Despite the continuous improvement of ongoing assisted reproductive technologies (ART programs), the rates of successful embryo implantation and clinical pregnancy vary greatly, and the frequency of early pregnancy losses remains significant. A key role in implantation and maintenance of pregnancy belongs to the balance of cytokines, disorders of which are an important risk factor for the failure of ART.

The aim of the work is to systematize modern ideas about the role of the cytokine network in the onset and maintenance of induced pregnancy and to assess the clinical significance of the cytokine profile as a tool for predicting and potentially correcting reproductive failures. The material for the analysis was publications indexed in the international databases as Web of Science, Scopus, PubMed and domestic database as RSCI, the search depth was 5 years (2020–2025).

Main provisions. The cytokine network is a fundamental regulator of implantation and maintenance of induced pregnancy. The imbalance towards proinflammatory (Th1) cytokines such as TNF-α, IFN-γ, IL-1 β may be the most significant factor in implantation failures, early pregnancy losses, and pregnancy complications after ART. In contrast, adequate levels of anti-inflammatory and immunoregulatory (Th2/Treg) cytokines IL-10, TGF-β, IL-35, andadequate Treg activity create anoptimal environment for embryo implantation and development, and correlate with favorable outcomes. A personalized approach based on the detection of cytokine imbalance and its targeted correction, including immunomodulation, the use of growth factors, intrauterine administration of Treg, represents a promising strategy to increase the effectiveness of ART and reduce the frequency of reproductive failures.

Conclusion. The results of the analyzed studies make a significant contribution to reproductive immunology, offering scientifically based approaches to improve the effectiveness of ART and reduce the frequency of reproductive failures through the prism of managing the immune landscape of induced pregnancy.

Collagen, a major structural protein in the human body, has long been considered primarily in the context of skin, joint, and connective tissue health. Recent years have seen a significant increase in interest in the systemic effects of collagen, expanding the range of its potential applications, including gynecological practice.

The aim. Comprehensively analyze current scientific data on the use of hydrolyzed collagen in medicine, with an emphasis on the rationale for its use in gynecological practice.

This review provides a detailed examination of the fundamental aspects of collagen, including its biochemistry, digestibility, safety, antioxidant properties, and its role in stimulating extracellular matrix synthesis. A comprehensive literature search was conducted in PubMed, Scopus, Web of Science, Google Scholar, Medline, and eLibrary for the period 2000–2024. Inclusion criteria for the review included randomized controlled trials, meta-analyses, systematic reviews, and relevant experimental studies in English and Russian. Based on a systematization of scientific literature, three key promising areas for the use of collagen in gynecological practice have been identified: the combined use of oral collagen hydrolysate supplements with energy-based therapies in the treatment of genitourinary syndrome of menopause in women; the correction of menopausal metabolic disorders, targeting key pathogenesis factors: inhibition of dipeptidyl peptidase-4 to improve insulin sensitivity, regulation of lipid metabolism in the liver and adipose tissue, and reduction of systemic inflammation; and nutritional support of bone metabolism in patients with postmenopausal osteoporosis. Hydrolyzed collagen, going beyond nutricosmetics, represents a promising multi-target therapeutic agent for comprehensively improving the quality of life of peri- and postmenopausal women.

Background. Leptin, a hormone secreted by adipose tissue, is considered as an important regulator of metabolism and energy homeostasis. Some leptin gene polymorphisms may be risk factors for obesity and other metabolic disorders, and there are ethnic differences in the prevalence and impact of these polymorphisms on anthropometric parameters.

The aim. To sequence fragment 128255194-128257652 (2458 bp) of the LEP gene (GRCh38/hg38, NM_000230.3) for identifying polymorphisms associated with biochemical and anthropometric parameters in adolescents with different weight status.

Materials and Methods. The study included adolescents aged 11 to 17 years with different weight status. Amplification conditions were selected, and sequencing of fragment 128255194-128257652 of the LEP gene was performed.

Results. Sequencing of the 128255194-128257652 region of the LEP gene revealed four polymorphisms: rs10954174, rs41434248, rs41457646, and rs11761556. When comparing the groups, statistically significant differences in the frequency distribution of the rs11761556 alleles were revealed among Russians and Buryats with normal body weight. The frequency of the alternative allele G rs10954174 was 1 in all groups; the alternative allele A rs41434248 was detected only in the main group of Russians with a frequency of 0.036; the frequency of the allele A rs41457646 in the control group of Russians and Buryats was 0.083 and 0.25, in the main group of Russians and Buryats – 0.107 and 0.091, respectively; the frequency of the allele A rs11761556 in the control group of Russians and Buryats was 0.583 and 0.958, in the main group of Russians and Buryats – 0.643 and 0.727, respectively. All the identified frequencies are consistent with world data, according to NCBI.

Conclusions. We found no significant associations between the identified polymorphisms and biochemical and anthropometric parameters in adolescents with different weight statuses. For rs11761556, statistically significant differences in the allele frequency distribution were demonstrated between Russians and Buryats with normal body weight.

Background. The study of the genetic predisposition to gastroesophageal reflux disease (GERD) and hiatal hernia (HH) will improve early diagnosis and рersonalize treatment approach.

The аim. To identify the association of polymorphic variants rs1107946 of the COL1A1 gene, rs17576 of the MMR-9 gene with GERD and HH type I.

Materials and methods. Twenty-three healthy volunteers of the control group, 31 patients with HH type I of the first group, 40 patients with HH type I and GERD of the second group were examined. Identification of polymorphic variants was carried out by real-time polymerase chain reaction using commercial SNP-screen kits (Synthol, Russia).

Results. Carriage of allele A rs1107946 COL1A1 gene increased the chances of developing HH type I by 3.84 times (p = 0.040). The frequency of the AG genotype rs17576 of the MMR-9 gene in the second group was 62.50 %, which is significantly different from the frequency of homozygous genotypes (AA and GG): p = 0.049. Simultaneous carriage of the A allele rs1107946 of the COL1A1 gene and the G allele rs17576 of the MMR-9 gene was associated with an increased chance of developing HH type I. However, the obtained result was characterized by a wide confidence interval (OR = 9.00; 95% CI 1.05–77.18; p = 0.030), indicating possible instability of the effect.

Conclusion. Associative relationships were established between the carrier of the A allele of the rs1107946 gene COL1A1, as well as the simultaneous carrier of the A allele of the rs1107946 gene COL1A1 and the G allele of the rs17576 gene MMR-9 with the development of HH type I. In patients with HH type I and GERD the highest frequency of AG rs17576 genotype of the MMR-9 gene (62.5 %) was noted.

Background. The breath-holding spells are reflex syncope in children, which are manifested during crying, screaming, discontent. The ECG during paroxysms shows episodes of asystole up to 30–70 seconds and bradycardia with a heart rate of 30–40 beats/min. Breath-holding spells disappear by the age of 3–5, but severe paroxysms with syncope and seizures sometimes need the pacemaker implantation. The course of breath-holding spells with pacemaker implantation have not been poorly studied.

The aim. To analyze the course of severe breath-holding spells with prolonged asystoles in children after permanent pacemaker implantation.

Materials and methods. We included 10 patients (aged 14–43 months) with breath-holding spells and syncope and implanted pacemaker. Electrocardiography, Holter monitoring and echocardiography were performed, the heart rate monitor was implanted in 3 patients.

Results. Provoking factors were screaming, pain, crying. In 60 % syncope were accompanied by seizures and asystoles lasting from 3 to 40 seconds were recorded. In 90 % syncope stopped after the pacemaker implantation, excluding one. One patient has reactive pericarditis. Pacemakers have been removed from 7 patients and replaced in 3 patients. In 6 out of 7 patients after pacemaker extraction syncope did not recur, one patient has reflex syncope.

Conclusion. The course of the breath-holding spells with prolonged asystoles after pacemaker implantation is associated with the disappearance of severe seizures in 100 % of children and relief from the syncope in 90 % of children. Complications of after the pacemaker implantation in children with severe breath-holding spells occur in 10 %.

Currently, research into compression neuropathies of the upper limbs is of great importance in the fields of neurology, orthopedics, and rehabilitation medicine. Particular attention is paid to pathologies affecting the median nerve, which is crucial for ensuring precise hand movements and sensitivity of the palmar surface of the fingers. In the case of significant prolonged nerve compression or prolonged lack of adequate treatment, the risk of persistent neurological deficit increases.

Purpose of the literature review. To systematize scientific publications and clinical studies focusing on compression neuropathy of the median nerve (pronator teres syndrome and carpal tunnel syndrome).

Analysis of sources suggests that the prognosis for conditions such as pronator teres syndrome and carpal tunnel syndrome depends on several key factors. First and foremost,itisimportanthowquicklyacorrect diagnosiscanbeestablished. Oneofthemain findings is the assessment of the role of electroneuromyography (ENMG) in the diagnosis of compression neuropathies. It is worth noting that ENMG in the early stages of neuropathy does not always provide complete information about the patient’s condition. Normal ENMG results in the initial stages of carpal tunnel syndrome or in dynamic forms of the disease cannot serve as grounds for ruling out the diagnosis. In such cases, other diagnostic methods may be more valuable, such as ultrasound neurography and ENMG performed using extended protocols – these enhance the accuracy and informativeness of the examination. When nerve compression is detected early, it is often possible to completely eliminate symptoms using conservative treatment methods. However, if the nerve has undergone significant compression or the patient has not received proper care for a long time, there is a risk of nerve fiber degeneration. Surgical decompression is typically resorted to in two cases: when conservative methods have not produced the desired effect, or when the degree of nerve compression is too severe.

Adherent–invasive Escherichia coli (AIEC), which have acquired the ability to adhere to and penetrate epithelial cells, survive and replicate within macrophages, and provoke inflammation, are attracting particular attention from researchers due to their role in the pathogenesis of Crohn’s disease (CD), a severe chronic inflammatory disease of the gastrointestinal tract. AIEC represent a phylogenetically diverse group of bacteria that lack the genetic determinants characteristic of pathogenic E. coli and possess unique metabolic plasticity, allowing them to adapt to various conditions. Currently, one of the key research questions is whether AIEC trigger CD or simply adapt to existing inflammation, exploiting it to survive and replicate in the face of reduced mucosal immunity and impaired intestinal epithelial barrier function. Of particular interest is the study of the mechanisms and causes of the transformation of commensal E. coli into the pathogenic AIEC phenotype.

The aim of this review is to systematize and analyze scientific data on the key molecular mechanisms that ensure successful colonization of the human intestine by AIEC. This paper examines in detail the strategies of AIEC to overcome the mucus layer, the mechanisms of adhesion and invasion, their ability to survive and replicate in macrophages, their metabolic plasticity that enables the utilization of alternative carbon sources, their ability to form biofilms, and their resistance to antibiotics and antimicrobial peptides. For this study, we used review and experimental articles available in full format in the PubMed database, using the keyword “adherent–invasive Escherichia coli” (AIEC). Articles dating back to 1998, when the first publications on AIEC appeared, were used as a filter.

Background. Although previously isolated from contaminated soils, new opportunistic human pathogens belonging to the genus Pseudoxanthomonas have been described. Analysis of the biological properties of a P. kaohsiungensis strain isolated from the blood indicated that it is a potential human pathogen in immunocompromised patients and not merely a bacterium that produces biosurfactants in the environment.

The aim. To conduct biological characterization, phylogenetic analysis, and protein spectroscopy to identify the P. kaohsiungensis strain, a potential new and rare human pathogen.

Materials and Methods. The P. kaohsiungensis strain IMB-1 was isolated from a child undergoing treatment in a city hospital. The strain was isolated and cultured on blood agar. Morphological and biochemical properties were studied. Ribosomal phylogeny was used for identification; additionally, protein spectra were obtained using MALDI-TOF mass spectrometry.

Results. Small gray colonies were isolated from an enrichment medium from cerebrospinal fluid sample. The cell morphology was Gram-negative rods, oxidase- and catalase-positive. Identification using the NEFERMtest system was inconclusive. The strain was susceptible to increased doses of trimethoprim-sulfamethoxazole. Protein spectrum with a low score and convergence indicated a primary identification as Stenotrophomonas maltophilia. A 1470-bp 16S rRNA gene sequence was assembled using Sanger sequencing. Primary identification using the NCBI database revealed 99.8 % homology to the type strain of the species P. kaohsiungensis. Protein spectra obtained using MALDI-TOF mass spectrometry were processed, and a reference protein profile was generated for identifying P. kaohsiungensis strains.

Conclusion. Difficulties in bacteriological identification of clinically significant new bacterial strains and the lack of reference protein spectra in databases highlight the importance of genomic tools for accurate pathogen identification and characterization and confirm the gold standard of molecular sequencing and ribosomal phylogeny. The obtained results highlight the urgent need to strengthen genomic monitoring and update databases for the rapid identification of opportunistic pathogens.

Background. The development of efficient and safe adjuvants for mucosal vaccines remains one of the key challenges in modern immunology, as traditional adjuvants, such as aluminum salts, have been shown to be insufficient in stimulating local immunity, particularly the production of secretory immunoglobulin A (IgA). Therefore, the development of novel, potent and cost-effective adjuvants presents a significant opportunity.

The aim. Development of a recombinant A4Z protein based on the Z-domain of Staphylococcus aureus protein A and investigation of its potential use as a mucosal adjuvant in a subunit vaccine model.

Materials and methods. A synthetic gene encoding the A4Z protein was constructed using genetic engineering methods. The protein consists of four repeats of the mutant Z-domain of protein A (with N3A, N6D, N23T amino acid substitutions to reduce toxicity) and a C-terminal hexahistidine tag. The protein was expressed in the E. coli BL21(DE3) system. Purification was performed using a two-step chromatography process: affinity chromatography and ion-exchange chromatography. Acute toxicity was assessed in CD-1 mice following intraperitoneal administration of doses up to 2 g/kg. The adjuvant properties were studied in Balb/c mice via intranasal immunization with a conjugate of the A4Z protein and the SARS-CoV-2 spike protein’s RBD domain. Immunogenicity was evaluated by measuring specific IgG antibody titers using ELISA.

Results. The A4Z protein was shown to be virtually nontoxic (hazard class 4), causing no animal mortality or significant toxic effects even at a dose of 2 g/kg. Intranasal administration of the A4Z conjugate with RBD induced high levels of specific IgG antibodies, the titers of which were not statistically different from those obtained with intramuscular immunization and significantly (p < 0.05) exceeded the titers in the control groups (RBD without adjuvant or in combination with chitosan).

Conclusions. These findings highlight the potential of A4Z as a promising mucosal adjuvant capable of enhancing humoral immunity. Further research should focus on investigating its effects on the local IgA response and cellular immunity.

Background. To date, no specific methods for the prevention and treatment of coronary artery calcification have been developed. A literature analysis demonstrates that the use of certain pharmacological agents in patients with coronary artery disease significantly reduces the risk of developing this pathological condition. Drugs whose mechanism of action involves regulating cellular metabolism may serve as a promising tool for managing osteogenic differentiation of multipotent cells in the cardiovascular system and, consequently, preventing the development of massive calcification of cardiac vessels.

The aim. To evaluate the effect of different concentrations of N,N-dimethylimidicarboimide diamide (DMDC) on the osteogenic differentiation of mesenchymal stem cells (MSCs) derived from epicardial adipose tissue (EAT).

Methods. MSCs were isolated from EAT biopsies collected during coronary artery bypass grafting. Cell cultures were passaged to the third passage, after which immunophenotyping and osteogenic differentiation were performed. For MSC differentiation, osteogenic medium was used, either native or supplemented with 10, 50, and 100 μmol DMDC. Osteogenesis was assessed by measuring protein levels (RUNX2, osteopontin, alkaline phosphatase) in cell culture supernatants and staining the cell cultures with subsequent determination of staining intensity.

Results. Throughout differentiation, cells incubated in medium supplemented with 50 μmol DMDC demonstrated high levels of osteogenic protein synthesis. Osteoblasts differentiated with 50 μmol DMDC synthesized 1.1 times more calcium than MSCs incubated with other DMDC concentrations, and 1.3 times more than in control cultures (p = 0.001).

Conclusion. Adding DMDC to the differentiation medium for EAT-MSCs from patients with coronary artery disease significantly enhances the synthesis of key markers of osteoblast differentiation. A particularly pronounced effect was observed at a concentration of 50 μmol of the drug.

SARS-CoV-2 is one of the few viruses that cause blood coagulation disorders. The pathogenesis of coagulopathies in COVID-19 is polyetiological: cytokine storm, NETosis, dysfunction of the renin-angiotensin system, thrombotic microangiopathy, disseminated intravascular coagulation (DIC), and hypofibrinolysis. However, the role of the immune system in the development of these disorders remains insufficiently described.

The aim. To characterize the role of the innate immune system in the development of coagulopathies in patients with severe COVID-19.

Methods. The study included a cohort of 103 patients with severe COVID-19 receiving anticoagulant therapy and undergoing treatment in Chita, Russia. Hemostasis was assessed using thrombodynamics testing, as well as measurement of fibrinogen, D-dimer, tissue plasminogen activator (tPA), and plasminogen activator inhibitor-1 (PAI-1). All patients with SARS-CoV-2 were stratified into four subgroups based on their hemostatic status. Levels of tissue factor (TF), D-dimer, tPA, PAI-1, myeloperoxidase (MPO), matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9), and cystatin C were determined by flow cytometry.

Results. In the pronounced hypercoagulation and hypercoagulation groups, elevated fibrinogen levels were observed, along with a parallel increase in tPA concentration and a sharp rise in PAI-1 levels. Meanwhile, maximal TF-values were recorded in patients with hypocoagulation. MMP-2 levels were lower than those in the control group in all COVID-19 patients, but progressively increased from normocoagulation to hypocoagulation, reaching a maximum in the latter group. MMP-9 and MPO concentrations were elevated across all groups, peaking in the normocoagulation group. Cystatin C concentration was increased in all patients.

Conclusion. Severe COVID-19 is associated with the development of thrombotic coagulopathy, driven by the formation of a vicious cycle of “thromboinflammation,” in which hemostatic disorders and systemic inflammatory response mutually reinforce each other.

Relevance. Systemic inflammation in bronchial asthma (BA) is associated with functional changes in subcellular structures, including mitochondria. Therefore, the study of mitochondrial structures is important for understanding the pathophysiological mechanisms of BA formation and progression. The functional activity of mitochondria largely depends on the qualitative and quantitative composition of fatty acids (FAs) of the mitochondrial membrane.

Objective. Establishing the characteristics of the FA composition of the mitochondrial membranes of blood leukocytes in patients with mild and moderate severity of bronchial asthma.

Materials and methods. The study involved 244 patients with BA (131 with mild and 113 with moderate severity) and 60 conditionally healthy individuals. The leukocyte suspension was obtained by Ficoll–Verografin density gradient centrifugation. Mitochondria were isolated from leukocytes by the standard method of differential centrifugation in sucrose medium. Methyl esters of FA were analyzed employing a gas chromatograph. Statistical processing of the results was performed using the STATISTICA 10.0 software package. The critical significance level (p) for testing statistical hypotheses was assumed at p < 0.05.

Results. With mild BA (of controlled and partially controlled course of disease) and with moderate BA of controlled course of disease, a compensatory increase in the summary indicators of monounsaturated fatty acids (MUFAs) and n-6 polyunsaturated fatty acids (PUFAs) occurs against the background of a decrease in the amount of saturated fatty acids (SFAs). With partially controlled BA of moderate severity, a breakdown in compensatory capabilities occurs, which is manifested in a decrease in the summary content of MUFAs and n-6 PUFAs. This may indicate both the development of pathological processes underlying BA and the activation of compensatory mechanisms at early stages of the disease.

Conclusions. Changes in the composition of fatty acids of mitochondrial membranes have been revealed in BA depending on the severity and level of disease control. Modification of the mitochondrial fatty acids composition may be an important criterion for assessing the progression of BA.

Background. Neoadjuvant chemotherapy (NAC) is a common treatment option for patients with triple-negative and HER2-positive breast cancer (BC) subtypes. The use of NAC in HER2-negative breast cancer is a matter of debate. For patients with HR+/HER2-breast cancer, the choice of NAC is still based on clinical and pathological characteristics rather than on biomarkers with a certain clinical value, in contrast to adjuvant therapy, where gene expression signatures are widely used for decision-making. Therefore, it is imperative to evaluate not only the efficacy of NAC but also to identify markers for disease prognosis in this specific patient group.

Aims. In this work, we studied the changes in the expression profile of HER2-negative breast tumors when using taxane-containing NAC regimens.

Material and methods. The material used was paired biopsy samples before treatment and tumor tissue (after NAC) for each patient. The expression landscape of the tumor was assessed using whole transcriptome microarray analysis using Clariom™ S Assay, human microarrays (Affymetrix, USA). Overall and metastasis-free survival curves for patients included in the study were constructed using the Kaplan-Meier method. The obtained result was validated on an independent sample.

Results. As a result, a comparison of the expression profile of the tumor of patients before and after NAC with taxane-containing regimens determined that the expression level of the PODXL2 gene in the tumor before treatment, depending on the response to therapy, and the level of expression of the NR2E1 and TMEM98 genes in the tumor after NAC, depending on the status of hematogenous metastasis, statistically significantly correlate with the OS and RFS of patients, respectively.

Conclusions. Potential expression markers of an objective response to the applied treatment and prediction of the occurrence of hematogenous metastasis of HER2-negative breast tumors were identified when prescribing taxane-containing treatment regimens.

Chronic postoperative endophthalmitis is a rare infectious complication following cataract surgery and develops 6 weeks or more later. Conservative therapy and even vitrectomy with intraocular lens (IOL) retention may provide only a temporary effect, because the “IOL–capsular bag” complex can remain a reservoir of infection.

The aim. To demonstrate the surgical and medical treatment experience of recurrent chronic postoperative endophthalmitis.

Materials and Methods. We report a clinical case of chronic postoperative endophthalmitis that manifested one month after cataract phacoemulsification with IOL implantation. Despite conservative therapy, sustained remission could not be achieved. Management was comprehensive and included three staged surgical procedures: subtotal pars plana vitrectomy with intravitreal antibiotic injection; revision of the vitreous cavity with removal of the “IOL–capsular bag” complex, repeated intravitreal antibiotics, and silicone oil tamponade (performed after recurrence of inflammation); and silicone oil removal followed by implantation of a three-piece IOL using the Yamane sutureless intrascleral fixation technique (performed 6 months after the previous procedure once inflammation had completely resolved).

Results. Following the first stage of treatment, uncorrected visual acuity (UCVA) was 0.4. A short-term remission of the inflammatory process lasting four weeks was achieved. A subsequent exacerbation served as an indication for the second stage of surgical intervention. Removal of the IOL-capsular bag complex combined with silicone oil tamponade of the vitreous cavity led to a sustained resolution of inflammation. Subsequently, aphakia correction was performed simultaneously with silicone oil removal. Over the two-year postoperative follow-up period, UCVA reached 0.8, with no recurrence of inflammation.

Conclusion. In recurrent chronic postoperative endophthalmitis, the most effective strategy is pars plana vitrectomy with removal of the “IOL–capsular bag” complex. Secondary posterior chamber IOL implantation using the Yamane sutureless intrascleral fixation technique is an effective method for aphakia correction in this setting.

The review reflects the current understanding of metabolomic research, which simultaneously identifies and quantifies thousands of metabolites in a single biological sample. The potential of small metabolites is of clinical interest from the standpoint of obtaining an invaluable tool for disease phenotyping and predicting various clinical course options. The achievements of metabolic profiling of blood plasma and moisture of the anterior chamber of the eye in patients with ophthalmological diseases such as cataracts, glaucoma, diabetic retinopathy and age-related macular degeneration of the retina are presented separately. Significant differences in the metabolic composition of the anterior chamber moisture were revealed. Modern mass spectrometry techniques based on artificial intelligence make it possible to study complex metabolic systems in detail with high accuracy and speed, which previously seemed unattainable. First, it is important to identify the key metabolomes. The next stage is clinical confirmation, during which the connection between biomarkers and the causes of diseases is established. Large-scale studies of healthy people are needed to confirm the diagnostic and prognostic reliability of biomarkers. Standardization of biological material collection, processing, and analysis of results is extremely important to achieve consistency between different studies and requires compliance with the methodology. The final stage is the introduction of the biomarker into clinical practice, the training of medical personnel and the assessment of cost-effectiveness to ensure accessibility and implementation in practice. Together, these approaches play a key role in the identification and measurement of biomarkers in everyday clinical trials, revealing their potential to determine diagnostic accuracy and improve individual patient care. When writing the review, the databases PubMed, Google Scholar, Scopus, and eLibrary.ru, Federal Electronic Medical Library, CyberLeninka Scientific Electronic Library were used with sources for the period 2015–2025. The following keywords were used for the search: metabolome, high performance liquid chromatography, diabetes mellitus, cardiovascular diseases, ophthalmological diseases.

Background. Mixed astigmatism is one of the most difficult refractive errors to correct. Traditional excimer laser techniques are associated with the risk of biomechanical complications due to the formation of a corneal flap. Lenticular technology offers a minimally invasive alternative, but its application in the case of mixed astigmatism is not well-studied and requires the development of specialized surgical approaches.

The aim. To evaluate the effectiveness of early clinical and functional results in the correction of mixed astigmatism using femtosecond lenticular technology.

Methods and materials. The study included 10 patients (15 eyes) aged 32.4 ± 6.13 years with mixed astigmatism. Following a comprehensive preoperative examination, all patients underwent refractive lenticule extraction using the SMILE method using a VisuMax™ 500 kHz femtosecond laser (Carl Zeiss Meditec AG) with preliminary calculation of lenticule parameters using the developed technology. Postoperative monitoring was performed on the 1st day, 1 week, and 1 month.

Results. After one month, the uncorrected visual acuity was 0.90 ± 0.11, corresponding to the preoperative best-corrected visual acuity (0.90 ± 0.18). The spherical equivalent stabilized at 0.06 ± 0.45 D. The cylindrical component decreased from -2.77 ± 0.79 D to -0.22 ±0.47 D. Keratometry readings decreased from 42.59 ±1.56 D to 40.80 ±1.08 D. Central corneal thickness decreased to 499.53 ± 34.27 µm (baseline: 555.87 ± 33.02 µm) while maintaining residual stroma at 376.27 ± 32.50 µm. No additional correction or complications were required.

Conclusion. The developed technology for correcting mixed astigmatism based on refractive parameter transposition in lenticular surgery is effective and safe – high visual function was achieved in the early postoperative period with minimal risk of complications and preserved biomechanical stability of the cornea, confirming the potential for further research.

Background. The diagnosis and management of fungal keratitis remain major challenges in routine ophthalmic practice. This is largely attributable to the severe, treatment-resistant course of the disease and the high risk of recurrence, even when appropriate antifungal therapy is administered. A distinctive feature of keratomycosis is the ability of filamentous fungi to extend beyond the clinically visible margins of the lesion, which may significantly compromise treatment efficacy.

The aim. To determine the true extent of mycelial fungal spread within the corneal stroma in keratomycosis.

Materials and Methods. The study was performed using an experimental rabbit model of keratitis induced with Fusarium solani isolates. To assess the actual extent of the pathological process, slit-lamp biomicroscopy, anterior segment optical coherence tomography (OCT), and histological examination were employed. Measurements were obtained with consideration of corneal anatomical features.

Results. On days 7–9 after keratitis induction, in 9 cases demonstrated a well-defined biomicroscopic appearance consistent with fungal keratitis, with confirmed fungal etiology. Histological examination revealed fungal cells in 17 of 45 sections. A quantitative visual assessment using a corneal microscope and histological examination revealed a difference between these parameters (p = 0.0036), with the median area of proliferation in the corneal stroma being greater than the visually detectable infiltrate. Fungal cells also penetrated the entire corneal thickness in all samples, with detection in the aqueous humor of the anterior chamber.

Conclusion. The findings indicate that by day 8 of keratitis progression, the spread of fungal cells along stromal collagen lamellae may exceed the clinically visible lesion by nearly half and extend in depth to involve anterior chamber structures. These growth characteristics of filamentous fungi should be considered when planning the extent of surgical intervention in fungal keratitis.

Background. Contemporary neuroimaging studies reveal that catatonia is associated with specific dysfunction patterns in cortico-striatal-thalamic networks, with particular involvement of fronto-striatal circuits regulating motor control and executive functions. Factor-analytic approaches to cognitive assessment can identify distinct neuropsychological profiles reflecting underlying neural network alterations in catatonic disorders.

Objective. To characterize the structure of neurocognitive deficits in endogenous disorders with catatonic symptomatology through factor analysis, identifying distinct cognitive profiles associated with cortico-striatal and temporo-parietal network dysfunction, and to evaluate the modifying effect of affective comorbidity on these patterns.

Material and Methods. The study included 139 patients: main group (n = 69) with endogenous disorders including catatonic symptomatology, divided into subgroups without (n = 35) and with pronounced depressive symptomatology (n = 34), and control group (n = 70) with similar subdivision. Catatonia was assessed using Bush-Francis Scale (BFCRS). Neurocognitive evaluation included BACS battery, MoCA and FAB scales. Factor analysis with varimax rotation was applied to identify cognitive deficit structure. Statistical analysis included MANOVA with Bonferroni correction.

Results. Factor analysis revealed distinct cognitive structures. In catatonia without affective symptomatology, three factors emerged: (1) a fronto-striatal factor (47.2 % of variance), comprising executive functions, psychomotor speed, and inhibitory control; (2) a temporo-parietal factor (26.3 % of variance), including visuospatial functions and constructive praxis; and (3) a hippocampal factor (19.8 % of variance), associated with episodic memory and delayed recall. In the presence of affective comorbidity, two factors were identified: (1) a fronto-limbic factor, accounting for 53.7% of the variance and encompassing attention, working memory, and emotional regulation; and (2) a fronto-striatal factor, accounting for 30.1 % of the variance and encompassing psychomotor speed and executive functions. MANOVA revealed significant group differences across all cognitive domains (d = 0.52–1.31, p < 0.001). Two-factor analysis showed main effect of catatonia (F = 31.2, p < 0.001, η² = 0.19), moderate effect of affectivity (F = 12.4, p < 0.01, η² = 0.08) and their interaction (F = 7.8, p < 0.01, η² = 0.05).

Conclusion. Catatonic disorders demonstrate distinct cognitive profiles on factor analysis, reflecting specific cortico-striatal and temporo-parietal network dysfunction. Affective comorbidity transforms the cognitive structure toward fronto-limbic involvement, indicating the need for differentiated rehabilitation targeting specific neural networks.

Background. A multiple and variable interrelations between the blood coagulation disorders, neuroinflammation and the psychotic syndromes pathogenesis mean an obvious scientific and clinical validity of the hemostasis system research in schizophrenia. This interdisciplinary track deals with a link between psychiatry, neurobiology and hematology. This itself is a step towards the new perspectives for further understanding of schizophrenia pathophysiology, and, consequently, for developments of the forth-coming therapeutic approaches.

The aim. Evaluation of the role of the hemostasis system using the “Fibrinodynamics” method in the pathophysiology of schizophrenia.

Materials and Methods. An observational cohort study was conducted on 66 female patients aged 16–57 years (32.2 ± 10.2 years) hospitalized in the clinic of the Mental Health Research Center in the acute stage of the disease. Blood coagulation and fibrinolysis patterns were detected and analysed using our original version of “Fibrinodynamics” method, while the patients` clinical status was elucidated by PANSS and HDRS scales.

Results. Prior to treatment, a statistically significant increase of all “Fibrinodynamics” control values, except for a hemostasis balance parameter (OFP%, p = 0.337) has been observed. This shows a high potential of coagulation (OCP, p < 0.0001) and fibrinolysis (OFP, p < 0.0001), whereas the whole system balance was found intact.

After the treatment, a clear hemostasis disbalances (OFP%, p = 0.394) with a probable predominance of coagulation and/or fibrinolytic potential in different patients (OCP, p <0.0001; OFP, p <0.0001): a lack of statistically essential changes of these parameters was demonstrated within this group in general.

Conclusion. The data obtained are in a favor to a statistically significant increase of the hemostasis function parameters in schizophrenia patients which correlates with their clinical status. This indicates to involvement of the hemostasis system into pathopysiology of the disease studied.

Taking into account the link between inflammation and hemostasis we’ve found, these results allows to assume an essential interrelation between the hemostasis disfunction and chronic inflammation, as long as both takes place in schizophrenia patients. It seems to be an important element of the disease pathogenesis path.

Background. Among the psychological risk factors for cardiovascular diseases, type D personality is studied. This type has a tendency to develop psychological distress and is associated with an unfavorable prognosis in patients with cardiovascular pathology. For the purposes of primary (including early) and secondary prevention of cardiovascular pathology, study of stress reactivity in individuals with type D personality is required for various physiological parameters, because the studies conducted to date have mainly concerned the stress reactivity of hemodynamics.

The aim. To study the influence of type D personality on various psychophysiological indicators of the body during psychoemotional stress.

Materials and methods. The study included 115 individuals among students of the Kemerovo State Medical University and employees of the Research Institute of Complex Problems of Cardiovascular Diseases of the Siberian Branch of the Russian Academy of Sciences (41 men and 74 women, aged from 18 to 64 years, median age – 22 years). According to the results of the DS-14 questionnaire, the individuals were divided into two groups: with type D personality (n = 59) and without it (n = 56). A study of stress reactivity was conducted for various physiological parameters using the BOSLAB professional plus biofeedback complex.

Results. A high percentage of individuals with type D personality (59 individuals, 51.3 %) was found in the cohort of subjects. During stress tests, individuals with type D personality had less pronounced dynamics of respiratory cardiac arrhythmia and pulse wave propagation time than individuals without type D (p = 0.020 and p = 0.032, respectively). More significant dynamics in type D personality were noted for the frequency of the respiratory mode (p < 0.001), the duration of the respiratory cycle (p < 0.001) and the data of integrated electromyography from the frontal muscles (p = 0.030).

Conclusions. The possibility of using the above-mentioned psychophysiological parameters in biofeedback programs for individuals with type D personality requires further study.

Introduction. False joints are relatively rare, but they also represent one of the most serious complications in trauma and orthopedic surgery, highlighting many factors that increase the risk of their formation.

Aims. To identify the risk factors of formation of false shoulder joints, as well as to determine the degree of their significance through a retrospective comparative analysis of own clinical material and literature data.

Materials and methods. The clinical base consisted of 176 patients with false shoulder diaphragm joints, who in the period from 2012 to 2022 were provided with operative treatment for pseudoarthrosis of the humerus. The influence of fracture nature, osteossynthesis techniques, bone plastic options, demographic characteristics and lifestyle on the formation of false joint development was studied.

Results. The false joint was most often attributed to types of fractures B2 and A2, especially if there is a history of 1 or 2 previous operations, their risk increases to more than 20 %. Type C3 copulation time in 100 % of cases was at least 8 months when treated without use of bone autoplastic and at least 6 months when used. Smoking and old age have lengthened the bone fusion process in a group without an autoplastic to 8 months at 47.7 % and 56.3 %, respectively, while in a group with a free autoplastic the same trend was observed in obese patients: in 50 % of cases the seeding time took 8 months.

Conclusions. New data on the degree of influence of various factors on the formation of false joint of the humerus were obtained. Analysis of this information will help to predict adverse anatomical and functional outcome of treatment and avoid its occurrence.

Background. The growth of morbid obesity worldwide has led to an increase in abdominoptosis, which occurs both as a result of the disease and bariatric surgery. This has led to an increase in the number of operations to restore the abdominal shape configuration. Accordingly, the number of complications developing in the early postoperative period after abdominoplasty has increased.

The aim. Compare the effect of preserving the Scarpa fascia during abdominoplasty on the immediate and long-term results of the surgery.

Materials and methods. The conducted examination included 48 patients who underwent an abdominoplasty operation. All patients were divided into 2 groups: group 1 – the operation was performed without preserving the Scarpa fascia, in group 2 – with preservation. To determine complications, instrumental diagnostics in the form of ultrasound examination was used, and changes in skin color, lumps on palpation, drainage discharge counts, and the nature of the evacuated fluid during puncture were determined.

Results. In the early postoperative period, the overall complication rate was significantly higher in group 1 (without Scarpa fascia preservation) – 20 complications in 26 patients (76.9 %) versus 9 complications in 22 patients (40.9 %) in group 2 (with preservation) (p < 0.05). The difference was most pronounced in patients with previous bariatric surgery. Seroma and lymphorrhea predominated among the complications that occurred in 14 patients (53.8 %) in group 1, and in 6 patients (27.3 %) in group 2. At 6-month follow-up, most patients (92–95 %) were satisfied with the surgical outcome. Recurrence of abdominoptosis was noted in 2 patients (one in each group).

Conclusion. The results of this study are consistent with the international literature on the preservation of the Scarpa’s fascia. Preservation of the Scarpa’s fascia helps reduce the incidence of postoperative seromas and improves immediate postoperative outcomes. However, the number of patients included in the study is insufficient to draw definitive conclusions. Preservation of the Scarpa fascia did not affect long-term outcomes. The current high rate of early postoperative complications necessitates further research into ways to reduce them.

Background. Accurate preoperative diagnosis of hiatal hernia dimensions is critically important for surgical planning, as underestimation of hernia parameters may lead to inadequate selection of surgical techniques and increased risk of recurrence. Development of an effective diagnostic algorithm using modern imaging methods contributes to improved quality of surgical treatment and reduced frequency of adverse outcomes.

Aims. To evaluate the diagnostic accuracy of various imaging methods for hiatal hernia and determine the optimal preoperative examination algorithm to improve surgical treatment outcomes.

Materials and methods. This retrospective cohort study included 81 patients with hiatal hernia (51 women, 30 men; mean age 44.5 ± 12.3 years) who underwent laparoscopic treatment between January 2019 and December 2024. All patients underwent esophagogastroduodenoscopy (EGD). When discrepancies were identified between the clinical presentation and endoscopic measurements, additional diagnostic imaging was performed: contrast radiography (n = 49, 60.5 %), multislice computed tomography (MSCT, n = 29, 35.8 %), and contrast-enhanced MSCT (n = 14, 17.3 %). Hiatal hernia dimensions were determined preoperatively and intraoperatively, followed by statistical analysis of diagnostic accuracy.

Results. Preoperative hiatal hernia dimensions were distributed as follows: ≤ 35 mm – 46 patients (56.8 %), 35–50 mm – 26 patients (32.1 %), > 50 mm – 9 patients (11.1 %). In 59 patients (72.8 %), intraoperative dimensions exceeded preoperative EGD estimates by an average of 8.4 ± 3.1 mm. The greatest discrepancies were observed in hernias >50 mm (13.8 ±4.2 mm). Contrast-enhanced MSCT demonstrated the highest diagnostic accuracy: sensitivity 95.1 %, specificity 90.2 %, surpassing EGD (91.8 % and 75.4 %) and contrast radiography (86.7 % and 82.1 %). During 6–36 months follow-up, complete symptom resolution was achieved in 84.2 % of patients, with recurrence rate of 3.9 %.

Conclusions. A differentiated approach to hiatal hernia diagnosis using MSCT as the method of choice ensures high accuracy of preoperative planning and improves treatment outcomes.

Rational. Thrombolytic therapy is an effective method of treating ischemic stroke, which has its limitations associated with the peculiarities of introducing a recombinant plasminogen activator (International non-proprietary name Alteplase); from 2020, it is possible to use an alternative thrombolytic drug “Recombinant protein containing the staphylokinase amino acid sequence” of Russian production.

Aims. To evaluate the clinical efficacy and safety profile of the domestic thrombolytic drug non-immunogenic staphylokinase in patients with acute ischemic stroke and to justify the possibilities of personalized therapy based on clinical and pharmacological predictors of outcome.

Materials and methods. A retrospective analysis of 576 patients with ischemic stroke who received systemic thrombolytic therapy with the drug produced in Russia–non-immunogenic staphylokinase was carried out. The dynamics of neurological deficits according to the National Institutes of Health Stroke Scale (NIHSS) at 24 hours, functional status according to the modified Rankin scale at 90 days, hospital and 90-day mortality, hemorrhagic transformation of the ischemia focus and intracerebral hemorrhages, including symptomatic ones, were evaluated. Additionally, a stratified analysis of out-comes by age, body weight, and comorbidity was performed, and a machine learning model (CatBoostClassifier) was constructed to predict death by calculating the area under the ROC-curve.

Results. The average age of patients was 68.2 ± 12.7 years, the proportion of women was 49.0 %. Hospital mortality was 11 %. Symptomatic hemorrhagic transformation of the ischemic focus was observed in 5.5 % of cases. Patients who died in hospital were characterized by greater baseline neurological deficits, greater functional dependence, older age, more frequent heart failure, abnormal heart rhythms, and cardioembolic stroke subtype. A prognostic model based on clinical laboratory features showed a ROC-AUC of 0.89 (95% confidence interval 0.82–0.95) when predicting fatal outcome.

Conclusions. Systemic thrombolysis with non-immunogenic staphylokinase in patients with ischemic stroke was associated with acceptable safety, a low incidence of clinically significant hemorrhagic complications, and reproducible predictors of fatal outcome. The data obtained indicate the possibility of risk stratification and clinical and pharmacological justification of personalized thrombolytic therapy in conditions of limited availability of imported drugs.