Aim. To study the possibility of the presence of coronary artery disease (CAD) depending on the smoking status, as well as to estimate the association of smoking with other traditional risk factors in residents of Kemerovo region aged 25–64 years.

Materials and methods. We analyzed the results of the multicenter epidemiological study “Epidemiology of cardiovascular diseases and their risk factors in the Russian Federation” in Kemerovo region obtained from a random sample of 1,599 subjects aged 25–64 years. Besides the smoking status, the following parameters were analyzed: gender, age, education, diabetes mellitus (DM) and arterial hypertension (AH) history, hypercholesterolemia, hypertriglyceridemia, high level of low-density lipoproteins, low level of high-density lipoproteins (HDL), hyperglycemia, obesity, alcohol abuse, and depression.

Results. Three groups were formed depending on the smoking status: group 1 included 484 (30.3%) current smokers, group 2 had 317 (19.8%) former smokers and group 3 had 798 (49.9%) individuals who had never smoked. The groups did not differ in the prevalence of CAD. When determining the rank significance of the impact of risk factors on the possibility of CAD development in the overall population, it was revealed that the age affected the risk of CAD the most, while smoking and low HDL had minimal impact.  The impact of the smoking factor on CAD was higher in the representatives of the older age group; however, even in the subjects aged ≥ 50 years,
the smoking factor was not the leading one and followed DM,  hypertriglyceridemia, depression, and obesity. The possibility of CAD development in smokers, as opposed to individuals who had never smoked, increased when smoking was accompanied by hypercholesterolemia, hypertriglyceridemia, male sex, lack of higher education, depression, and age of ≥ 50 years. The possibility of CAD development in former smokers as opposed to nonsmokers increased when smoking was accompanied by hyperglycemia.

Conclusion. Smoking is not the primary risk factor in CAD detection in the studied sample. In the presence of additional risk factors, the impact of smoking on the possibility of CAD detection increases.  

 Aim. To prevent infectious processes in the area of a recipient wound in free skin grafting with a split-graft.

Materials and methods. A method was developed for immobilizing bacteriophages in the area of split thickness skin grafts through transferring a solution containing bacteriophages into a gel form. Microbiological and clinical studies of the effectiveness of the proposed method were performed.

Results. The viability of bacteriophages in a gel dressing for up to 4 days was confirmed, as well as the reduced likelihood of local infectious complications in skin grafting.

Conclusion. The gel composition containing bacteriophages allows quick response to changes in current hospital microflora and effectively counteract the dangers of nosocomial infection. 

 Background. The main purpose of the Her2/neu status determination in clinical practice is to determine the indications for the appointment of targeted therapy. The main methods for detecting the Her2/neu status are the immunohistochemical method (IHC) and the fluorescence in situ hybridization (FISH); however, despite their widespread use, they have a number of significant disadvantages. Over the past few years, radionuclide diagnostics using a new class of alternative scaffold proteins that meet all the requirements for optimal delivery of radionuclides to tumor cells has become widespread.

Aim. To study the possibility of clinical use of a radiopharmaceutical based on technetium-99m-labeled target molecules for the diagnosis of breast cancer with the Her2/neu overexpression in humans.

Materials and methods. The study included 11 patients with breast cancer (T1–4N0–2M0) before systemic therapy: 5 with Her2/neu overexpression; expression of the marker was not detected in 6. In all cases, morphological
and immunohistochemical studies were performed. In case of Her2/neu 2+, FISH analysis was performed. The radiopharmaceutical was prepared immediately before administration, after which it was slowly injected intravenously into the patient. Scintigraphic studies in the “WholeBody”  mode and SPECT of the chest organs were performed 2, 4, 6 and 24 hours after injection.

Results. Radiochemical yield, radiochemical purity and activity before administration were (80 ± 4)%, (98 ± 1)% and (434 ± 19.5) MBq, respectively. The greatest uptake by normal organs was observed at a time interval of 6 hours in the kidneys and at a moderate activity in the liver and lungs at the same time interval. The organ with the highest absorbed dose was the  kidneys; significant accumulation was also detected in the adrenal glands,  gallbladder, liver, pancreas and spleen. The smallest accu mulation of the  studied drug was observed in the brain (0.001 ± 0.000) mGy and skin (0.001  ± 0.000) mGy. The effective dose was (0.009 ± 0.002) mGy. The difference between tumors with positive and negative Her2-neu expression was found at all time points. In this case, the best indicator was determined after 2 hours of drug injection (р < 0.05).

Conclusion. Based on the results obtained, it can be indicated that the investigated radiopharmaceutical can be considered as a new additional method for the diagnosis of Her2-positive breast tumors. 

 The goal is to identify topographic, anatomic, and constitutional features of thoracodorsal and musculocutaneous nerves of brachial plexus.

Materials and methods. Anthropometry of 45 corpses was carried out to determine growth; length of the trunk and upper extremities; circumference of neck, thoracic cage, shoulder and forearm; lateral dimensions of shoulders, thoracic cage and pelvis; anteroposterior size of thoracic cage; neck circumference. Morphometry of all brachial plexus components (length, thickness of nerves and angles of their origin) was performed after its  anatomic preparation.

Results. The cephalic type of brachial plexus with participation of C4 spinal nerve was found in 7% of cases. The caudal type with inclusion of Th2 spinal nerve was found in 4% of cases. In 4% of cases, there was no musculocutaneous nerve, at the same time shoulder biceps innervates median nerve. In 93% of cases, the thoracodorsal nerve originates from posterior secondary bundle along lower posterior surface, in 7% it is an axillary nerve branch. Neck circumference is directly correlated with thoracodorsal nerve length: the larger the neck circumference is, the greater is the nerve length. In females, linear regression equations were derived, which allow estimating thoracodorsal nerve length knowing the thoracic cage width.

Conclusion. The length of the thoracodorsal nerve determines the possibility of its transplantation into the musculocutaneous position. The size of neck circumference and, in females, the width of the thoracic cage, for reliability, should be used as external size biomarkers for donor and recipient nerves. 

 The aim of the study was to test the work of plugins for segmentation and virtual resection of focal liver lesions based on CT data.

Materials and methods. Analysis of CT data of the abdominal organs with bolus contrast enhancement in 80 patients with focal liver lesions was carried out. Segmentation and 3D-modeling of the CT data was carried out by radiologists and the surgeon in the ‘Autoplan’ system.

Results. The liver nosological structure in patients was determined (the most common were hemangiomas in 21.25% of 80 patients, cysts in 20%, parasitic cysts in 20%, etc.), according to the computed tomography results. The segmentation of the liver, its focal lesions, arteries and veins was carried out using the ‘Autoplan’ system. The surgeon determined the volume of the parenchyma and focal liver formations using the standard function ‘volume of segmentation’, chose the optimal treatment tactics and performed a  virtual liver resection. In some cases, the use of segmentation and preoperative planning made it possible to avoid an inefficient surgery. The effectiveness of modeling changed the treatment tactics of 42 patients.

Conclusion. The obtained results indicate that the use of the ‘Autoplan’ system plugins for planning an abdominal surgery allows doctors: 1) to carry out the segmentation of liver, focal lesions and blood vessels; 2) to determine the location of a focal formation in a particular segment, their combination; 3) to perform a virtual resection, evaluate the structures passing through it; 4) to choose the optimal tactics of intervention or  abandon it due to objective anatomical reasons. 

 Aim. To assess the effect of a single physical activity on the concentration of endothelial NO-synthase and plateletactivating factor in blood plasma of athletes training in cyclic and strength sports, as well as in untrained volunteers.

Materials and methods. The study involved 28 men aged 18–25 years, who were relatively healthy and had no disorders of the cardiovascular system. Three groups were formed according to the sports classification. Group 1 (TFG): highly qualified athletes (Candidates for Master of Sports (CMS),  Master of Sports (MS)) of cyclic sports – track and field athletics (middle-distance running, 800–1500 m), n = 10. Group 2 (WG): highly qualified athletes (CMS, MS) of strength sports – weightlifting, n = 8. Group 3 (CG): control group – untrained men with no sports category, n = 10. All volunteers were examined in the morning on an empty stomach. One day before the study, the athletes were advised to stop the training process. The blood from cubital vein was taken from all the subjects three times: before exercise (test A), immediately after performing the standard PWC170 test on a bicycle ergometer (test B), and 60 minutes after performing the stress test (test C). Determination of the concentration of endothelial NO-synthase (eNOS) and platelet-activating factor (PAF) in plasma was performed by enzyme immunoassay.

Results. It has been shown that the features of endothelial reactivity in athletes of various specializations in comparison with untrained volunteers are significantly associated with the level of eNOS production both at rest and in response to short-term physical exertion. Platelet-activating factor  can also affect endothelial reactivity, but to a lesser extent, and is involved only in the mechanisms of adaptation to repetitive high-intensity physical  loads. 

 Aim. To establish biomarkers for clinical, radiological, and laboratory severity of COVID-19 infection and to identify their relationships.

Materials and methods. A retrospective study was carried out which included 155 patients undergoing treatment at the Hospital for War Veterans No. 3 with a confirmed diagnosis of novel coronavirus infection caused by nCoV from April 6 to June 10, 2020. All patients underwent clinical and laboratory examination. An intergroup statistical analysis of clinical and laboratory parameters was carried out depending on the criteria of clinical severity and severity of radiological signs of chest organ pathology according to computed tomography (CT).

Results. Patients with mild COVID-19 showed a lower level of leukocytes, urea, creatinine, bilirubin, and aspartate dehydrogenase (AsAT), as opposed to the corresponding levels in patients with extremely severe course of the 
disease. A lower level of calcium in the peripheral blood was found in patients with severe COVID-19, along with an increase in blood glucose.
Patients from the CT1 group as well as patients with a clinically mild course of the novel coronavirus infection had significantly lower levels of neutrophils, urea, creatinine, AsAT, and blood glucose and a higher level of 
blood calcium in comparison with patients with various CT patterns. In the group of patients with a fatal outcome, cardiovascular diseases were significantly more often detected, as opposed to the discharged patients.

Conclusion. A number of biomarkers characterizing the severity of the novel coronavirus infection caused by the SARS-CoV-2 virus have been identified. However, the revealed differences in the laboratory markers of the clinical and radiological severity of the disease do not currently allow to give a clear answer about the nature of the relationship between the clinical severity of the disease, CT findings, and laboratory indicators of COVID-19 severity. 

 Background. The increased incidence of inflammatory bowel disease (IBD) in the world and the lack of consensus on the causes and development mechanisms of IBD are the key elements that determine the relevance of the study. According to some authors, in the pathogenesis of the development and occurrence of ulcerative colitis, one of the leading causes is a change in the composition of the colon microflora and the impact of the products of their metabolism on the enteric system and intestinal motility.

The aim was to study the qualitative and quantitative changes in the colon microbiota in rats when modeling ulcerative lesions by the original method.

Materials and methods. The experimental study was carried out using male Wistar rats (n = 24). Ulcerative colitis was modeled in an original way. The quantitative and qualitative composition of the parietal microflora of the distal colon was determined.

Results. When modeling ulcerative lesions of the colon using the original method, changes in the qualitative and quantitative composition of the parietal microflora of the colon were revealed. On the 3rd day there was a decrease in Lactobacillus ssp. and Escherichia coli, as well as the growth of  fungal microflora and the appearance of representatives of opportunistic microflora. The changes were progressive in nature, and by the 7th day of the study revealed a marked reduction of the total parietal concentration of the normal flora bacteria and an increased percentage and absolute number of representatives of conditionally pathogenic microflora. By the 10th day of the experiment, with a small increase in the total number of parietal bacteria, the  predominant microorganisms were Bacteroides ssp. (26.8%) and Peptococcus ssp. (27.6%). 

 Aim. To assess the state of the ‘lipid peroxidation – antioxidant defense’ system using an integral indicator (coefficient of oxidative stress) in women with ovarian hyperandrogenism in various periods of reproductive age.

Materials and methods. During an annual preventive medical examination at the Scientific Сentre for Family Health and Human Reproduction Problems, 92 women of reproductive age (18–45 years old) were divided into a group of women with polycystic ovary syndrome (PCOS) (n = 47) and a control group of healthy women (n = 45). The group of women with PCOS was further divided into subgroups according to age characteristics: the 1st subgroup consisted of women with PCOS of early reproductive age (18–35 years old), and the 2nd group had women with PCOS of late reproductive age (35–45 years old). Practically healthy women of the corresponding ages  made up the 3rd and 4th control subgroups. Standard methods were used  to study the LPO–antioxidant defense system. The oxidative stress severity was assessed by an integral indicator: the coefficient of oxidative stress.

Results. An increase in ketodiens and coupled trienes serum levels, a decrease in reduced glutathione, α-tocopherol and retinol levels, and an increase in SOD activity in PCOS women of reproductive age (18–45 years old) were detected in comparison with the control group. Early reproductive age PCOS women also demonstrated an increase in oxidized glutathione and retinol concentration decrease. In the late reproductive age group of PCOS women, an increased superoxide dismutase activity was registered. The integral indicator of oxidative stress in the main group of women with PCOS was 2.5, which shows the enhancement of oxidative processes, and imbalance in the LPO–antioxidant defense system. This indicator was the most pronounced (2.8) in early reproductive age women. In women of late reproductive age, this indicator was equal to 1.9.

Conclusion. The obtained data indicate the development of oxidative stress  in women with ovarian hyperandrogenism, which is mоre pronounced in the  group of late reproductive age women.  

 Aim. To determine gender differences in self-reported social functioning of patients with comorbidity of affective disorders (ADs) and chronic coronary artery disease.

Materials and methods. Self-reported social functioning of 248 cardiological patients (194 men (78.2%) and 54 women (21.8%)) with chronic coronary artery disease (CAD) and ADs was studied using the Social Adaptation Self-evaluation Scale (SASS). The mean age of patients with chronic CAD in men was (57.2 ± 6.5) years, and in women (59.3 ± 7.1), p = 0.04. Qualitative and quantitative indicators were investigated using the Mann – Whitney, Wilcoxon and T-test; χ2 (Pearson›s goodness-of-fit test) was used to estimate the frequencies.

Results. ADs were represented by chronic mood disorders (45%), first-time depressive episodes (DEs) 24%, recurrent DEs 24.5%, as well as bipolar II disorder (BD II) 6.5%. ADs in 42.4% of patients were associated with psychosocial stressors (mainly, loss), p = 0.02. Men statistically significantly  more often (37.1%, 72/194) than women (16.7%, 9/54) communicated more scarcely with others as a result of projection mechanisms, a high level of hostility, passive aggressiveness and lack of initiative, typical for patients with ADs, p = 0.003.

Conclusion. The social functioning of patients with ADs and chronic coronary artery disease was complicated irrespective of gender. Women were single and bereaved of their children more often than men. Due to the low level of communication outside the family and outside of professional activity, most of the patients maintained communication mainly with the family. However, due to ADs, they were not able to feel support from family
members and rarely initiated communication with other people (men did it statistically significantly more often than women). 

 Background. The tolerance of colon cleansing by Fortrans is associated with a number of negative factors. This determines patient compliance and quality of bowel preparation. The relevance of this issue is increasing due to the prevalence of this method in the diagnosis and treatment of colon pathology.

The aim of the study was to investigate tolerance to Fortrans in colon preparation for colonoscopy and factors affecting comfort.

Materials and methods. Before colonoscopy, a questionnaire method was used to study 84 patients who underwent colon preparation with Fortrans. Patient satisfaction with the preparation was evaluated on the visual  analogue scale (VAS).

Results. 45 (52.4%) people were satisfied with comfort of the preparation and rated its level 0–2 points on the VAS. 39 (47.6%) patients were not satisfied with the preparation, a discomfort level of 3–10 points was estimated. Factors affecting patient tolerance of Fortrans administration were determined.

Conclusion. Satisfactory tolerance of the colon preparation by Fortrans is observed in half of the patients, which depends on their psychological state and expectations of the preparation comfort. The intolerance predictors to the colon preparation are negative side effects of Fortrans, which are largely leveled by the use of the split mode, as well as incorrigible factors: higher education, repeated colonoscopy, history of constipation. 

 Aim. To investigate links between the attachment style and ability to detect facial emotions using a functional magnetic resonance imaging (fMRI) paradigm in depressed patients.

Materials and methods. Participants diagnosed with mild to moderate depression or dysthymia (19 patients) and healthy volunteers (20 individuals) were to identify one of eight basic emotions on 48 photos by choosing 
the appropriate answer from two options. Attachment was measured using  the Experience in Close Relationships Scale. In addition, depression, alexithymia, and rumination were estimated as other possible correlates.

Results. In the group of patients with depression, anxious attachment score had a negative correlation with the accuracy of angry facial expression detection (ρ = –0.65, p < 0.01) and a positive correlation with the accuracy of sad facial expression recognition (ρ = 0.48, p < 0.05). Patients with high total rumination (ρ = –0.48, p < 0.05) and depressive rumination (ρ = –0.53, p < 0.05) scores also detected angry facial expression less accurately. None of the mentioned links were present in healthy people, however, they demonstrated a correlation of the total number of portraits tagged as “sad” with the brooding rumination score (ρ =0 .53, p < 0.05).

Conclusion. Attachment disruptions in depressed patients may be related to aggravation of the deficit in the ability to detect emotions of others. 

 The aim of the study was to assess the changes in physical performance parameters in the progeny of rats with experimental preeclampsia (EP) undergoing early and late pharmacological treatment with gamma- aminobutyric acid (GABA) derivatives.

Materials and methods. At the first stage, physical performance of 3- and 18-month old progeny of female rats with EP after early pharmacological treatment (from 40th to 70th day of life) with GABA derivatives, succicard (22mg/kg), salifen (7.5 mg/kg), phenibut (25 mg/kg) and a comparator drug,  pantogam (50 mg), was studied. At the second stage, succicard (44 mg/kg), salifen (15 mg/kg), phenibut (50 mg/kg) or pantogam (100 mg) were intragastrically administered in the progeny of rats with EP for 30 days (from  24th to 25th months of life). The horizontal rope walking test (HRWT), Rotarod performance test, Forced swim test with weight load (FSTwWL) were used in the study.

Results. The HRWT, Rotarod performance rest and FSTwWL showed a decrease in muscle strength, coordination and motor activity, and aerobic and anaerobic endurance in rats with EP aged 3, 18 and 25 months as compared to the values of the animals born to intact rats. Succicard, a GABA-derivative, and pantogam, a comparator drug, were effective both in early and late pharmacological interventions, whereas salifen and phenibut were effective only when administered during puberty. As the offspring of EP rats were aging, their muscle strength, coordination, and motor activity were decreasing, while their aerobic and anaerobic endurance was increasing. 

Conclusion. Physical performance in the progeny of rats with induced EP aged 3, 18 and 25 months tended to decrease. Pharmacological treatment with GABA derivatives in the adolescent period attenuated EP consequences.
When administered in the puberty period, only succicard and the  comparator drug, pantogam, had a therapeutic effect. This fact provides evidence that a succicard-based drug can be developed for preventive  management of preeclampsia consequences. 

 Aim. To study the prevalence of chronic bronchitis (CB) against the background of abdominal obesity (AO) in young people aged 25–44 in Novosibirsk.

Materials and methods. A simultaneous population survey of the population of 25–44 year-olds in Novosibirsk was carried out. The study included 906 people (414 men and 492 women). AO was recorded with a waist circumference of more than 94 cm in men and more than 80 cm in women. CB was recorded according to standardized epidemiological (questionnaire, pulmonary questionnaire) and functional (spirometry) criteria.

Results. The prevalence of AO and CB in the population was 42.9% and 8.7%, respectively; in men 43.2% and 7.7%; in women 42.7% and 9.6%. The prevalence of CB against the background of AO in the population was 1.95 times higher (p = 0.003) compared with individuals with CB without AO (OR  = 2.08 [CI 1.302–3.333]). In women, the prevalence of CB against the background of AO was 2.15 times higher (p = 0.005) compared with women with CB without AO (OR = 2.35 [CI 1.267–4.359]). The prevalence of CB in smokers in the population was 1.65 times higher (p = 0.015) compared with non-smokers (OR = 1.72 [CI 1.081–2.739]). In male smokers, the prevalence of CB was 2.02 times higher (p = 0.031) compared with non-smoking men (OR = 2.15 [CI 1.020–4.514]). The multivariate logistic regression analysis showed that in people aged 25–44, the presence of CB is associated with smoking [Exp(B) = 1.966, p = 0.006] and the presence of AO [Exp(B) = 2.091, p = 0.003].

Conclusion. Significant effects of AO and smoking on the development of CB in the population of 25–44 year-olds as a whole were revealed. At the same time, in men aged 25–44, the relative risk of developing CB is  significantly affected by smoking, and in women aged 25–44, by the presence of AO.  

 Aim. Determination of neurotrophin levels in gray and white matter of the brain in rats with tumor growth associated with chronic neurogenic pain (CNP).

Materials and methods. The study included white outbred male rats (n = 74). In the main group, the CNP model was created (by bilateral sciatic nerve ligation), and after 45 days, M1 sarcoma was transplanted subcutaneously (n = 11) or into the subclavian vein (n = 11). Two comparison groups (n = 13 each) consisted of sham operated animals with M1 sarcoma transplanted subcutaneously and intravenously, but without CNP. Control groups were animals with CNP and sham operated animals. Rats were euthanized on the  21st day of carcinogenesis. The enzymelinked immunosorbent assay (ELISA)  was used to determine brain levels of brain-derived neurotrophic factor (BDNF) (R&D System, USA & Canada), nerve growth factor (β-NGF),  neurotrophin-3 (NT-3), neurotrophin 4/5 (NT-4) (RayBiotech, USA).

Results. CNP caused an increase in β-NGF levels in the cortex and white matter and BDNF levels only in white matter of the rat brain. Chronic pain stimulated M1 sarcoma growth in both subcutaneous and intravenous transplantation. The dynamics of neurotrophins levels in brain structures  differed depending on the tumor site.

Conclusion. Thus, the results demonstrated that in both normal peripheral tumor growth and in tumor growth against the background of CNP, changes in neurotrophin levels in the brain of experimental animals can reflect the body reaction to chronic pain and stress caused by the peripheral tumor  growth. 

 The traditional view of immunoglobulin (Ig) production only by B-lymphocytes and plasma cells has been revisited. Non-lymphoid tumor cells can also synthesize and secrete Ig with unidentified specificity. Expression of Ig genes was detected in the cells of malignant neoplasms of epithelial origin, such as breast carcinoma, colorectal cancer, prostate cancer, as well as in epithelial tumor cell lines. mRNA of the IgG1 heavy (H) chain constant region, sterile Iɣ-Cɣ transcript, H and light (L) chains of IgG, V(D)J recombination of H and L chain gene segments, as well as RAG1 (recombination-activating gene 1) and RAG2 enzymes, which are required for V(D)J recombination, were found in cancer cell lines and resected carcinoma tissues. IgG produced by cancer cells can be involved in the invasion and metastasis of these cells through interaction with E-cadherin, as well as with the metastasis-associated protein MTA1. Tumor-derived IgG plays an important role in malignant progression via activation of platelets by interacting with their FcγRIIa receptors and inducing the production of low levels of reactive oxygen species. The level of IgG in malignant neoplasms is positively correlated with proliferation markers, stage of progression, growth and survival of the tumor. These data modernize the current views on the mechanisms of carcinogenesis and create the basis for the search for new diagnostic and prognostic markers in malignant neoplasms, as well as methods of their target therapy. Further in-depth studies of the  phenomenon of Ig production by tumor cells will contribute to more effective practical application of the accumulated knowledge in this field. 

 The authors of the article have analyzed the problem of advanced heart failure (AHF). Despite significant and, it is not an exaggeration to say, revolutionary achievements in clinical pharmacology, cardiac surgery and implantation arrhythmology, the number of patients with chronic heart failure (CHF) in many  countries is not decreasing, and in some, for example, in Russia, it is increasing. At the same time, unfortunately, often the immediate and longterm results of the so-called optimal therapy of CHF are disappointing for both the patient and the doctor. In 2007, experts from The Heart Failure Association of the European Society of Cardiology proposed the term AHF to refer to CHF in which optimal drug therapy, as well as cardiac resynchronization therapy, are not effective, which causes repeated hospitalizations and justifies the need for the advanced  treatment methods such as heart transplantation and mechanical circulatory support, and/or transition to palliative care. The agreed positions of experts from the established cardiological communities in the Old and New Worlds on the definition, diagnostic criteria and treatment of AHF have been changing over time. Unfortunately, this evolution has not yet arrived at a consensus. The lecture consistently addresses the issues of terminology, diagnosis, prognostic stratification and routing of patients with AHF, as well as short- and long-term strategies for treating these patients. 

 The 2020 coronavirus infection pandemic has potentiated a large number of studies in the world on the etiopathogenesis, clinical and morphological manifestations of COVID-2019 infection. This review presents biochemical, molecular genetic and clinical aspects of COVID-2019. 

 Bronchial asthma (BA) and obesity are common diseases with a tendency towards a steady and progressive increase in the number of patients. A combination of these diseases is one of the major problems of modern medicine, requiring close attention due to a decrease in the quality of life, poor control over the course of the primary disease, and an increase in the frequency and duration of hospitalization. The association between asthma and obesity is obvious. However, detailed mechanisms underlying it require further investigation. In the last decade, in the formation of the phenotype of BA combined with obesity, much attention has been paid not only to the immune, but also to the neurogenic mechanisms of inflammatory response. It is known that the functioning of all parts of the nervous system can be controlled by neurotrophic growth factors due to their ability to influence many signalling mechanisms. Currently, there is evidence that neurotrophic factors are involved in the pathogenesis of bronchopulmonary and metabolic diseases. The review is devoted to detailed investigation of the mechanisms of neurogenic inflammation in obesity and asthma with participation of neurotrophic factors that may play a significant role in the formation of the BA phenotype associated with obesity. The study of new mechanisms involved in the pathogenesis of asthma and obesity will make it possible to find common therapeutic targets for this asthma phenotype. 

 A review of current techniques of instrumental and laboratory diagnosis of crystal arthropathies is presented. Advantages and disadvantages of various methods of diagnostic radiology and diagnostic radiologic criteria employed in primary and differential diagnosis of crystal deposits are discussed in relation to their etiology and clinical peculiarities. It is proven from a wide pool of published studies that the method of ultrasonic diagnosis is the most available one, has no contraindications and demonstrates the best sensitivity and specificity in the diagnosis of crystalline arthropathy. 

 Background. Today, myocardial perfusion scintigraphy is an informative and accessible method for evaluating ischemic changes in the heart. However, this method has limitations, which are more connected with a semiquantitative assessment of the study results. Currently, there is a class of specialized gamma cameras with detectors based on cadmium-zinc-telluride, which allow quantitative analysis of scintigraphic data on coronary hemodynamics, i.e. evaluate indicators of coronary blood flow and reserve.

The aim of the review was to present and summarize the information about the coronary circulation within physiological and pathological conditions, as well as the possibilities of modern radionuclide methods in assessing coronary blood flow and reserve.

Materials and methods. In the process of preparing the review article, “PubMed”, “Web of Science”, “ScienceDirect” and “Elibrary” scientific databases were used. Search requests included keywords such as: coronary artery disease, myocardial blood flow, coronary (myocardial) flow reserve, single-photon emission computed tomography, cadmium-zinc-telluride, positron emission tomography.

Results. The review includes information on the state and methods of regulating coronary hemodynamics under normal conditions and against the background of pathological changes. It also includes information about radionuclide methods for assessing coronary hemodynamics, which are of  historical importance, currently used and promising, as well as dynamic single-photon emission computed tomography.

Conclusion. The potential of dynamic single-photon emission computed tomography as a method for quantification of coronary blood flow and reserve is high. This technique can become a simple and affordable alternative to the existing methods for assessing coronary (myocardial) blood flow and reserve. This will increase the information content of radionuclide diagnostics in assessing the severity of coronary insufficiency for more accurate risk stratification and determination of appropriate treatment tactics for cardiac patients. 

 Currently, numerous studies undeniably prove the influence of metabolic syndrome on osteoarthritis (OA) progression.
In hyperlipidemia, free fatty acids abnormally accumulate in the cartilage tissue and provoke cell dysfunction and necrosis. Studies show that palmitate and stearate have a pronounced proapoptotic effect on chondrocytes of the articular cartilage.
Mediators of the systemic inflammatory response produced by the adipose tissue act as a significant link in the pathogenesis of metabolic OA in the knee joint. Metabolic disorders, insulin resistance, and dyslipidemia 
boost production of inflammatory mediators and glycosylated compounds and formation of free oxygen radicals provoking endothelial dysfunction.
A relationship between intra-articular structures (articular cartilage, synovial membrane, subchondral bone and synovial fluid) and the intra-articular infrapatellar fat pad is a local pathogenetic factor in the metabolic OA of
the knee. It is proven that the intra-articular infrapatellar fat pad increases significantly in obese patients. Due to proximity to the articular cartilage and synovial membrane, the adipose tissue is in close contact with them. 
The influence of systemic metabolites activates the growth of adipocytes, preadipocytes, macrophages, fibroblasts, and other fat body cells which enhance the production and release of adipokines, such as leptin, adiponectin, visfatin, and cytokines, that in turn stimulate aseptic inflammation resulting in development of synovitis, cartilage degeneration, and gonarthrosis progression.
Therefore, the metabolic syndrome has a negative impact on the condition of the joint tissues, contributing to the development of gonarthrosis or its progression. It manifests itself both through systemic effects and the local impact of the hypertrophied infrapatellar fat pad on the components of the synovial joint environment. 

 Coronary artery disease (CAD) remains one of the leading causes of death in developed industrial countries. Timely and effective medical care for CAD patients depends on availability and application of endovascular methods for CAD treatment. Percutaneous coronary intervention (PCI) using drug- eluting stents allows to achieve good clinical results even in most severe patients. The issues of personalized invasive treatment for patients with chronic coronary syndrome and optimal prevention of recurrent clinical events in survivors of acute coronary syndrome and PCI remain relevant.
One of most important and unresolved problems in the pathophysiology of CAD is assessment of the nature of the inflammatory reaction that develops in the coronary vessels and myocardium in response to ischemic damage and PCI. Clinical studies focused on exploring correlation between the pro-inflammatory parameters of the patient’s status and the rate of secondary adverse events and aimed at revealing triggers of systemic and local inflammation are of great interest. Such a trigger could be the intestinal endotoxin (ET) which is capable of inducing systemic inflammation and, therefore, plays a significant role in the atherogenesis. A relationship between the endotoxin and cytokine system parameters should be investigated to develop a therapeutic concept for supporting CAD patients, including individuals after PCI. Parameters of systemic endotoxemia could be used as additional factors  in developing the biomarker-based approach to identify patients with active inflammation or fibrosis. This could result in development of specific therapy aimed at suppressing pro-inflammatory mediators and protecting the heart from inflammation. 

 The article describes a clinical case of chromosomal mosaicism in a boy, 4 months and 3 weeks old. Cytogenetic analysis of peripheral blood lymphocytes of the child made it possible to establish the karyotype mos47,XY,+8/46,XY with an approximately equal ratio of normal and abnormal cells. The pathogenetic effects of the mosaic form of trisomy 8 are discussed. The authors discussed the results of examination of the patient’s mother during pregnancy as part of a combined prenatal screening for congenital and hereditary diseases. The difficulty in prenatal diagnosis of chromosomal mosaicism is noted and explained by the lack of specific biochemical and ultrasound markers.
However, in late pregnancy, ultrasound signs of impaired development of the brain, heart and kidneys associated with a chromosomal abnormality can be detected. 

 Clinical case of ataxia development associated with accidental phenobarbital overdose is presented. Clinical manifestations and differential diagnostics are described; the results of laboratory examinations for this pathology are presented. In conclusion, there is an emphasis on the importance of collecting  anamnestic data.