IL-18 as an additional laboratory tool for the diagnosis, risk stratification, and prediction of cardiovascular events in patients with a cardiac profile. The effect of blockade of this cytokine on reducing morbidity and mortality in patients with cardiovascular diseases remains to be assessed for more detail, while considering reasonable economic costs and the side effects of drugs.

It has been proven that in patients with heart failure (HF), there is an increased level of adrenomedullin (ADM) in plasma. Biomarker indices correlate with the severity of hemodynamic dysfunction, as well as with neurohumoral indices, which are activated depending on the severity of congestive circulatory failure. In addition, the expression of the ADM gene in the heart and kidneys is increased in experimental and clinical HF. A small number of studies have examined the effect of ADM infusion. These studies have generally shown that hormone infusion has beneficial hemodynamic effects and promotes the maintenance/improvement of renal function, but most of the studies have been short-lived. The available results suggest that increasing ADM levels reduce the negative effects of vasoconstriction and sodium retention. A better understanding of the role of a biological marker in congestive circulatory failure may lead to the development of drugs that target ADM receptors.

Currently, the search and study of new biological markers that can assist in the early diagnosis of cardiovascular diseases, serving as a laboratory tool for assessing the efficiency of ongoing therapy and being a prognostic criterion of possible clinical outcomes and a significant indicator in risk stratification, remain relevant. Two decades have passed since fibroblast growth factor 21 (FGF21), the 21st member of the FGF family, was identified and cloned. FGF21 is a secreted protein that acts as a metabolic regulator and participates in glucose homeostasis, ketogenesis, and regulation of insulin sensitivity. FGF21 expression is controlled by PPAR alpha receptor, which activates peroxisome proliferation. The liver is the main site of FGF21 production. Extrahepatic tissues such as white adipose tissue, brown adipose tissue, and skeletal muscle also express FGF21. Human FGF21 contains 209 amino acids, whereas the mouse counterpart has 210. Mouse and human FGF21 have 75% homology. Endocrine actions of FGF21 include enhancing glucose uptake by adipocytes of white adipose tissue via a unidirectional glucose transporter protein and activating the thermogenic function of brown adipose tissue. Furthermore, FGF21 has autocrine/paracrine effects, such as the induction of hepatic ketogenesis. FGF21 affects target cells with the participation of FGFR1 and FGFR4 receptors and beta-Klotho, a single-pass transmembrane protein that functions as an obligate cofactor of FGF21 signaling. Animal studies have clearly demonstrated that FGF21 acts directly on cardiac tissue, preventing the development of cardiac hypertrophy and reducing post-infarction damage and diabetic cardiomyopathy. Accumulating data emphasize the value of FGF21 as a new biological marker for diagnosis and prognosis assessment in patients with cardiac issues. Moreover, the role of FGF21 in heart diseases is very interesting because of its cardioprotective effects. Future large-scale prospective studies are necessary to confirm of the diagnostic, predictive, and possibly therapeutic role of this marker.

This review highlights the current literature data on the peptide hormone ghrelin. Ghrelin is a 28-amino-acid peptide, which is the only known peptide hormone modified with fatty acids. Ghrelin is a natural receptor ligand that stimulates the secretion of growth hormones. In addition to the stomach, ghrelin is expressed in many organs such as the duodenum, jejunum, ileum, colon, lungs, heart, pancreas, kidneys, testicles, pituitary gland, and hypothalamus. The main biological functions of this peptide include growth hormone secretion, appetite stimulation, modulation of gastric acid secretion and motility, and an increase in endocrine and exocrine pancreatic secretions. Reference intervals for ghrelin are 8.50216.6 pg/mL. The studies analyzed have shown a strong relationship between ghrelin and cardiovascular system function. Studies have also described the cardioprotective effects of ghrelin. However, the molecular mechanisms underlying the effects of ghrelin on the heart are not fully understood. A further deeper understanding of the role of ghrelin and future clinical studies are necessary to determine the diagnostic, prognostic, and possibly therapeutic significance of this biomarker.

Relevance. Verification of a new coronavirus infection (COVID-19) requires clear algorithms for the diagnosis and treatment of patients, depending on clinical, laboratory and instrumental dates. Timely and informed decisions on optimizing management tactics and prescribing proactive anti-inflammatory therapy before development of a complete symptom complex life threatening conditions are needed in some cases. Aim of the study. To analyze the course and outcomes of a new coronavirus infection, depending on the initial characteristics of the patients and treatment options. Materials and methods. A preliminary analysis of the case histories of 129 people hospitalized in the center for treating patients with a new coronavirus infection at North-Western State Medical University n.a. I.I. Mechnikov was made by random sampling. Among the hospitalized patients there were 67 men (51.9%), the average age was 57.9 16.4 years, 62 women (48.1%), and the average age was 60.2 13.6 years. During hospitalization, all patients underwent standard clinical laboratory and instrumental examination, as well as determination of saturation (SpO2), markers of the cytokine storm (CRP, ferritin, AST, D-dimer, fibrinogen, lymphocytes), compute tomography (CT) of the lungs. The effectiveness and safety of therapy was evaluated by the outcome (recovery, death), as well as by the presence of adverse events in the background of the therapy. Statistical processing of the research results was carried out using the Statistica 12 for Windows application software package, the significance of differences between the two relative values was evaluated using the Student t-test (t 2, p 0.05). Results. Fatal outcomes were significantly more frequently recorded among patients of older age groups and males. The presence of concomitant diseases such as obesity, diabetes mellitus, pathology of the cardiovascular system was accompanied by more frequent fatal outcomes. That allows considering comorbidity as a risk factor for severe course and poor prognosis of COVID-19. However, in general, in the presence of the indicated forms of concomitant diseases, it was not possible to establish significant differences with the outcomes of COVID-19, which may be due to an insufficient amount of patients. Predictors of fatal outcome was low values of saturation, the presence of respiratory failure, a significant amount of lung tissue damage (CT-3-4), as well as high values of CRP, ferritin, AST, D-dimer, neutrophilia, lymphopenia, thrombocytopenia. The use of anticytokine drugs (ACD) in complex therapy can be considered a favorable predictor of outcome, which indicates the advisability of wider use. The materials of the study allow not only a preliminary assessment of the course and effectiveness of complex therapy using anticytokine drugs with COVID-19 in patients with comorbid diseases, but also to develop therapeutic and diagnostic algorithms in patients of this category.

Aim. Aesthetic rehabilitation of patients with secondary post-traumatic enophthalmos. Methods. From 2013 to 2018, 14 patients with secondary post-traumatic enophthalmos were treated at the maxillofacial surgery clinic of the Azerbaijan Medical University. All patients underwent reconstruction of the damaged orbital wall, so its bone volume was restored. However, in the postoperative period, a deficiency of the orbital soft tissue was noted. In preparation for the surgery, all patients underwent the following types of examination: three-dimensional computed tomography, photographic, anthropometric measurements with the determination of proportional indices and computer simulation. Based on the data obtained, the orbital proportion indices were calculated: intercanthal index (en-en)100/(ex-ex); orbital protrusion index (ex-ex)100/(ex-en,rl)+(en-en); orbital width index (ex-en,l)100/(en-en); eye fissure (palpebral) index (ps-pi, l)100/(ex-en,l); orbital index (os-or,l)100/(ex-en,l); eyebrow orbital height index (os-or,l)100/(sci-or,l); index of vertical orbital contour (os-or,l)100/(ps-os+pi-or)+(ps-pi); eyelid height index (pi-or,l)100/(ps-os,l). Microlipografting was performed according to the Coleman method with modification by T. Marten. Fat aspiration was performed with a blunt cannula with a diameter of 2.12.4 mm and a 10 ml syringe, without anesthetic administration. Prior to microlipografting, fibrotic cords between the skin and underlying tissues were dissected using a sharp needle and a V-shaped cannula. Microlipografting was performed using microcannulas of 0.71.1 mm. The fat microtransplant was introduced in two layers: under the circular muscle of the eye and subperiostally in the orbit. Results. In 11 cases, with an unexpressed form of secondary post-traumatic enophthalmos, a good aesthetic result was recorded. In 3 patients with a pronounced form of enophthalmos, a satisfactory aesthetic result was obtained; in these cases, repeated microlipografting was carried out. Conclusion. Microlipografting based on the calculation of the orbit proportions indices during rehabilitation of patients with secondary post-traumatic enophthalmos is a minimally invasive and effective procedure.

One of the determinants of the birth rate trends is value system and attitudes of the population, especially young people. Increasingly building a successful career, achieving high social status and financial independence become the priorities of modern youth. The presence of children in this case could considered being a hindrance in achieving these goals. The emergence of the childfree phenomenon indicates the processes of changing the family-value orientations of the population. With the aim to analyze the attitude of the medical university students to the childfree phenomenon in dynamics, we conducted surveys among Sechenov University students in 2009 and 2019. A comparative analysis of the survey results allowed us to make conclusions about a decrease in the number of students with chronic diseases (54.0% and 63.9% respectively deny the presence of chronic diseases), a decrease in the number of students with bad habits (31.0% and 14.5% of students smoke, 16.0% and 9.2% drink alcohol, respectively), a decrease in the number of students with children from 20.0% to 2.3%, as well as an increase in the number of students who are not ready for independent childrearing from 59.0% to 76.2%. In addition, our findings show an increase in number of students aware about childfree phenomenon (from 36.0% to 84.8%) and a more loyal attitude towards it among students (3.0% in 2009 and 18.5% of students in 2019).

Aim. The study of the results of chemoradiotherapy for cervical cancer with the use of two-fraction brachytherapy. Methods. The article presents analysis of the examination and treatment results of 17 patients with IIB-IIIB stage cervical cancer. The average age was 51±4.6 years (44 to 62 years). External beam radiotherapy was performed with single boost dose of 1.8 Gy to total dose of 45 Gy. Also the patients received 40 mg/m2 of weekly cisplatin. Intracavitary/interstitial high dose-rate brachytherapy with insertion of parametrial needles consisted of two weekly fractions of 10.0 Gy. Results. Due to the use of interstitial needles the average dose was 82.2 Gy when recalculated to classical 2 Gy fractions. The median follow up was 16±3,2 months. The used radiotherapy modality for cervical cancer allowed achieving complete tumor involution in 16 (94.1%) patients and partial involution only in 1 (5.9%) case. All females had favorable tolerance and received the entire regimen of planned radiation. Conclusion. The first experience of the use of concurrent chemoradiotherapy for locally advanced cervical cancer with external beam radiotherapy, two-fraction intracavitary/interstitial adaptive brachytherapy with single boost dose of 10 Gy and 5 weekly infusions of 40 mg/m2 of cisplatin showed high probability of complete and partial tumor response rate with favorable tolerance and acceptable incidence and severity of toxicity.

Despite the wide possibilities of applying various methods of local and systemic treatment and their continuous improvement, the results of treatment of patients with hepatocellular cancer in general remain unsatisfactory. Based on the latest achievements of science and technology, modern radiation therapy can be used as an effective method of local exposure to liver tumors because of its relative effectiveness and acceptable tolerability. Radiation treatment in the mode of stereotactic body radiation therapy is a promising direction in the complex treatment of patients with hepatocellular carcinoma. It makes it possible to apply ablative doses with a significant reduction of the doses on healthy organs and tissues in a short period of time and the combination of this technique with other approaches of antitumor treatment.

Aim. To study the course and outcomes of pregnancy and labor in women with obesity. Materials and methods. The results of retrospective study of 110 medical cards of pregnant women and their labor anamnesis are presented in the work. Peculiar features of pregnancy and labor course in patients depending on the class of obesity were studied. Digital material was processed using the program “Microsoft Excel” (data analysis package), Biostat. To determine the normality of distribution, Shapiro-Wilk criterion was used, followed by calculation of Fisher’s exact criterion. Odds ratio with CI 95 % was evaluated. Results. It was revealed that irrespective of excess body mass value, pregnancy and labor in women with obesity are accompanied by complications. At the early stages of gestation, all women with obesity have a high rate of a threat of miscarriage, anemia, at the late stages – a threat of hypertensive disorders, anemia and impaired carbohydrate metabolism. The greatest incidence of Cesarean section was detected in women with class 3 obesity – 87 % versus 54 % and 43 % with class 1 and 2 obesity, respectively. Conclusions. Obesity during pregnancy is an actual problem owing to elevated risk of the development of unfavorable outcomes for a mother and a fetus.

We observed 50 patients aged 30 to 60 years. Colitis after dysentery - 26, after toxicoinfections - 5, colitis of mixed etiology - 14, alimentary etiology - 2 and unclear - 3 people. 28 had relapses, and 22 had a monotonous course. From concomitant diseases, anacid, normocidal and hyperacid gastritis prevailed. Angiocholecystitis and mesenchymal hepatitis were diagnosed in 29 patients.

Aim. Study of the effect of modified twin block activator used for distoclusion treatment on stomatognathic system and its improvement. Methods. 55 patients with skeletal distoclusion were examined. Out of them 28 patients treated orthodontically comprised the study group and 27 non-treated patients were included into the control group. The patients' age was 10-14 years (mean age 11.78±0.91), the duration of treatment was 1.5-2 years (mean duration 1.82±0.43). To avaluate the changes in stomatognathic system, cephalometric analysis was performed before and after treatment, and in the control group cephalometric analysis was performed with a 2-year interval. Results. During treatment with modified twin block appliance, SNB angle reached norm (80°). This is an important positive result in the treatment of distoclusion. ANB angle reflecting sagittal relationship between the upper and lower jaws and WITS decreased and reached normal size. Overjet normalized due to upper incisors retrusion and repositioning of the mandible forward in patients of the study group. In this group due to changes in soft tissues, in-profile esthetic and harmonious appearance of lips and chin was restored. In case of relative physiological rest the opened lips became closer and provided esthetic optimum of the face. Conclusion. Use of modified twin block appliance for the treatment of patients with distoclusion due to repositioning of the mandible forward allows improving sagittal relationship between the upper and lower jaws as well as overjet correction without increasing face height; use of modified twin block appliance allows normalizing sagittal occlusion and protrusion of upper incisors and upper lip.

Introduction: Nowadays the stereotactic radiotherapy (SRT) of clinical stage I-II lung cancer patients is the choice of the treatment modality for functionally inoperable patients. It shows safety and high efficiency in achieving local control. Though there is a range of unsolved issues connected with the prediction of the treatment efficiency and frequency of complications, an integration of new technologies in the planning and treatment process allows widening the search of the predictive factors. Material and methods. Since 2014, 39 patients (17 T1N0M0 patients, 22 T2N0M0 patients) with clinical stage I-IIa lung cancer have undergone SRT. The majority of patients (35) have been recognized as functionally inoperable due to the concurrent broncho-pulmonary pathology, 4 conditionally operable patients have refused an operation. 11 patients had the primary multiple tumors in their anamneses. 36 patients had a peripheral tumor. The options for the fractionation were: 10 Gy × 5 fractions (n = 26) and 7 Gy × 8 fractions (n = 13) - BED = 100 Gy. Results. The median follow-up was 26 months (range: 3-38 months). The 2-year local control was 94%. The isolated local recurrences were not registered. Overall and 2-year recurrence-free survival rate was 84% (95% CI, 70-99) and 83.2% (95% CI: 70.5-99) respectively. During the first year, 4 patients (10%) had the locoregional and distant progression and 3 of them died. 7 patients had experienced pulmonary toxicity of grade 2 or more. One patient with central tumor died from pulmonary hemorrhage (toxicity of grade 5). Grade 3 chest pain was observed in 2 patients, one of them had a rib fracture. One-factor analysis, revealed a reliable influence of the fractionation regimen (р = 0.04) and, close to reliability, the initial SUVmax level (р = 0.07) on the prognosis. A reliable relationship between the radiation toxicity level and dosimetric radiation index (V10, V5, MLD) was not registered. There was a tendency to reliable correlation with the total lung capacity indices (р = 0.058). Conclusions. A search for additional treatment efficiency and toxicity predictors of SRT treatment should include modern approaches to planning and delivery. The total dose delivery regimen and initial tumor SUVmax can be predictive efficiency factors, while the pulmonary tissue volume can be a predictive toxicity factor.

Цель. Изучение изменения содержания концентрации циркулирующих иммунных комплексов, уровней иммуноглобулинов E и G и гистамина в крови и лимфе при экспериментальном анафилактическом шоке и феномене Артюса. Методы. Эксперименты проведены на 27 кроликах породы шиншилла в двух сериях. Контролем служили исследуемые показатели концентраций циркулирующих иммунных комплексов, гистамина и иммуноглобулинов E и G в крови и лимфе интактных животных. Результаты. Уровень гистамина при анафилактическом шоке повышается в 3,8 раза, тогда как уровень иммуноглобулинов E и G повышается соответственно в 14,7 и 3,5 раза в сравнении с интактными животными, а концентрация циркулирующих иммунных комплексов возрастает до 23 ммол/л за этот период. В условиях феномена Артюса уровень иммуноглобулина E в крови повышается в 1,3 раза, а иммуноглобулина G - в 4,3 раза. Концентрация циркулирующих иммунных комплексов возрастает в 11,8 раза, уровень гистамина повышается только в 3,5 раза в сравнении с интактными животными. Вывод. Концентрация циркулирующих иммунных комплексов повышается как при анафилактическом шоке, так и при феномене Артюса; уровни иммуноглобулинов изменяются по-разному: при анафилактическом шоке происходит увеличение уровня иммуноглобулина E и снижение иммуноглобулина G, а при феномене Артюса, наоборот, повышение уровня иммуноглобулина G и снижение иммуноглобулина E; уровень гистамина увеличивается как при анафилактическом шоке, так и при феномене Артюса, однако при анафилактическом шоке - более значимо; в повышении концентрации гистамина в обеих аллергических реакциях роль циркулирующих иммунных комплексов не исключена, но основная роль, по-видимому, принадлежит иммуноглобулину E.

Aim. Study of the frequency of radiation therapy complications in patients with prostate cancer. Methods. The study included 142 patients who underwent radiation therapy combined with hormonal therapy in 2001-2015. Average age of patients was 68 years. All of them received 3D-conformal radiotherapy by linear accelerators with 6 to 15 MV photon beams. Single boost dose was 2 Gy, total boost dose was 75 Gy. We studied frequency and severity of acute hematological toxicity and early and late gastroenterological and urological complications of the treatment. Treatment-related toxicity was assessed by RTOG/ EORTC and CTCAE v. 4.0 scales. Results. Early radiation-induced proctitis of I, II and III degree were registered in 95 (66.9%), 32 (22.5%) and 8 (5.6%) patients, respectively. Acute cystitis of I, II and III degree were noted in 22 (15.5%), 87 (61.3%) and 16 (11.3%) patients, respectively. Signs of late radiation-induced proctitis of I degree was diagnosed in 21 (14.8%) cases. Late radiation-induced cystitis of I degree was diagnoswed in 37 (26.1%) patients. No late complications of higher severity occurred. Conclusion. The results of the conducted study showed that use of high-tech precision external-beam radiotherapy techniques in the treatment of prostate cancer along with high efficacy allows to reduce the number of early and late complications.

Local and systemic methods are used for the treatment of hidradenitis suppurativa, the choice of which depends on the stage of the disease. For local treatment adapalene, clindamycin, azelaic acid, silver preparations in combination with surgical excision, laser therapy and cryo are used. For systemic treatment antibiotics (clindamycin, rifampicin, erythromycin, amoxicillin with clavulanic acid, minocycline), prednisolone, cytostatics (methotrexate, azathioprine, cyclosporine), retinoids, biologicals (etanercept, efalizumab, adalimumab, infliximab), a non-steroidal anti-inflammatory drugs are used. The aim of therapy is to get anti-inflammatory effect, the removal offollicular occlusion and pain, correction of immune and hormonal status, stimulation of healing of skin defects, improving the quality of life of patients.

The data on the clinical features and course of suppurative hidradenitis characterized by severe course and a tendency to relapse are presented. To select the treatment strategy the scale of the severity and staging process are proposed. The atypical localization of purulent suppurative hidradenitis and follicular occlusion tetrad, which also includes conglobata acne, folliculitis sycosiformis atrophicans / exfoliating scalp cellulitis and pilonidal abscess are described. It is proved that manifestation of suppurative hidradenitis are phenotypically heterogeneous. The role of genetic, comorbid factors, metabolic and hormonal disorders, as well as the role of the immune system in the development of the disease are discused. For the diagnosis index Sartorius (Sartorius score), microbiology, immunohistochemistry and other research methods, which largely determine the tactics of treatment of severe dermatosis were used.

The article describes step by step formation and development of cancer care facilities in the Republic of Uzbekistan. It also presents the current status and perspectives for the development of cancer care for the population in Uzbekistan.

Hydradenitis suppurativa is a multifactorial disease. The pathogenesis has not been well studied yet. The views about antecedence of lesions of structural elements of the skin are disputable and that is what determines the actuality of scientific studies in this field. The article presents literature review on modern data regarding prevalence and etiology of the disease. The classification of clinical features and Satorius score for quantitating the severity of the disease, the methods of diagnosis (bacteriological, immunopathological and etc.) are suggested. The role of the genetic, comorbid factors, metabolic and hormonal disorders and the immune system part in the development of the disease are discussed. Topical and systemic medications with the primary purpose of reducing bacterial load, elimination offollicular occlusion, normalization of immune response, correction of hormonal status, improvement of skin defects healing, pain syndrome removal, improving the quality of life ofpatients, are suggested for the therapy.