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The literature review is devoted to the chromosomally integrating viruses, the integration property. These are revealed using modern diagnostic methods, including highthroughput sequencing. The review describes various types of viruses, such as retroviruses, adenoviruses, herpes viruses, papillomaviruses, hepatitis B, SARS-CoV-2 and others. These viruses have the ability to integrate their genomes into the host cell genomes and their prevalence. Modern information on the molecular mechanisms of viral integration and methods of differential diagnostics is presented. Each of these viruses has its own unique ways of interacting with the host cell genome to maintain a latent state, which determines the specifics of the infectious process and pathological consequences for the body due to the possibility of effective reactivation.

Aim: The study aims to evaluate the incidence of recurrent thromboses in patients with primary antiphospholipid syndrome (PAPS) and its association with the presence of different antiphospholipid antibodies (aPLs) and known thrombogenic risk factors. Methods: This retrospective study included 52 patients. The median age of the patients was 38.5 years [31.5; 43.5], and the duration of the disease was 9.0 years [3.1; 13.0]. aPLs, including IgG/IgM/IgA antibodies to cardiolipin (aCLs), IgG/IgM/IgA anti-beta2-glycoprotein I (anti-β2-GPI), IgG anti-domain I-β2-GPI (anti-β2-GPI DI) antibodies, IgG/IgM antibodies to the phosphatidylserine/prothrombin complex (aPS/PT), and other thrombosis risk factors were included for analysis. Results: Recurrent thrombosis was reported in 34 (65%) out of 52 patients and 18 (35%) did not have it. The main reason for the recurrence of thrombosis was the lack of anticoagulant therapy: in 18 (52.9%) out of 34 patients with recurrent thrombosis. Three patients were taking warfarin at the time of thrombosis recurrence, but target international normalized ratio (INR) levels were not achieved. Other patients with recurrent thrombosis were taking direct oral anticoagulants (DOACs). The risk of recurrent thrombotic events with positive IgG aCL was 10.33 (P = 0.002) and 21 (P = 0.007) times higher were examined in enzyme-linked immunoassay (ELISA) and chemiluminescent assay (CLA), respectively. The risk of thrombosis was 4.58 times higher in patients who were IgA aCL-positive (P = 0.01). Compared with other antibodies, with positive IgG values of anti-β2-GPI and IgG aPS/PT by ELISA, a lower probability of thrombosis recurrence was observed: 7.56 and 7.25, respectively. A high risk of recurrent thrombosis [odds ratio (OR) = 32.0] was observed in IgG anti-β2-GPI (CLA). The combination of IgG aCL with IgG anti-β2-GPI and with IgG anti-β2-GPIDI is more informative with respect to the risks of thrombosis recurrence compared to double positivity for aCL with anti-β2-GPI (OR = 20.71 vs. OR = 10.18). Triple positivity for IgG aCL with IgG anti-β2-GPI and with IgG aPS/PT also shows better results compared to positivity for aCL with anti-β2-GPI (OR = 6.06 vs. OR = 5.79). Among other risk factors, arterial hypertension (AH) and obesity were significant in relation to the recurrence of thrombosis. AH occurred in 22 (42%) of 52 patients with PAPS. AH was associated with recurrent thrombosis in PAPS patients: 18 (53%) out of 34 with recurrent thrombosis had AH versus 4 out of 18 without recurrent thrombosis (P = 0.003). Conclusions: Recurrent thrombosis in antiphospholipid syndrome (APS) is largely associated with IgG aCL, IgG anti-β2-GPI, IgG anti-β2-GPIDI, IgG aPS/PT, and IgA aCL positivity. AH was a significant risk factor for recurrent thrombosis.

Aim. To determine the significance of antibodies to the phosphatidylserine/prothrombin complex (aPS/PT) in patients with systemic lupus erythematosus (SLE) antiphospholipid syndrome (APS). Materials and methods. A total of 190 patients were included in the study: 123 (64.7%) with reliable SLE and 55 (29%) with PAPS. The control group included 100 relatively healthy subjects of comparable age. All patients were tested for classical aPL as well as IgG/IgM-anti-PS/PT by enzyme immunoassay. Results. Based on the average values of IgG/IgM aPS/PT of the control group, the levels of positivity were allocated mean (M) + 3 or 5 standard deviations (SD): M+3SD and M+5SD. IgG aPS/PT levels above 73.6 U/ml (M+5SD) were more accurate diagnostic, for IgM aPS/PT above 18.0 U/ml. IgG-aPS/PT were detected in 84 (44%) of 190 patients. Levels above diagnostic levels were detected in 68 (65%) of 104 patients with APS (55 with PAPS and 59 with SLE+APS). Thrombosis was significantly more common in patients with IgG aPS/PT compared with patients negative for IgG aPS/PT. Arterial but not venous thrombosis was associated with IgG aPS/PT positivity. Conclusion. The frequency of detection of IgG aPS/PT in the examined patients was 44%, IgM aPS/PT 29% and their combination 19% of 190 patients. Half of the patients with probable APS had positive IgG aPS/PT and third IgM aPS/PT. Median IgG aPS/PT were significantly higher in patients with APS compared to patients without APS and the control group. Thrombosis was associated with IgG aPS/PT. Arterial thrombosis was significantly more frequently reported in patients with IgG aPS/PT. The sensitivity of IgG aPS/PT for reliable APS at levels greater than 73.6 units/ml was 59%, specificity 92%, for IgM aPS/PT 35% and 91%, respectively.

Abstract Despite significant insights into the neural mechanisms of acute placebo responses, less is known about longer-term placebo responses, such as those seen in clinical trials, or their interactions with brain disease. We examined brain correlates of placebo responses in a randomized trial of a then controversial and now disproved endovascular treatment for multiple sclerosis. Patients received either balloon or sham extracranial venoplasty and were followed for 48 weeks. Venoplasty had no therapeutic effect, but a subset of both venoplasty- and sham-treated patients reported a transient improvement in health-related quality of life, suggesting a placebo response. Placebo responders did not differ from non-responders in total MRI T2 lesion load, count or location, nor were there differences in normalized brain volume, regional grey or white matter volume or cortical thickness (CT). However, responders had higher lesion activity. Graph theoretical analysis of CT covariance showed that non-responders had a more small-world-like CT architecture. In non-responders, lesion load was inversely associated with CT in somatosensory, motor and association areas, precuneus, and insula, primarily in the right hemisphere. In responders, lesion load was unrelated to CT. The neuropathological process in MS may produce in some a cortical configuration less capable of generating sustained placebo responses.

The development of mineral deposits causes changes that are comparable to natural exogenous geological processes, and prevail over the latter in local areas of intensive mining activity. In this article, a diamond deposit is selected, developed by quarries of great depth, and a forecast is made of the impact of drainage water discharge on changes in the composition of surface water and bottom sediments during the entire period of development of the deposit. Modeling was performed according to various scenarios, taking into account changes in the total dissolved solids of groundwater from 0.5 to 21.7 g/kg H2O. Thermodynamic calculations were carried out using the HCh software package. The role of dissolved organic carbon in the migration of chemical elements and the effect of DOC on the precipitation of chemical elements from mixed solutions is given. It has been established that fulvic acid completely binds to Fe in the Fe(OH)2FA− complex in all types of natural waters and under all mixing scenarios. With humic acid, such a sharp competitive complex formation does not occur. It is distributed among the various elements more evenly. It was determined that the mass of precipitating iron in the presence of DOC decreases by 18–27%, and its precipitation in winter is more intense. In contrast to Fe, the precipitation of Ca, Mg, and C from solutions with DOC is higher in summer, and there are more of them in the solutions in winter. This study contributes to a better understanding of the behavior of heavy metals in surface waters and sediments under anthropogenic pressures in order to improve the sustainable management of water resources in the face of anthropogenic activities.

Aim. To evaluate the status of vitamin D in women with rheumatoid arthritis (RA) and establish its associations with comorbidity, disease activity, and body composition components. Materials and methods. 86 women with RA (average age 58.18.5 years) were enrolled in the study. We analyzed the relationship of vitamin D levels with clinical and laboratory parameters and with the results of two-energy x-ray absorptiometry. MannWhitney or KruskalWallis, 2 and Spearman tests were performed using Statistica for Windows 10.0 (StatSoft Inc., USA). Results. Vitamin D level was 22.4 [17.8; 27.3] ng/ml: deficiency was detected in 33%, and insufficiency in 46% of women with RA. Only 41% of patients with low vitamin D levels received supplements of cholecalciferol, while only 9% in a sufficient dose. 25(OH)D level was significantly lower in RA patients with sarcopenia, obesity, high activity according to DAS28 and in those who did not receive vitamin D supplements. There werent differences in 25(OH)D levels among subgroups of patient according to age, fertility, BMD status, comorbidity index, RA duration, ESR and CRP levels, medical therapy performed. Conclusion. 79% of patients with RA had low levels of vitamin D, while less than half of them received additional cholecalciferol supplements. Low vitamin D levels in RA patients were associated with high disease activity, sarcopenia, and obesity.

Objective: to study cognitive functions and mental performance of team sports athletes’ and persons who are not involved in sports. Materials and methods: The study has 141 participants (23,2 ± 1,7 years), 76 female (23,4 ± 1,8 years) and 64 male (23,0 ± 1,6 years). Group of team sports athletes (main group) consisted of 61 participants: 31 male (22,3 ± 1,3 years), 30 female (23,1 ± 2,1 years). Control group consisted of persons who were not involved in sports, and included 80 people, (23,6 ± 1.5 years):men - 34 (23,7 ± 1,5 years), women - 46 (23,6 ± 1,5 years). Diagnostics of mental health included psychophysical tests focused on memory, attention and mental productivity assessment. Results: athletes have demonstrated higher level of visual memory, volume and switching of attention, mental productivity and mental performance in comparison with persons who were not involved in sports. Male athletes had higher rates of visual memory, volume and switching attention, mental performance in comparison with men who were not involved in sports. Female athletes and women who are not involved in sports have similar level of aural, visual memory, attention but mental productivity and mental capacity are higher in the group of female athletes. Male athletes had higher level of volume and switching of attention, mental productivity and mental performance in comparison to female athletes. Men and women who are not involved in sports differ only in terms of visual memory upwards at women side. Conclusions: high rates of cognitive functions of athletes comparing with persons who are not involved in sports confirm positive impact physical activities on central nervous system. Findings may be used as baseline data for testing cognitive functions and mental performance of athletes in different time segments of sports activity.

This article presented a review of the literature on the features of nutritional support for oncohematological patients who have undergone allogeneic (alloHSCT)/autologous hematopoietic stem cell transplantation (autoHSCT). Bone marrow transplantation associated with a high risk of developing nutritional deficiencies. Nutritional support (NP) is indicated for patients undergoing alloHSCT and autoHSCT in order to reduce the incidence of infectious complications and reduce the risk of developing severe forms of acute and chronic GVHD. Currently, there are recommendations for conducting NP in alloHSCT, while there are no recommendations for patients with autoHSCT. An important task in planning NP is the calculation of the daily energy requirement. Bone marrow transplantation accompanied by a prolonged negative nitrogen balance. The protein requirement for alloHSCT is significantly higher than for patients with chemotherapy alone – 1.5–2 g/kg per day. An effective method of controlling the needs of hematological patients during the analysis of HSCT and alloHSCT is the calculation of the nitrogen balance and the daily protein norm. In this article was analyzed the role of macronutrients and immunonutrients in the recovery of patients during alloHSCT. It has been shown that low levels of vitamin D and vitamin A increase the risk of development and the severity of the transplant versus host reaction. The addition of omega-3 fatty acids helps maintain an optimal proportion of calorie intake from lipids, as well as maintain the necessary level of triglycerides in the blood. The article presents data on reducing the risk of developing acute GVHD with systemic addition of omega-3 fatty acids. For a final assessment of the effect of the neutropenic diet on the development of infectious complications in oncohematological patients, randomized prospective multicenter studies with the development of a unified approach in choosing a diet for HSCT are needed.

Modern slot machines are among the more harmful forms of gambling. Psychophysiological measures may provide a window into mental processes that underpin these harms. Here we investigated pupil dilation derived from eye tracking as a means of capturing changes in sympathetic nervous system arousal following outcomes on a real slot machine. We hypothesized that positively reinforcing slot machine outcomes would be associated with increases in arousal, reflected in larger pupil diameter. We further examined the contribution of game luminance fluctuations on pupil diameter. In Experiment 1A, experienced slot machine gamblers (N = 53) played a commercially-available slot machine in a laboratory for 20 minutes while wearing mobile eye tracking glasses. Analyses differentiated loss outcomes, wins, losses-disguised-as-wins, and (free-spin) bonus features. Bonus features were associated with rapid increases in pupil diameter following the onset of outcome-related audiovisual feedback, relative to losses. In Experiment 1B, luminance data were extracted from captured screen videos (derived from Experiment 1A) to characterize on-screen luminance changes that could modulate pupil diameter. Bonus features and wins were associated with pronounced and complex fluctuations in screen luminance (≈50 L and ≈25L, respectively). However, the pupil dilation that was observed to bonus features in Experiment 1A coincided temporally with only negligible changes in screen luminance, providing partial evidence that the pupil dilation to bonus features may be due to arousal. In Experiment 2, 12 participants viewed pairs of stimuli (scrambled slot machine images) at luminance difference thresholds of ≈25L, ≈50L, and ≈100L. Scrambled images presented at luminance differences of ≈25L and greater were sufficient to cause pupillary responses. Overall, pupillometry may detect event-related changes in sympathetic nervous system arousal following gambling outcomes, but researchers must pay careful attention to substantial in-game luminance changes that may confound arousal-based interpretations.

Abandoned mines are sources of potentially toxic chemical elements, although the development of these objects was completed. The Lupikko I mine area (Karelia Republic, Russia) is an excellent example of such technogenic objects. It is one of the largest mines in the Pitkäranta area, which was abandoned more than one hundred years ago. The dump rocks here are characterized by significant mineral diversity. Disseminated ore mineralization of the study area contains heavy metals, which enter the natural waters due to the oxidative dissolution of sulfides. Dump rocks and water from the Lupikko I mine area were collected to research the behavior of toxic elements. The samples were analyzed using ICP-MS, ICP-AES, potentiometric titration, ionic chromatography, X-ray microanalysis, X-ray fluorescence, and SEM to obtain information about the geochemical environment. According to new data, the content of Fe, Zn, Cu, Pb, Cd, and Ni in the natural waters of the mine significantly exceeds the geochemical background. For a more detailed study of the behavior of heavy metals, equilibrium-kinetic modeling, which considers the dissolution rate of ore minerals and the accumulation of toxic elements over time, was applied. A comparison of modeling data and field observations agreed. It was also found that for accurate modeling of Fe behavior, it is necessary to consider the organic matter content. Despite some model limitations, such retrospective assessments allow us to approve the applicability of this method for forecasting estimates.

Aim: to evaluate the role of laboratory biomarkers in monitoring effectiveness of rituximab (RTM) biosimilar therapy in a total dose of 1200 mg. Materials and methods. 20 patients (pts) with rheumatoid arthritis (RA) (18 woman, mean age 61.5(54-66.5) years, mean disease duration 39.5(20-84) months, mean DAS28 5.6(4.9-6.8)) received two intravenous RTM biosimilar infusions (600 mg №2) in combination with DMARDs and glucocorticoids. Laboratory biomarkers were assessed at baseline and weeks 12 and 24 after the first infusion of RTX. Results. RTM biosimilar induced decreases in DAS28, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) at week 12 and 24, p

The technogenic impact of the development of the Lomonosov diamond deposit is associated with the discharge of quarry and drainage water into the river, which has a special conservation status. Earlier studies on the composition of bottom sediments showed that there are signs of increased accumulation of heavy metals and radionuclides at wastewater discharge sites. The purpose of this work was to predict changes in the composition of surface water and bottom sediment in the river during the further development of mining operations with brackish and salty water captured by drainage systems, the presence of which was established in the zone of their future influence. For this, a simulation of changes in the composition of the water in the river was carried out using the GEOCHEQ software package by minimizing the free energy of the system using a convex simplex algorithm. It was found that the maximum salinity of surface water can reach 1.51 g/L. In this case, the MPC of Cl−, Na+, SO42−, Mg2+, Sr, V, and U can be exceeded for fishery watercourses. The genetic basis of the accumulation of these components in solutions for mixing was considered. According to the calculations, when about 5000 m3/h of drainage water is discharge d into the river, the mass of precipitated chemical elements will be 56–191 t/h, including up to 2.1 t/h of iron; therefore, accumulation in the discharge zone must be controlled.

Objective: to evaluate the safety and effectiveness of vaccination with trivalent split virion influenza vaccine in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS), estimate the effect of vaccination on rheumatoid disorder (RD) activity and influenza and influenzalike illnesses morbidity.Materials and methods. The study included 86 patients (58 females and 28 males aged 22–82 years) with RDs (52 patients with RA and 34 patients with AS), as well as 40 subjects without RD (control group). At the time of study inclusion, all patients were receiving drug therapy. Duration of RD varied from 2 months to 46 years. The Vaxigrip vaccine containing the currents trains of the flu virus for 2016–2017 season or 2017–2018 season was administered subcutaneously as 1 dose (0.5 ml) with continuing antirheumatic therapy. The main control stages were visits 1, 3, and 6 months after vaccination. During the visits, standard clinical and labtests, clinical examination with disease activity evaluation were performed.Results. In 98 patients, vaccination tolerability was high, no post vaccination reactions were observed. In 20 cases, pain, swelling, and hyperemia of the skin 2 cm in diameter at the point of vaccination were observed; in 8 cases, low-grade fever, myalgia, discomfort, headache were observed. No RD flares or development of new autoimmune disorders were diagnosed during the follow-up period. No cases of influenza or influenza-like illnesses were registered during the follow-up period.Conclusion. The obtained data demonstrate high tolerability, clinical effectiveness of trivalent split virion influenza vaccine in patients with RA and AS.

The aim of the study was to study the efficacy, safety and immunogenicity of trivalent split influenza vaccine in patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS), systemic scleroderma (SSD). Material and methods. Ninety three patients were enrolled in the study, including 52 patients with RA, 34 with AS, 7 with SSD, and also 40 persons without rheumatic diseases (RD) (control group). At the time of enrolment, all patients received RD drug therapy. The duration of RD was from 2 months up to 46 years. Vaxigrip vaccine, which included the actual strains of influenza virus for the 2016-2017 or 2017-2018 seasons was administered subcutaneously in the amount of 1 dose (0.5 ml) against the backdrop of continuing RD therapy. The main stages of control were visits at 1-, 3- and 6-month intervals after vaccination. Standard clinical and laboratory tests, a clinical examination of the patient and assessment of disease activity were performed during the visits. Immunogenicity of the vaccine was evaluated at each stage of the control procedure using the commercial ELISA kits manufactured by PPDP LLC (St. Petersburg). Results. No cases of influenza or influenza-like illness were recorded during the entire period of observation. 81% of patients had no post-vaccination reactions in the RD group. Pain, swelling and hyperaemia of the skin with a diameter of up to 2 cm at the injection site were reported in 14% of cases and subfebrility, myalgia, malaise, headache in 5% of cases. The frequency of postvaccinal reactions among patients was not significantly different from that in the control group. There were no cases of exacerbation of RD or the occurrence of any new autoimmune disorders. The parameters of the humoral immune response in patients with RD did not significantly differ from those in the control group. Conclusion. The obtained data testify about good clinical efficacy and tolerability of trivalent split influenza vaccine in patients with RD.

To develop elements of a system for contact-free transportation of objects in space has now become an urgent task for the contemporary space-related activities. The purpose of work that is presented hereinafter was to conduct ground tests of the ion source, which is a key element of the above-mentioned system, and to compare the obtained experimental data with the mathematical simulation results in order to build a refined physical and mathematical model of the ion source. Such model was built on the basis of the classical problem regarding the motion of charged particles in an electrostatic field. Parameters of the ion source have been determined experimentally for several operating modes using various structural designs of the ion source electrodes. Two types of ion optics were tested—with slit and round apertures. Good correlation between simulation results and experimental data has been demonstrated. The optimum ion source operation modes have been identified to ensure minimum divergence angles for the plasma beam exiting from the ion source, which in its turn maximizes the pulse transmitted to the transported object.

The prevalence of osteoarthrosis (OA) among adults over 40 years is taking one of the leading places in the common structure of joint pathology. Obesity – is of the comorbidities associated with OA, one of the risk factors of development and progression of OA. The aim of this study was to evaluate the influence of obesity on the structure of knee and hip OA on the stage of total joint replacement, depending on the patient`s gender, age and degree of obesity. The study involved 170 inpatient case histories of patients with OA undergoing treatment in the department of large joints replacement (64 men and 106 women): 95 patients with OA of hip joint and 75 – with OA of knee joint, among whom there were 110 patients with obesity and 60 – without it. The middle age of the patients was by 63,8±7,69 years. High prevalence of obesity among patients with OA of knee and hip joints was found, with significant higher number of obese patients with OA of knee joint and among female patients. It has been demonstrated a significant increase in the frequency of total knee joint replacement associated with the increase of body mass index among patients with OA of knee joint. The presence of obesity was associated with earlier terms of the total joint replacement performing, especially among male patients.

Aim. To estimate a relationship between matrix metalloproteinase-3 (MMP-3) levels and articular radiographic changes in early and extended rheumatoid arthritis (RA); to analyze the role of this biomarker in predicting the progression of joint destruction in RA. Subjects and methods. Forty-five patients with early RA and 42 with extended RA were examined. Radiography of the hands and distal feet was performed before and one year after therapy. Serum MMP-3 levels were measured by an enzyme immunoassay prior to and 12 and 24 weeks after treatment. Results. After 52 weeks, in the early RA group, 16 patients continued monotherapy with methotrexate (MT); because of its inefficiency, 29 additionally received a biological agent in different follow-up periods. The extended RA group took tocilizumab for 24 weeks, then the drug was discontinued and the patients continued the former therapy with disease-modifying antirheumatic drugs, nonsteroidal anti-inflammatory drugs, and glucocorticosteroids. One year later, radiographic progression was recorded in 20.5 and 22.5% of the patients with early and extended RA, respectively. ROC analysis indicated that in the early RA group the MMP-3 level of more than 34.3 ng/ml at 12 weeks of MT therapy was associated with the radiographic progression of articular destructive changes after 52 weeks of therapy (the area under the curve (AUC) was 0.7; 95% confidence interval (CI) 0.46 to 0.93). In the patients with extended RA, the baseline MMP-3 levels of ≤51.3 ng/ml was related to no radiographic progression following 52 weeks (AUC, 0.587; 95% CI 0.33 to 0.84). Conclusion. MMP-3 may be regarded as an early marker for joint destruction in RA. The determination of MMP-3 level with other immunological markers may be useful to identify a group of patients who have a potentially severer disease course and need more intensive therapy.

For the possibility of forming an objective basis for determining the diagnosis and creating the ultimate goal of orthodontic treatment, it is necessary to have a clear understanding of the individual variables of the basic metric characteristics of certain individual parameters of bone structures and soft facial tissues. The aim of the study – to construct and analyze the regression models of gnatometric indices, depending on the parameters of basal cranial structures in boys and girls with orthognathic bite. Materials and Methods. Teleroentgenography and computed tomography studies were performed on 38 boys (aged from 17 to 21) and 55 girls (aged from 16 to 20 years) who had a physiological bite as close as possible to orthognathic. The construction of regression models of gnatometric indices, depending on the parameters of basal cranial structures, was carried out in the licensed package "Statistica 6.0". Results and Discussion. As a result of the regression analysis conducted in the boys with orthognathic occlusion, the following models of gnatometric parameters were constructed depending on the parameters of the basal cranial structures: effective length of the maxilla = - (16.11+1.01)×distance Se_N + 0,45×magnitude of the base of the maxilla + 0.28×distance S_E (determination factor is 0.612); length of the upper jaw = - (15.42+0.50) ×distance Se_N + 0.50×the size of the base of the upper jaw (the determination coefficient is equal to 0.550); angle SND = 107.8 – 0.47×H-angle + 0.39×magnitude of the base of the upper jaw – 0.38×distance S_E (determination coefficient is equal to 0.502); distance S_L = (13.05+1.51) ×distance Se_N – 0.87×H-angle – 0.86×distance S_E + 0.63×magnitude of the base of the upper jaw (determination coefficient is 0.626). Conclusions. Of the 43 possible regression models of gnatometric indices, depending on the parameters of the basal cranial structures in boys with orthognathic occlusion, only 4 valid models with a determination coefficient greater than 0.5 were constructed, namely, effective length of the upper jaw, maxilla length, SND angle and distance S_L. In girls with orthognathic bite, models with a determination coefficient greater than 0.5 are not built at all.

The article is devoted to the study of features of lower respiratory tract infection associated with respiratory syncytial virus. 40 cases of RSV-bronchiolitis in preterm children under year with/without bronchopulmonary dysplasia were analyzed. It was established that disease in those groups of patients had severe course because of the respiratory failure, which dominates in clinical pictures as symptoms of bronchial obstruction and apnea. Treatment of severe RSV-infection often demand admission to intensive care unit, supplemental oxygen and/or mechanical ventilation.

The article discusses value-motivational orientations and patterns of students’ social behavior, formed under the influence of modern social and political challenges. The youth as a social group characterized by a specific position in the social structure. Values and attitudes of young people are influenced by the macro, this social group is the subject of social reproduction and dynamics. Analysis of selected youth life strategies in the rapidly changing social environment (including regional specificity of residence) predicts the development trends and monitor the processes occurring among young people. The results of empirical studies: the All-Russian population surveys (VCIOM, 2014) aimed at identifying the characteristics of perception of today's youth as a social group of Russians and quantitative survey of students in the Republic of Bashkortostan (1992, 1993, 1994, 1999, 2015). The results made it possible to form a representation of the external form of self-identification and characteristics of regional youth to identify common strategies for self-realization of Representatives considered socio-demographic group, consider the patterns of behavior in critical areas, the structure of the value orientations of Bashkir Youth in the changing socio-political environment. The above trends indicate a steady trend to preserve traditional rules governing the intergenerational relations in the Republic of Bashkortostan: the installation of students in the region are characterized by a stable social orientation, based on the traditional mentality, adequate to the Russian reality.

Alterations in catecholamine signaling and cortical morphology have both been implicated in the pathophysiology of attention deficit/hyperactivity disorder (ADHD). However, possible links between the two remain unstudied. Here, we report exploratory analyses of cortical thickness and its relation to striatal dopamine transmission in treatment-naïve adults with ADHD and matched healthy controls. All participants had one magnetic resonance imaging (MRI) and two [11C]raclopride positron emission tomography scans. Associations between frontal cortical thickness and the magnitude of d-amphetamine-induced [11C]raclopride binding changes were observed that were divergent in the two groups. In the healthy controls, a thicker cortex was associated with less dopamine release; in the ADHD participants the converse was seen. The same divergence was seen for baseline D2/3 receptor availability. In healthy volunteers, lower D2/3 receptor availability was associated with a thicker cortex, while in the ADHD group lower baseline D2/3 receptor availability was associated with a thinner cortex. Individual differences in cortical thickness in these regions correlated with ADHD symptom severity. Together, these findings add to the evidence of associations between dopamine transmission and cortical morphology, and suggest that these relationships are altered in treatment-naïve adults with ADHD.

Given the high rate of recurrence of epithelial ovarian cancer after radical treatment is necessary to improve the therapeutic approach to its treatment. New drug of marine origin trabectedin has shown high efficacy in monotherapy and in combination with different cytostatics in the treatment of platinum-sensitive recurrent of ovarian cancer. A randomized trial OVA-301 showed the greatest benefit of a combination of trabectedin with pegylated liposomal doxorubicin in the subgroup of patients with partially platinum-sensitive recurrent of ovarian cancer. Acceptable toxicity profile of the drug, presented mainly neutropenia and transient increase of transaminases, making it promising for further study.

Antitumor activity of trabectedin as a monotherapy in different solid tumors (soft tissue sarcoma, ovarian cancer, breast cancer, melanoma) contributed to research trabectedin-based drug combinations. Phase I trials were searching for optimal dose and schedule of administration trabectedin and trabectedin-based combinations. This review considers aspects of clinical applications and toxic profile of trabectedin alone and combinations, including a rare adverse event – rhabdomyolysis and data of own experience.

AIM: To evaluate the impact of tocilizumab (TCZ) therapy on the level of matrix metalloproteinase-3 (MMP-3) 4, 24, and 48 weeks after treatment initiation in relation to the clinical efficiency of TCZ therapy by the Disease Activity Score (DAS28), the Clinical Disease Activity Index (CDAI), and the Simplified Disease Activity Index (SDAI)/MATERIAL AND METHODS: Forty-two rheumatoid arthritis (RA) patients who had received 6 intravenous infusions of TCZ 8 mg/kg at a 4-week interval during permanent therapy with disease-modifying anti-rheumatic drugs (DMARD) and glucocorticosteroids (GCS) were examined. Then TCZ was discontinued and the patients continued to receive the previous therapy with DMARD and GCS. The European League Against Rheumatism (EULAR) classification criteria, as well as SDAI and CDAI were used to evaluate the efficiency of TCZ therapy. The serum concentration of MMP-3 was measured by enzyme immunoassay using the test systems (Invitrogen, USA)/RESULTS: After 24 weeks of TCZ therapy (at 48 weeks following trial initiation), DAS28 was 4.69 (3.86; 5.44); the SDAI of 17.8 (10.7; 29.5) and the CDAI of 17.1 (7.2; 26.2) corresponded to moderate disease activity. At 48 weeks, DAS28 remission (

AIM: To evaluate the efficacy of rituximab (RT) in cryoglobulinemic vasculitis (CGV) and MALT lymphomas of the parotid gland (PG) in patients with Sjögren's disease (SD). /MATERIAL AND METHODS: RT therapy was performed in 13 patients with SD and CGV and in 17 with SD and PG MALT lymphoma. Eleven patients with SD received RT monotherapy and 19 with this disease had combined therapy with RT and cyclophosphan (CP). RT was used intravenously dropwise at a dose of 500 mg weekly or once every two weeks in combination with intravenous dropwise CP 1000 mg the next day with 4-6 per course. For the diagnosis of MALT lymphomas, all the patients with SD underwent incisional PG biopsy under local anesthesia at the Research Institute of Rheumatology, Russian Academy of Medical Sciences. PG biopsy specimens were histologically and immunohistochemically studied at the Russian Cancer Research Center, Russian Academy of Medical Sciences. In 11 cases, B-cell clonality was identified from immunoglobulin (Ig) heavy chain genes rearrangements, by using polymerase chain reaction at the Hematology Research Center, Ministry of Health and Social Development of the Russian Federation /RESULTS: Cutaneous manifestations of vasculitis disappeared in 75% of cases after monotherapy with RT and in 100% of cases after combination therapy with RT and CP. At 6-month follow-up, a complete response to therapy remained in 25% of the patients after a course of monotherapy and in 83% after combined therapy. Serum monoclonal Ig cryoglobulins and their urinary light chains ceased to be detectable in 75% of the patients in both groups at 3 months. At 6 months, a recurrence of mixed monoclonal cryoglobulinemia was seen in 50 and 43% of cases after monotherapy and combined therapy, respectively. The clinical and laboratory response of cryoglobunemic glomerulonephritis to combined therapy with RT and CP was complete in 60% of cases at 6-month follow-up. After RT monotherapy, the patients with SD and PG MALT lymphoma achieved a complete clinical response in 88%, of whom histological and immunohistochemical reexaminations of PG biopsy specimens revealed no signs of MALT lymphoma in 71% of cases. B-cell clonality remained in the PG biopsy specimens following RT monotherapy. After the combination of RT and CP, a complete clinical response to therapy was observed in 100% of the patients, a complete histological response and a complete molecular one were seen in 83 and 60%, respectively /CONCLUSION: RT showed its efficacy in treating SD patients with CGV and PG MALT lymphomas.

Evolutionary theories suggest that depression has evolved as an adaptation to insurmountable adversity or defeat. One prediction stemming from these models is that individual attributes associated with defeat in a given social environment could be risk factors for depression. We hypothesized that in young military men, where physical prowess was important, short stature might constitute a risk of depression and that this risk would be specific to depression and not to other prevalent mental disorders such as anxiety. A preliminary analysis of the diagnostic profile of a sample of male military personnel treated for mental health indicates that men both shorter and taller than average by 1 standard deviation may be predisposed to higher rates of depressive but not anxiety disorders. Practical and theoretical implications of our findings are discussed.

Objective. To make individualised decisions regarding treatment is one of the most important challenges in clinical practise, and identification of sensitive and specific markers of prognosis is an important research question. The main objective of this study was to evaluate relationships between the level of autoantibodies, radiographic changes and laboratory markers of bone, and cartilage destruction. Methods. A total of 114 RA patients were examined. The serum concentration of IgM RF, antibodies to cyclic citrullinated peptide (anti-CCP), modified citrullinated vimentin (anti-MCV), matrix metalloproteinase 3 (MMP-3), and cartilage oligomeric matrix protein (COMP, ng/mL) were measured. The van der Heijde-modified Sharp Score was used to quantify the radiologic changes. Results. Among the patients who were high-positive for anti-MCV, the value of total modified Sharp score (mTSS) (96.5; 66–120) was higher as well as the joint space narrowing (82; 60.5–105.5), and a higher level of MMP-3 was recorded more frequently (56%) in comparison with negative/low-positive patients (57; 31–88, 50; 29–82, 31% resp., P

In the 1990s, the Newly Independent and Baltic States of the former Soviet Union experienced the largest diphtheria outbreak since the 1960s; it was caused by Corynebacterium diphtheriae strains of a unique clonal group. To address its origin, we studied 47 clinical isolates from Russia and demonstrated that this clonal group was an integral part of the endemic reservoir that existed in Russia at least 5 years before the epidemic began.

Antineutrophil cytoplasmic antibody-associated systemic vasculitis (ANCA-SV) is a group of rare and potentially severe systemic diseases. The search for reliable methods to assess ANCA-SV activity remains relevant. Among the indicators of neutrophil activation that have emerged in clinical practice, the level of serum calprotectin (CLP) stands out, which can be a marker for monitoring vasculitis activity and identifying patients at risk of disease relapse. Objective: to determine serum CLP levels in patients with ANCA-SV. Material and methods. The study group comprised 64 patients (37 with granulomatosis with polyangiitis, 11 with eosinophilic granulomatosis with polyangiitis and 16 with microscopic polyangiitis) aged 18 years and older with a confirmed diagnosis of ANCA-SV. The control group consisted of 30 healthy individuals. ANCA-SV activity was determined using the BVAS index; high activity corresponded to a BVAS value of >3. Damage was assessed using the VDI index. Depending on ANCA-SV activity, patients were divided into two groups: high activity group (group 1, n=33) and low activity group (group 2, n=31). In addition to the generally accepted indicators, serum CLP levels were assessed in all patients with ANCA-SV and healthy donors. Results and discussion. Statistically significant differences (p

Thrombotic antiphospholipid syndrome (APS) is a condition affecting young people in whom a thromboembolic event occurs in the presence of circulating antiphospholipid antibodies (aPL).The aim of this study was the evaluation of the incidence of recurrent thrombosis and its risk factors in antiphospholipid syndrome.Material and methods. The retrospective study included 98 patients with aPL who were followed up at the institute from 2014 to 2023, of whom 66 (67%) were women and 32 (33%) were men. Of the 98 patients with aPL, 48 (49%) had a diagnosis of systemic lupus erythematosus (SLE). Antiphospholipid antibodies (aPL), including antibodies to cardiolipin (IgG/IgM aCL), antibodies to ß2-glycoprotein 1 (IgG/IgM aß2GP1), antibodies to ß2-glycoprotein IgG against domain 1 (IgG aß2GP1-D1), antibodies to phosphatidylserine/prothrombin complex (IgG/ IgM aPS/PT) and other thrombotic risk factors. aPL was assessed by enzyme-linked immunosorbent assay (ELISA) and chemoluminescence assay (CHLA).Results. Thrombosis recurrence was reported in 62 (63%) of 98 patients, and 36 (35%) did not. The main cause of recurrent thrombosis was treatment with direct oral anticoagulants (DOACs). 24 (38.7%) of 62 patients with recurrent thrombosis were treated with DOACs, the duration of which ranged from 6 to 24 months. The next most common cause of recurrent thrombosis was the lack of continuous anticoagulant therapy in 20 (32.5%) of the patients. In 17 (27.4%) of the patients, the recurrence occurred while they were still taking warfarin. In 10 (41.7%) of the 24 patients, the recurrent thrombosis was arterial in origin. This was associated with recurrent cerebral circulation problems. The level of positivity did not matter, but all had triple IgG aPL positivity. 5 had lupus anticoagulant (LA) at the onset of the disease before anticoagulant use. IgG aPS/PT was most important in association with recurring thrombosis in the ELISA: 45 (72.6%) of 62 patients with recurring thrombosis were positive for IgG aPS/PT, compared with 19 (52.8%) of 36 patients without recurring thrombosis. The detection of all aPL was more frequent in CHMA than in ELISA. However, the definition of aPL in ELISA is recommended according to the latest classification criteria. Triple IgG positivity for aCL of IgG aß2GP1, IgG aß2GP1-D1 and CHMA remained a risk factor for recurrent thrombosis and increased the risk of recurrence more than threefold. Obesity was a risk factor for recurrent thrombosis, with a 5-fold increased risk of recurrent thrombosis in obese compared to non-obese patients (p=0.01).Conclusions. Recurrent thrombosis in APS is largely associated with IgG aCL, IgG aß2GP1, IgG aß2GP1-D1, IgG aPS/PT. Triple IgG aPL positivity in any combination significantly increased recurrent thrombosis risk.The presence of any type of aPL IgG in both ELISA and CHLA influenced the recurrence rate of thrombosis in APS.Obesity was a significant risk factor for recurrent thrombosis.

The Beck mine, located in the Republic of Karelia, Russia, is an abandoned mining site with significant potential for environmental contamination due to the presence of potential pollutants in its waste rocks. In this study, we investigated the chemical composition of mine waters and waste rocks and developed a theoretical model to understand waterrock interactions and the release of potential pollutants. Water samples collected from various locations on the Beck mine property were analyzed for chemical composition and showed low concentrations of total dissolved solids with pH values ranging from 6.42 to 7.74. The chemical composition of natural waters was determined by ICP-MS, ICP-AES, ion chromatography, potentiometric titration, and spectrophotometry. Equilibrium kinetic modeling was used to simulate water-rock interactions. The model predicted the concentrations of major and trace elements, demonstrating that dissolution-precipitation and complexation are the primary mechanisms shaping the chemical composition of mine waters. The dynamics of dissolution-precipitation of Fe-containing minerals highlighted the importance of the duration of water-rock interaction, with stagnant mine waters exhibiting higher concentrations of heavy metals. In addition, the presence of dissolved organic matter played a critical role in the accumulation of iron and arsenic in the studied mine waters. Overall, this study highlights the utility of equilibrium kinetic modeling in understanding the behavior of heavy metals during water-rock interactions and provides valuable insights into the potential environmental impacts of abandoned mine sites such as the Beck mine.

This study analyses and compares higher education in Germany, France, and Singapore. The authors highlight the similarities and differences between higher education systems in some countries of the European and Asia-Pacific regions. Its structure is described, with consideration to characteristics of each state, the place of these countries in the leading world rankings on the level of education is given (Education Index 2022 of the United Nations Development Programme and Human Development Report 2021–2022). A comparative analysis of the study duration, principles of building a higher education system was conducted. Also, the authors studied participation of employers (organisations and enterprises) and state in the process, along with issues of employment of graduates as a criterion for this method. The role of the relative independence of higher educational institutions in resolving admission issues was identified. The authors examined the stages of mastering programmes, the requirements for applicants when entering educational organisations, the types of degrees, and the procedure for awarding them. The system of dual (practice-oriented) training was explored as a basis for employment of graduates in France and Germany, the principles and goals of its functioning in the analysed states of the European region were clarified.

Citrullinated histone H3 (CitH3) is a specific marker for NETosis; its role in determining the clinical and laboratory manifestations of systemic lupus erythematosus (SLE) remains to be elucidated.Objective: To evaluate the role of CitH3 in the development of clinical and laboratory manifestations in patients with SLE with and without an-tiphospholipid syndrome (APS).Material and methods. The study included 30 patients with SLE and 39 with SLE+APS, including 51 (73.9%) women and 18 (26.1%) men. The median age of the patients was 36 [32; 46.5] years. The control group consisted of 26 healthy individuals.SLE activity was assessed by the SLEDAI-2K index. Patients were divided into two groups: 41 patients with moderate and high SLE activity (SLEDAI-2K ≥6) were included in the first group, and 28 patients with low activity or remission (SLEDAI-2K

The “Treat-to-target” (T2T) strategy for axial spondyloarthritis (axSpA) has made it possible to optimize therapy in most patients, but in some of them the treatment goals are not achieved.Objective: to analyze the clinical features of patients with ankylosing spondylitis (AS) with inefficacy of two or more biological disease modifying antirheumatic drugs (bDMARDs).Material and methods. From February 2020 to March 2022 458 patients with AS, who met the modified New York criteria of 1984, were admitted to V.A. Nasonova Research Institute of Rheumatology. From this group, 30 (6.6%) patients with high clinical disease activity and inefficacy of at least two bDMARDs were selected. The control group consisted of 139 (30.5%) patients with AS, who either had no history of bDMARDs use, or had previously received only one of them. All patients were examined in accordance with generally accepted methods and underwent a double expert control.Results and discussion. Men predominated in the main and control groups (67 and 60%, respectively). In patients of the main group, there was a higher laboratory activity of the disease, especially ESR (p=0.002), more often peripheral arthritis was detected. In both groups, there was a high incidence of coxitis (69.2 and 69.7%, respectively), while in the main group there were significantly more patients who underwent total joint arthroplasty, and the frequency of detected syndesmophytes was 2 times lower compared to the control. Differences in the features of AS onset were also established: in the main group, the disease often began with reactive arthritis (ReA), while in the control group, with inflammatory back pain.Conclusion. The T2T strategy in axSpA does not always lead to the achievement of the intended goals, and, according to our data, among inpatients with AS, the number of people with a history of inefficacy of two or more bDMARDs reaches 6%. In these patients, compared with the control, the following features of the disease can be distinguished: frequent onset with ReA, a significant incidence of peripheral arthritis and joint arthroplasty, and a higher ESR.

Infections remain one of the main causes of morbidity and mortality in patients with immuno-inflammatory rheumatic diseases. Objective – to study the efficacy, immunogenicity and safety of the 23-valent polysaccharide pneumococcal vaccine (PPV-23) in patients with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (AРS). Materials and methods. 91 patients were included in the study: 78 with SLE, of which 18 (23 %) – with secondary AРS, 13 – with primary AРS. 85 patients received immunosuppressive therapy, including 30 – genetically engineered biological drugs (bDMARD); 23 – anticoagulants. PPV-23 was administered subcutaneously, patients were observed for a year after vaccination. Results. Local reactions were observed in 49% of patients with SLE and secondary AРS, in 23% of patients with primary AРS. General reactions were noted in isolated cases, were short-term and did not require additional prescriptions. During the follow-up period, no exacerbations of SLE, relapses of thrombosis and thromboembolism associated with vaccination were detected; no development of new autoimmune diseases was registered. 10 (13%) patients with SLE were immunized against the background of high activity of the disease, no adverse reactions were recorded. In some patients, a transient increase in a-DNA and ANF was observed during the year without signs of exacerbation of the disease. 56% of patients with SLE and secondary AРS, 15.4% with primary AРS were “responders” to the vaccine. There was no negative effect on the immune response of the dose of GC >10 mg/day, age, duration and activity of the disease. With the treatment of bDMARD, a full-fledged vaccine response was recorded much less frequently than with standard therapy (38% and 67.4%, respectively; p=0.01). After vaccination, there was a significant decrease in the number of lower respiratory tract infections (LRTI) (p=0.0001), including community-acquired pneumonia (PN) (p=0.03) and acute bronchitis (p=0.04), ENT infections (p=0.001). In the treatment of rituximab (RTM), compared with belimumab (BLM), a greater number of LRTI was observed, mainly due to PN. After vaccination on RTM therapy, the number of INDP in general (p=0.008) and PN in particular (p=0.03) decreased, isolated cases of LRTI and ENT organs were recorded on BLM therapy. Within 4–6 years after vaccination, 30 patients with SLE retained the clinical effect of vaccination, while immunogenicity decreased to 18%. Conclusion. Safety, sufficient immunogenicity, and clinical efficacy of PPV-23 in patients with SLE and AРS have been shown. The use of bDMARD reduces the vaccine response. Immunization performed prior to or during treatment with bDMARD lasting

Introduction. The Global Antiphospholipid Syndrome Score (GAPSS) is a tool proposed to quantify the risk of clinical manifestations associated with antiphospholipid antibodies (aPL) and certain cardiovascular risk factors.Objective. To validate GAPSS in a cohort of patients with systemic lupus erythematosus in Russia.Material and methods. 115 patients with SLE were included in the study, including 51 (44%) patients with systemic lupus erythematosus (SLE) with antiphospholipid syndrome (APS), 14 (12%) – SLE with aPL, and 50 (44%) – SLE.Results. There was a history of thrombosis in 58 (50%) patients with 115, of them 14 (24%) had arterial thrombosis, 29 (50%) – venous, 15 (26%) – combined. Pregnancy against the background of the disease occurred in 43 women included in the study. Of them, 29 (67%) had obstetric pathology. Patients with thrombosis and obstetric pathology had a GAPSS score of 7.17±5.64, versus 4.48±4.55 without these manifestations (p=0.0003). There was a significant association between GAPSS levels and thrombosis – patients with thrombosis had a GAPSS of 7.31±5.70, those without thrombosis – 4.00±4.81 (p=0.001). GAPPS values were higher in arterial thrombosis compared to venous thrombosis (10.40±25.30 versus 5.82±5.28; p=0.01). GAPSS levels ≥6 and ≥10 were analyzed to select GAPSS values at which a high risk of recurrent thrombosis and/or obstetric pathology could be indicated. All GAPSS levels had a significant association with clinical manifestations of APS. The quality of GAPSS by ROC analysis showed an area under the curve (AUC) for GAPSS of 0.697.Conclusion. GAPSS can be used to assess the risk of recurrence or development of thrombosis and/or obstetric pathology in patients with SLE in the Russian Federation. The GAPSS ≥6 values should be used to stratify patients with SLE into high risk group for recurrence of vascular complications. Further prospective follow-up is needed to confirm the value of GAPSS.

The article deals with the activities of a psychologist-educator and his role in relation to the problem of student deviation in the digitalisation context and the widespread use of the Internet. A comprehensive analysis of adolescent deviations and various aspects of dealing with students’ destructive behavior and with their parents using knowledge from different subject areas – law, sociology, psychology, medicine, pedagogy, has been conducted. The features and characteristics of adolescence are considered, and the factors influencing the formation of deviant behavior, including medical ones, are identified. The role of the educational organisation’s psychologist in identifying and correcting learners behavior destructive forms is outlined. The necessary ratio between the staff of psychologists and medical specialists and the students number in educational organisations is given. As a result of the analysis of the current legislation, the shortcomings of certain legal provisions and the need to change them in destructive behavior prevention part were noted. Recommendations for professionals in the helping professions have been developed and projected positive results of the outlined activities have been given. The authors’ conceptual findings are applicable to creating a safe and supportive environment for learners, reducing juvenile delinquency and amending legislation.

This work is devoted to the analysis of the right to access the Internet and its safe use. The main purpose of the article is to consider the right to access the Internet and to a favorable social environment, as well as the introduction of these rights into the legislation of the Russian Federation. The authors analyzed the legislation of various states and international organizations in the field of free Internet access, considered the impact of a favorable Internet environment on the human psyche. The object of the study is the subjective human rights to access the Internet and to use the Internet safely. The subject of the study is the legal norms of the Russian Federation and foreign states, the norms of international law. The authors consider the role of a favorable environment on the Internet for minors, describe the main factors of restrictions on access to the Internet for teenagers. The methodological and theoretical basis of the research are private and general scientific approaches to the study of this topic. Formal logical and comparative methods were used, as well as methods of structural analysis. During the study, conclusions about the main differences in approaches to digital rights in the Russian Federation, foreign legal systems, and international law were drawn.

Objective. To evaluate the ovarian reserve in women with systemic sclerosis (SSc) and to analyze the relationship of the concentration of anti-Müllerian hormone (AMH) with the main manifestations of the disease and therapy. Material and methods. The study included 74 SSc patients aged 18 to 40 years; the control group consisted of 32 healthy women, matched by age. The concentration of follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, estradiol (E2) and testosterone was determined by enzyme immunoassay (ELISA), AMH quantitatively using standard chemiluminescent analysis on paramagnetic particles in blood serum. The AMG level of 1.0– 10.6 ng/ml was taken as normative values. Values

In the coming XXI century, infectious diseases still retain their importance both in medical and social terms, this problem is very relevant for rheumatology, where comorbid infections (CI) have a significant impact on both the course of the main immuno-inflammatory rheumatic disease (IIRD) and mortality. One of the leading places in the structure of serious CI in patients with IIRD is occupied by pneumonia, which is a weighty argument in favor of the vaccination of these patients from pneumococcal infection. The article presents generalized data on the use of 23-valent pneumococcal polysaccharide vaccine (PPV-23) in patients with IIRD who received inpatient and outpatient treatment at the V.A. Nasonova Research Institute of Rheumatology for the last 10 years. It has been shown that the vaccination of PPV-23 in patients with IIRD is characterized by high preventive efficacy (>90%), is safe and does not increase the risk of exacerbation of the disease. The sufficient immunogenicity of vaccination is evidenced by a significant increase in the levels of pneumococcal antibodies in the blood serum and the coefficient of post-vaccination response. The use of glucocorticoids (methylprednisolone, prednisolone) has no significant effect on the effectiveness, immunogenicity and safety of PPV-23 vaccination. The possibility of vaccination of PPV-23 with any activity of the process in patients with rheumatoid arthritis, systemic lupus erythematosus and spondyloarthritis (ankylosing spondylitis, psoriatic arthritis) with the condition of adequate therapy has been demonstrated. In order to develop clearer indications for vaccination, to determine time intervals for revaccination, to evaluate the effectiveness and safety of new pneumococcal vaccines, as well as to study the effect on the results of immunization of various anti-rheumatic drugs in patients with IIRD, further multicenter large-scale studies are needed.

The study of antiphospholipid antibodies (aPL), not included in the Sydney diagnostic criteria, in antiphospholipid syndrome (APS) and systemic lupus erythematosus (SLE) is poorly understood.The aim of this study – to determine the clinical significance of IgG antibody testing for domain I β2 -glycoprotein 1 (β2 -GP1DI) – IgG anti-β2 -GP1DI in patients with APS with and without SLE.Materials and methods. The study included 187 patients with APS with or without SLE, 49 patients formed a comparison group, and 100 relatively healthy individuals formed a control group. IgG/IgM antibodies to cardiolipin and IgG/ IgM anti-β2 -GP1 were determined by enzyme immunoassay (ELISA) in patients with or without APS, and IgG antiβ2 -GP1DI was determined by chemiluminescence assay in all patients and controls.Results. IgG anti-β2 -GP1DI was detected in 37 (71%) of 52 patients with primary APS (PAPS), in 6 (50%) of 12 patients with probable APS, in 42 (71%) of 59 patients with SLE+APS, in 17 (26%) of 64 patients with SLE, in 1 (2%) of comparison group and in none of control group. IgG anti-β2 -GP1DI was significantly associated with PAPS and SLE+APS compared with patients with SLE (p=0.0002 and p=0.0001, respectively). The association of IgG anti-β2 -GP1DI with clinical manifestations of APS (thrombosis (χ2 =9.69; p=0.001) and obstetric pathology (χ2 =4.19; p=0.04)) was detected. There was a significant association of IgG anti-β2 -GP1DI with arterial thrombosis (χ2 =8.84; p=0.002) and with late gestational obstetric pathology (χ2 =6.35; p=0.01). High specificity of IgG anti-β2 - GP1DI depending on the diagnosis and clinical manifestations of APS was noted despite low sensitivity: specificity for thrombosis was 84%, for obstetric pathology – 94%, for APS – 89%. Isolated IgG anti-β2 -GP1DI positivity was reported in 2% of 50 aPL negative patients and was not associated with APS manifestations.Conclusion. The frequency of IgG anti-β2 -GP1DI detection was higher in patients with APS compared to patients with SLE, comparison group and control (p˂ 0.05). Positive IgG anti-β2 -GP1DI values were significantly associated with thrombotic complications and with obstetric pathology (χ2 =8.84; p=0.002 and χ2 =6.35; p=0.01). Specificity of IgG anti-β2 -GP1DI for APS and its clinical manifestations (thrombosis and obstetric pathology) was higher than sensitivity: 89%, 94%, and 84%, respectively.

This work is devoted to the analysis of the sociological and legal aspects of the implementation of authentication in social networks through passport data. In the article, along with authentication, the uses of biometric data, as well as the features of Russian legislation in the sphere of personal data, are considered. The positive and negative aspects of introducing authentication by passport data in social networks are shown and the psychological and legal aspectsare reveled. The authors analyzed all the features of authentication, the complexity of application and the impact of this innovation on the prevention of deviant behavior among the adolescent age group. The object of the research is authentication by passport data in social networks. The subject of the research is psychological and legal aspects of establishing authentication based on passport data. The methodological and theoretical basis of the research is made up of particular and general scientific approaches to the study of this topic, formal logical and comparative methods, as well as methods of structural analysis were used. In the course of the study, conclusions about the main features of storing citizens’ data, the complexity of storing data of Russians on foreign Internet platforms, conclusions on the need to filter information for minors were drawn, and also considered the phenomenon of deviant behavior among adolescents and the influence of information in social networks on their consciousness.

Objective: to evaluate the effect of the generic drug of zoledronic acid on bone mineral density (BMD) and markers of bone metabolism in patients with osteoporosis (OP), as well as possible long-term adverse reactions (AR) 12 months after drug administration.Patients and methods. The study included 30 postmenopausal women with OP (mean age 64±8 years) who signed an informed consent of participance in clinical observation. Patients received a single dose of generic zoledronic acid (5 mg) as a 15-minute infusion. All patients additionally took calcium and vitamin D. The dynamics of BMD and bone metabolism markers, as well as the safety and tolerability of the drug, were evaluated. Fractures that might have occurred during follow-up should have been reported as ARs.Results and discussion. During treatment with generic zoledronic acid, the increase in BMD in the lumbar region was 4.9% (p2%) in the spine was detected in 26 (86.7%) patients, in the proximal femur – in 20 (66.7%) patients. There was a decrease in the intensity of pain in both the thoracic (by 62%; p=0.038) and lumbar (by 29%; p=0.022) spine. Three months after the administration of the drug, a decrease in the level of bone metabolism markers was revealed: CTX – by an average of 29.7%, and P1NP – by an average of 25.5%. ARs were post-dose reactions that occurred within the first 48 hours after drug infusion. Remote ARs, fractures of peripheral bones and vertebrae were not recorded.Conclusion. The use of the generic drug of zoledronic acid has demonstrated its positive effect on BMD and markers of bone metabolism, as well as safety.

Classical serological markers of antiphospholipid syndrome (APS) are antibodies to cardiolipin, antibodies to β2-glycoprotein 1, and lupus anticoagulant. The utility of testing other antiphospholipid antibodies, not included in the classification criteria for improving the diagnosis of autoimmune thrombophilia continues to be debated. The review presents literature data on the study of antibodies to prothrombin and the phosphatidylserine/prothrombin complex in patients with systemic lupus erythematosus and APS.

Objective – to find a potential relationship between ACPA and disease activity, bone destruction, and ACPAs responses to various therapeutic regimens.Materials and methods. The study included 232 patients with rheumatoid arthritis (RA); 90 patients had early RA; 142 patients had advanced stage of the disease.Results. 77 (85.6%) patients with early RA were high positive for anti-CCP, and 29 (70.7%) patients – high positive for anti-MCV. A positive correlation was found between anti-MCV and DAS28 (r=0.4; p=0.04). As for advanced RA, 78 (80.4%) patients were high positive for anti-CCP, and 70 (79.5%) – for anti-MCV. There was a positive correlation between anti-MCV concentration and SDAI (r=0.4; p=0.02), as well as CDAI (r=0.4; p=0.02). No significant correlations were found between the anti-CCP levels and activity indices, anti-CCP and acute-phase parameters in both early and advanced RA groups. Higher total Sharp scores (96.5 (65.0–122.0)) were found in pts high positive for anti-MCV (n=79), compared to low-positive/negative (n=27) patients (57.0 (31.0–88.0); p