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Background. Glaucoma is one of the most acute medical and social problems that cause enormous economic damage to society. Secondary glaucoma is the result of complications of such eye diseases as inflammation of the choroid of the eye, retinal vascular thrombosis. The purpose was to determine the effect of Briroza and Rozacom on the condition of the visual analyzer in patients with secondary glaucoma. Material and methods. The study involved 58 patients (58 eyes) with a unilateral process. All patients were divided into three groups. Groups 1 and 2 consisted of the patients with se-condary glaucoma after anterior recurrent iridocyclitis — 32 patients (32 eyes) in remission and relapse, respectively. Group 3 included patients with secondary (neovascular) glaucoma, which resulted from the central vein stenosis (CVS) and its branches — 26 patients (26 eyes). Results. In the first and second groups, Briroza administration resulted in the intraocular pressure decrease by 21.6 % (p = 0.001) — 21.0 ± 3.5 mm Hg. After a course of treatment in groups 1 and 2, electrical phosphene excitation decreased significantly by 22.4 % (p < 0.05). The critical frequency of flicker-induced phosphene in the mode 3 and 1.5 increased by 20.6 % (p < 0.05) and 47 % (p < 0.05), which indicates an increase in the functional activity of visual analyzer. Conclusions. The inclusion of the drugs Briroza and Rozacom twice a day for 2 months in the treatment of patients with secondary glaucoma is effective due to the increased functional activity of the visual analyzer and normalization of intraocular pressure in patients with secondary glaucoma.

Background. In view of the worsening forecast for global temperature rise worldwide, it seems relevant to study the effects of abnormal heat waves on systemic regulatory processes in people with chronic diseases, in particular coronary artery disease (CAD).Aims. This study aimed to investigate the effect of hyperthermia on oxidative stress parameters in patients with various severity of CAD and in healthy subjects.Materials and methods. We studied the level of malonic dialdehyde (MDA) and the activity of Cu,Zn-containing superoxide dismutase (Cu,Zn-SOD) in healthy subjects under conditions of 30-day long simulated hyperthermia and in patients with different severity of CAD after the summer heat wavesResults. We revealed signs of oxidative stress in healthy volunteers during model hyperthermia that manifested as an increase in content of MDA in blood plasma. At the same time we observed increasing activity of Cu,Zn-SOD in erythrocytes that utilizes reactive oxygen species. The increase of Cu,Zn-SOD activity started with a certain latency what also can be explained by de novo enzyme biosynthesis induction. We also studied oxidative stress parameters in patients at high and moderate cardiovascular risk according to the SCORE risk chart with uncomplicated CAD course and in patients with complicated CAD with severe coronary damage according to angiography during the summer heat waves. We observed accumulation of MDA in blood plasma and increasing activity of erythrocyte Cu,Zn-SOD in patients with uncomplicated CAD. At the same time we noted that accumulation of MDA in blood plasma was not followed by any increase in activity of red blood cell Cu,Zn-SOD in patients with severe complicated CAD. This fact indicates dysregulation of free radical processes in patients with severe course of CAD during the heat waves.Conclusions. The dysregulation of free-radical processes in patients with a severe clinical course of CAD has been revealed.

The possibility of utilization of inactive fly ash in road concrete compositions by bringing of ash into a non-equilibrium condition with increased reactivity by mechanical activation in a vibration eraser is investigated. It was revealed that the optimal content of binder and fly ash in samples of soil concrete was 8 and 10 wt. %, respectively. It is shown that, due to mechanical activation, the specific surface area of fly ash increases by 2 times, dehydration and carbonization occur and silicon is replaced by aluminum in silicon-oxygen tetrahedra. It has been established that an increase of the content of crystalline carbonate phases is the reason for an increase in the strength of ground concrete. It is determined that the introduction of mechanoactivated fly ash into the composition of soil concretes contributes to increasing their physical and mechanical characteristics to the maximum strength grade M100. This indicates the competitiveness of ground concrete and the possibility of direct use of inactive fly ash in road construction.

Postoperative pain (POP) is a serious complication that reduces the result of total knee (TKA) or hip arthroplasty (THA) in patients with osteoarthritis (OA). The search for predictors of postoperative pain is an actual problem.The aim of the study – to assessing relationship the polymorphisms of the KCNS1, COMT and OPRM1 genes and the development of POP in OA patients who underwent TKA or THA.Material and methods. The study group consisted of 95 patients with OA knee or hip (64.6% of women, 65.4±9.0 years) who underwent TKA (47.8%) or THA (52.2%). The presence of POP was determined when pain in the area of surgical intervention ≥40 mm (100 mm visual analog scale, VAS) persisted or appeared 3 and 6 months after surgery. All patients underwent genotyping of polymorphisms of the genes KCNS1 (rs734784), COMT (rs6269, rs4633) and OPRM1 (rs1799971) by polymerase chain reaction in real time using original sequence-specific primers and samples labeled with various fluorescent labels. Registration and interpretation of the obtained results were carried out on the DT-96 amplifier (DNA-Technology LLC, Russia).Results. POP was observed in 32.6% of patients who underwent TKA or THA. The frequency of POP after TKA and THA was 30.2% and 34.0% (p=0.882). Statistical analysis revealed no differences in the frequencies of the genotypes of the studied genes (p>0,05). The presence of a homozygous genotype of the GG polymorphism of the KCNS1 gene (rs734784) was associated with the presence of POP in accordance with the recessive genetic model (GG vs AA+AG; odds ratio (OR) – 3.96 [95% confidence interval (CI): 1.51; 10.37]; p=0.005). The presence of the mutant allele T (TT+CT) in the genotype of the COMT polymorphism (rs4633) reduced the risk of POP compared to the carrier of the CC genotype (OR=0.32 [95% CI: 0.12; 0.83]; p=0.02) in accordance with the dominant genetic model. There was no significant correlation between the development of POP and the carrier of different genotypes and alleles of the COMT (rs6269) and OPRM1 (rs1799971) genes.Conclusions. There is a statistically significant association the polymorphism of the KCNS1 (rs734784) and COMT (rs4633) genes and the development of chronic POP in patients who underwent TKA or THA. Further studies of the genetic predisposition to POP are required on more clinical material.

Purpose: To provide a clinical case of recurrent keratoconus from our practice.Materials and method. A patient came to the clinic with a complaint of decreased visual acuity in the right eye. A series of standard instrumental examinations and Scheimpflug keratotopography were performed, and astigmatism of the right eye was diagnosed. Similar examinations were carried out during the patient’s attendance at follow-up examinations.Results. Based on the results of scanning Scheimpflug keratotopography, the diagnosis of keratoconus (forme fruste) was made. On examination after 1 year, there were no complaints of decreased visual acuity and data from the same instrumental examinations indicating keratoconus. After this examination, the patient came 3.5 years later with complaints of a new decreased visual acuity in the right eye. During instrumental examinations and keratopography, data were obtained indicating the presence of posterior keratoconus. After 1 year, a follow-up examination took place without complaints. The data of instrumental studies are identical to the previous visit; keratotopography revealed a decrease in posterior elevation.Discussion and conclusion. It was revealed that the patient was constantly taking the hydroxyurea drug against the background of systemic disease up to the 3rd visit, at the time of the 4th visit she had not taken it for 1 year. There are publications in the literature on the effect of this type of drugs on the collagen of the dermis of the skin, the type of which corresponds to the collagen of the cornea. We hypothesize that drugs may have an effect on the biomechanical properties of the cornea, which requires further in-depth study.

Проведен анализ морфометрических и функциональных изменений зрительного анализатора в группе больных с возрастной макулярной дегенерацией с относительно рано выявленным процессом и высокими зрительными функциями. Включение в комплексное лечение больных с дегенерацией макулы и заднего полюса препарата Слезавит, содержащего лютеин и зеаксантин, витамины и микроэлементы, является патогенетически направленным и оказывает положительное влияние на активность фотоптической афферентной системы сетчатки.

Aim: The aim of the study is to analyze the features of the spectrum of lipids of the water-lipid mantle of the skin before and after pathogenetically sound therapy of patients with psoriasis. Methods: Comparative evaluation of the therapeutic efficacy of monotherapy with the immunobiological drug Humir (adalimumab), as well as its combination with a non-hormonal drug based on natural components Psori Active (cream) in the examined patients with psoriasis vulgaris was performed according to the dynamics of regression of dermatoses clinical manifestations erythema, infiltration, peeling of the skin psoriatic rash, changes in the index PASI, PGA, BSA. Results: The study involved 137 patients. Changes in the level of other components of the lipid spectrum of the water-lipid mantle of the skin, in particular phospholipids, cholesterol and cholesterol esters in patients of the first observation group changed insignificantly compared to their values before treatment. When comparing the normalization of the level of the studied spectrum of lipids of the water-lipid mantle of the skin in patients of the second group with different seasonal types (autumn-winter, spring-summer, off-season) and previously diagnosed with varying severity treatment, no statistically significant differences were found between seasonal types of dermatosis. Conclusion: Analysis of the results of clinical follow-up of the examined patients with psoriasis of the first and second groups after completion of treatment and achieving clinical clinical remission indicates significant benefits of systemic immunobiological therapy in combination with topical therapy with Psori Active.

The article presents own clinical observation of the chromosome 22q11.2 microdeletion syndrome in a child with congenital heart disease. Phenotype also includes facial skull anomalies, immune disorders, developmental delay and even cognitive deficits. The authors analyzed the current world definition criteria, standards for diagnosis and monitoring of patients to diagnose this syndrome. The epidemiology of 22q11.2 deletion syndrome is determined in the work. Its incidence varies between 1 : 3,000–1 : 6,000 newborns, the inheritance is autosomal dominant, however, in Ukraine the syndrome is rarely diagnosed, which in our opinion is due to the lack of neonatal screening and insufficient awareness of physicians of clinical features of the disease. Section 22q11.2 is one of the most structurally complex regions of the genome, primarily through several large blocks. The locus of low copy repeats in region 22q11.2 is prone to a genetic error, which is due to 96% identity. Attention is focused that clinical manifestations vary with age. In young children, typical symptoms include a combination of congenital heart disease, immunodeficiency, malformation of the palate, hypocalcaemia, difficulty in feeding, delayed mental and speech development, behavioral disorders, kidney and genital abnormalities, laryngo-tracheo-esophageal malformations, hypothyroidism, skeletal dysmorphology. In some children, the disease manifests in school-age by behavio­ral anomalies and mental retardation, and hypocalcaemia. The presence of facial features can contribute to identifying the syndrome at any age. At the same time, difficulties in diagnosis are associated with widespread phenotypic variability. The article describes in detail the genetic diagnosis of the syndrome using several methods (fluorescence hybridization in situ, multiplex ligation-dependent probe amplification and chromosomal microarray), the choice of which depends on the period of life and the expressiveness of phenotypic traits. To monitor the child with the syndrome of chromosome 22q11.2 microdeletion, the authors describe approaches that include multidisciplinary team approach and system after system method.

The purpose is to estimate the content of pro- and anti-inflammatory cytokines (IL-1 , IL-8, IL-10, MCP-1, ICAM-1, VEGF) in the tear liquid of patients with advanced proliferative diabetic retinopathy (PDR) and complicated primary cataract after phacoemulsification and IOL implantation performed simultaneously with vitreoretinal surgery vs. vitreoretinal surgery alone. Material and methods . 34 patients with PDR and complicated primary cataract were divided into two groups. Group 1 received a two-phase surgical procedure: (a) vitreoretinal surgery (VRS) with silicone oil tamponade followed by (b) phacoemulsification surgery, IOL implantation and silicone oil removal. Group 2 was subjected to (a) phacoemulsification simultaneously with vitreoretinal surgery and silicone oil tamponade and (b) silicone oil removal from the vitreous cavity. Both groups had their tear liquid samples examined before the surgery and on the 2 nd day after the 1 st phase. Results . Group 2 revealed a 2 to 2.5 times higher concentration of IL-8, MCP-1 and ICAM-1 as compared to Group 1. Conclusion . Increased concentrations of IL-8, MCP-1, and ICAM-1 in the tear after phacoemulsification surgery and IOL implantation coupled with vitreoretinal surgery as compared to vitreoretinal surgery alone requires additional research of the role played by the inflammatory component in the pathogenesis of postsurgical complications in advanced PDR patients.

Aims: To evaluate Atopic dermatitis (AD) and Chronic hand eczema (CHE) course in adults after discontinuation of acute or sub acute relapse treatment. Study Design: three groups of adult patients that finished standard treatment for relapse of AD and CHE were followed up within 24 weeks of period to check disease severity, itch intensity and skin management effectiveness. Place and Duration of Study Sample: population of Ivano-Frankivsk region of Ukraine September 2015 – May 2021. Methods: 155 patients (51 females and 104 males; age between 20 and 50 years) with AD or CHE were enrolled in the study. The patients were randomized into three study groups depending on diagnosis. SCORAD index was used to assess disease severity, visual analog scale (VAS) was used to assess skin itch intensity. Frequency of disease treatment re-start with topical or systemic anti-inflammatory drugs as well as patients’sintention to ask for a treatment were calculated. Results: Results of our study have shown that cases of new disease worsening occured within nearest 24 weeks after AD and CHE aggravation treatment discontinuation and are quite frequent despite appropriate skin care. Conclusion: part of adult patients continues suffering from skin itch or mild skin lesions within nearest 24 weeks after discontinuation of intensive treatment of AD or CHE relapse. Prescription of antihistamines and/or topical anti-inflammatory treatment in addition to generally recommended skin care with emollients is crucial for patients with new worsening of the disease. Among patients with a new signs of worsening a part would unlikely ask for a new treatment immediately unless this worsening is moderate or severe.

Spontaneous pneumothorax is the most common acute chest disease. Often, giant bullae give the impression of the presence of air in the pleural cavity. Inadequate differential diagnosis leads to vain drainage of the pleural cavity, damage to the lung with its collapse and pneumothorax.The aim. Analyze diagnostic and tactical mistakes in patients with pulmonary emphysema, which manifests with giant bullae, and outline the ways to prevent complications.Methods. The analysis of the treatment of 1,636 patients with pulmonary emphysema and its complications undergoing treatment in the thoracic surgical department of the Samara Regional Clinical Hospital named after V.D.Seredavin in the period from 2001 to 2018 is presented.Results. Giant bulla were diagnosed in 35 (2.1%) patients, 16 of them were hospitalized ungently. In 6 patients, the diagnosis of a giant bulla of the lung was correct, and the patients were referred to the thoracic surgical department. In 10 patients, a giant bulla of the lung was regarded as pneumothorax, and pleural drainage was performed before referral to the thoracic surgical department.Conclusion. The correct interpretation of the radiological data and comparison with the clinical picture allows avoiding diagnostic errors and the associated danger and complications.

Purpose. The aim is to estimate the content of pro- and anti-inflammatory cytokines (IL-1β, IL-8, IL-10, MCP-1, ICAM-1, VEGF) in tear of patients with advanced proliferative diabetic retinopathy and complicated primary cataract after phacoemulsification surgery and IOL implantation with vitreoretinal surgery accomplished at once in comparison with vitreoretinal surgery only. Material and methods. 34 cases of surgery treatment of patients with PDR and complicated primary cataract were enrolled. This patients were divided into two groups depending on the treatment tactics. In the 1st group patients were subjected to a two–step surgical procedure: vitreoretinal surgery (VRS) with silicone oil tamponade performed as the 1st step in their treatment; followed by the 2nd step, phacoemulsification surgery and silicone oil removal, and the IOL implantation, respectively. In the 2nd group phacoemulsification performed simultaneously with vitreoretinal surgery: phacoemulsification, IOL implantation, vitreoretinal surgery with silicone oil tamponade. The second step differed in the removal of silicone oil from the vitreous cavity. On the 2nd day after the 1st step surgery and before surgical treatment the tear samples of the patients of both groups have been examined. Results. A concentration of the following cytokines: IL-8, MCP-1, ICAM-1 in the 2nd group was 2,5-5 times higher than in the 1st group. Conclusion. The research revealed that the patients with advanced PDR are accurately determined by the increased concentration of IL-8, MCP-1, ICAM-1 in tear after phacoemulsification surgery and IOL implantation with vitreoretinal surgery accomplished at once in comparison with vitreoretinal surgery only. Keywords: cytokines, diabetic retinopathy, cataract, vitreoretinal surgery.

Purpose. The aim is to conduct a comparative analysis of status of macular area of retina of patients with advanced proliferative diabetic retinopathy and complicated incipient cataract according to phacoemulsification surgery time frames: after vitreoretinal surgery only or after vitreoretinal surgery as an integral component. Material and methods: 26 cases of surgery treatment of patients with PDR and complicated primary cataract were analyzed. This patients were divided into two groups depending on the treatment tactics. Retinal thickness in the fovea was measured by optical coherence tomography before surgery and 1 and 3 months after phacoemulsification cataract. Results. Visual functions improved in 85.8% of cases in group 1, and in 66.7% in group 2. Conclusion. Outcomes of the preliminary studies suggest that the frequency of macular edema development after phacoemulsification surgery and IOL implantation with vitreoretinal surgery is recorded more often than when performing with phacoemulsification surgery and silicone oil removal simultaneously by the second stage. Key words: diabetic retinopathy, cataract, vitreoretinal surgery, macular edema.

Purpose. To compare and evaluate long-term results of two-stage surgical treatment of patients with advanced proliferative diabetic retinopathy and complicated incipient cataract. Material and methods. 73 patients with advanced proliferative diabetic retinopathy and complicated incipient cataract performed by vitrectomy from 2016 to 2020 were analyzed. In the 1st group patients were subjected to a two-step surgical procedure: vitreoretinal surgery with silicone oil tamponade performed as the 1st step in their treatment; followed by the 2d step, phacoemulsification surgery and silicone oil removal, and the IOL implantation, respectively. In the 2d group phacoemulsification performed simultaneously with vitreoretinal surgery: phacoemulsification, IOL implantation, vitreoretinal surgery with silicone oil tamponade. The second step differed in the removal of silicone oil from the vitreous cavity. Results. Visual functions improved in 88.8% of cases in group 1, and in 51.3% in group 2. Conclusion. Outcomes of the studies suggest that it is more viable to perform phacoemulsification surgery sometime later along with silicone oil removal on PDR patients with complicated primary cataract. This sequence of treatment procedure ensures a more gentle approach to the anatomic structures of the eye during the first stage (vitreoretinal surgery) and contributes to the reduction in the number of intraoperative and postoperative complications. Key words: diabetic retinopathy, cataract, vitreoretinal surgery.

The purpose of the review is to present an analysis of the current literature data on the pathogenesis and therapy of liver damage in Covid-19. Liver damage in COVID-19 patients can be caused by the direct cytopathogenic effect of SARS-CoV-2, an uncontrolled immune response, sepsis, severe hypoxia, or drug damage. In addition, COVID-19 can exacerbate and decompensate previously formed chronic liver diseases with the development of acute liver failure. Physicians should carefully assess the initial state of the liver, and after prescribing therapy, intensify monitoring of its functional state, especially in patients with severe COVID-19. In each clinical case, the doctor needs to establish the possible mechanisms of organ damage in order to select the most optimal patient management tactics, which would take into account all aspects of the COVID-19 course and liver damage. Currently, additional scientific information is required to uncover the features of liver damage during SARS-CoV-2 infection and in the postcovid period. Patients who have undergone COVID-19 need further monitoring to assess the long-term effects of the disease.

Persistent diarrhea can be a sign of a number of medical conditions, including a gastrointestinal food allergy. Diagnosis in childhood is not very informative, since allergic diseases at this age often have a non-IgE-dependent mechanism of development. Objective. To study the diagnostic value of the fecal eosinophilic neurotoxin test for the diagnosis of gastrointestinal food allergy in young children with persistent diarrhea. Material and methods. The authors examined 70 young children (from 1 month to 3 years) with persistent diarrhea and 20 conditionally healthy children of the same age without burdened allergic background. They determined fecal eosinophilic neurotoxin levels in all children. The children were divided into 2 groups according to the results of this examination: Group with normal level of neurotoxin and Group with increased level of neurotoxin. Results. The physical development of children with persistent diarrhea with high levels of eosinophilic neurotoxin is often assessed as low or very low. With persistent diarrhea, blood and mucus in the stool was significantly more often detected in children with a high level of eosinophilic neurotoxin. Persistent diarrhea with an increased level of eosinophilic neurotoxin, was significantly more often combined with atopic dermatitis reflecting its allergic nature. The total IgE test turned out to be a highly specific marker of the allergic nature of persistent diarrhea, however, it has a low sensitivity and it is positive only in 26.3% of children with an increased eosinophilic neurotoxin. This fact confirms the non-IgE dependent pathogenetic mechanisms of gastrointestinal allergy. Conclusion: The study demonstrated a high differential diagnostic value of the eosinophilic neurotoxin test in the feces of children with persistent diarrhea. The authors revealed a statistical interconnection of a high level of eosinophilic neurotoxin and other markers of allergy. The results obtained substantiate the advisability of the eosinophilic neurotoxin test as a non-invasive method in the diagnosis of gastrointestinal food allergy.

To assess the impact of summer heat waves on key parameters of oxidative stress in patients with coronary heart disease.We included 30 male patients aged 5213 years with stable angina pectoris of IIIII functional class with at least one coronary artery stenosis proved by angiography (ischemic group) in comparison with 10 male patients aged 487 years with no angiographic sings of significant coronary stenosis and without angina manifestation (non-ischemic group). The following parameters were studied: activity of superoxide dismutase (Cu,Zn-SOD), catalase (CAT), glutathione peroxidase (GSH-Px), the level of malondialdehyde (MDA) and MDA-modified low-density lipoproteins (MDA-LDL). The analysis of indicators was performed at normal average daily temperature (daytime temperature not higher than 20С) and after a heat wave (daytime temperature above 27C for more than 2 consecutive days).Our study revealed the decrease of CAT and GSH-Px activities with increased activity of Cu,Zn-SOD in both groups after the heat wave. At the same time we observed accumulation of MDA and increased MDA-LDL level in both groups. Initially ischemic patients showed significantly increased level of CAT and GSH-Px activity compared to the non-ischemic group, while it was no difference in activity of Cu,Zn-SOD and MDA and MDA-LDL level. We observed significant reduce of Cu,Zn-SOD activity in ischemic patients compared to non-ischemic group with no significant differences in all other studied parameters of oxidative stress after heat wave.Changes in the key parameters of oxidative stress in patients with ischemic heart disease during summer heat waves are comparable to those in patients without ischemia, however significantly greater inhibition of GSH-Px activity and significantly lower increase in Cu,Zn-SOD activity was noted. These results may indicate misregulation of free radical processes in patients with ischemic heart decease.Цель. Исследовать изменение ключевых параметров окислительного стресса у больных с ишемической болезнью сердца (ИБС) при волнах летней жары. Материалы и методы. В исследование включены 30 мужчин (5213 лет) со стабильным клиническим течением ИБС и стенокардией напряжения IIIII функционального класса. Группу сравнения составили 10 мужчин (487 лет) с ангиографически доказанным отсутствием значимого поражения коронарного русла без проявлений стенокардии. Биохимические исследования включали: измерение активности эритроцитарных антиоксидантных ферментов (супероксиддисмутазы Cu,Zn-SOD, каталазы CAT, глутатионпероксидазы GSH-Px) и содержание продуктов свободнорадикального окисления (малонового диальдегида МДА и МДА-модифицированных липопротеидов низкой плотности МДА-ЛПНП). Анализ биохимических показателей проводили при нормальной среднесуточной температуре окружающей среды (дневная температура не выше 20С) и после волны жары (дневная температура не менее 27C на протяжении более 2 сут). Результаты. В обеих исследованных группах в ответ на тепловой стресс при волне жары отмечено снижение активности CAT и GSH-Px при увеличении активности Cu,Zn-SOD. Одновременно наблюдали увеличение уровня МДА и снижение уровня МДА-ЛПНП. Исходно в группе с ИБС выявлен достоверно повышенный уровень активности CAT и GSH-Px в сопоставлении с группой сравнения, тогда как по активности Cu,Zn-SOD, содержанию МДА и МДА-ЛПНП достоверных отличий не выявлено. После волны летней жары наблюдали существенное снижение активности Cu,Zn-SOD у больных с ИБС, тогда как достоверных межгрупповых различий всех других исследованных параметров окислительного стресса не отмечено. Заключение. Изменения ключевых параметров окислительного стресса в крови пациентов с ИБС при волнах летней жары в целом сопоставимы с таковыми в группе сравнения (без стенокардии с ангиографически доказанным отсутствием значимого поражения коронарного русла), однако при практически идентичном росте уровня МДА у пациентов этих групп отмечено значительно большее ингибирование активности GSH-Px при значительно меньшем увеличении активности Cu,Zn-SOD у больных с ИБС, что может свидетельствовать о большем нарушении регуляции свободнорадикальных процессов у этих пациентов.

Аbstract. Factors predisposing to the development of osteoarthritis in military personnel are analyzed. The physical stress inherent in military labor, for example, in the airborne troops, creates a high load on the joints and can cause the early dismissal of military personnel from the ranks of the Armed Forces of the Russian Federation. Based on the pharmacodynamics of chondroprotectors (stimulation of chondrocyte function, cartilage tissue regeneration processes, inhibition of the synthesis of inflammatory mediators, etc.), it can be argued that they have a significant effect on the pathogenetic mechanisms of the development of osteoarthritis, i.e. the mechanism of action of chondrocytes is reduced to the suppression of catabolic and stimulation of anabolic processes in the joints. The main principles of therapeutic nutrition for osteoarthritis are, a decrease in calorie intake, limiting the amount of carbohydrates, animal fats and salt consumed. A balanced diet, including sufficient macro- and micronutrients, has a therapeutic effect in patients with complaints of joint pain, helping to restore the damaged structure of the elements of the musculoskeletal system. The inclusion of dietary supplements in the diets of patients with complaints of joint diseases ensures the intake of nutrients necessary for the synthesis of glycosaminoglycans. These factors accelerate the rehabilitation of patients after extreme physical exertion and injuries of the musculoskeletal system inherent in military labor. An analysis of the materials of a clinical study a comparative study of the effectiveness of the treatment of osteoarthritis of the knee joint at the initial stage of the disease with the help of a representative of the group of chondroprotectors Аrthra containing chondroitin sulfate, glucosamine and non-steroidal anti-inflammatory drugs, is carried out. The introduction of chondroprotectors as a means of preventing osteoarthritis in the diets of military personnel experiencing extreme joint loads will strengthen the ligamentous-articular apparatus by normalizing cartilage moisture saturation, inhibiting the action of proteolytic enzymes and stimulating the synthesis of glucuronic acid, which improves the elasticity of connective tissue.

Aim. To perform a comparative analysis of clinical and anamnestic data and of the condition of primary hemostasis in chronic liver diseases in children and to identify additional informative diagnostic criteria that reflect severity of the course of autoimmune hepatitis (AIH) and chronic viral hepatitis C (CVHC) in children. Materials and Methods. 91 Patients from 3 to 7 years old were examined, of them: 60 children with AIH and 31 children with CVHC. The control group included 15 children of I and II health groups. In all the patients the clinic-anamnestic data and the condition of the primary hemostasis were evaluated. Concentrations of endothelin-1 and homocysteine, activity of Willebrand factor, amount of platelets and their aggregation activity were determined. Results. AIH is characterized by a more aggressive course as compared to CVHC manifested by clinical signs of a severe liver damage, significant biochemical changes and a high rate of fibrosis within the first two years. In all the children there were found disorders in the primary hemostasis interrelated with the main clinical and laboratory syndromes reflecting the severity of the liver damage. AIH is characterized by a higher concentration of homocysteine (р=0.007) and of the activity of Willebrand factor (р=0.037) in comparison with CVHC. Conclusions. Signs of a severe liver damage are not characteristic of children with CVHC in the first 10 years of the disease, however, disorders of the primary hemostasis are present characterized by hyperaggregation of platelets and by endothelial dysfunction. AIH in children is characterized by aggressive course and more pronounced deviations of the primary hemostasis in comparison with CVHC. In AIH and CVHC, the pathology of the primary hemostasis is closely related to some clinical-laboratory symptoms that reflect severity of the disease.

In modern obstetrics, an abnormal placental invasion is a serious problem associated with the following high perinatal losses: massive obstetric bleeding that leads to the death of both the mother and the fetus. Objective. The purpose of the study was to analyze the methods of delivery in patients with placenta accreta. Materials and methods. The study group consisted of 31 patients aged 25 to 42 years with placenta ingrowth, who underwent metroplasty in the Perinatal Center of V. D. Seredavin Samara Regional Clinical Hospital in the period from May 2018 to December 2019. Most often, placental ingrowth was detected in the second trimester of pregnancy (41.94 %). In 5 cases, placental ingrowth was diagnosed in the operating room (16.3 %). On average, the time of detection of ingrowth is 24.96 weeks of gestation. Results. Out of 31 patients we observed, 27 underwent metroplasty using complex compression hemostasis, and 1 patient underwent temporary balloon occlusion of the internal iliac arteries. The total volume of blood loss was 1625 485 ml, and the median was 1455 ml. Only 5 (17.24 %) patients had a blood loss of more than 2000 ml, and there was no blood loss of more than 3000 ml. Conclusions. Introduction of organ-preserving operations allows maintaining a woman's reproductive health, avoiding massive blood loss, and improving perinatal outcomes. Patients with a scar on the uterus after cesarean section, with placentation on the anterior wall and in the area of the scar on the uterus should be immediately sent to the third level of rendering specialized medical care.

The literature review compares the combined (vitreoretinal surgery with silicone tamponade and phacoemulsification of incipient cataract with intraocular lens implantation) and two-stage (phacoemulsification with intraocular lens implantation as a second step, simultaneously with the silicon oil removal, after vitreoretinal surgery) surgical treatment of patients with advanced proliferative diabetic retinopathy and complicated incipient cataract. Modern concepts of treatment tactics of this disease, its efficacy are analyzed. Benefits and drawbacks of each of the discussed surgical treatment methods are specified.

Introduction Hoffa's disease is a common condition, and is a severe pathology of the knee joint in many cases. Ultrasound with its capabilities and advantages can be a convenient method of primary diagnosis of this pathology. However, in the literature there is almost no description of the characteristic ultrasound picture of Hoffa’s disease and an analysis of the most common and pathognomonic symptoms. Objective To study ultrasound signs of Hoffa's disease and present the characteristic sonographic complex of its symptoms. Methods Ultrasound examination of the knee joint and arthroscopy of 37 patients diagnosed with Hoffa's disease, confirmed by a comprehensive clinical and instrumental study, was conducted. Results The most characteristic signs of Hoffa's disease in terms of pathological changes are hypertrophy of the Hoffa’s fat pad and changes in its structure, which were detected by ultrasound in 62 % and 84 % of cases, respectively. A new symptom, displacement of the patellar ligament, was identified by ultrasound examination of the knee joint according to the standard protocol in 32 % of the examined. The same percentage comprised the patients who had non-specific sonographic symptoms: an increase in the amount of synovial fluid, as well as signs of infrapatellar bursitis. Ultrasound data were compared with the results of arthroscopic examination, their correspondence was determined. Conclusion It has been established that the ultrasound examination of the knee joint according to the standard method enables to identify a complex of symptoms that are pathognomonic for Hoffa’s disease. It is recommended to introduce it in the protocol of the conclusion.

Obesity reduces the quality of life and life expectancy, whereas nonoperative interventions have shown poor results so far. Statins effectively combat hypercholesterolemia but are not well tolerated at high doses, raising the need for coprescription with cholesterol sorbents and/or absorption inhibitors. Montmorillonite (MMT) clay was found to attenuate hypercholesterolemia and obesity by reducing cholesterol and fat absorption. However, acicular clay-like sepiolite may offer better results due to its more substantial adsorption of nonpolar molecules. We herein aimed at (1) assessing in vitro the capacity of sepiolite to adsorb edible oil and cholesterol compared with that of MMT and (2) assessing in vivo the effect of continuous feeding on a high-fat high-cholesterol diet (HFD) (53.6% w/w fat and 0.2% cholesterol) supplemented with 5% (w/w) edible sepiolite, on diet-induced obesity rate, hypercholesterolemia, and hyperlipidemia. Fourier transform infrared spectroscopy showed in vitro that sepiolite adsorption of olive oil and cholesterol was five to eight times greater than that of MMT clay. Sepiolite supplementation to HFD fed to mature mice for 12.5 weeks resulted in lower total blood cholesterol and triacylglycerol levels and attenuated body weight gain, by reducing fat gain. Sepiolite supplementation did not affect energy intake but increased fecal extraction of sterols and lipids, without notable side effects. These results demonstrate that supplementing a HFD with sepiolite attenuates gastrointestinal absorption of dietary lipids and sterols, thus mitigating obesity, hyperlipidemia, and hypercholesterolemia. Further exploration of the efficacy, mechanism of action, and safety of sepiolite as a food supplement for combating the metabolic syndrome is needed.

The search for methods of cognitive impairment treatment and prevention in neurological and neurodegenerative diseases is an urgent task of modern neurobiology. It is now known that various diseases, accompanied by dementia, exhibit a pronounced neuroinflammation. Considering the significant docosahexaenoic and eicosapentaenoic polyunsaturated fatty acids’ therapeutic potential, we decided to investigate and compare anti-inflammatory activity of their N-acylethanolamine derivatives. As a result, we found that both N-docosahexaenoylethanolamine (synaptamide) and N-eicosapentaenoylethanolamine (EPEA) prevents an LPS-mediated increase in the proinflammatory cytokines TNF-α and IL-6 production in the SIM-A9 microglia culture. In an in vivo experiment, synaptamide reversed an increase in LPS-mediated hippocampal TNF-α and IL-1β, but EPEA did not. However, both compounds contributed to the microglia polarization towards the M2-phenotype. Synaptamide, rather than EPEA, inhibited the Iba-1-positive microglia staining area increase. However, both synaptamide and EPEA prevented the LPS-mediated astrogliosis. A study of BDNF immunoreactivity showed that synaptamide, but not EPEA, reversed an LPS-mediated decrease in BDNF production. Despite the more pronounced anti-inflammatory activity of synaptamide, both compounds were effective in maintaining a normal level of hippocampal long-term potentiation in neuroinflammation. The results indicate a high therapeutic potential for both compounds. However, some tests have shown higher activity of synaptamide compared to EPEA.

Background Abdominal circulation plays the important physiological role for structure and function of the digestive system, maintenance of nutrient homeostasis. Purpose To study the features of abdominal hemodynamics in patients with visceroptosis. Methods We studied 69 patients (mean age 22.28±3.7 years) with splanchnoptosis (visceroptosis) and 52 age- and sex- matched patients without splanchnoptosis (controls). Exclusion criteria: a history of digestive system surgery of taking blood circulation activating drugs. Doppler ultrasonography of the common hepatic artery, splenic artery, superior mesenteric artery, portal vein was performed on an empty stomach and 30 minutes after a food sample (standardized for proteins (14 g), fats (10 g) and carbohydrates (45 g)) using the Sonoace-8000 ultrasound scanner (Medison, South Korea). The data were analyzed using the Statistica-6 packages. Results There were no differences in hemodynamic parameters of fasting abdominal blood flow (ABF). After a food testing, in the postprandial period the ABF in all vessels in patients with splanchnoptosis was lower than in controls: the portal vein blood flow (BF) 1124,0 [1030,0–1419,0] ml/min vs 1373,0 [1136,0–1567,5] ml/min respectively (U=433,5; Z=−2,1; p=0,0342); the common hepatic artery BF 341,0 [295,0–394,0] ml/min vs 412,0 [331,0–521,0] ml/min respectively (U=335,0; Z=−2,3; p=0,0218); the splenic artery BF 396,0 [292,0–538,0] ml/min vs 502,0 [394,0–594,0] ml/min respectively (U=328,0; Z=−2,1; p=0,0399); the superior mesenteric artery BF 988,0 [837,0–1272,0] ml/min vs 1136,5 [992,0–1465,0] ml/min respectively (U=1625,5; Z=−2,2; p=0,0314). Changes in ABF were correlated with splanchnoptosis: the portal vein BF with any ptosis (rs=−0,21; p Conclusions Patients with splanchnoptosis in the postprandial period have low volumetric BF in abdominal aorta vessels. This can be associated with the length of the mesenteric vessels, which undergoes the greatest changes in splanchnoptosis. Food testing reveals latent BF deficit in patients with splanchnoptosis. Funding Acknowledgement Type of funding sources: None.

Under physiological conditions in vivo astrocytes internalize and degrade neuronal mitochondria in a process called transmitophagy. Mitophagy is widely reported to be impaired in neurodegeneration but it is unknown whether and how transmitophagy is altered in Alzheimer’s disease (AD). Here we report that the internalization and degradation of neuronal mitochondria are significantly increased in astrocytes isolated from aged AD mouse brains. We also demonstrate for the first time a similar phenomenon between human neurons and AD astrocytes, and in murine hippocampi in vivo. The results suggest the involvement of S100a4 in impaired mitochondrial transfer between neurons and aged AD astrocytes. Significant increases in the mitophagy regulator Ambra1 were observed in the aged AD astrocytes. These findings demonstrate altered neuron-supporting functions of aged AD astrocytes and provide a starting point for studying the molecular mechanisms of transmitophagy in AD.

Carcasses of northern fur seal pups, Callorhinus ursinus, collected from the rookeries of Bering Island (n = 133), were examined for hookworms Uncinaria spp. The parasite was found in 90% of the pups from the Severo-Zapadnoe rookery and in 45% of the pups from the Severnoe rookery. This difference in prevalence of nematode infection between the rookeries is associated with the type of substrate, as well as with the pattern of distribution of the seal reproductive groups on each of the rookeries.

Objective. To study the anemia relative frequency in hospitalized patients with chronic ischemic heart failure (CIHF), to assess its impact on the clinical course of the disease, to identify the frequency of risk factors and comorbid background that are associated with the presence of anemia. Material and methods. A retrospective analysis of 986 medical charts of inpatients with CIHF, who underwent inpatient treatment during the period from January 2016 to March 2019, has been carried out. The median age of the patients is 76 (53; 94) years. General clinical data, the results of laboratory and instrumental research methods have been evaluated. The statistical processing of the results has been performed using the software package “Statistica 13.0” according to modern requirements. Results. Among patients with CIHF, concomitant anemic syndrome occurred in 10.75% of cases, among which 57% were the ones with mild and moderate iron deficiency anemia. The distribution of patients with iron deficiency by the stage and functional class (FC) of CIHF has revealed that the majority of patients had CIHF stage IIA, FC II-III. More than half of the patients had a reduced left ventricular ejection fraction (LVEF). The severity of anemia affected the development of systolic dysfunction of the left ventricle, which was confirmed by the direct correlations of moderate strength between LVEF and hemoglobin and serum iron levels (rs = 0,51, rs = 0,36, respectively; p

Reduced dependence on glasses is an increasingly common expectation among those who want to take advantage of new surgical opportunities, especially for patients who lead an active lifestyle. Currently, due to the increase in the duration of active life in people over 40, there is a need for effective correction of presbyopia. Multifocal intraocular lenses are increasingly used in the treatment of presbyopia. After implantation of multifocal intraocular lenses most patients have no need for spectacle or contact vision. However, complications can affect the patient’s quality of life and level of satisfaction. The most common complications of multifocal correction are blurred vision and the presence of optical phenomena (“halo” and “glare”), associated with residual ametropia, clouding of the posterior capsule, large pupil size, anomalies of the wave front, dry eye and lens decentration. The main reasons for this are the failure to attempt to neuroadapt a patient, the dislocation of the lens, the residual refractive error and the clouding of the lens. The review presents the main features of various models of multifocal intraocular lenses, their implantation techniques, associated complications and methods for their correction. The development of multifocal correction of presbyopia and ametropia seems to be a promising direction in ophthalmic surgery.

The article substantiates the need for the use of botulinum therapy in the management of bruxism as a movement disorder. We present the technique of injecting a new Russian botulinum neuroprotein Relatox into the masticatory muscles of patients with bruxism. We have the positive clinical effects of botulinum therapy, a decrease in the level of pain on the visual analogue scale, normalization of muscle activity according to the surface electromyography of masticatory muscles, a decrease in number of nocturnal bruxism according to abrasion on the foil surface on Brux Checker are shown.

Background The Global Influenza Hospital Surveillance Network (GIHSN) aims to determine the burden of severe influenza disease and Influenza Vaccine Effectiveness (IVE). This is a prospective, active surveillance and hospital-based epidemiological study to collect epidemiological data in the GIHSN. In the 2016–2017 influenza season, 15 sites in 14 countries participated in the GIHSN, although the analyses could not be performed in 2 sites. A common core protocol was used in order to make results comparable. Here we present the results of the GIHSN 2016–2017 influenza season. Methods A RT-PCR test was performed to all patients that accomplished the requirements detailed on a common core protocol. Patients admitted were included in the study after signing the informed consent, if they were residents, not institutionalised, not discharged in the previous 30 days from other hospitalisation with symptoms onset within the 7 days prior to admission. Patients 5 years old or more must also complied the Influenza-Like Illness definition. A test negative-design was implemented to perform IVE analysis. IVE was estimated using a logistic regression model, with the formula IVE = (1-aOR) × 100, where aOR is the adjusted Odds Ratio comparing cases and controls. Results Among 21,967 screened patients, 10,140 (46.16%) were included, as they accomplished the inclusion criteria, and tested, and therefore 11,827 (53.84%) patients were excluded. Around 60% of all patients included with laboratory results were recruited at 3 sites. The predominant strain was A(H3N2), detected in 63.6% of the cases (1840 patients), followed by B/Victoria, in 21.3% of the cases (618 patients). There were 2895 influenza positive patients (28.6% of the included patients). A(H1N1)pdm09 strain was mainly found in Mexico. IVE could only be performed in 6 sites separately. Overall IVE was 27.24 (95% CI 15.62–37.27. Vaccination seemed to confer better protection against influenza B and in people 2–4 years, or 85 years old or older. The aOR for hospitalized and testing positive for influenza was 3.02 (95% CI 1.59–5.76) comparing pregnant with non-pregnant women. Conclusions Vaccination prevented around 1 in 4 hospitalisations with influenza. Sparse numbers didn’t allow estimating IVE in all sites separately. Pregnancy was found a risk factor for influenza, having 3 times more risk of being admitted with influenza for pregnant women. Electronic supplementary material The online version of this article (10.1186/s12889-019-6713-5) contains supplementary material, which is available to authorized users.

The review presents data on the antigenic structure and the current classification of epidemically significant serovariants of Listeria. Description of species-specific properties of serovariants of Listeria, which may be common for two or more species, and common antigens with staphylococci and typhoid and paratyphoid bacteria, are given. It has been shown that only the antigenic scheme of Listeria monocytogenes is of practical interest for medical microbiology. Importance of serotyping in the epidemiological analysis to determine the source of infections and ways of its spreading has been determined. Differences in the designation of serovariants in the diagnosis of listeriosis in medical practice are observed. High level of adaptive properties of Listeria, its ability to reproduce in an abiotic environment, including food, susceptibility of immunodeficient individuals, prevalence of food pathway of infection pose a significant danger of increased sickness rate with listeriosis. Serological diagnostics of Listeria has not been developed in detail, and the existing serological methods are aimed at identifying specific antibodies to listeria. Advantages of the serological method include: quick results and the possibility to study any biological material. Currently available serological methods have a number of disadvantages: low reliability of results and low specificity of the study. The most promising method for identification of a serological group of cultures, according to the world classification, is the multiplex PCR method, based on the correlation between the serogroup of an isolate and the presence of specific open reading frames in its genome.

Purpose. Evaluation of short-term (up to 9 months) results of new one-piece aspherical diffractive trifocal intraocular lens implantation. Patients and Methods. A prospective, open-label study included 65 patients (100 eyes) with presbyopia, who received cataract extraction with the implantation of a new IOL AcrySof PanOptix® trifocal. The average age of the patients was 60.0 ± 12.1 years. 35 patients underwent bilateral correction with multifocal IOLs, and 30 had a monolateral correction. In 21 % (n = 21) cases, femtolaser support of cataract extraction was performed. In 9 eyes (9 %) the primary posterior capsulorhexis was performed. The range of optical power of implanted IOLs was 13 to 30 D. The follow-up period was from 6 to 9 (6.8 ± 0.9) months.Results. On the 1 day after the MIOL implantation, an UCIVA increase was from 0.22 ± 0.19 to 0.76 ± 0.23 (p < 0.05), at follow-up to 6 months up to 0.85 ± 0.22. One day after surgery, the UCIVA increased from 0.23 ± 0.19 to 0.7 ± 0.25 (p < 0.05), with following raise up to 0.84 ± 0.24 in the maximum follow-up period of 6 months. UCFVA in the preoperative period was 0.27 ± 0.23, with an increase to 0.78 ± 0.23 (p < 0.05) for 1 day and 0.93 ± 0.18 at 6 months. The BCNVA increase was from 0.56 ± 0.25 before surgery to 0.8 ± 0.19 on the 1st day after cataract removal (p < 0.05) and 0.98 ± 0.16 at the 6 months follow-up period. Similar data (0.58 ± 0.29, 0.82 ± 0.21, and 0.95 ± 0.14) was noted for BCIVA. An BCFVA increase was from 0.71 ± 0.28 in the preoperative period to 1.0 ± 0.04 (p < 0.05) after 6 months. The primary endpoint of the study (BCFVA = 1.0) in the group was achieved in 83 % of cases (n = 83). The effect of glare was noted in 17 patients (26.1 %), halo in 9 (13.8 %), driving difficulties in 6 (9.2 %). The overwhelming majority of patients (96.9 %) rated the result of the operation as “excellent” (n = 51, 78.5 %) and “good” (n = 14, 21.5 %).Conclusion. Implantation of the examined IOL is associated with a high efficiency for near, intermediate distance and far vision correction. A new trifocal IOL may be recommended for use in clinical practice. Further comparative studies including other multifocal IOLs are needed to determine the indications and contraindications for its implantation.

Emerging research has outlined the possibility for virtual reality (VR) experiences, which situate users into the perspective of someone living with dementia, to enhance dementia awareness. Currently, there is limited VR research that engages care home practitioners. It is imperative this population has high levels of dementia education given their requirements to provide care and support to residents, many of whom will be living with the condition. This paper reports on an exploratory qualitative study designed to elicit the experiences of care home practitioners who engaged with the VR application: ‘A walk through dementia’. Twenty practitioners, across four care homes in the United Kingdom, watched the VR scenarios and provided their views on the experience and the potential for the VR tool to be developed into a wider training programme to support dementia awareness. Data were collected via focus group discussions. Following an inductive thematic analysis, we constructed three themes. These suggested participants perceived the VR application offered them a convincing and immersive experience that was insightful and evocative, and provided ‘next-level’ dementia-awareness training that enabled them to reflect on care practices. Although the findings highlight important challenges for practitioners and developers wishing to use VR within dementia care, they suggest this application may be an engaging experiential learning tool that can provide care home staff with deeper cognitive and emotional awareness of living with dementia. Further work, drawing on these preliminary insights, is required to ensure the VR tool can be incorporated into a training programme that can positively contribute to the ‘dementia-friendly communities’ agenda.

Glaucoma is a chronic progressive disease. It involves more than 60 million people worldwide. Primary open-angle glaucoma (POAG) is one of its commonest forms. About 2.71 million people in the United States suffered from POAG in 2011. Currently, POAG is a major cause of irreversible vision loss. The risk of blindness in patients with treated open-angle glaucoma is 27%. It is known that the death of optic nerve cells can be triggered by mechanical stress caused by ocular hypertension, which induces neuronal apoptosis and occurs in patients with POAG. Many scientific publications are dedicated to proteins and genes involved in the development of POAG, including neuronal apoptosis and the cell response to mechanical stress (CRMS). However, the molecular mechanisms underlying the pathophysiology of POAG are still poorly understood. The reconstruction of associative networks describing the functional interactions between these genes/proteins, including biochemical reactions, regulatory interactions, and transport, requires automated knowledge extraction from scientific publications. This work aims to analyze the associative networks describing molecular interactions between proteins and genes involved in CRMS, neuronal apoptosis, and the development of POAG. It has been shown that genes associated with POAG are statistically significantly overrepresented among the genes involved in the interactions between CRMS and neuronal apoptosis in comparison to what is expected on a random basis. This finding may explain how POAG causes the death of the retinal ganglion cell.

The Tomsk region located in the south of Western Siberia is one of the most high-risk areas for tick-borne diseases due to elevated incidence of tick-borne encephalitis and Lyme disease in humans. Wild birds may be considered as one of the reservoirs for tick-borne pathogens and hosts for infected ticks. A high mobility of wild birds leads to unpredictable possibilities for the dissemination of tick-borne pathogens into new geographical regions. The primary goal of this study was to evaluate the prevalence of tick-borne pathogens in wild birds and ticks that feed on them as well as to determine the role of different species of birds in maintaining the tickborne infectious foci. We analysed the samples of 443 wild birds (60 species) and 378 ticks belonging to the genus Ixodes Latraille, 1795 collected from the wild birds, for detecting occurrence of eight tick-borne pathogens, the namely tick-borne encephalitis virus (TBEV), West Nile virus (WNV), and species of Borrelia, Rickettsia, Ehrlichia, Anaplasma, Bartonella and Babesia Starcovici, 1893, using RT-PCR/or PCR and enzyme immunoassay. One or more tick-borne infection markers were detected in 43 species of birds. All markers were detected in samples collected from fieldfare Turdus pilaris Linnaeus, Blyth’s reed warbler Acrocephalus dumetorum Blyth, common redstart Phoenicurus phoenicurus (Linnaeus), and common chaffinch Fringilla coelebs Linnaeus. Although all pathogens have been identified in birds and ticks, we found that in the majority of cases (75.5%), there were mismatches of pathogens in birds and ticks collected from them. Wild birds and their ticks may play an extremely important role in the dissemination of tick-borne pathogens into different geographical regions.

Vitreoretinal surgery (VRS) is the «gold standard» for surgical treatment of patients with proliferative diabetic retinopathy (PDR). However, the timing for the removal of primary cataract in this category of patients remains uncertain.To evaluate the effectiveness of multistage surgical treatment of patients with advanced PDR complicated with primary cataract.The study involved 94 cases of surgical treatment of patients with PDR and complicated primary cataract. These patients were divided into two groups depending on the treatment tactics. In the first group, patients were subjected to a two-step surgical procedure: VRS with silicone oil tamponade performed as the first step in their treatment followed by phacoemulsification, silicone oil removal, and IOL implantation, respectively, as the second step. In subgroup 1a - VRS was performed with standard pharmacological support. In subgroup 1b - intravitreal injection of angiogenesis inhibitors preceded VRS. In the second group, the first step was phacoemulsification performed simultaneously with vitreoretinal surgery with silicone oil tamponade; the second step consisted of removing silicone oil from the vitreous cavity. Subgroup 2a - surgical treatment was performed with standard pharmacological support (similar to subgroup 1a). Subgroup 2b - intravitreal injection of anti-VEGF drugs preceded VRS.Visual functions improved in 88.8% and 83.4% of cases in subgroups 1a and 1b, and in 51.3% and 66.7% in subgroups 2a and 2b, respectively.The study confirms the effectiveness of staged (multi-step) surgical treatment of patients with advanced proliferative diabetic retinopathy and complicated primary cataract. Conducting phacoemulsification sometime later along with silicone oil removal in PDR patients with preoperative intravitreal injection of angiogenesis inhibitors is a gentler approach for the anatomic structures of the eye during the first stage (VRS) and contributes to the reduction in the number of intraoperative and postoperative complications.«Золотым стандартом» хирургического лечения пациентов с далекозашедшей стадией пролиферативной диабетической ретинопатии (ПДР) является витреоретинальная хирургия (ВРХ). При этом вопрос о сроках удаления начальной катаракты у этой категории больных остается открытым до настоящего времени.Изучить эффективность многоэтапной витреальной хирургии у пациентов с далекозашедшей стадией ПДР и осложненной начальной катарактой.В исследование включены 94 пациента с ПДР и осложненной начальной катарактой, разделенных на две группы. 1-я группа: первый этап — ВРХ с силиконовой тампонадой, второй этап — факоэмульсификация катаракты (ФЭК) с имплантацией ИОЛ одновременно с плановым удалением силиконового масла (СМ). Подгруппа 1a — ВРХ проводилась со стандартным фармакологическим сопровождением. Подгруппа 1b — ВРХ с предварительным интравитреальным введением (ИВВ) ингибитора ангиогенеза. 2-я группа: первый этап — ФЭК с имплантацией ИОЛ одномоментно с ВРХ+силиконовая тампонада, второй этап — удаление СМ из витреальной полости. Подгруппа 2a — хирургическое лечение выполняли на фоне традиционной фармакотерапии (аналогично подгруппе 1a). Подгруппа 2b — перед ВРХ интравитреально вводили анти-VEGF-препарат.Улучшение зрительных функций в подгруппах 1a и 1b достигнуто в 88,8 и 83,4%, в подгруппах 2a и 2b— в 51,3 и 66,7% случаев соответственно.Результаты проведенного исследования подтверждают эффективность поэтапного хирургического лечения пациентов с далекозашедшей стадией ПДР и осложненной начальной катарактой. Выполнение ФЭК вторым этапом после ВРХ во время удаления СМ у пациентов с предварительным ИВВ ингибиторов ангиогенеза обеспечивает наиболее щадящий подход к хирургическому лечению этой категории больных, что позволяет улучшить анатомические и функциональные результаты ВРХ и способствует уменьшению числа интра- и послеоперационных осложнений.

Theranostic approach is currently among the fastest growing trends in cancer treatment. It implies the creation of multifunctional agents for simultaneous precise diagnosis and targeted impact on tumor cells. A new type of theranostic complexes was created based on NaYF4: Yb,Tm upconversion nanoparticles coated with polyethylene glycol and functionalized with the HER2-specific recombinant targeted toxin DARPin-LoPE. The obtained agents bind to HER2-overexpressing human breast adenocarcinoma cells and demonstrate selective cytotoxicity against this type of cancer cells. Using fluorescent human breast adenocarcinoma xenograft models, the possibility of intravital visualization of the UCNP-based complexes biodistribution and accumulation in tumor was demonstrated.