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Cardiovascular diseases (CVD) are a global medical, social and economic problem. Currently, the search and study of new biological markers that can provide early diagnosis of CVD, serve as a laboratory tool for evaluating the effectiveness of treatment or be used as prognostic markers and criteria for risk stratification continues. The interest of scientists is focused on the study of the type 1 lectin-like receptor for oxidized low-density lipoproteins (LOX-1) as a diagnostic and prognostic marker in CVD. The presented literature review highlights the potential significance of the LOX-1 study as a diagnostic and prognostic laboratory tool in CVD. It is expected that future clinical and experimental studies will confirm the possibility of using LOX-1 as an additional non-invasive tool for diagnosis and prognosis assessment in patients with CVD. Modulation of LOX-1 levels and expression using pharmacological drugs may prove to be a promising direction for the treatment of CVD.

We present a case of a rare lymphoproliferative disease diagnosed while differentiating between the causes of exudative-constrictive pericarditis. An 83-year old man was hospitalized with shortness of breath, edema and newly diagnosed atrial fibrillation (AF). Initially, the signs and symptoms were interpreted as manifestations of heart failure due to old myocardial infarction, arterial hypertension and AF. However, no significant systolic or diastolic dysfunction of the left ventricle and valve disease were identified and natriuretic peptide level was normal. Despite treatment, dyspnea and edema persisted, and pleural effusion (requiring drainage) and pericardial effusion increased. Repeated echocardiography showed signs of exudative-constrictive pericarditis. We consequently excluded the infectious (tuberculosis) and non-infectious (electrolyte disorders, hypothyroidism, solid tumors) etiologies of effusion. Taking into account the long-standing mediastinal lymphadenopathy (the patient had been previously examined, but the cause not identified), anemia, episodes of low-grade fever, weight loss, and polyneuropathy, a lymphoproliferative disease was suspected. Serum protein electrophoresis identified an M spike in the gamma globulin region. Immunophenotyping of peripheral blood lymphocytes and immunohistochemical examination of bone marrow confirmed the diagnosis of mantle cell lymphoma. The patient was referred for specialized treatment. At 5 months of the follow-up, the therapy was successful, the patient was stable with no cardiac complaints, no edema, and no new AF episodes. The case demonstrates the need to strictly follow differential diagnostic algorithms to identify the causes of nonspecific symptoms beyond one medical specialty.

Chronic heart failure (CHF) is a global medical, social and economic problem. Currently, the search and study of new biomarkers that can provide early diagnosis of CHF, serve as a laboratory tool for assessing the effectiveness of treatment, or be used as prognostic markers and risk stratification criteria are ongoing. Scientists' interest is focused, in particular, on studying the role of fibroblast growth factor 21 (FGF21) in CHF. There is increasing evidence highlighting the value of FGF21 as a new marker for the diagnosis and assessment of prognosis in patients with CHF. The role of FGF21 in CHF is very interesting due to its cardioprotective aspects. Final confirmation of the diagnostic, prognostic and therapeutic roles of FGF21 will come from future studies.

Chronic heart failure (CHF) is a global medical, social, and economic problem. It is a syndrome caused by imbalanced neurohumoral regulation of the cardiovascular system, which is accompanied by impaired systolic and/or diastolic function of the heart. Currently, the search and study of new biological markers that can help in the early diagnosis of CHF, serve as a laboratory tool for assessing treatment effectiveness, or be used as prognostic markers and risk stratification criteria are ongoing. Researchers focused on studying the role of Klotho protein, fibroblast growth factor 23 (FGF23), and sclerostin in patients with CHF. Klotho expression decreases as the body ages, and impaired production has been reported in various aging-related diseases. The FGF23 / Klotho axis plays a key regulatory role in cardiovascular pathology. Laboratory, clinical, and genetic studies have suggested that sclerostin is associated with heart disease, although available data are not entirely consistent. Clinical work conducted on the study of the Klotho protein, FGF-23, and sclerostin indicates the potentially important diagnostic and prognostic significance of their analysis in patients with CHF. Thus, more studies of the issues related to serial testing of these biological markers, including in the aspect of the multibiomarker model, are needed.

Despite significant advances in medicine, cardiovascular disease continues to be the leading cause of death worldwide. An important task in cardiology is the search and study of new cardiovascular biological markers. In recent years, salusins have attracted the interest of scientists. Salusins are endogenous biologically active peptides, which were first identified in 2003. Thus far, studies have demonstrated that salusin-α and salusin-β play important roles in vascular remodeling, inflammation, hypertension, and atherosclerotic processes. Salusin-α exhibits an antiatherogenic effect, whereas salusin-β plays a proatherogenic role. Despite the diverse biological, physiological, and pathophysiological aspects of salusins, the exact mechanism of their cardiovascular effects is not fully known. Further in-depth studies of the role of salusins in cardiovascular diseases are required. The regulation of the concentration and expression of salusin-α and salusin-β may prove to be a promising strategy for the treatment of patients with cardiac diseases.

Cardiovascular pathology is a leading cause of morbidity and mortality. An important task of modern cardiology is the search and study of new biological markers. Scientists’ interest is actively focused on the study of interleukin-38. Interleukin-38 is an anti-inflammatory cytokine and a member of the interleukin-1 family. This study aimed to analyze literature sources devoted to the study of interleukin-38 as a cardiovascular biological marker. Literature sources, including all relevant publications in PubMed (MEDLINE), RSCI, Google Scholar, and Science Direct, were analyzed. The search depth was 9 years. Interleukin-38 is found in the skin, heart, placenta, fetal liver, spleen, thymus, and activated B cells of the tonsils. Interleukin-38 protein is detected in human plasma, serum, and cell cultures by enzyme-linked immunosorbent assay. Interleukin-38 regulates immune and inflammatory responses by binding to its receptors and activating downstream signals. Its deficiency is associated with increased systemic inflammation in aging, cardiovascular diseases, and metabolic diseases. Currently, not much clinical and experimental data have been accumulated regarding the effect of interleukin-38 on the cardiovascular system; however, further studies are expected to demonstrate the possibility of its use as an additional laboratory tool for diagnosis and assessment of prognosis in patients with cardiac problems. Regulating the concentration and expression of interleukin-38 is a promising strategy for the treatment of cardiovascular diseases.

Introduction. The objects of the research are experimental specimens of glued laminated wood with a steel rod glued along the wood fibres in each of them. The subject of the research is the values of resistance of wood to pulling out or push-through of the rod glued along the fibres, as well as the compliance of the joint. The goal of the research is to calculate the resistance according to the test results and compare the obtained value with normative data. The relevance of the research is due to the widespread application in construction of glued wood structures and joints on glued rods. The obtained data can be used in calculation models and in the calculation of nodes.Materials and methods. Experiment and calculation methods are used in the research.Results. The results of five specimens were used to obtain the values of total deformations for each stage of loading. It occurred due to chipping of the wooden element along the fibres at the border of the adhesive joint and the wood. Wood resistance and compliance values for each specimen were calculated and tabulated. The normative value of wood resistance was obtained. It exceeded the value specified in the normative document data. A numerical normative value of compliance was also obtained.Conclusions. The excess of the resistance obtained from the experiment over the value in the normative document indicates its applicability with provided safety factor. In the calculation of unique structures according to special technical specifications, it is possible to use an increased resistance value obtained as the result of the experiment. The compliance of a rigid joint on rods glued along the fibres is small. In wooden structures it is not possible to avoid it completely.

The main cause of many cardiovascular diseases is atherosclerosis. The atherosclerotic process, manifested by acute vascular accidents, such as myocardial and/or cerebral infarction, or chronic ischemic conditions, such as coronary heart disease and cerebrovascular disease, is essentially a systemic inflammatory process. The significant role of T-cells, macrophages, neutrophils and cytokines in this pathological process has been proven. The presented literature review indicates the potentially important diagnostic and prognostic value of the interleukin-27 assessment. It is expected that further scientific and clinical studies will demonstrate the possibility of using this cytokine as an additional laboratory tool for the diagnosis, risk stratification and prediction of cardiovascular events in patients with a cardiac profile.

Abstract The genomic landscape of Stone Age Europe was shaped by multiple migratory waves and population replacements, but different regions do not all show similar patterns. To refine our understanding of the population dynamics before and after the dawn of the Neolithic, we generated and analyzed genomic sequence data from human remains of 56 individuals from the Mesolithic, Neolithic, and Eneolithic across Central and Eastern Europe. We found that Mesolithic European populations formed a geographically widespread isolation-by-distance zone ranging from Central Europe to Siberia, which was already established 10,000 years ago. We found contrasting patterns of population continuity during the Neolithic transition: people around the lower Dnipro Valley region, Ukraine, showed continuity over 4000 years, from the Mesolithic to the end of the Neolithic, in contrast to almost all other parts of Europe where population turnover drove this cultural change, including vast areas of Central Europe and around the Danube River.

Аim: diagnosis and treatment algorithms in the clinical recommendations intended for general practitioners, gastroenterologists, infectious disease specialists, hepatologists on the of chronic hepatitis C are presented.Summary. Chronic viral hepatitis C is a socially significant infection, the incidence of which in the Russian Federation remains significantly high. Over the past 10 years, great progress has been made in the treatment of hepatitis C — direct acting antiviral drugs have appeared. The spectrum of their effectiveness allows to achieve a sustained virological response in more than 90 % of cases, even in groups that were not previously considered even as candidates for therapy or were difficult to treat — patients receiving renal replacement therapy, after liver transplantation (or other organs), at the stage of decompensated liver cirrhosis, HIV co-infected, etc. Interferons are excluded from the recommendations due to their low effectiveness and a wide range of adverse events. The indications for the treatment have been expanded, namely, the fact of confirmation of viral replication. The terms of dispensary observation of patients without cirrhosis of the liver have been reduced (up to 12 weeks after the end of therapy). Also, these recommendations present approaches to active screening of hepatitis in risk groups, preventive and rehabilitation measures after the end of treatment.Conclusion. Great success has been achieved in the treatment of chronic hepatitis C. In most cases, eradication of viral HCV infection is a real task even in patients at the stage of cirrhosis of the liver, with impaired renal function, HIV co-infection, after solid organs transplantation.

In recent years, the attention of scientists has been actively focused on studying the role of endocan as a biological marker of endothelial dysfunction in cardiovascular diseases. Until recent years, endocan has been studied in acute kidney injury, chronic kidney disease, and renal replacement therapy. Endocan, formerly known as endothelial cell-specific molecule-1, is a soluble dermatan sulfate proteoglycan expressed and secreted into the circulation from endothelial cells. Currently available studies demonstrate the diagnostic and prognostic value of endocan evaluation in cardiovascular pathology. It is expected that further scientific and clinical studies will demonstrate the possibilities of using endocan as an additional laboratory tool for diagnosing and assessing the prognosis in patients with a cardiac profile. Drug regulation of endocan concentration and expression may be a promising target for the treatment of cardiac and vascular pathology.

Bakers cyst (BC) is a common condition and can be caused by both inflammatory and non-inflammatory disorders. Small BCs are usually asymptomatic and accidentally revealed. Large BCs present with pain and discomfort in the posterior knee as well as certain limitations of mobility. Large BCs may rupture resulting the fluid efflux down into the calf, which in turn presents with acute pain and number of potential thrombotic and neural complications. On another note, BC rupture requires differentiation with some urgent conditions such as venosus or arterial thrombosis, soft tissue infections etc. In this article we present some aspects of the etiopathogenesis, clinical signs and course of the BC. We also discuss the problematic issues of assessment and diagnostic work-up in case of BC ruptures.

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

Breast cancer (BC) is the most common malignant neoplasm in women in the Russian Federation. Today, biological markers that characterize the individual characteristics of the tumor, such as the tendency to metastasize, hormonal sensitivity, are of great importance for the diagnosis and treatment of patients with breast cancer. Among the genes associated with hereditary breast cancer, there are genes with high penetrance (BRCA1, BRCA2, MLH1, MSH2, STK11, PTEN, TP53 and APC) and genes with moderate penetrance (CHEK2, ATM and PALB2). All of the listed above genes are responsible for DNA repair by homologous recombination, and they represent a group of HRR genes (homologous recombination-related genes). Mutations in the BRCA1 and BRCA2 genes can also initiate cancer of the ovaries, pancreas, and prostate. Understanding of the molecular and genetic nature of an oncological disease allows applying targeted drugs to therapy of a disease.

Melanoma is an aggressive malignancy of the skin and mucosa of neuroepithelial nature, heterogeneous both in phenotype and molecular genetic characteristics, with a high risk of progression and a steadily increasing incidence of about 5% a year. The development of melanoma is due to both external (UV exposure) and internal factors, the main ones being mutations in oncogenes and tumour suppressor genes. Hyperactivation of RAS/RAF/MEK/ERK signalling pathway is observed in 75% of skin melanoma cases, and one of its key factors is serine threonine kinase encoded by BRAF gene. Oncogenic mutations of BRAF mimic the phosphorylation of the activation loop of the protein, which results in BRAF being in a permanently activated state. Subsequent operation of the MAPK signalling pathway in a non-stop mode and loss of BRAF negative feedback leads to uncontrolled cell growth and proliferation. The most common mutations in the BRAF gene are p.V600E (valine replacement for glutamic acid), which accounts for up to 95% of all BRAF-mutant melanomas, and p.V600K (valine replacement for lysine), which can account for up to 20% of cases or more. Development of non-selective and selective inhibitors of mutant BRAF protein make mutation in this gene a predictive marker of response and efficacy of targeted therapy.

Currently, the search and study of new biological markers that can provide early diagnosis of cardiovascular diseases, serve as a laboratory tool for assessing the effectiveness of treatment, or be used as prognostic markers and risk stratification criteria is ongoing. Our literature review indicates the potentially important diagnostic and prognostic value of assessing members of the interleukin-6 family. It is expected that further scientific and clinical studies will demonstrate the possibility of using members of the interleukin-6 family as an additional laboratory tool for the diagnosis, risk stratification and prediction of cardiovascular events in cardiac patients. It is necessary to evaluate in detail the possibilities of blockade of these interleukin-6 molecules in patients with cardiovascular diseases in vitro and in vivo.

Patients with chronic liver diseases (CLD) are at high risk of infection and severe COVID-19 (Corona Virus Disease).Aim: to create a database of patients with CLD, including an analysis of the frequency of detection of SARS-CoV-2 markers, the causes of hospitalization, an assessment of 30-day mortality in the presence of COVID-19 markers and in the absence of infection.Materials and methods. A one-time retrospective observational comparative study was conducted, the result of which was the creation of a database. 693 electronic case hystories of patients with CLD of various etiologies hospitalized in the V.M. Buyanov State Clinical Hospital for the period 01.04.2020–01.10.2021 were analyzed. Th e analysis included the following parameters: gender, age, etiology of the disease, reasons for hospitalization, the presence of ribonucleic acid (RNA) SARS-CoV-2 in a smear of the nasal mucosa and oropharynx, antibodies to SARS-CoV-2 immunoglobulins of classes M, G (IgM, IgG), the outcome of the disease (30-day mortality).Results. Markers of past new coronavirus infection (IgG) were detected in 268 (38,7 %), SARS-CoV-2 RNA was detected in 67 (9,7 %). Th e analysis of the causes of hospitalization revealed the predominance of edematous ascitic syndrome (64,5 %), an increase in hepatic encephalopathy (31,6 %) and an increase in the number of cases of portal vein thrombosis (PVT) (8,9 %). When assessing the 30-day mortality, signifi cant diff erences were found in patients with Alcohol-related liver disease (ARLD), chronic viral hepatitis in the presence of COVID-19 markers and in cases of their absence.Conclusion. SARSCoV-2 markers were found in 335 (48,3 %) of patients with CLD. Th e main reason for hospitalization is the appearance /increase of edematous ascitic syndrome, including due to PVT. 30-day mortality in the postcovid period is signifi cantly higher (р = 0,0246) in ARLD compared with patients without COVID-19 (218 (34,9 %) и 300 (25,3 %), respectively, р = 0,0246).

Heart failure is an important medical, social and economic problem around the world. In recent years, a number of diagnostic and prognostic biological markers of blood in cardiovascular diseases have been studied. Identification of new biological markers, analysis of their pathophysiological aspects and changes in concentration under the influence of various treatment options, allow us to understand many pathogenetic features of the development and course of heart failure. In recent decades, natriuretic peptides have been introduced into clinical practice, which are widely used as reliable markers for diagnostic and prognostic assessment. Growth differentiation factor-15 is a cytokine belonging to the family of transforming growth factors, the activity of which is significantly increased under stress and inflammation. In patients with chronic heart failure, the concentration of this marker is associated with an increased risk of overall mortality and adverse cardiovascular events; in patients with heart failure with preserved left ventricular ejection fraction, the use of the marker showed prognostic and diagnostic significance. Data from the Framingham Heart Study showed that growth differentiation factor-15 was the only marker in multivariate analysis that showed a statistically significant association with all adverse cardiovascular events. Eight studies showed that overexpression of growth differentiation factor-15 was associated with an increased risk of mortality in patients with heart failure. It was shown that growth differentiation factor-15 as a prognostic marker in patients with acute heart failure is not inferior to the brain natriuretic peptide precursor. To confirm the value of this marker in blood in patients with heart failure, it is necessary to conduct extensive prospective randomized clinical trials.

The epidemic of heart failure (HF) is one of the problems that the global health system has been facing for decades. HF is a multicomponent clinical syndrome caused by dysfunction of the heart and its pathological remodeling. In addition to the well-known natriuretic peptides, a number of cardiovascular biological markers have now been identified that provide clinicians with additional opportunities in diagnosing, classifying, predicting, and monitoring the effectiveness of treating patients with HF. From the position of establishing the sympathetic load in patients with HF, it seems very promising to assess the concentrations of catestatin. The presented data of our literature review suggest that catestatin is probably a reliable biological marker of the activity of the sympathetic division of the autonomic nervous system, and its elevated concentrations in patients with HF reflect the severity of the pathological process. However, despite the reliable results of studies, the clinical significance of assessing the values of this marker both separately and in the framework of a multimarker model requires further study in larger prospective clinical studies.

Aim: present clinical guidelines, aimed at general practitioners, gastroenterologists, cardiologists, endocrinologists, comprise up-to-date methods of diagnosis and treatment of non-alcoholic fatty liver disease.Key points. Nonalcoholic fatty liver disease, the most wide-spread chronic liver disease, is characterized by accumulation of fat by more than 5 % of hepatocytes and presented by two histological forms: steatosis and nonalcoholic steatohepatitis. Clinical guidelines provide current views on pathogenesis of nonalcoholic fatty liver disease as a multisystem disease, methods of invasive and noninvasive diagnosis of steatosis and liver fibrosis, principles of nondrug treatment and pharmacotherapy of nonalcoholic fatty liver disease and associated conditions. Complications of nonalcoholic fatty liver disease include aggravation of cardiometabolic risks, development of hepatocellular cancer, progression of liver fibrosis to cirrhotic stage.Conclusion. Progression of liver disease can be avoided, cardiometabolic risks can be reduced and patients' prognosis — improved by the timely recognition of diagnosis of nonalcoholic fatty liver disease and associated comorbidities and competent multidisciplinary management of these patients.

There are significant medical, social and economic effects, such as decrease in the frequency of postoperative complications, mortality and reduction of hospital stay. The key aspects of the enhanced recovery program are preoperative preparation, anesthesia, postoperative analgesia, in particular multimodal analgesia and regional analgesia, and early rehabilitation. The implementation of the enhanced recovery program for knee and hip replacement in medical institutions of the Russian Federation based on clinical studies and meta-analyses of a high level of evidence, will improve the quality of medical care and patient satisfaction. It is important to note the need to develop the Russian recommendations taking into account experience of using various methods of enhanced recovery in domestic medical institutions, as well as the specific organization features of the Russian healthcare system. This will serve as a basis for further widespread implementation of protocols for enhanced recovery after surgery in this country.

Osteoporosis is a widespread metabolic disease of the skeleton among the elderly. Osteoporotic fractures are significant manifestation of the disease, which can substantially affect the quality of life. The purpose of this article is to review approaches to the management of patients with acute osteoporotic fracture. This article consists of two parts. The first part reviews general information about osteoporosis, clinical course of osteoporotic fracture, differential diagnosis of pain syndrome, methods of visualization of fractures, differential diagnosis of osteoporosis. In the second part, we discuss differential diagnosis of osteoporotic fracture according to the data of imaging methods, non-pharmacologic, pharmacologic and surgical methods of treatment.

Inflammation is a universal response of a living organism to various damaging factors and is aimed at restoring tissue integrity and minimizing cell death. Proinflammatory cytokines, in particular interleukins, are active participants in the inflammatory response. In patients with heart failure, inflammatory reactions lead to damage to cardiomyocytes, their apoptosis and activation of neurohumoral systems, which contribute to the initiation of myocardial hibernation and mechanisms of its remodeling. The purpose of this review is to consider IL-1 as a diagnostic and prognostic marker in heart failure, as well as the effect of treatment with a recombinant form of IL-1R on the course of the disease.

Colorectal cancer is one of the most frequently diagnosed malignant tumors in men and women, which is a highly heterogeneous group of neoplasms consisting of subclasses with different molecular and clinical characteristics, and, as a consequence, patients with different types of tumors require different treatment protocols. Among the predictive factors of treatment response in patients with metastatic colorectal cancer, the most studied are the genes of the RAS family (KRAS, NRAS). Determination of RAS status is the first step in individual selection of drug therapy in patients with metastatic colorectal cancer. Patients with certain mutations in KRAS and NRAS genes are resistant to anti-EGFR therapy and have a lower median survival than WT (wild type) genotypes, indicating a negative prognosis in the presence of mutations.

Background: assessment of type, prevalence and duration of residual symptoms after COVID-19 in recent studies is controversial because of differences in design. Aim: to assess the prevalence and severity of symptoms in the long-term period after COVID-19. Materials and methods: patients hospitalized with COVID-19 in the period 13.04.2020-10.06.2020 were interviewed by phone: 195 (58,2 %) convalescents at 143 (131-154) days after disease onset and 183 (54,6 % ) of them at 340 (325-351) days. Results: The subjective assessment of health status with 100-point scale before and after the COVID-19 was 95 (80-100) and 80 (70-96) points, p< 0,001, at first interview; 90 (80-100) and 80 (60-90) points, p< 0,001, at second one. Various complaints were detected in 63 % of respondents at the first interview and in 75 % at the second, the number of identified symptoms was 2 (0-6) and 4 (1-8) respectively. The most frequent complaints were weakness/fatigue (31.3 and 47.5 % of respondents), joint pain (31.3 and 47.5 %) and dyspnoe/shortness of breath (31.3 and 43.2 %). The growth of these indicators can be associated with a change in the interview methodology. The severity of the symptoms at second interview was low: fatigue — 3 (0-6) points, shortness of breath — 0 (0-3) points; joint pain, weakness and dyspnoe — 0 (0-5) points each. Conclusion: a decrease of health status can sustain for a long time after COVID-19. Symptoms persist in a significant proportion of convalescents, but their severity in the end of follow-up is quite low.

Osteoporosis is a widespread metabolic disease of the skeleton among the elderly. Osteoporotic fractures are significant manifestation of the disease, which can substantially affect the quality of life. The purpose of this article is to review approaches to the management of patients with acute osteoporotic fracture. This article consists of two parts. The first part reviews general information about osteoporosis, clinical course of osteoporotic fracture, differential diagnosis of pain syndrome, methods of visualization of fractures, differential diagnosis of osteoporosis. In the second part, we discuss differential diagnosis of osteoporotic fracture according to the data of imaging methods, non-pharmacologic, pharmacologic and surgical methods of treatment.

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

Introduction. Currently, the search and study of new biological markers that can help early diagnosis of heart failure, serve as a laboratory tool for assessing the effectiveness of therapy, be a predictive marker of possible adverse clinical outcomes and a significant criterion for risk stratification is very relevant. While cardiospecific markers, including natriuretic peptides, their precursors, and highly sensitive troponins, are widely used in clinical practice, the need to use other markers does not have sufficient evidence. aspect of a biological marker of heart failure.Gamma-glutamyl transpeptidase is an enzyme localized on the outer side of cell membranes and involved in the metabolism of glutathione and cysteine. This enzyme is a dimeric glycoprotein (68 kDa), consisting of 2 subunits – a large and a small (46 and 22 kDa). Gamma-glutamyl transpeptidase is encoded by a multigene family consisting of at least 7 different genes located on chromosome 22; however, only 1 of these genes is involved in the formation of a functional enzyme. Gamma-glutamyl transpeptidase was found in all cells except erythrocytes. There is a significant variability in enzyme activity, which is especially high in tissues with a secretory and absorptive function, such as the kidneys, biliary tract, intestines, and epididymis.Purpose of the review is to present an overview of current publications devoted to the study of γ-glutamyl transpeptidase in the aspect of a biological marker of heart failure.Materials and methods. The analysis of literature sources (foreign and domestic articles) was carried out in the databases: PubMed, RSCI, MedLine, Google Scholar, Science Direct. The search was performed according to the following keywords: biological markers, heart failure, γ-glutamyl transpeptidase, biological markers, heart failure, γ-glutamyl transpeptidase.Results. In addition to its clinical use as a test for liver disease, biliary tract disease, and alcohol abuse, γ-glutamyl transpeptidase is of great interest because of its association with cardiovascular disease, diabetes, metabolic syndrome, and cancer. In the literature available to us, we found a small number of works devoted to the study of γ-glutamyl transpeptidase in patients with heart failure. In the review, we have presented data from experimental and clinical studies indicating a clear link between γ-glutamyl transpeptidase and heart failure. The pathogenetic mechanism of the possible relationship between γ-glutamyl transpeptidase and heart failure is not completely clear. The localization of this enzyme in tissues with a transport function has led to the assumption that it is involved in the transport of amino acids through the γ-glutamyl cycle.Conclusion. Further deeper understanding of the structure and function of the enzyme is needed, as well as future clinical studies to determine the diagnostic, prognostic and possibly therapeutic significance of this biological marker.

Introduction. Hepatitis B retains the status of socially significant infection and remains a major health problem worldwide, including the Russian Federation. The improvement of the effectiveness of the current complex of preventive measures, especially vaccination, is an important task for public health. Although vaccination against hepatitis B is highly successful, 5% to 10% of individuals do not experience a response to vaccine with an adequate level of antibodies to hepatitis B surface antigen (anti-HBs). One of the key factors determining the absence or insufficiency of post-vaccination immunity against hepatitis B may be the single-nucleotide polymorphisms (SNPs) that change gene sequences, including those that determine the mechanism of immunogenesis. Such genetic changes may affect the signaling pathways and result in significant decrease in antibody response to hepatitis B vaccine. Assessment of epidemiological significance of such SNPs is an important task, considering its possible associations with failure to respond adequately to vaccination.The aim of the study was to determine the effect of SNPs of IL1B (rs1143634, rs1143627), IL1RN (rs4251961, rs419598), IL6 (rs1800795), IL10 (rs1800896), TULP1 (rs9380516), TLR4 (rs4986790), MERTK (rs4374383) genes on the formation of post-vaccination immunity against hepatitis B.Materials and methods. Healthcare workers (n = 271) of the Treatment and Rehabilitation Center of the Ministry of Health of the Russian Federation with known vaccination history, data on age, work experience and department of the medical institution were included in this research. The presence and levels of anti-HBs and anti-HBcore IgG antibodies were determined by the ELISA method using the DS-ELISA-ANTI-HBs and DS-ELISA-ANTI-HBc kits, according to the manufacturer’s instructions. Genotyping was performed by real time polymerase chain reaction. Statistical analysis of data was carried out using the "Statistica 6.0" software.Results. Statistically significant differences in the frequencies of CC (rs9380516) genotypes (p = 0.034; OR 0.497; 95% CI 0.261–0.949) and CT (p = 0.044; OR 1.967; 95% CI 1.015–3.812) of the TULP1 gene in the group of individuals with anti-HBs concentrations of 10–100 IU/l were found in association with the intensity of the post-vaccination response against hepatitis B. Also, for this group, differences were found in the structure of the TT/CT genotype pair of IL-10/TULP1 genes (rs1800896/rs9380516) (p = 0.003; OR = 5.39; 95% CI 1.7–17.4) and for the combination of AA/TT SNP MERTK/IL1RN genotypes (rs4374383/rs4251961) (p = 0.003; OR = 7.96; 95% CI 1.7–37.6).Conclusion. Our study revealed that above variants of genotypes could play a role in predicting an increased risk of low (or absence) post-vaccination immune response against hepatitis B. It seems appropriate to use the relationship between the gene polymorphisms and a low concentration of post-vaccination anti-HBs antibodies in assessing scenarios for the development of the epidemic process of hepatitis B, since the identified associations allow to quantify the risks of poor herd immunity against this infection.

Aim. Current clinical recommendations address the epidemiology, causes, clinical manifestations and pathogenesis of possible immediate and long-term complications, as well as the problematic issues related to treatment and rehabilitation of adult short bowel syndrome patients.Key points. Short bowel syndrome (SBS) is a symptom complex of impaired digestion caused by the reduction of small intestine absorptive surface and manifested by intestinal failure (IF) of various severity (maldigestion and malabsorption) developing into malnutrition and systemic somatogenic disorders. The vital strategic aspects of its treatment are the personalisation of liquid, macro- and micronutrients consumption as well as avoidance of intestinal failure- and parenteral nutrition-associated complications. Various nutritional support regimes and the indications for infusion therapy and maintenance parenteral nutrition are considered in this patient category, also in outpatient settings. To mitigate the dependence on intravenous fluid- and nutrient administration and attain enteral autonomy in SBS-IF patients, the use of recombinant glucagon-like peptide-2 (GLP-2) is justified as exerting a pronounced trophic effect on the epithelial regenerative potential as well as structural and functional adaptation of intestinal mucosa. The SBS-IF patients prescribed with home parenteral nutrition and/or their caregivers should be trained in a special programme that covers the catheter care, preparation of infusion solutions and nutrient mixture container, infusion pump operation as well as the prevention, recognition and management of complications. The main referral indications for small bowel transplantation (SBT) are: fast-progressing cholestatic liver disease-complicated irreversible intestinal failure; thrombosis of two or more central venous conduits used for parenteral nutrition; recurrent catheter-associated bloodstream infection.Conclusion. Current recommendations on diagnosis and treatment as well as the developed criteria of medical aid quality assessment are applicable at different levels of healthcare.

In the first part we reviewed the issues of perioperative administration of steroids, disease-modifying antirheumatic drugs, biologics and nonsteroidal anti-inflammatory drugs. In this part we will discuss cardiovascular risks, prevention of infectious and thromboembolic complications and the impact of some structural alteration on the process of surgery and perioperative management.

Heart failure (HF) remains a serious problem in Russian and world health care due to the growing morbidity and mortality from complications of heart failure, despite the development and implementation of programs for the early detection and treatment of heart failure in asymptomatic patients. Currently, a large number of new biological markers have been studied that could serve as a laboratory tool for diagnosing and predicting the course of heart failure, but only brain natriuretic peptides have found application in real clinical practice. Renalase is a recently discovered cytokine that is synthesized by the kidneys and released into the blood. To date, seven subtypes of renalase have been found, each of which plays a different physiological role in the human body. Renalase is usually positioned as a signaling molecule that activates cytoprotective intracellular signals, leading to a decrease in blood pressure and protection of the heart muscle. The concentration of renalase freely circulating in the bloodstream of an adult is approximately 3–5 ng / ml. Currently, the level of renalase is determined by the enzyme immunoassay with a detection range of 3.12 to 200 ng / ml, while the minimum detectable concentration of the marker is less than 1.38 ng / ml. The presence of missense polymorphism of renalase is associated with myocardial dysfunction. Data from animal and human studies have shown that renalase plays a key role in the metabolism of catecholamines and in cardioprotective processes. Studies have shown the contribution of renalase to the occurrence of cardiovascular diseases: ischemic heart disease, arterial hypertension, diabetes mellitus, and aortic stenosis. Moreover, detailed protocols of multicenter prospective studies have demonstrated that functional polymorphism of the renalase gene was associated with myocardial hypertrophy in patients with aortic stenosis, hypertension, metabolic syndrome, unstable angina pectoris and stable forms of coronary artery disease, as well as in patients receiving renal replacement therapy. Based on these data and further studies, renalase has been proposed as a predictive biomarker of ischemia in patients with coronary microvascular dysfunction, as well as a predictor of clinically significant progression of chronic kidney disease in patients with cardiovascular diseases.Our review presents data on the role of renalase in heart failure. Further study of the structure and function of renalase, as well as future clinical studies, will allow determining the diagnostic, prognostic and, possibly, therapeutic significance of this biological marker in HF and other cardiovascular diseases.

The National Consensus was prepared with the participation of the National Medical Association for the Study of the Multimorbidity, Russian Scientific Liver Society, Russian Association of Endocrinologists, Russian Association of Gerontologists and Geriatricians, National Society for Preventive Cardiology, Professional Foundation for the Promotion of Medicine Fund PROFMEDFORUM. The aim of the multidisciplinary consensus is a detailed analysis of the course of non-alcoholic fatty liver disease (NAFLD) and the main associated conditions. The definition of NAFLD is given, its prevalence is described, methods for diagnosing its components such as steatosis, inflammation and fibrosis are described. The association of NAFLD with a number of cardio-metabolic diseases (arterial hypertension, atherosclerosis, thrombotic complications, type 2 diabetes mellitus, obesity, dyslipidemia, etc.), chronic kidney disease and the risk of developing hepatocellular cancer were analyzed. The review of non-drug methods of treatment of NAFLD and modern opportunities of pharmacotherapy are presented. The possibilities of new molecules in the treatment of NAFLD are considered: agonists of nuclear receptors, antagonists of pro-inflammatory molecules, etc. The positive properties and disadvantages of currently used drugs (vitamin E, thiazolidinediones, etc.) are described. Special attention is paid to the multi-target ursodeoxycholic acid molecule in the complex treatment of NAFLD as a multifactorial disease. Its anti-inflammatory, anti-oxidant and cytoprotective properties, the ability to reduce steatosis an independent risk factor for the development of cardiovascular pathology, reduce inflammation and hepatic fibrosis through the modulation of autophagy are considered. The ability of ursodeoxycholic acid to influence glucose and lipid homeostasis and to have an anticarcinogenic effect has been demonstrated. The Consensus statement has advanced provisions for practitioners to optimize the diagnosis and treatment of NAFLD and related common pathogenetic links of cardio-metabolic diseases.

This study presents a rare clinical case of encapsulated necrotic pancreatitis, which was a complication of acute pancreatitis that arose against the background of alimentary disorders. The aspects of the semiotics of radiation diagnostic methods in the follow-up control of these pathologies were presented. This case is notable for the manifestation of diseases upon hospital admission, as in the classical edematous form of acute pancreatitis, with a further increase in negative dynamics. This demonstrated the possible stepwise disease development, accompanied by a series of follow-up computed tomography between the clinical and morphological phases of acute pancreatitis and before the formation of pancreatic necrosis, which was complicated by sequestration of the pancreatic body with peripancreatic abscess formation. Afterward, the therapeutic paradigm was changed, and the place of the conservative approach was taken by active surgical tactics, followed by repeated manipulations and follow-up computed tomography and magnetic resonance until the improvement of the patients condition.

The rheumatic patients are characterized by various structural and functional changes, caused by chronic disease the necessity of constant medication intake, including anti-inflammatory drugs and immunosuppressants. In this regard, the rheumatic patients have an increased risk of intraoperative and postoperative complications. The purpose of this publication is to review current recommendations on the topic of perioperative management of rheumatic patients. The publication consists of two parts. In the first part we review the issues of perioperative administration of steroids, disease-modifying antirheumatic drugs, biologics and nonsteroidal anti-inflammatory drugs.

According to many studies, inflammation plays a very significant role in the pathogenesis of heart failure. Many studies have demonstrated an increase in circulating levels of inflammatory markers and cytokines such as C-reactive protein, tumor necrosis factor-a (TNF-a), and interleukins. C-reactive protein is produced in the liver in response to stimulation by various cytokines, mainly interleukin-6, and is a member of the pentraxin superfamily. Pentraxin-3, which is a long pentraxin, has a C-terminal domain of pentraxin similar to the classic short pentraxins, but differs from them in the presence of an unrelated long N-terminal domain. Various cell types can produce pentraxin-3 when exposed to primary inflammatory signals such as interleukin-1, tumor necrosis (TNF-a), oxidized low density lipoprotein, and microbial fragments (eg, lipopolysaccharide, lipoarabinomannans). Data in experimental animal models have demonstrated that pentraxin-3 can play cardioprotective and atheroprotective roles through its influence on the inflammatory process. Pentraxin-3 has been studied in several clinical protocols as a potential biomarker for cardiovascular disease.

The establishment of agrarian economy in Eneolithic East Europe is associated with the Pre-Cucuteni-Cucuteni-Trypillia complex (PCCTC). PCCTC farmers interacted with Eneolithic forager-pastoralist groups of the North Pontic steppe as PCCTC extended from the Carpathian foothills to the Dnipro Valley beginning in the late 5th millennium BCE. While the cultural interaction between the two groups is evident through the Cucuteni C pottery style that carries steppe influence, the extent of biological interactions between Trypillian farmers and the steppe remains unclear. Here we report the analysis of artefacts from the late 5th millennium Trypillian settlement at the Kolomiytsiv Yar Tract (KYT) archaeological complex in central Ukraine, focusing on a human bone fragment found in the Trypillian context at KYT. Diet stable isotope ratios obtained from the bone fragment suggest the diet of the KYT individual to be within the range of forager-pastoralists of the North Pontic area. Strontium isotope ratios of the KYT individual are consistent with having originated from contexts of the Serednii Stih (Sredny Stog) culture sites of the Middle Dnipro Valley. Genetic analysis of the KYT individual indicates ancestry derived from a proto-Yamna population such as Serednii Stih. Overall, the KYT archaeological site presents evidence of interactions between Trypillians and Eneolithic Pontic steppe inhabitants of the Serednii Stih horizon and suggests a potential for gene flow between the two groups as early as the beginning of the 4th millennium BCE.

Usatove was an important southeast European culture, part of Gimbutas’ kurgan cultures, that connected the world of farmers of Old Europe with the rising influence of steppe nomads at the Eneolithic–Bronze Age transition. While the Usatove culture is currently placed within the late Eneolithic–Early Bronze Age chronological period, emerging evidence suggests the culture formed genetically and culturally in the early part of the 4th millennium BCE. We propose that the biological and cultural foundations of Usatove lie at the juncture of the Suvorove–Novodanylivka branch of the Seredny Stig complex of the North Pontic Steppe, the Trypillian farmers of southeast Europe, with influences from Varna–Karanovo VI–Gumelniţa and late Stone Age cultures of the North Caucasus.

Aim: to assess the results of chest computer tomography (CT) of patients with novel coronavirus infection in correspondence with their outcomes, clinical and laboratory data. Methods: retrospective analysis of 962 chest CT scans, outcomes, clinical and laboratory data of all 354 COVID-19 patients hospitalized from April to June 2020. Results: Sensitivity and specificity of CT with polimerase chain reaction (PCR) as a reference were: 98.0 % and 5.7 % respectively; for PCR with CT as a reference: 54.6 % and 70.7 % respectively. Patients with positive and negative PCR tests had no significant differences in mean CT score and CO-RADS score. Cumulative survival was better in patients with lower CT score (significant only for maximal, not baseline scores). CT score changed during hospitalization in survived patients clinically insignificant (from 2 (1-2) to 2 (1-2), p=0.001), and increased in dead (from 2 (1,5-3) to 4 (4-4), p

This study reviewed the head and neck cancer diagnosis publications using dual-energy computed tomography (DECT). The qualitative and quantitative analysis of the data was DECT obtained using intravenous contrast enhancement for localized tumors, which shows the importance of constructing iodine maps for obtaining additional diagnostic information. Including the article is described aspects of improving visualization of the oropharyngeal region against the background of artifacts from dental implants. Several research articles highlight the current state of the issue and the role of post-processing of raw data DECT, obtaining a range of monochromatic images of a tumor and other pathological changes in the head and neck region in the article. Several learned treatises were also reflected. DECT with intravenous contrast enhancement and routine computed tomography to reduce radiation exposure to patients were compared particularly due to the possibility of obtaining virtual native diagnostic images from a contrasting series of DECT volumes during post-processing. In addition, this review also includes references to works that highlight the development of DECT as the method. Finally, the physical principles underlying DECT and the prospects for the development of the method are briefly represented.

Inflammation plays a role in the pathogenesis of heart failure. Neopterin, pteridine, synthesized mainly by activated macrophages, is a marker of inflammation, activation of the immune system, and an active participant in cardiovascular disease. Measuring neopterin levels can help track the evolution of specific inflammatory conditions. In addition, neopterin was associated with cardiac dysfunction after cardiac surgery and improved the accuracy of predicting the risk of postoperative cardiac dysfunction. In this review, we provide current insights into neopterin and its relationship to heart failure.

The article considers the features of pharmacotherapy of patients with chronic infectious diseases and co-morbidities in conditions of polypharmacy, the principles of drug metabolism, variants of adverse effects and drug-drug interactions, the possibilities of effective drug combinations. The purpose is to substantiate the possibility and emphasize the relevance of the additional search of the creation of the most optimal combinations of drugs for long-term and massive pharmacotherapy, that could be due to a beneficial drug-drug interaction, optimization of the regimen, route of drug administration and multitarget of the therapeutic effect, reduce the pharmacological load while maintaining the effectiveness of the treatment, increase patient adherence to drug therapy.

Novel biological markers, such as fibrosis marker galectin-3, peptide hormone adrenomedullin, soluble ST2, chemokine CX3CL1, surrogate marker of vasopressin, and others, are every year one step closer to being introduced into health practice. Over the past decades, significant progress has been made in the study of cardiovascular biomarkers. A key moment was the introduction of deter mining the concentration of natriuretic peptides used as markers for the diagnostic and prognostic evaluation of patients with heart failure. Currently, in order to search for novel markers for early diagnosis and risk stratification, studies have been conducted on the analysis of promising inflammatory marker tenascin-C (TNC) in cardiovascular patients. Data have been obtained that allow us to consider TNC as a tool for risk stratification and assessment of cardiovascular disease prognosis. The combination of TNC with other biological markers, in particular brain natriuretic peptide, may improve prognostic power. Nevertheless, serial testing to assess the prognosis and effectiveness of ongoing treatment, including in the conditions of a multimarker model, requires further research.

As practice shows, there are many alternative drugs that cause drug damage to the liver. A case of medicinal damage to the liver with an immunomodulatory herbal preparation Immunostimulating collection, which included St. John's wort, Elecampane, Kopeichnik, Echinacea, Licorice, Rosehip, is presented. A 39-year-old patient came to the clinic with complaints of yellowing of the skin, whites of the eyes, heaviness in the epigastrium after eating, lightening of feces, dark urine, sour taste in the mouth, bloating, pruritus, decreased appetite, pronounced general weakness, drowsiness 10 days after you start taking herbal immunostimulant. The diagnosis of drug damage to the liver was made taking into account the history and laboratory parameters, since the patient had negative markers of viral hepatitis and increasing of biochemical blood tests: alanine transferase up to 2800 U/l (norm up to 32 U/L), aspartate transferase up to 1776 U/l (norm up to 31 U/l), total bilirubin up to 577 U/l (norm up to 21 U/l), direct bilirubin up to 116 U/l (norm up to 4.3 U/l), alkaline phosphatase up to 112 U/l (norm up to 98 U/l). After the withdrawal of the immunomodulator and the appointment of therapy, including diet, enzyme replacement therapy, drugs clinical and laboratory manifestations of liver drug damage completely disappeared. This confirms the leading role of the immunoactive drug, which the patient took in the toxic effect on the liver.

Colorectal cancer occupies one of the leading positions in the world in the structure of cancer incidence. The vital processes of cancer cells largely depend on the production of growth factors and their receptors. One of these is epidermal growth factor (EGFR), which is a tyrosine kinase receptor for cell membranes. Normally, binding of EGFR ligands and transforming growth factor alpha (TGFα) induces receptor activation, which triggers ERK and PI3K signaling pathways that control cell proliferation, migration, invasion, and many other processes. It was found that in 80% of cases, colorectal cancer occurs as a result of EGFR overexpression, which leads to increased growth and division of tumor cells due to hyperactivation of the RAS-RAF-MEKERK signaling cascade. The RAS-RAF-MEK-ERK cascade is a pathway that regulates cell proliferation, cell cycle, and cell migration. In the development of human cancer, mutations of the RAS/RAF family are most often the cause of dysregulation of signal transduction through this pathway. According to current data, about a third of all malignant neoplasms are associated with mutations in the genes of the RAS family, which include HRAS, KRAS, NRAS, RRAS, and other homologous proteins. Proteins of the RAS family are involved in the activation of tyrosine kinase signaling pathways, which leads to gene mutations. This process determines proliferative activity, ability to differentiate, metastasis, avoidance of apoptosis, induction of angiogenesis. Permanent RAS activation leads to malignant cell degeneration. Thus, the expression and mutation of the EGFR gene are associated with various variants of tumor progression and poor prognosis in malignant neoplasms of various localizations. Over the past decades, significant advances have been made in the treatment of metastatic colorectal cancer. However, the expansion of the spectrum of effective anticancer drugs also creates a number of difficulties in choosing the optimal drug therapy regimens in patients with metastases of colorectal cancer.

The diagnosis and treatment of systemic amyloidosis remains a significant clinical problem for physicians of various specialties. Infectious complications and sepsis account for up to 8% of deaths in amyloidosis patients. This clinical case describes the development of an initially asymptomatic monoclonal gammopathy of unclear significance into systemic AL-amyloidosis, which was complicated by the formation of a renal carbuncle after the first cycles of chemotherapy. There was a significant discrepancy between the severity of the patient’s overall clinical state and changes in laboratory parameters. There were no objective factors for the ascending spread of urinary tract infection or hematogenous dissemination from other foci, so a primary bacteremia was assumed.

Determination of the mutations' status in the KRAS and NRAS genes is a necessary requirement in the treatment of patients with colorectal cancer (CRC). Patients with certain mutations in the KRAS and NRAS genes are resistant to anti-EGFR drug therapy and have a lower median survival rate than those with WT (wild type) genotypes, that indicates a negative prognosis in the case when mutations are present. Currently, there are no registered targeted drugs for carriers of the KRAS and NRAS genes mutations, however, preparations based on small molecules are under way. The gold standard for detecting mutations in the KRAS and NRAS genes is the analysis of the biopsy material in paraffin blocks. However, this method has significant limitations that can be circumvented by the analysis of circulating tumor DNA a promising new method in the diagnosis of colorectal cancer.

Carpal tunnel syndrome is the most common peripheral compression neuropathy and can be caused by many diseases and conditions, including the formation of gouty tophi in various structures of the tunnel. This publication provides a review of literature and a case report on Carpal tunnel syndrome in a 58-year-old male patient with tophaceous gout. The case is characterized by the extremely rare combination of median nerve compression and tendons dysfunction due to the tophi deposits in the flexor tendons of the hand.