Search

Current article represents the modern clinical guidelines on management of severe bronchial asthma (BA) in children and practical use of genetically engineered biologic drugs. Clinical efficacy and safety of omalizumab has its special role. Efficacy analysis was carried out in real-life' clinical setting (considering high economical expenses of biological treatment) to estimate effective response predictors and principles of patients selection for such therapy. Two years of anti-IgE treatment experience in inpatient pediatric department settings demonstrates that omalizumab inclusion to treatment of children with severe asthma resistant to standard therapy allows to solve asthma symptoms, to forgo high doses inhaled glucocorticosteroids, to improve lung function parameters, and to increase significantly quality of life in 95% of our patients.

During COVID-19 pandemic the issue of diagnosis and rational therapy of community-acquired pneumonia in children became acute. This is caused by difficulties in verification of the diagnosis of community-acquired pneumonia in the outpatient department, peculiarities of interpretation of the respiratory system lesions. The article presents clinical cases of communityacquired pneumonia in children admitted to the pulmonology department of a pediatric hospital.Clinical case 1. 5-year-old child, medical history: acutely fell ill, on 28.11.20, had a sore throat and fever up to 39.0 C. Received Kagocel, Miramistin, Nurofen. PCR for COVID-19 on 08.12.20 was positive, on 18.12.2020, 22.12.2020, 20.01.2021 - negative. Immunoassay (ELISA) on 12.23.20: IgM - 4.47, IgG - 255.25. Lung and pleural cavity ultrasound: echo signs of sharply pronounced interstitial syndrome, massive fibrinothorax on both sides, indirect signs of bronchopleural fistulas; lung radiography: bilateral polysegmental pneumonia, bilateral hydrothorax, bilateral fibrinothorax, with no marked progression; CT scan with IV contrast: CT picture of hydrothorax on the left, hydropneumothorax on the right, pleurisy on both sides, compression atelectasis of lower lobe segments of both lungs. With no marked progression. Treatment. Thoracentesis; antibiotic therapy, antimycotics, infusion therapy, immunotherapy, partial parenteral nutrition. Against the background of the therapy, positive dynamics was obtained. Clinical examples are also given: an 8-year-old child with suspected new coronavirus infection and a 5-year-old child with bilateral polysegmental pneumonia.

Introduction. In MRI, the difference in sensitivity between tissues is used to obtain images weighted by the inhomogeneity of the magnetic field termed susceptibility-weighted imaging (SWI) and a high-resolution 3D radiofrequency gradient echo scan with full speed compensation is applied. The aim was to determine the features of lesions caused by traumatic brain injury in children using the SWI sequence. Materials and methods. 535 TBI children aged two months up to 18 years old (average age 9.58 ± 1.5) were studied. There were 325 boys (60.7%), 210 girls (39.3%). MRI was performed without and with intravenous contrast on a Phillips Achieva 3 T scanner with T1- and T2WI, 2D and 3D images, FLAIR, magnetic resonance angiography (TOF MRA), SWI, and DW/DTI, MRS and fMRI, SWI were used for visualization of DAI. Results. Patients included children with severe TBI - 178 (33.3%), moderate TBI - 172 (32.1%) and mild TBI - 185 (34.6%). Of the 535 injured children, 129 (24.1%) had MRI performed within the first 24 hours from the moment of injury, up to 48 hours - at 91 (17.0%), up to 72 hours - in 78 (14.6%) and up to 13 days - in 237 (44.3%). DAI foci at all degrees of TBI were detected in 422 (78.9%) children out of 535 children. Conclusion. SWI is a sensitive method for diagnosing brain lesions in TBI and significantly contributes to predicting outcomes in the early stages after trauma. The amount of brain lesions diagnosed by SWI correlates with the degree of injury according to the Glasgo Coma Scale. The study of the brain functional connections can inform about possible relationships between the localization of the SWI lesion and cognitive deficits, potentially providing an opportunity to use SWI in the hyperacute phase.

An observation from practice was devoted to the experience of an interdisciplinary approach in the diagnosis and surgical treatment of a patient with complicated course of Crohn’s disease against the background of the formation of a stricture of the terminal ileum, an enterovesical fistula, the penetration into the mesentery of the sigmoid colon.

Purpose To describe characteristics of the vitreomacular interface (VMI) in traumatic macular holes (TMH) compared to idiopathic macular holes (IMH) using immunofluorescence and electron microscopy, and to correlate with clinical data. Methods For immunocytochemical and ultrastructural analyses, premacular tissue with internal limiting membrane (ILM) and epiretinal membrane (ERM) was harvested during vitrectomy from 5 eyes with TMH and 5 eyes with IMH. All specimens were processed as flat mounts for phase-contrast microscopy, interference and fluorescence microscopy, and transmission electron microscopy (TEM). Primary antibodies were used against microglial and macroglial cells. Clinical data was retrospectively evaluated. Results Surgically excised premacular tissue of eyes with TMH showed a less pronounced positive immunoreactivity for anti-glutamine synthetase, anti-vimentin and anti-IBA1 compared to eyes with IMH. Cell nuclei staining of the flat-mounted specimens as well as TEM presented a lower cell count in eyes with TMH compared to IMH. All detected cells were found on the vitreal side of the ILM. No collagen fibrils were seen in specimens of TMH. According to patients’ age, intraoperative data as well as spectral-domain optical coherence tomography (SD-OCT) analysis revealed an attached posterior vitreous in the majority of TMH cases (60%), whereas all eyes with IMH presented posterior vitreous detachment. Conclusion The vitreomacular interface in TMH and IMH shows significant differences. In TMH, glial cells are a rare finding on the vitreal side of the ILM.

The current state of the problem of informatization of education in Ukraine has been analyzed. It is shown that information technologies largely determine the nature and direction of higher education, and their active implementation in the educational process contributes to effective training of future competitive professionals. The main aspects of solving the problem of informatization are considered: computerization of educational institutions and acquisition of information and communication competencies by research and teaching staff of universities.

Infant high grade gliomas (HGG) are the most frequent tumors of the central nervous system in children below 1 year of age. Standard therapy involves surgical resection and chemotherapy. Prognosis in infant HGG is better than in older patients, however, the absence of effective regimens of anti-recurrence therapy and the impossibility of radiation therapy implementation predetermine a negative prognosis in the group of infant gliomas in case of disease progression. In most patients with infant HGG of hemispheric localization, gene rearrangements of receptor tyrosine kinases – NTRK1/2/3 (24%), ALK (41%), ROS1 (28%), MET (7%) are described. The results of tyrosine kinase inhibitor administration show high efficacy and safety in the treatment of patients with NTRK-positive gliomas. The study was approved by the Independent Ethics Committee of the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology. The paper presents two examples of the successful use of targeted therapy in patients with infant HGG lacking the efficacy of the standard chemotherapy. In both cases, a persistent response was obtained: in the first case, a complete response to therapy was achieved, the duration of treatment is currently 1 year, in the second case – there is no progression of the disease during 20 weeks of therapy. Of the adverse events (AE) of targeted therapy in patients, only transitory neutropenia was noted in the first case, in the second case, AEs were not detected. In order to expand therapeutic options and prescribe targeted therapy drugs, a molecular genetic investigation of tumor tissue is mandatory for patients with hemispheric infant gliomas. The parents of the patients agreed to use the information, including photos of children, in scientific research and publications.

Tomosynthesis is a modern effective and informative method of low-dose X-ray diagnostics, which allows obtaining a significant number of layered images with the subsequent volumetric image reconstruction. The use of tomosynthesis provides a one-time examination of a large anatomical area without loss of the image quality and diagnostics of difficult-to-visualize pathological changes that are not detected by digital radiography. The article presents an overview of the problem of improving low-dose imaging options in the radiation diagnostics, as well as the authors own data on the use of tomosynthesis for the diagnosis of community-acquired pneumonia in children.

Fever in children is one of the most common reasons for seeking medical care and use of antipyretic drugs. The reasons can be various. It is extremely important for the pediatrician to find the cause of the fever and prescribe adequate therapy. Antipyretic drugs are symptomatic, they only relieve the condition of the child and improve the quality of life. The article reviews national and international studies and clinical guidelines of professional communities on fever in children. Currently, only ibuprofen and paracetamol fully meet the safety and efficacy criteria, and they are recommended for use in pediatric practice as antipyretic drugs.

Purpose.Analysis of the immediate results of emergency glomus-sparing auto-transplantation of the internal carotid artery (ICA) in the acute period of ischemic stroke, developed on the basis of the City Alexandrovskaya Hospital, St. Petersburg.Material and methods.In this prospective, single-center study from January 2017 to August 2020. 49 patients were included in the acute period of ischemic stroke with hemodynamically significant extended atherosclerotic lesions of the ICA. All patients underwent glomus-sparing ICA autotransplantation, developed on the basis of the City Alexandrovskaya Hospital, St. Petersburg (Kazantsev A. N., Zarkua N. E., Chernykh K. P. et al. Аrteries with extended atherosclerotic lesions of the internal carotid artery. Patent application No. 202.013.4151/14 (062595), filing date 10/16/2020). Glomus-sparing ICA autotransplantation, developed on the basis of the City Alexandrovskaya Hospital, St. Petersburg, was performed as follows. On the inner edge of the external carotid artery (ECA), adjacent to the carotid sinus, 2–3 cm above the orifice, depending on the spread of atherosclerotic plaque (ASB), arteriotomy was performed with the transition to the common carotid artery (CCA) (also 2–3 see below the mouth of the NSA). The ICA was cut off at the site formed by the sections of the wall of the NSA and the CCA. Then the ICA was cut off as distally as possible in front of the hypoglossal nerve, so that the artery was completely resected. In view of the presence of an intact carotid glomus on the resected area of the ICA, which connects it to the wound, endarterectomy from the ICA was performed inside the operating field by its complete eversion. Then, open endarterectomy from ECA and CCA was performed. At the next stage, the ICA was implanted in its previous place with the creation of proximal and distal end-to-end anastomoses, so that the continuing ASB above the endarterectomy zone was fixed with a circular vascular suture.Results.There were no complications in the postoperative period. No cases of restenosis / thrombosis of the reconstruction zone were identified in all the sample according to the color duplex scanning data. On the 7th day after the operation, all patients were diagnosed with regression of neurological symptoms according to the National Institute of Health Stroke Scale: on admission, the mean score was 10.5±3.5; at the moment of the control point — 6.5±1.5; p=0.001. This reflects the effectiveness of the chosen treatment strategy. According to the data on the dynamics of systolic blood pressure, stable systolic parameters were observed in the postoperative period against the background of antihypertensive therapy taken before the operation.Conclusion.Carotid endarterectomy in the acute period of ischemic stroke is safe in the presence of mild neurological deficits (up to 25 points on the National Institute of Health Stroke Scale) and the diameter of the ischemic focus in the brain not exceeding 2.5 cm according to the computer data. tomography. Glomussparing ICA autotransplantation, developed on the basis of the Aleksandrovskaya Hospital, St. Petersburg, does not require the use of a patch and is not characterized by the risk of developing ICA thrombosis as a result of intimal detachment behind the endarterectomy zone. Preservation of the carotid glomus during reconstructive intervention on the ICA prevents the development of labile arterial hypertension and hemorrhagic transformation in the postoperative period.

Background. Juvenile idiopathic arthritis (JIA) is characterized by chronic inflammation of the joints with progressive course and a strong tendency to development of early disability. Long-term follow up of a patients with JIA allows us to trace the evolution of the disease, and to assess the correlation between the course of pathological process and the type of disease onset, age, sex, degree of activity and other factors, which contribute to the use of more exact methods for early detection of the adverse health consequences of JIA and the correct treatment. The purpose of the research was an improvement of the prognostic criteria for JIA by the retrospective chart review in patients with disease duration 1 year and 5–7–10 years. Materials and methods. The study included 47 children with joints form of JIA aged from 2 to 18 years. For diagnosis, clinical examination, standard laboratory and instrumental tests were used. A regression analysis was used for the determination of prognostic criteria, the informative value of the features and the predictive factors for each of criteria. Results. It was established that for prediction of the further 5–7-year course of JIA, the patient’s gender, inflammation of small joints of the hands, the presence of the rheumatoid factor (RF) played an essential role; and for 10-year and longer prognosis — the presence of eye lesions, the number of both affected and active joints were important. The significance of the following parameters has increased in prognostic model: the presence of RF, the duration of morning stiffness, radiological stage of the disease, laboratory indicators, such as erythrocyte sedimentation rate, level of C-reactive protein. For the 10-year prognosis of JIA, the effectiveness of treatment with methotrexate on initial stage was beneficial. These models determine variants of long-term course of JIA and include remission (up to 2 points), stabilization of the pathological process (from 2 to 3 points), which are assessed as favorable signs; and repeated exacerbations of the pathological process without progression of destructive changes in joints (from 3 to 4 points), clinical progression of disease, including radiological changes and joint destruction (more than 4 points), is classified as an unfavorable. Conclusions. The given methods for predicting the course of the JIA should be used at the initial stages of disease, it will allow to determine the real risk of adverse effects at early stage of pathological process and make it possible to choose adequate treatment.

Takayasu’s arteritis is a chronic granulomatous arteritis with predominant involvement of the aorta and its main branches. It occurs both in youth and childhood, manifests between the ages of 10 and 30 years, female patients predominate. This article presents a clinical case of Takayasu’s arteritis in a child with prolonged fever. Clinical case. A 10-year-old girl E. was hospitalized with complaints of febrile fever episodes during the last two months; weakness and back pain were also noted. Observed by an endocrinologist since 2015 with a diagnosis of Stunted growth. Delayed physical development. Diffuse changes of the thyroid gland, euthyroidism. Since 2020 has been observed with the diagnosis Constitutional immaturity. A tendency toward constipation was noted. Observed by an allergist with atopic dermatitis, food and respiratory allergies were diagnosed. By the time of hospitalization, the girl had been ill for two months. During this period, four episodes of fever with scanty catarrhal manifestations were recorded. The diagnostic search went in different directions, infectious, systemic and oncological diseases were excluded. The echographic pattern was typical and highly specific for Takayasu’s arteritis. Additional examination also revealed changes in the celiac trunk in the form of narrowing of its lumen. Clinical diagnosis «Non-specific aortoarteritis, type III, acute phase, stenotic variant, grade 1–3 activity with lesions of the right and left common carotid arteries and the celiac trunk» was made as a result of clinical, laboratory and instrumental examination. This clinical observation demonstrates the difficulty in making a diagnosis due to the variety of clinical forms and the absence of specific disease markers. It takes on average a year and a half from disease debut to clinical diagnosis of the patient. However, lack of therapy over a long period can be crucial for an adverse outcome of the disease.

In spite of a relatively good prognosis of most patients with nephroblastoma, there are some subgroups characterized by different unfavorable prognostic factors, in which the overall prognosis is much worse. In particular, this can be applied to patients with very high risk relapse. As in these cases the tumor is often resistant to most chemotherapy modalities, the quality of surgical control is of utmost importance.We present a case of a 9-year-old patient with second local nephroblastoma relapse involving a large portion of inferior vena cava. During the course of complex therapy a radical surgical resection with vascular plastic by xenopericardium implant was performed. The follow-up, albeit short, yields no signs of disease progression or graft malfunction.This case demonstrates the possibility of successful vascular plastic in a child with relapsed tumor. This method may allow more radical tumor resection.

Islands in the form of truncated triangular pyramids on the surface of an epitaxial Ge3Sb2Te6 layer grown on a Si(111) substrate are identified by scanning electron microscopy. It is established that sides of their bases are oriented along the Si〈110〉 directions, and sizes vary from several tens to several hundred nanometers. It is shown by high-resolution electron microscopy of cross-sectional specimens that the (111) planes of the cubic phase or (0001) planes of the hexagonal phase of Ge3Sb2Te6 in the epitaxial layer are oriented parallel to Si(111) and, in surface domains, can make an angle of 70.5° with the layer–substrate interface. It is established, using an atomic structure analysis and energy-dispersive X-ray microanalysis, that the composition in islands changes from Ge3Sb2Te6 to GeSb2Te4 along the growth direction.

The current state of studies on application and safety of food additives in various technologies for food production is examined. Considerable attention should be given to studies dedicated to analysis of food safety criteria due to a possibility of appearance of adverse consequences for human health and the trend towards increasing life quality. Special emphasis is placed on such parameters as genotoxicity and mutagenicity. It is shown that the most rapid and convenient tool for complex monitoring of product toxicity can be the bioassay procedure. Based on the review of the literature on bioassays for edible meat and meat products, canned foods, carbonated soft drinks, beer, milk and milk containing products as well as seasonings, the authors show that above mentioned products had the cyto- and genotoxic potential when tested on animal and human cell cultures, microorganisms and plants. With that, it was found that a list of relevant publications is quite small despite a significant growth in scientific research dedicated to food toxicity assessment using bioassays. A review on the conducted research on assessment of genotoxic and mutagenic effects of foods by bioassay methods will make it possible to extend the understanding of the processes and mechanisms of this toxicity and form more rational concept of consumption.

The specific features of social needs and life strategies of students as a special social group, the significant role of universities in the formation of civic consciousness and the peculiarities of the transformation of the civic sphere in Russia actualize the study of the social behavior of university students in the civic sphere. The main purpose of the study is to identify the features of the social behavior of university students in the civic sphere and to determine their types. The methodological framework is based on the synthesis of socially deterministic and neoinstitutional approaches, the theory of mental programs, M. Rokeach's value approach and the activity-based approach to studying social practices. As external factors, the authors examine the features of organizational and institutional conditions for the implementation of civil-social and civil-political practices by students. The authors investigate the following internal factors: conservative and liberal mental programs which include ideas about civic participation as a terminal and instrumental value, attitudes and motives behind practices. The study is based on the data of the author's questionnaire of 382 students from seven universities in the Rostov region. According to the results of the study, there are four types of social behavior of students in the civil sphere: civic type, career-leisure type, hybrid type and conformist type. The most common type of behavior remains conformist as it is formed under the influence of conservative mental programs and formal conditions for the implementation of civil practices. The most adaptive to modern realities in the civil sphere is the hybrid type of students' social behavior. The university is a platform of special social trust between students and determines broad prospects for the development of informal civic events.

The widespread introduction of intravitreal drug injections into clinical practice has highlighted a number of issues to be solved, including the risk of serious complications, the treatment burden on patients and the patient’s insufficient adherence to treatment, as well as a significant effect on the healthcare cost and effort. One of the ways to resolve the issues is to increase the patients’ awareness concerning the therapy they are about to receive, which contributes to the patients’ understanding of the details of treatment and enables them to make correct decisions. The best option of presenting such information to the patient is to provide them with a written document. The Expert Council on Retinal and Optic Nerve Diseases of the All-Russian Association of Ophthalmologists has developed, approved and tested an information brochure for patients who receive intravitreal injections. It offers brief information on what the procedure is, contraindications, details of preparation, and symptoms, both common ones and those requiring emergency assistance. The paper outlines the results of the study and presents a layout of an information leaflet for patients recommended for use in the Russian Federation.

Background: Various methods of physical therapy are widely used in the rehabilitation of patients with cancer (magnetotherapy, pneumocompression, electrotherapy, laser therapy). The goal of such rehabilitation is to minimize side effects and complications after radical treatment. However, a staged approach to the appointment of physiotherapeutic factors in the early period after surgical treatment of breast cancer has not been developed enough. Aim: To develop a staged approach to the appointment of physiotherapeutic factors at different times after surgical treatment of breast cancer. Design: a randomized-placebo-controlled study. Location: the clinic named after professor Yu. N. Kasatkin of the Russian Medical Academy of Continuing Professional Education of the Ministry of Health of the Russian Federation, Moscow. Population: Examination and treatment of 78 patients aged 30-70 after surgery for breast cancer were performed. The main group of 39 patients underwent a 2-stage course of medical rehabilitation: the first course on days 2-4 after surgery and the second course after 1-1.5 months against the background of adjuvated radiation therapy. The control group of 39 patients underwent physiotherapy placebo procedures. Methods: All the patients underwent medical rehabilitation: individual exercise therapy, balance-therapy, sessions with a medical psychologist, course exposure to an alternating low-frequency electrostatic field and general magnetic therapy. Results: two-stage physical rehabilitation improves the quality of life, decreases swelling, increases the range of motion, decreases pain, decreases the number of postoperative complications, and shortens the duration of lymphorrhea. Conclusions: It is advisable to include general magnetic therapy procedures and exposure to an alternating low-frequency electrostatic field in combination with physiotherapy exercises, balance-therapy and individual lessons from a medical psychologist in rehabilitation courses. Clinical Rehabilitation Impact: Prescribing two courses of medical rehabilitation after breast cancer surgeries in the early stages (on days 2-4) and 1-1.5 months after surgery contributed to a decrease in pain and postoperative edema, and an increase in the range of motion in the shoulder joint, preventing severe lymphostasis and improving the quality of life.

Introduction The aim of this article was to study the effect of native tissue cardinal/uterosacral ligament repair on overactive bladder (OAB) and pelvic organ prolapse (POP). Material and methods Inclusion criteria included decrease of urge symptoms following insertion of a gauze tampon in the posterior fornix of vagina (‘simulated operation’). Exclusion criteria included SUI, POP grades 3–4. The surgery consisted of plication of cardinal/uterosacral ligaments. Post-operative assessment was performed at3, 6, 12 and 18 months after surgery and included evaluation by stage of prolapse, Urinary Distress Inventory Short Form 6 (UDI-6), Overactive Bladder Questionnaire (OAB-q), Pelvic Floor Impact Questionnaire- Short Form 7 (PFIQ-7), and International Consultation on Incontinence Questionnaire – Urinary Incontinence Short Form (ICIQ-SF) questionnaires and voiding diary. Results At 3 months, cure rates for frequency, urgency, nocturia and prolapse were comparable. By the 6-month review, catastrophic failure commenced in the postmenopausal group, parallel for all pa-rameters, starkly contrasting with premenopausal group. At 18 months, % cure rates for pre-menopausal (post-menopausal in brackets) were 79.6 (15.4) for POP, 67.3 (20.5) for urgency, 87.7 (20.5) for nocturia and 59.2 (15.4) for frequency. Conclusions We hypothesize the stepwise parallel recurrence of POP and symptoms in the menopausal group was a consequence of collagen deficiency in the plicated ligaments. Nevertheless, plication of uterosacral-cardinal ligament complex is simple, inexpensive, effective, especially applicable pre-menopausally for POP and as an alternative treatment option in that difficult group of pre-menopausal women who have major OAB/nocturia symptoms but only minimal prolapse.

The objective of the study: to evaluate the effectiveness of diagnosis of tuberculosis and mycobacteriosis in bronchobiopsy specimens obtained during navigation by radial endobronchial ultrasonography (rEBUS) in patients with peripheral lung lesions without bacterial excretion.Subjects and methods. A retrospective analysis of the diagnostic effectiveness of bronchoscopic examination with biopsies was carried out in 179 patients (75 men and 104 women) suffering from pulmonary tuberculosis or mycobacteriosis without bacterial excretion; peripheral lung lesions had been visualized by computed tomography (CT). The patients were divided into two groups: 93 underwent bronchoscopy with biopsies with rEBUS navigation, 86 underwent bronchoscopy with classical biopsies and preliminary CT navigation. Each patient underwent multiple biopsies, at least one fluid biopsy (bronchoalveolar lavage or bronchial lavage), and one tissue biopsy (transbronchial lung biopsy or brush biopsy). Specimens collected by all types of bronchobiopsy were sent for microbiological and cytological tests, specimens of pulmonary transbronchial biopsy were additionally sent for histological examination.Results. The diagnosis of tuberculosis was verified by bronchobiopsy in 106 (67.5%) of 158 patients with tuberculosis, but statistically significantly more often in the group with rEBUS navigation versus the group without it – 81.9% (68/83) versus 50.7% (38/75), respectively (pχ2 < 0.01). The diagnosis of non-tuberculous mycobacteriosis was verified by bronchobiopsy in 13 (61.9%) of 21 patients, in the group with rEBUS navigation – in 80.0% (8/10) patients, in the group without it – in 45.5% (5/11) (pφ > 0.05). The use of rEBUS navigation while collecting bronchobiopsy specimens made it possible to increase the etiological verification of tuberculosis using the following microbiological methods: microscopy – from 14.7 to 49.4% (pχ2 < 0.01), molecular genetic – from 41.3 to 72.3% ( pχ2 < 0.01), culture (Bactec MGIT960) – from 44.0 to 67.5% (pχ2 < 0.01) The greatest enhancement of diagnostic effectiveness was achieved in the specimens of bronchoalveolar lavage and bronchial lavage – from 33.3 to 71.1% (pχ2 < 0.01) and in brush biopsy specimens – from 25.6 to 57.6% (pχ2 < 0.01).

Intravitreal injection (IVI) is a drug delivery method, widely used in modern ophthalmology. To increase the awareness of patients receiving treatment in the healthcare system of the Russian Federation, the Expert Council on Retinal and Optic Nerve Diseases of the Association of Ophthalmologists, an All-Russian Public Organization in 2020 proposed a leaflet “Intravitreal injections (information for patients)”.Purpose: to conduct a clinical assessment of the leaflet by multicenter anonymous surveying of patients.Material and methods. Patients who had experienced IVI treatment were asked to read the leaflet for 20 minutes and then answer 12 questions of the specially designed questionnaire. 93 patients were interviewed in clinics in Moscow, St. Petersburg, Yekaterinburg and Novosibirsk: of these, 57 (61.3%), the average age of all patients was 63.9 years, the most common diagnosis was neovascular age-related macular degeneration (52 cases, 55.9%), the experience of previous treatment ranged from 1 to 104 months.Results. The leaflet had a positive response from the patients (91.4% of the questionnaires received “excellent” and “good” ratings), 90.3% patients reported that the information contained was fully or largely consistent with their experience of IVI treatment. The overwhelming majority of respondents (88.2%) did not experience any difficulties in reading the leaflet. At the same time, the patients revealed insufficient awareness on issues related to the treatment. Also, the patients showed insufficient awareness of issues concerning their health: only 20 (21.5%) respondents could answer all five questions of the questionnaire about the understanding of the relevant information, and 31 patients (33.3%) could answer four questions. This fact emphasizes the importance of information support for the patient.Conclusion. The clinical assessment of the leaflet “Intravitreal injections (information for patients)”, which contains brief information about what the procedure is, contraindications, preparation details, symptoms of the postoperative period that require urgent assistance, allows us to recommend the leaflet for use in the clinical healthcare practice of the Russian Federation.

Introduction. The impact of high information and neuro-emotional loads on teachers and medical workers contributes to professional stress and the development of production-related diseases. The development of preventive programs in health-saving behavior is quite relevant. It reveals the need to study the peculiarities of the labor activity in employees of pedagogical labor and the medical sphere. The study aims to substantiate hygienic and medical-preventive programs to prevent the development of overstrain and maintain health in pedagogical and medical workers with different work intensities. Materials and methods. Researchers carried out comprehensive physiological and hygienic studies, a hygienic assessment of the intensity of the labor process, and factors of the production environment. We have a questionnaire survey and the results of medical examinations of teachers and surgeons. Scientists did physiological studies on the state of the cardiovascular system with characteristics of the response to stress loads (ECG recording on a 12-channel electrocardiograph and continuously using Holter monitoring, determination of systemic blood pressure). We calculated the total risk of fatal cardiovascular complications on the SCORE scale. Researchers carried out statistical processing of the obtained data using the statistical program EpiInfo 3.5.2., Statistika 10, Microsoft Excel 2010. Results. 85.7% of medical university teachers have chronic diseases, and diseases of the circulatory system prevail in the structure of morbidity, the frequency of which increases with age. The results of the questionnaire survey established the priority behavioral risk factors for teachers. There is a high (from >5% to 10%) and very high (>10%) absolute risk of fatal cardiovascular complications on the SCORE scale in teachers. In surgeons, the study of the features and degree of adequacy of the cardiovascular system's response to stress during work revealed the tension of the regulatory mechanisms of the circulatory system, which indicates a decrease in the functional capabilities of the myocardium. Conclusions. Neuro-emotional stress of work is the leading professional factor in the teaching staff of higher medical education (2 permissible, 3 class of harmfulness of the 1st degree) and surgeons (class 3.2). It determines the formation of the functional state of neuropsychiatric tension.

This study aimed to systematize data on the possibility of using extracorporeal magnetic stimulation of the pelvic floor neuromuscular system in urological practice. Materials and methods. Based on the available scientific data and our own clinical cases, information regarding the use of extracorporeal magnetic stimulation in the treatment of urological diseases has been summarized. The historical aspects of the application of magnetic stimulation are presented, along with the physical and biological essence of the method, and indications and contraindications to the procedures. The principles of prescribing extracorporeal magnetic stimulation of the pelvic floor neuromuscular system have also been described in detail, and international and Russian data concerning the clinical application of this method in urological practice have been summarized.

The aim of the study was to study the quality of life of patients with alkaptonuria.Material and methods. The study included 50 patients with a reliable diagnosis of alkaptonuria aged 18 to 78 years (mean age 58.2±10.8 years). Among them, men predominated (n=31; 62%), in most cases (98%) complaining of pain in the joints and/or spine. For the first time, the articular syndrome debuted at the age of 17 to 39 years (average age of debut – 29.4±4.76 years). The duration of clinical manifestations of the disease before diagnosis ranged from 7 to 47 years (mean 23.35±8.17 years). 74% of patients had a disability group. In the study cohort, the body mass index (BMI) was slightly higher than normal values and averaged 28.18±4.95 kg/m2. The quality of life of patients was assessed using the EuroQol-5D questionnaire (EQ-5D).Results. The quality of life corresponding to a satisfactory state of health according to EQ-5D was observed in 56% of patients. Their quality-of-life index (LQI) values were more than 0.5. 22% of patients had 0

The article presents the results of a study of hemostasis in children with vascular malformations and inflammatory diseases of the maxillofacial region using standard and integrated methods for assessing hemostasis. Objective of the research: to assess the state of the hemostatic system in children with vascular malformations and inflammatory diseases of the maxillofacial region using standart and integrated methods. Materials and methods: on the basis of St. Vladimir's Children's Clinical Hospital in 2015–2019. А prospective open controlled comparative nonrandomized selective study of coagulological status was performed using standard coagulological tests and integral methods for assessing hemostasis (thromboelastography – TEG, thrombodynamics – TD) in 105 patients with lymphatic, lymphovenous, venous, arteriovenous vascular malformations of the head and neck (age 6 [5; 9] years), 47 children with infectious and inflammatory diseases of the maxillofacial area (age 10 [4; 17] years). The control group included 37 children (age 9 [5; 13] years). Results: according to the data, in most patients with vascular malformations, the coagulogram did not reveal pronounced shifts in hemostasis. TEG indices demonstrated hypercoagulability in vascular malformations: the onset time of clot R formation was 11,20 [8,72; 15,75] min (the norm is 9–27 min); clot K formation time was reduced to 3,90 [2,30; 6,02] min (the norm is 2–9 min). According to TD data, the process of fibrin clot growth in patients with vascular malformations accelerated: the clot V growth rate was 32,80 [28,70; 40,20] μm/min (norm 20–29 μm/min), an increase in the rate was observed mainly due to the acceleration of the clot growth initiation. The formation of spontaneous clots was noted in 32% of cases. In the group of infectious and inflammatory diseases of the maxillofacial area, the hypercoagulation was most pronounced: fibrinogen level significantly increased compared with the control group (3,21 [2,69; 4,72] g/l vs 2,69 [2,37; 3,17 ] g/l; p=0,0025). The soluble fibrin monomer complex (SFMC) indicator statistically significantly increased to 5,50 [0,00; 6,00] mg% (1,50 [0,00; 5,00] mg% in the control group, p=0,006). TEG showed a decrease in R (11,10 [8,82; 14,32] min vs 15,2 [11,8; 20,6] min; p=0,001) and K (3,65 [2,45; 5,10] min vs 6,70 [4,20; 8,25] min; p=0,0001), statistically significant compared to the control group. The alpha angle increased to 45,70 [36,20; 56,02] (30,8 [23,25; 41,15] in the control group, p=0,0001); maximum amplitude (MA) and clot density (G) increased in comparison with the control: 56,6±8,68 mm vs 48,10±6,20 mm; p=0,0001 and 6,50 [4,80; 8,00] Kd/sc vs 4,60 [3,60; 5,30] Kd/sc; p=0,0001. The TD indices in patients in this group also reflected a hypercoagulable state: the rate of V clot formation increased to 38,60 [33,00; 51,40] μm/min (30,45 [27,60; 33,30] μm/min in the control group, p

Background. Today, osteoarthritis, in particular its clinical form of gonarthrosis, is the most common degenerative-dystrophic diseases of the joints in practice in all countries. The objective: of the present study was to estimate the efficacy of local pulsed magnetotherapy on capillary blood flow in patients with osteoarthritis of the knee joint. Methods. A total of 50 patients aged from 36 to 65 years with I−III stage gonarthrosis. All patients of the main group (n = 25) received treatment with a pulsed magnetic field and NSAID therapy (diclofenac 25 mg 3 times a day, course 15 days). Patients in the comparison group (n = 25) received only NSAIDs. The functional state of the capillary bed was assessed by biomicroscopy of the vessels of the outer corner of the eye using a fiber optic ophthalmoscope with a Riester Ri-Scope L diode lamp (Germany). The state of the vessels of the angle of the eye was assessed by capillary (KI1) intravascular (KI2), extravascular (KI3) and general (KIgen) indices. Results. After a course of local pulsed magnetotherapy, normalization of the ateriol-venular ratio, restoration of blood flow through the capillaries and the disappearance of a cloudy background were noted in all patients of the main group. After 6 months, the found changes were preserved in the patients of the main group, while in patients receiving NSAID mototherapy, all positive changes from the capillary blood flow disappeared. Conclusions. In recent years, magnetotherapy, both general and local, has been successfully used to treat patients with gonarthrosis. One of the mechanisms of action of magnetic fields is to improve microcirculation in tissues. The therapeutic effect of magnetic fields in gonarthrosis has been studied, and its high efficiency has been proven.

Relevance. Acute kidney injury (AKI) is one of the leading causes of death worldwide. However, the epidemiology of AKI is not well understood. In Russia, toxic kidney damage plays a significant role in the nosological structure of AKI — 12.2%.Aim of study. To study the features of AKI in patients with acute chemical poisoning.Material and methods. We analyzed 26 case histories of patients with acute chemical poisoning with AKI (according to KDIGO). The comparison group included 25 patients with acute chemical poisoning without AKI. All patients were hospitalized in a toxicological center on the basis of the emergency department of the Ryazan Region State Budgetary Institution “City Clinical Emergency Hospital” (SBI RR “CCH EMC”) in 2016–2018. The analysis of the annual reports of the chief toxicologist of the Ministry of Health of the Ryazan Region for 2016–2018 was carried out. Data processing was performed using Microsoft Office Excel 2013 and on the website medstatistic.ru (Pearson’s chi-square test and Fisher’s exact test).Results. In most patients AKI developed during poisoning with cauterizing action substances - 38.4% (23% - vinegar essence, 15.4% - unidentified cauterizing action substance). The poisoning with alcohol substitutes (12%) took the 2nd place, with narcotic substances (8%) – the 3 rd place. Also, isolated cases of AKI (4% each) were reported in case of poisoning with pregabalin, tramadol, ketorol and ethanol. Poisoning with an unknown toxicant was noted in 29.6% of cases. Most patients (69.2%.) had stage 3 AKI. The second stage was registered in 7.7% of patients, the first — in 23.1%. Proteinuria was detected in all patients who underwent common urine test (CUT). Infusion therapy using crystalloids was performed in 100% of cases.Conclusion. Acute renal injury most often develops in acute poisoning with cauterizing poisons. The development of acute kidney injury in acute chemical poisoning leads to an increased risk of death. Acute kidney injury is the second most common immediate cause of death in acute chemical poisoning. Infusion therapy is an integral part of the management of toxicological patients with acute kidney injury.

In the theory and practice of real estate valuation, in analytical studies of the dynamics of real estate markets there is a problem of tracking changes in market prices. The apparent simplicity of this task leads to the fact that in everyday practice both market participants and professional analysts are satisfied with observations of average prices. The advantage of this traditional approach is computational simplicity. However, in the conditions of presence of a large number of special software and extensive statistical material can be used more complex research methods. The purpose of this article is to research big current market data of real estate objects and compare these data with the cadastral value determined in accordance with Russian legislation as the market value at the specified date. In this regard, there are problems associated with the multidimensional distribution of market prices and cadastral values. The article presents the method of calculation of changes of the real estate market prices on the basis of comparison of two-dimensional prices distributions of offers and cadastral prices for two periods. The main problem in studying the dynamics of real estate market prices is the inability to track the change in market prices for each property, as objects are constantly put up for sale and removed from it. The work carried out in the Russian Federation in 2014 to establish the cadastral value of real estate opens opportunity to analyze two-dimensional distributions of current market and cadastral prices and to assess the dynamic characteristics of the market for any real estate objects. The main result of article is the method which allows to apprise the market value of real estate in real time when new market data come by their comparison with the previously established cadastral value. Cadastral value is assumed to be defined as market value at the valuation date.

Omalizumab, is the first targeted biologic therapeutic approved for the treatment of moderate and severe persistent uncontrolled asthma. The aim: was to evaluate the clinical efficacy and safety of Omalizumab as additive treatment in children with severe uncontrolled asthma in real clinical practice. Materials and methods: 23 children with severe uncontrolled atopic asthma aged from 6 to 18 years were included in this study. Examination included studying clinical data, level of total IgE, eosinophil count, skin tests, spirometry, chest X-ray, oxygen saturation monitoring, Childhood Asthma Control Test, Asthma Control Test. Patients were treated with Omalizumab once every four weeks. The duration of follow-up was from 1 to 5 years. Results: The average age of the patients was 10.5 years±2.23 (6-11 years - 34.8%, 12-17 years - 65.2%). The duration of Omalizumab therapy was different: 1-2 years-39.1% children, 3-4 years-47.8% children, more than 5 years-13.1% children. 95.6% children have demonstrated positive dynamics for 12 months of therapy with Omalizumab. 82.6% patients achieved full control of asthma symptoms. 95.6% of patients had a decrease in the amount of antiinflammatory therapy (60.9% of patients changed therapy from LABA/ICS to monotherapy with ICS in medium doses, in 26.1% children the dose of ICS in the combined LABA/ICS was reduced from high to medium), decrease in total IgE, increased physical activity, reduced exacerbations. Serious adverse events were not observed. Conclusions: Omalizumab is effective and safe in real clinical practice as addition to baseline therapy in severe uncontrolled asthma. It lowers the risk of exacerbations, achieves of control of asthma symptoms and improves quality of children’s life.

The main purpose of this study was to evaluate the structural transformation in rats’ tongue tissue after oral administration of lead salts. Under the conditions of acute experiment during 5 days Wistar rats were orally administered the lead acetate solution in the amount of 24 mg per day. Histological studies were carried out at OSMU upon the completion of the experiment. Effect of toxic doses of lead results in symptoms of both hyperkeratosis and destruction of tongue tissue. It is assumed that the oxidative stress and tissue irritation, induced by lead intoxication, causes pathological changes in the shape, height and number of filiform papillae of the tongue. This results in hyperkeratosis, hydropic degradation of the epithelium and in the presence of an inflammatory infiltrate in the connective tissue.

Introduction. The social function of a public opinion leader is to draw public attention to the most important issues of public life, participate in public discussions, explain and influence public opinion. Political communication is implemented in two dimensions – pragmatic and symbolic, which have very close relationships. The symbolic dimension develops and promotes ideas about society that create, maintain, or destroy political identity. For external target groups of image-making (political and business elites, decision-makers at the federal level, investors, highly qualified migrants, partially residents of other regions), significant repeaters of information about the region are representatives of state authorities and management, leaders of political parties and socio-political movements, bright representatives of the political opposition, etc. Materials and Methods. The research methodology was based on the method of cognitive mapping, which allowed analyzing and visualizing information transmitted by public opinion leaders about the regional space, determining the specifics of the perception of the Republic in the external power environment, and a historical and evolutionary approach that made it possible to trace the evolution of content. Time period of the study: 2012–2019. The study traced a series of judgments, stable expressions used by political and public figures about Mordovia, its potential, development prospects, and its leadership. Results and Discussion. Public opinion leaders (political and business elite, party figures, opposition, etc.) are significant repeaters of information about the region. Political communication is implemented in two main dimensions – pragmatic and symbolic, where the latter involves not rational understanding, but the suggestion of stable meanings. Symbolic politics has always been used by the authorities, especially in times of crisis, so the opinions conveyed by person-images become the basis of symbolic capital that promotes ideas about society (territory), creates, supports or destroys political identity. The external image of the Republic of Mordovia, which is formed on the basis of broadcast opinions, is contradictory. During the study period, we can note some evolution of the image of the Republic, broadcast by the leaders of public opinion. Attention to the region is noticeably increasing due to significant events of various scales. The high authority of the former leadership and loyal “electoral behavior” of the region contributed to the creation and broadcast of a positive image from the federal government and was a reason for criticism from opposition leaders. The celebration of the Millennium of unity of the Mordovian people with the peoples of the Russian state in 2012 was perceived positively by the majority of public opinion leaders and was actively broadcast in the media. The inclusion of Saransk among the host cities of the world football championship was received ambiguously: from a positive assessment to skeptical doubts about the correctness of such a choice. The legacy of the championship was not only the modernized infrastructure, but also the aggravated socio-economic problems of the region, which could not but affect its external image. Discussion and Conclusions. Thus, the positive image of the “territory of innovation”, “dynamically developing region with high-quality agricultural products” and “region of spiritual revival” coexists with the image of the territory of “total falsification”. The nature of the broadcast opinions is closely related to the peculiarities of the political situation and the official/oppositional position of the leader of public opinion in the discourse space.

Scoliosis is an orthopedic disease characterized by complex multi-plane deformation of the spinal column and chest, accompanied by a violation of the functions of organs and systems of the body, which is the cause of severe physical and psychological suffering in children. It is very important to carry out effective conservative treatment of scoliosis in I and II severity to prevent further progression of spinal deformity. It is proved that physical treatment methods are required in the complex treatment of patients with scoliosis. The purpose of physiotherapy is to eliminate dystrophy, improve contractile function of the muscles of the back and abdomen, eliminate instability of the spine and reduce pain.

The analysis of troponin T (TnT) blood levels in the patients with acute coronary syndrome (ACS) and the underlying chronic obstructive pulmonary disease (COPD) is relevant to assessment of the cardiovascular prognosis and the risk of respiratory complications. The aim of the study was to investigate TnT levels in the patients hospitalized with ACS and underlying COPD in order to analyze the cardiopulmonary relationships. Methods. 52 patients (29 men and 23 women) were divided into 2 groups depending on outcomes of ACS: the 1st group - 30 patients (57.7%) with acute myocardial infarction (AMI); the 2nd group - 22 patients (42.3%) without AMI. The acute exacerbation of COPD (AECOPD) was found in 33 patients (63.5%) upon admission to the hospital, and 19 patients (36.5%) did not have AECOPD. All patients underwent spirometry, the assessment of symptoms severity by COPD Assessment Test (CAT test) and the analyses for the level of TnT and oxygen saturation. Results. AECOPD was found upon admission in the 1st group more often than in the 2nd group: 76.7% vs 45.5% (p = 0.022). The patients with AECOPD had significantly higher levels of TnT than patients without AECOPD in both groups: 0.78 ± 0.17 and 0.59 ± 0.14 ng/mL respectively (p = 0.014) in the 1st group vs 0.19 ± 0.08 and 0.11 ± 0.04 ng/mL respectively (p = 0.002) in the 2nd group. In the 2nd group, 8 patients (80.0%) with AECOPD and 4 patients (33.3%) without AECOPD had levels of TnT in the range of «a myocardial necrosis» (p = 0.029) in the absence of AMI. The inverse correlation between levels of TnT and forced expiratory volume in 1 second (FEV1) was also found (R = 0.376; p = 0.009). Conclusion. Thus, the significantly increased levels of TnT in patients with ACS are associated with AECOPD upon admission, development of AMI and deterioration of the indexes of spirometry. It was shown that blood levels of TnT were significantly higher in the patients with AECOPD than in the patients with stable COPD in absence of AMI.

Background. Alkaptonuria is an orphan, autosomal recessive disease in which clinical symptoms debut in adulthood and are characterized by progressive degenerative changes in large joints (knee, hip, shoulder) and the spine, often leading to the need for joint replacement. Developing changes often lead to persistent disability. The purpose of this study was to evaluate disability among adult patients with alkaptonuria. Materials and methods. The study included 46 adult patients (31 m 67.4% and 15 w 32.6%) with a reliable diagnosis of alkaptonuria at the age of 20 to 76 years (avg age 56.83 10.52). The assessment of the presence of a disability group at the time of patients treatment to a rheumatologist was carried out. Results. It turned out that disability was determined in 34 (75.6%) patients, there were no signs of persistent disability in 11 patients (24.4%). Among the patients who had signs of persistent disability, most often during the survey period, group 2 disability was established (61.8%), the differences between this and other groups were statistically significant (p 0.05). For the first time, disability in the study cohort of patients was established at the age of 31 to 59 years (the average age was 50.83 5.5 years). Conclusions. It is important to note that in the vast majority of cases, persistent disability occurs in patients who were of working age, which underscores the importance of alkaptonuria as a medical and social problem.

Background. High-grade gliomas are characterized by a wide range of genetic abnormalities. The heterogeneous genomic landscape of pediatric high-grade gliomas allows identifying distinct subgroups of the disease in children and young adults. Most importantly, these subgroups differ by clinical course and prognosis, as well as treatment response to standard therapy.Objective: to assess the profile of molecular genetic markers of high-grade gliomas in children.Materials and methods. In the current study, we examine the frequency of H3F3A, Hist1H3B, BRAF, IDH1 / 2 mutations, the copy number alterations of CDKN2A / 2B genes and the expression of ETV6‑NTRK3 fusion gene in a cohort of 53 pediatric high-grade gliomas.Results. Driver mutations and CDKN2A / 2B deletions were observed in 24 (45 %) and 15 (28 %) of 53 tumors, respectively. Overall, the studied high-grade gliomas harbored 41 genetic aberrations including 24 (58.5 %) somatic missense mutations, 1 (2.4 %) genetic variant of unknown clinical significance, 1 (2.4 %) oncogenic fusion gene and 15 (36.6 %) deletions of the tumor suppressor genes.Conclusion. These findings point to the importance of molecular profiling of tumors for the optimal clinical care and development of new approaches to treatment aimed at molecular targets for personalized anticancer therapies.

The article provides a review of the literature, allowing to give a historical basis for the emergence of modern approaches to the physiotherapeutic treatment of ENT diseases. Several main highly effective directions of non-pharmacological action in ENT pathology are presented. Issues of physiotherapeutic treatment, which are focused on correcting complications of the disease or adverse reactions, are discussed. The indications are given for various methods of physiotherapeutic treatment in the pathology of the ENT organs.

The articles describes the biography of Mikhail Gavrilovich Atamanov, the Udmurt linguist, doctor of Philology, honorary professor of Udmurt State University, cleric of the Russian Orthodox Church (Russian Patriarchate), member of the Finno-Ugric Society (Finland), honorary citizen of the Udmurt Republic and Grakhovo district, laureate of Trokai Borisov Award and Kuzebai Gerd Award (Udmurtia), laureate of Kindred Peoples’ Literary Award (Estonia). M. G. Atamanov is the author of 11 academic books and 13 publicist and literary works; he translated the Bible and other liturgical and biblical literature into Udmurt (25 books). He also compiled the national epic ‘Tangyra’.The article focuses on the review of the scholar’s linguistic research as well as the analysis of his literary works and translation of canonical literature into Udmurt.

The transformational processes in the field of higher education in Russia, associated with the introduction of new educational practices, actualize the importance of studying changes in the social behavior of university students. The main purpose of the study was to clarify the characteristics of the social behavior of university students, conditioned by external and internal factors. The methodological construct included synthesis of socially deterministic and neoinstitutional approaches, the theory of mental programs, the theory of generations, the value approach of M. Rokeach, as well as the activity-based approach to the study of social practices. Reforms in the higher education system in Russia, which were accompanied by the emergence of a new educational environment and excessive social inequalities, were studied as external factors. Mental programs were studied as internal factors, which included ideas about education as a terminal and instrumental value, attitudes and motives of practices. The research was based on the data of the authors' questionnaire survey of 382 students from 7 universities of the Rostov region. Identifying the features of the mental programs of university students and their educational practices made it possible to identify six types of social behavior of students in the educational sphere: traditional, career, pragmatic, traditional and career, traditional and pragmatic, and career and pragmatic. The analysis of the results allows drawing conclusions about the high readiness of students to new educational practices, which are still poorly implemented. At the same time, motivation depends on mental programs, and the educational practices themselves depend on the conditions created in universities. The results of the study may be of interest to specialists dealing with the issues of social behavior of students in the context of transformations of the higher education system.

In this article, we review the basic principles of brief psychotherapeutic intervention in patients with urolithiasis. The brief psychotherapeutic intervention has proven successful in the treatment of addictive behaviour. Currently, this method is also used in the treatment of many chronic diseases, such as hypertension, diabetes mellitus, and ischemic heart disease. Adaptation of this method can be a successful tool to increase the level of adherence to therapy for patients with urolithiasis since adherence to medical recommendations can significantly reduce the frequency of recurrent stone formation.

Introduction. In view of the ongoing research into the negative effects of fruit juice on human health, we aimed to study the subchronic toxicity of apple juice, a model mixture based on its components, and ethanol on biomass growth, cellular oxidative enzymes, and chromosomal abnormalities in Allium cepa roots. Study objects and methods. Our objects of study included clarified apple juice and its components such as fructose, glucose, sucrose, D-sorbitol, and malic acid. After treating Allium cepa roots with apple juice and a model mixture in different concentrations, we analyzed their toxic effects on biomass growth, malondialdehyde levels, as well as the nature and frequency of proliferative and cytogenetic disorders in the plant tissues. Results and discussion. The incubation in an aqueous solution of apple juice at a concentration of 1:5 inhibited the growth in root mass by 50% compared to the control (water). The mitotic index of cells decreased with higher concentrations of juice, reaching zero at a 1:5 dilution. The fructose and model solutions in the same concentrations appeared less toxic in relation to cell mitosis and root mass growth. Although malondialdehyde levels increased in the onion roots treated with juice and model solutions, they were twice as low as in the control due to the juice’s antioxidant activity. Adding 1% ethanol to the 1:2 diluted juice abolished the effect of acute toxicity on root growth and reduced malondialdehyde levels by 30%. Conclusion. The study revealed a complex of interdependent biomarkers of apple juice responsible for its subchronic toxicity in Allium cepa roots. These data can be used to create biological response models based on the approaches of systems biology and bioinformatics.

An overactive bladder (OAB) is a constellation of lower urinary tract symptoms, including urgency, increased frequency of urination during the day and/or night (nocturia), and, in some cases, urge incontinence. This syndrome can be caused by different conditions, and currently no universal pathogenetic treatment has been developed. In addition, there are virtually no Russian-language publications providing information on the neurophysiology and neuroanatomy of the lower urinary tract. At the same time, the importance of this topic can hardly be overestimated. Often, a patient with a neurogenic dysfunction of the lower urinary tract has different comorbidities, which requires to deeply understand the mechanisms of development of certain symptoms. Considering an absence of clear data about the peripheral bladder innervation, role of the structures of the central nervous system and importance of neurotransmitters, it is rather difficult to provide high-quality specialized care. However, in recent years, a lot of new facts and theories have been described in basic researches. This lecture is dedicated to the current data on the pathogenesis of OAB. The purpose of the lecture is to summarize the results of fundamental and clinical studies on the pathogenesis of OAB.

The article presents a clinical example of a case of accidental diagnosis of human immunodeficiency virus in a child at the age of 1 year 10 months with an abscess in the parotid region on the left and the newly diagnosed lymphoproliferative syndrome. The expression of lymphoproliferative syndrome did not correspond to the clinical picture of the underlying disease, therefore differential diagnosis was made between such diseases as histiocytosis, haemoblastosis, primary immunodeficiency disorders, salmonellosis, yersiniosis, tuberculosis. As a result, a human immunodeficiency virus was diagnosed in a child of young age who does not have an apparently burdened history. As a result, the child was timely sent to a specialized hospital for in-depth examination and treatment.