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Introduction. The use of doxorubicin in clinical practice has shown cumulative and dose-dependent toxic effects on cardiomyocytes, leading to an increase of mortality risk among patients with cancer and as a resulting to restrictions in the indications for its use.Text. A dangerous adverse reaction of doxorubicin is cardiomyopathy, leading to congestive heart failure. Cardiotoxicity is based on at least several pathophysiological mechanisms (described in more detail in the first part of the review), leading to damage to cardiomyocytes as a result of oxidative stress with the formation of free radicals, dysfunction of mitochondria, autophagy, release of nitric oxide and inflammatory mediators, as well as changes in gene expression and proteins leading to apoptosis. The current (second) part of the review provides detailed information on the actual understanding of the pathophysiological mechanisms underlying the described cardiotoxicity, the effect of doxorubicin on other heart cells. The use of cardioprotective strategies will reduce the severity and likelihood of developing cardiotoxicity. This article describes strategies based on reducing the maximum cumulative dose, changing the speed of doxorubicin administration, using pegylated liposomal formulations and cardioprotective agents, as well as exercise.Conclusion. Despite the huge number of scientific papers devoted to various aspects of cardiotoxicity of doxorubicin, its prevention and treatment, this issue requires more careful study and development of more advanced methods of early diagnosis, prevention and more effective therapy the complication.

Introduction. Long-term use of anthracyclines during cancer chemotherapy has been associated with the development of potentially life-threatening cardiotoxicity. Despite researches ongoing since the middle of the last century, approaches to the choice of therapy remain limited.Text. Doxorubicin currently is the most widely used chemotherapy. The leading side effect mechanism of the drug is the formation of reactive oxygen species in mitochondria with the mediated development of oxidative stress, which contributes to myocardial damage. However, despite the huge number of scientific papers devoted to various aspects of doxorubicin cardiotoxicity, its prevention and treatment, this issue requires detailed investigation in order to develop more advanced methods for early diagnosis and timely cardioprotective therapy.Conclusion. The current review discusses the pathogenetic mechanisms of cardiotoxicity associated with the use of doxorubicin chemotherapy. The pathogenesis of the cardiomyocytes death mechanism will provide an opportunity to develop new diagnostic and therapeutic approaches in the clinical practice.

Objective: to study the indicators of carnitine metabolism in young athletes of various specializations.Materials and methods: This study involved 46 people with different levels of physical activity aged 15 to 18 years. The first group consisted of 18 girls professionally involved in field hockey (mean age, 16.17 ± 0.31 years). The second group included 21 swimmers (10 girls and 11 boys, mean age 17.00 ± 0.26 years). The control group included 7 young men with a standard mode of motor activity, not involved in sports (the age of the subjects was 16 years). In the course of the study, the method of liquid tandem chromatography-mass spectrometry with ionization in an electrospray was used. The material for research is capillary blood. As a result of the analysis of the material, the concentrations of bound carnitine (acylcarnitines) and free carnitine were determined in µmol/l.Results: Comparative blood analysis between the three groups showed differences in free carnitine levels. It was shown that the concentration of free carnitine in the blood plasma of field hockey athletes was significantly lower than in the groups of swimmers and non-athletes (p < 0.001). At the same time, the values of indicators of bound carnitine did not differ significantly between all subjects. We also studied that the values of the carnitine coefficient were significantly higher in the group of hockey players compared to other groups (p < 0.001).Conclusion: The decrease in free carnitine levels in the group of hockey players is probably the result of long-term adaptation of the body to conditions in which glucose is the main energy substrate for working muscles. Further studies are needed to clarify the exact mechanisms of development of this phenomenon.

Purpose of the study. The aim of this work was to study the effect of conservation in various cryoprotectants on the biomechanical and morphological properties of the umbilical cord (UCA) arteries.Materials and methods. The material for this work was 12 umbilical arteries, which were divided into 4 study groups: (1) native UCA – control without freezing; (2) APC frozen in 5 % dextran with the addition of dimethyl sulfoxide (DMSO) to 10 % and 7.5 % human serum albumin (HSA); (3) APC frozen in glycerin and (4) UCA frozen in propanediol. For all groups, morphological and biomechanical studies were carried out. The statistical data were processed using the GraphPad Prism 9.2.0 program. Analysis of variance was used to find significant differences.Results. Freezing with 5 % dextran, 10 % DMSO and 7.5 % human albumin did not lead to significant changes in the morphology of vascular tissue compared to control. The conserved vascular tissue retains a moderate level of type I collagen, regardless of the method of conservation. The presence of statistically significant differences between the control and frozen UCAs was shown for Young's modulus (p < 0.05; 6.9 [6.8; 7.0] for the native artery; 2.3 [2.0; 2.6] for the artery preserved with the use of dextran, DMSO and human albumin; 2.3 [1.4; 3.2] for the artery preserved in glycerin and 0.8 [0.6; 1.0] – in propanediol, respectively).Conclusion. 1) Freezing and storage of UCA at 5 % dextran, 10 % DMSO and 7.5 % HSA does not lead to a significant change in the morphology of vascular membranes and cell nuclei; 2) The preservation of type I collagen according to the results of IHC is qualitatively reduced from a conditional indicator of +2 to +1 for frozen agroindustrial complexes compared with control ones; 3) Conservation leads to a significant decrease in the modulus of elasticity of the walls of the agroindustrial complex compared with control vessels (p < 0.05).

Objective: to evaluate the effectiveness of psychocorrection based on the methods of self­regulation in athletes.Materials and methods: the effectiveness was evaluated on 104 male athletes who had an optimal level of psychoemotional state of the body during a background examination by electroencephalography (EEG). The subjects were randomly assigned to three groups of psychocorrection: control, EEGtraining, and VR­therapy. Mathematical and statistical processing was carried out in Statistica 7.Results: the average values of the wave intensity index (WII) after psychological correction using the following methods: EEG­training and VRtherapy showed positive EEG dynamics in athletes of the second group (EEG­training) 65,6 % (21) and the third group (Vr­therapy) 73,8 % (31) of the subjects, respectively. Whereas in the control group, self­healing was recorded in 9 (30 %) athletes without psychocorrection procedures.Conclusion: the quantitative criterion of WII is a universal informative indicator of the functional activity of the brain for evaluating the effectiveness of psychocorrection aimed at optimizing the psychoemotional state. Psychocorrection of athletes using EEG­training and VR­therapy provides efficiency in 73.8 and 65.6 % of cases, which significantly softens pre­start tension as a result of reducing anxiety and restoring the psychoemotional state of the body to an optimal level by involving the psychological reserve.

Myasthenia gravis is an autoimmune neuromuscular disease characterized by pathologically rapid fatigue of striated muscles [1]. The main symptom of myasthenia gravis is the presence of pathological muscle weakness with involvement of the ocular, bulbar and skeletal muscles in the pathological process. The provoking factors for the development of myasthenia gravis can be infectious diseases, surgery, drugs [2, 3]. The main danger is represented by myasthenic and cholinergic crises, which are characterized by a severe course and high mortality; therefore, the problems of treating myasthenia gravis are still of high medical and social significance. The prevalence of myasthenia gravis is 17.5–20.3 per 100 thousand population, and the number of patients is increasing by 5–10% annually [4, 5]. In recent years, there has been a steady increase in morbidity with an increase in age over 50 years [6, 7]. Myasthenia gravis is a serious disease with a high mortality rate of up to 30–40% [3]. There are difficulties in the early differential diagnosis of muscle weakness in patients with respiratory failure between myasthenia gravis, myasthenic syndrome and critical illness polyneuropathy. These difficulties and insufficient awareness of patients and doctors of various specialties about myasthenia gravis can lead to the choice of the wrong treatment tactics and the development of myasthenic crisis, which is manifested by respiratory failure, requiring respiratory support. The progression of respiratory failure against the background of myasthenic crisis may require the use of extracorporeal membrane oxygenation (ECMO).It is necessary to expand the differential diagnosis of muscle weakness in a patient during the period of resolution of respiratory failure, allowing to move away from compulsory respiratory support, termination of ECMO.

Objective: assessment of the resistance of the body of athletes-divers to the hyperbaric oxygen toxicity on indicators of the heart rate variability (HRV). Materials and methods. The study involved 38 healthy athletes-divers aged 23 to 32 years. Before the session of hyperbaric oxygenation (HBO), the test subject was measured the blood pressure and pulse by the method of oscillometry while he was sitting at rest, after which a five-minute recording of HRV in sitting position at rest was made. After that, the two test subjects were placed together, sitting with a physician in a pressure (decompression) chamber, where an absolute pressure of 0.25 MPa was created. The test subjects were given 100 % medical oxygen to breathe, their pulse and blood pressure were measured every 15 minutes, and their cardiac output (CO) was calculated by the Starr formula. When there was an increasing tendency of the CO, and also after 75 minutes of oxygen breathing, the test subjects were taken out of the pressure chamber. Immediately after leaving the pressure chamber, the HRV of the test subjects was recorded. According to the results of measurement of hemodynamic parameters, the test subjects were divided into 3 groups. The first group — unstable, whose CO began to increase in the first 45 minutes of HBO, the second group included those whose CO began to increase from 46 to 75 minutes, the third group included test subjects whose CO did not increase. Results. HRV analysis showed the most significant reliable (p < 0.001) VLF spectrum power (ms2) and relative VLF power (%), as well as Alpha 2 after HBO in the first group of test subjects (unstable) compared to the initial parameters and other groups, which reflects the activation of the sympathetic nervous system and suprasegmental structures of the brain. The essence of changes in the HRV time domain indicators (decrease in SNS index, pNN50 (%), PNS index) confirms the presence of pronounced sympathicotonia in the first group. Conclusions: the three most significant metrics (VLF (ms2), VLF (%) and Alpha 2) were determined with high confidence (p < 0.001), which have a moderate negative correlation (–0.70 < r < –0.30) with the level of divers’ resistance to the to the hyperbaric oxygen toxicity. Observations of athletes with high stability showed that they were characterized by changes in hemodynamics of the vagotonic type, while unstable ones were characterized by the sympathicotonic type of regulation. Evaluation of the results showed amoderate correlation between HRV and symptom of oxygen toxicity on divers and is recommended for a reliable (p < 0.05) diagnosis.

Abstract. Levetiracetam (LEV) is one of the most commonly prescribed antiepileptic drugs (AED). However, there were no studies on its efficacy and safety in terms of the correlation with epileptiform activity index (EAI) performed among the Russian population.Aim. To evaluate the efficacy and tolerability of LEV monotherapy in patients with newly-diagnosed epilepsy using epileptiform activity index (EAI) assessment.Materials and methods. The study included 107 patients (46 (43.0%) male and 61 (57.0%) female) with focal epilepsy (FE) (39.3%; n=42) or idiopathic generalized epilepsy (IGE) (60.7%; n=65). At each visit, video-electroencephalographic (video-EEG) monitoring was performed (baseline and in 1, 3, 6, and 12 months of the therapy). Therapeutic drug monitoring was performed at dose titration in 1 month of the therapy or in case of therapy correction. Treatment efficacy was assessed using the criteria of seizure absence (medically induced remission), seizure rate decrease by >50% (responders), seizure rate decrease by

Objective: to develop an algorithm for determining the extent of surgical intervention for pain in the heel region based on a comprehensive clinical and instrumental assessment of the functional state of the lower extremities. Materials and methods: during the examination of 18 athletes with pain in the heel area, we used a thermal imaging examination (at rest and after exercise) in combination with magnetic resonance imaging data. Infrared thermography was performed using an infrared camera. Data analysis was carried out using the specialized online service tvision.pro, which allows you to track the dynamics of the patient's thermographic picture. The combination of images of thermographic and MRI studies makes it possible to assess the functional state of the structures of the heel region with the identification of the structures most involved in the pathological process. Results: based on the experience of treating athletes with pain in the heel area, we developed an algorithm for determining the extent of surgical intervention for Haglund deformity. The algorithm is based on the analysis of MRI data and their comparison with the results of the examination of the soft tissue of the heel area using functional thermal imaging. Conclusions: a comprehensive analysis of the data of thermographic and tomographic studies allows you to perform an objective assessment of the functional state of the patient based on the primary localization of the pathological process. The developed algorithm is applicable for planning the extent of surgical intervention and making a choice of preferable technique. The proposed tactic contributes to early return to competitive load. The infrared thermography technique provides important additional data on the functional state of the athlete's musculoskeletal system. It is absolutely safe for both the patient and the specialist who conducts the study.

The article reviews the existing methods of injury prevention in sport currently used in Russia and abroad. The article analyzes therapeutic exercises for injury prevention programs and the possible mechanisms of their action. The authors studied the perspectives of prophylactic exercises for injury prevention. The article presents genetic methods for musculoskeletal system injury prevention. The article raises issues of predisposition to various sports depending on the genotype. In addition, the article describes the psychological aspects of the sport injury prevention, in particular, international experience of the injury psycho-prevention in top-level sports.

Objective: to improve the methodology of timely functional body’s reserves assessment, to reduce the probability of an infectious disease in divers during the training and competition period in the countries with severe climate. Materials and methods: We performed the mathematical and statistical analysis of the examination data and the frequency of infectious diseases in 2018-2019 in 47 male divers (mean age 30,5±3,56). Th e study involved volumetric compression oscillometry (VKO) and heart rate variability (HRV). Results: in the volumetric compression oscillometry and heart rate variability analysis, we determined the most signifi cant (p

Lacosamide (LCM) is one of the most promising antiepileptic drugs (AEDs) for focal epilepsy (FE); however, in Russia there are only a few works devoted to its practical application.Objective: to evaluate the efficiency of LCM therapy in adolescents and adults with new-onset FE.Patients and methods. The investigation enrolled 36 patients aged 16-78 years. All the patients underwent video-ECG monitoring with quantification of the epileptiform activity index (EAI) at baseline and 1, 3, 6 and 12 months of treatment. The treatment efficiency was evaluated using the standard measures: drug-induced remission, a response rate of ≥50%, an insufficient efficiency of ≤50%, higher seizure frequency, and therapy retention rates. Adverse events (AEs) were assessed using the SIDe-effects of AntiEpileptic Drugs (SIDAED) questionnaire.Results and discussion. Just 3 months after starting treatment, the total EAI substantially decreased from 2.92 [0; 6.7] to 1.95 [0; 3.07] (p

The article identifies areas of joint activities and mechanisms of interaction of Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor) and Federal Medical and Biology Agency (FMBA of Russia), their territorial bodies and institutions in the event of radiation accidents. Extensive practical experience gained by specialists of FMBA of Russia and Rospotrebnadzor, was the basis for the development of the draft of Concept “Organization of radiation and hygienic measures in emergency situations of a radiation nature and coordination the activities of forces and means of FMBA of Russia and Rospotrebnadzor organizations and institutions” (2018). The article presents the main provisions of the draft document, which, after discussion and refinement, as the authors hope, this publication will contribute, draft of Concept can be submitted for approval. The modern infrastructure of Rospotrebnadzor and FMBA of Russia has all the necessary elements and prerequisites for coordinated work of expert support groups, use of the mobile specialized radiation-hygienic teams in emergency situations. The possible types of radiation accidents that may require joint activities of the bodies and institutions of Rospotrebnadzor and FMBA of Russia are considered. In the initial period of a radiation accident in conditions of large uncertainties related to the assessment of the radiation situation and doses on personnel and the public, it is necessary to ensure operative preparedness of consolidated proposals on making decisions on a complex of sanitary, hygienic, anti-epidemic and protective measures. Much attention is paid to mutual notification and information interaction. An important element in ensuring emergency preparedness, working out algorithms of the interaction of management bodies and practical skills of the personnel of Rospotrebnadzor and FMBA of Russia is the joint planning, organization and conduct of training and exercises.

Planned surgical interven ons account for more than half of all opera ons in the Russian Federa on, of which more than 20–30% are performed for oncological diseases. Characteris c is an increase in the number of operated pa ents in older age groups with severe concomitant pathology and a high percentage of postopera ve complica ons, including due to psychoemo onal pathology, which can be excluded or adjusted at the preopera ve stage.Purpose. Evalua on of the infl uence of the psychoemo onal state of the oncochirical soma cally burdened patient on the lethality and revealing the possibility of correc on of the psychoemo onal state at the preopera ve stage.Paents and methods. In the period from 2006 to 2016 in the departments of therapy and oncology of the Regional Clinical Hospital of the City Clinical Hospital No. 40 of the Moscow City Health Department, AI.Burnazyan The FMBA of Russia analyzed the treatment of 958 soma cally burdened pa ents with various oncopathology who underwent opera ve interven on in a planned manner. An analysis of the psychoemo onal state of pa ents before and aft er surgery was performed using Hamilton diagnos c scales.Results. After a retrospec ve evalua on, it was determined that prac cally all patients of the oncosurgical profi le undergo various psychoemo onal strains of varying strength and dura on, both before and after surgery. This can disrupt the blood fl ow in the organs andssues, and lead to various complica ons, which manifests itself in the form of hypoxia and ischemia, which, in turn, jus fy the development of postopera ve delirium and myocardial infarc on.Conclusions. Clear distinctions between the anxiety severity in groups on outcomes of hospitaliza on of the oncosurgical patient were determined, and the tendency of the rela onship between the level of the anxiety state and the postopera ve complica ons that had been ridden in the early postopera ve period in soma cally burdened pa ents was determined. Patients of the oncosurgical profi le without fail are shown psychopharmacotherapy in the pre- and postopera ve periods, depending on the revealed pathology.

Aim. To develop a safe protocol for cryopreservation of segments of iliac arteries straight after their retrieval from post-mortem donor with the use of polydimethylsiloxane as a coolant and cryoprotectant.Materials and methods. Eleven segments of iliac arteries were retrieved from post-mortem donor and divided into four groups including control. Based on preliminary heat and cold transfer mathematical modeling and tests with tissueequivalent phantom arterial segments were placed on plastic mounts and cryopreserved by following protocol: groups 1 and 2 were immersed in polydimethylsiloxane and cooled rapidly at 180 °С/min to –75 °С. Group 3 segments were cryopreserved at 1,6 °С/min in PDMS – fi lled cryo-container placed in the freezer at –80 °С. All segments were defrosted by immersion in PDMS at +24 °С and then examined for morphology changes by histological methods and SEM. EDS analysis with the use of AzTech software also was performed for Si – content evaluation. Restricted biomechanical tests were conducted for group 2 segments.Results. There were no signifi cant morphological differences between segments of the control and cryopreserved groups except for the segment with slow cooling.Conclusion. Mobile cryopreservation may allow increasing the effi ciency of retrieval of a large number of donor tissues for possible later use in the processing of bioprostheses of blood vessels; or, after decellularization, as well as tissue-specifi c matrices for tissue-engineering blood vessels.

This article is the review of literature concerning use of proton beam therapy in treatment of oncology. The staticized data on comparison of effi ciency of this method at an eye melanoma are lit. Advantages of proton therapy on the level of local control and depression of frequency of development of the radio induced cataract are refl ected in the provided data. In evident material the technology of preparation and carrying out radiation of an eye is shortly covered with a fascicle of protons. The experience of use of proton therapy of tumors of a skull base got for the last several decades, showed good results. Physical properties of a fascicle of protons allow to achieve the maximum dose conformality, having lowered, thereby, a radial load on the next crucial anatomical structures. The presented material on an oncopediatrics shows insuffi cient knowledge of scientists concerning advantage of a fascicle of protons over modern methods of photon radiation. There are only preliminary clinical results concerning generally of treatment of cranyopharyngiomas. At cancer therapy of a mammary gland, proton therapy showed the best local control of postoperative recurrent tumors, and also depression of a dose load on the contralateral party. The available results of the retrospective analysis of clinical data in the University medical center of Lome Linda, testify to advantages of proton therapy of the localized prostate cancer. The lack of a biochemical recurrence and a local tumoral progression within 5 years after radiation was shown. The data obtained from experience of use of proton radiation therapy with passively scattered fascicle for cancer therapy of a prostate at an early stage showed the admixed results in comparison with modern methods of radiation therapy with the modulated intensity. In treatment of non-small cell cancer of mild advantage of proton therapy aren’t absolutely proved yet. There are data on extreme toxicity of a combination of a chemotherapy and photon radiation. It is supposed that physical properties of protons will allow to reduce toxicity of such technique, however clinical trials in comparison of protons and RTMI aren’t fi nished yet. The main directions of development of a method of proton therapy are shortly lit.

It is common knowledge that from the cellular level upwards all vital functions of the body represent a continuous chain of adaptive reactions based on the use of energy. The leading element in non-specific mechanisms of adaptation is stress reaction [1]. In the early stages of stress development, the electrical activity of limbic-reticular structures of the brain changes first, followed by the activation of somatovegetative reactions [2].

The article is dedicated to the cryptography attack on Bluetooth handsfree headset. The authors describe the situation when hackers could eavesdrop mobile phones talks if a person is using the Bluetooth headset. The vulnerability in the authentication process allows hackers to crack PIN code and to decipher the packets transmitted between the headset and the mobile phone.

Total knee replacement (TKR) surgery has been performed in increasing number of patients in recent years. Postoperative complicationsoften occur despite the improvement of the technique for performing this surgical intervention. All of the above confirms the need forthe development and implementation of modern rehabilitation programs for patients after TKR.Aim. To substantiate scientifically the feasibility of the combined use of cryotherapy and electrical stimulation in patients after TKR.Material and methods. We examined 90 patients who were admitted 3 months after TKR and were randomized into 3 groups. In thefirst group – 30 subjects received electrical stimulation of the quadriceps muscles and carried out therapeutic exercises for a course of10 procedures. In the second group – 30 subjects received electrical stimulation of the quadriceps muscles and air cryotherapy, performedtherapeutic exercises for a course of 10 procedures. In the third group – 30 people were given physical therapy classes only.Results. From the standpoint of the ICF, it has been proven that the physical factors application in the complex treatment of the abovepatients’ category contributes to the improvement of “b 710 – the function of joint mobility”. This is confirmed by the operated jointfunction improvement according to the KSS scale, microcirculation state enhancement, and the decrease in pain syndrome accordingto the VAS. The mobility level advance was revealed when evaluating the effectiveness of the proposed rehabilitation programs in thedomain “d 450-walking” based on the ICF. When assessing the domain “d 5-self-service”, the HAQ questionnaire data indicate an increasein the ability to perform most activities in everyday life. However, more statistically significant results were obtained in patients aftera course of quadriceps electrical stimulation, air cryotherapy and therapeutic exercises.