Background. Acute myocardial infarction (AMI) with ST segment elevation is associated with high incidence of complications. Mortality from AMI is about 5%, which has not decreased in recent years. Revascularization provides recovery of coronary blood flow, but also contributes to the occurrence of reperfusion injury to the heart. Remote ischemic postconditioning (RIPostC) is a promising, non-invasive method that can effectively and safely reduce the infarct size.

The aim of the study was to investigate the role of protein kinase C and PI3-kinase in the development of the infarct-limiting effect of remote ischemic postconditioning.

Materials and methods. The study was performed on Wistar rats. Coronary artery occlusion (45 min) and reperfusion (2 h) were performed. The infarct size (IS) and the size of area at risk (AAR) were assessed. RIPostC was modeled by applying tourniquets to the hind limbs in the hip joint immediately after the restoration of coronary blood flow. All inhibitors were administered intravenously 10 min before reperfusion.

Results. In the control group, the IS / AAR ratio was 44%. RIPostC reduced the IS / AAR ratio by about 50%. Preliminary administration of the protein kinase C inhibitor chelerythrine and the PI3-kinase inhibitor wortmannin eliminated the cardioprotective effect of RIPostC.

Conclusion. The mechanism of the infarct-limiting effect of RIPostC is implemented through activation of protein kinase C and PI3-kinase. 

Aim. To study the effect of vaginal probiotic therapy on the outcome of human papillomavirus (HPV) infection.

Materials and methods. The study included HPV-infected patients: 29 patients with normal vaginal flora and 146 patients with a deficiency of vaginal lactobacilli, of which 117 patients received vaginal probiotic therapy. In samples obtained before and after the therapy, the effect of the probiotic on the change in the ratio of living, apoptotic, and necrotic vaginal epithelial cells after preliminary exposure to oxidative stress was studied.

Results. It was found that probiotics reduce the number of infected epithelial cells that survived the oxidative damage and shift the balance of cell death forms towards apoptosis. Vaginal probiotic therapy in patients with a deficiency of lactobacilli increased the frequency of HPV elimination by 2.5 times and reduced the likelihood of treatment failure from 1.5 to 4 times, depending on the viral load. The probiotic therapy made the structure of HPV outcomes in Lactobacillus-deficient patients similar to that in patients with normal vaginal flora.

Conclusion. Vaginal probiotic therapy improves outcomes of HPV infection in patients with a deficiency of lactobacilli by reducing the number of survived infected cells and shifting the cell death pattern towards apoptosis. 

Aim. To study clinical and morphological phenotypes in different variants of the course of intrathoracic sarcoidosis and isolate new phenotypes.

Materials and methods. The study included 121 patients with intrathoracic sarcoidosis aged 21–66 years (50.4% were men, 49.6% were women, the average age at the time of the disease onset was 38 years) over the period 2007– 2019. During the examination, patients’ complaints were studied thoroughly, and the diagnosis was histologically verified in all cases. During an extended histological examination, the quantitative and qualitative composition of biopsy specimens was investigated. The number of granulomas in the field of vision and the content of giant cells, macrophages, lymphocytes, neutrophils, and eosinophils in them were studied. Qualitative parameters were assessed for the presence of hyalinosis, Schaumann bodies, necrosis, stamping, calcification, fibrosis, and vasculitis. All patients were retrospectively divided into two clinical groups depending on the outcomes of the disease: group 1 included patients with a favorable course of sarcoidosis, proceeding without relapses and signs of progression; group 2 encompassed patients with an unfavorable course of the disease with relapses and progression, requiring long-term administration of systemic glucocorticoids.

Results. The analysis showed that among all general clinical manifestations, only the presence of dyspnea, skin manifestations, and weight loss occurred significantly more often in the patients with an unfavorable course of intrathoracic sarcoidosis (р = 0.04; 0.02; and 0.01, respectively). Among morphological parameters, a large number of macrophages was significantly more frequent in the biopsy specimens in this group of patients (р < 0.01). 

Aim. To investigate formation of neutrophil extracellular traps (NETs) and their impact on fibrinolysis in patients with colon cancer.

Materials and methods. The study was performed in two groups. The experimental group consisted of patients with stage 2–3 non-metastatic colon cancer (n = 17, average age – 67 years). The control group included healthy volunteers matched by sex and age (n = 30, average age – 68 years). An experimental model was created from the whole blood. It included platelet-poor plasma and an isolated culture of neutrophils, previously induced to NETosis by adding 100 nmol PMA. The samples were incubated for 4 hours, then the test tubes were centrifuged to pellet cells and their remnants, and the plasma was transferred for subsequent examination. The plasma incubated with intact neutrophils was used as a control. The levels of interleukin-8 (IL-8) and P-selectin glycoprotein ligand-1 (PSGL-1) were used to determine the degree of cell activation. NETosis was confirmed by enzyme-linked immunosorbent assay (ELISA) and fluorescent microscopy. Fibrinolysis was assessed using the thrombodynamics test. The results were compared with the levels of fibrinolytic system components measured by flow cytometry.

Results. In the control group, NETosis induction contributed to pronounced neutrophil activation that was accompanied by an increase in the IL-8, PSGL-1, and plasminogen levels, a decrease in PAI-1, and enhancement of fibrinolysis, compared with the intact samples. Higher levels of IL-8, PSGL-1, plasminogen, and PAI-1 and intensified fibrinolysis were detected in the intact samples. However, PMA-induced NETosis did not result in an increase in the degree of activation and significant changes in the given parameters.

Conclusion. NETosis promotes both formation and lysis of fibrin clots. However, in cancer patients, suicidal NETosis does not contribute to fibrinolysis due to intracellular protease depletion, which may be one of the mechanisms causing hypercoagulation and insufficient fibrinolysis in cancer. 

Aim. To determine the saliva level of immunoregulatory proteins in patients with rampant caries and 25-hydroxyvitamin D (25(OH)D) deficiency and evaluate the association of their concentration with 25(OH)D plasma level.

Materials and methods. The study was performed in two groups. The experimental group included 15 patients aged 20–22 years with rampant caries and the 25(OH)D plasma level of < 20 ng / ml. The control group encompassed 15 healthy age-matched volunteers with the 25(OH)D plasma level of 20–100 ng / ml. The concentrations of B7.2 (CD86), free active TGF-β1, CTLA-4, PD-1, Tim-3, LAG-3, IGFBP-4, and ICAM-1 were assessed using flow cytometry. The levels of LL-37 and secretory immunoglobulin A (sIgA) were measured using ELISA. The Spearman’s rank correlation coefficient was used to reveal a correlation between the indicated proteins and the 25(OH)D plasma level.

Results. A decrease in B7.2 (CD86), PD-1, Tim-3, sIgA, and LL-37 and elevation of IGFBP-4 and ICAM-1 saliva levels were detected in patients with rampant caries and 25-hydroxyvitamin D deficiency. A positive Spearman’s rank correlation coefficient was revealed between plasma 25(OH)D and saliva levels of free active TGF-β1, CTLA4, B7.2 (CD86), LL-37, and sIgA. A negative correlation was revealed between 25(OH)Dand ICAM-1.

Conclusion. 25(OH)D deficiency in patients with rampant caries is associated with decreased levels of B7.2 (CD86), PD-1, Tim-3, sIgA, and LL-37 and elevated levels of IGFBP-4 and ICAM-1 in the saliva. 

Aim. To study the prevalence of abdominal obesity in young people aged 25–44 years in Novosibirsk, as well as the prevalence of diseases and pathological conditions in individuals with abdominal obesity.

Materials and methods. We conducted a cross-sectional, population-based study of the population of Novosibirsk aged 25–44 years. The screening examined 1,415 people, including 670 men and 745 women. For all individuals, we evaluated the presence of such conditions as abdominal obesity (AO), arterial hypertension (AH), increased body mass index (BMI), coronary heart disease (according to validated epidemiologic and functional criteria with ECG findings classified according to the Minnesota Code), diabetes mellitus (DM), reduced glomerular filtration rate (GFR), chronic bronchitis (CB), increased blood levels of total cholesterol (hypercholesterolemia) and lowdensity lipoprotein (LDL) cholesterol (hyper-LDL-cholesterolemia).

Results. The prevalence of AO in the population of Novosibirsk aged 25–44 years was 42.4%: in men – 42.7%, in women – 42.1%. We found that AO had a significant direct effect on the development of AH (odds ratio (OR) = 2.550, 95% confidence interval (CI) 1.899–3.422, p = 0.0001), CB (OR = 1.830, CI 1.326–2.527, p = 0.0001), hypercholesterolemia (OR = 1.486, CI 1.193–1.851, p = 0.0001), hyper-LDL-cholesterolemia (OR = 1.527, CI 1.222–1.907, p = 0.0001) and a reverse effect on reduced GFR (OR = 0.603, CI 0.427–0.852, p = 0.004). In the male population under 45 years of age, AO had a significant direct effect on the development of AH, CB, hypercholesterolemia, and hyper-LDL-cholesterolemia. In the female population under the age of 45, AO had a significant direct effect on the development of DM, AH, CB, and hyper-LDL-cholesterolemia and a reverse effect on the reduced GFR development.

Conclusion. Therefore, in the young Siberian population under 45 years of age, abdominal obesity is associated with the development of common diseases and pathological conditions. 

The aim of this study was to identify the morphometric features of the human portal venous system by means of multislice computed tomography (MSCT).

Materials and methods. A contrast X-ray study of the portal vein was carried out in 53 men who were treated in the surgical departments of the Krasnoyarsk Regional Hospital No. 1. The average age of the patients was 54.9 ± 1.7 years (36–71 years). Measurements were performed on 3D models of the vascular bed in the portal venous system (GE Advantage Workstation and Siemens singo.via workstations). Branching patterns, length, diameter, angle of the portal vein formation relative to the midline of the human body, and angles of formation of the vessels forming the portal vein in the frontal plane were evaluated.

Results. Variations in the morphometric parameters of the intrahepatic vessels of the portal vein are obvious, although the branching patterns are not diverse and are reduced to one type – the magistral pattern (according to V.N. Shevkunenko). The veins that form the portal vein are represented by three systems, each of which has a stem and tributaries that differ in branching patterns and other morphological characteristics.

Conclusion. The findings of the study made it possible to supplement the scientific materials regarding branching patterns and morphological characteristics of the portal vein and its tributaries as well as to use the morphometric characteristics of the superior and inferior mesenteric and splenic veins to resolve the issues of surgical intervention on the abdominal organs. 

Aim of the study was to compare the cutting and coagulation properties of 1.56 and 1.94 μm fiber lasers with those of a 0.98 μm semiconductor laser.

Materials and methods. A comparative study of the biological effects of 1.56 and 1.94 µm lasers and a 0.98 µm semiconductor laser used in a constant, continuous mode was carried out. The cutting properties of the lasers were evaluated on the chicken muscle tissue samples by the width and depth of the ablation zone formed via a linear laser incision at a speed of 2 mm/s, while the coagulation properties were assessed by the width of the lateral coagulation zone. The zones were measured using a surgical microscope and a calibration slide. For statistical analysis, power values of 3, 5, 7, 9, and 11 W were chosen for each laser wavelength.

Results. Analysis of the findings confirmed that laser wavelength had a statistically significant effect on the linear dependence between incision parameters and laser power. It was found that the 1.56 μm fiber laser (water absorption) had a greater coagulation ability but a comparable cutting ability compared with the 0.98 μm laser (hemoglobin absorption). When used in the power mode of 7W or higher, the 1.94 µm laser provided superior cutting performance compared with the 0.98 µm semiconductor laser at the same exposure power. Elevating the power in any of the lasers primarily increased the width of the ablation zone, and to a lesser extent – the crater depth and the width of the lateral coagulation zone. Therefore, in comparison with the 0.98 μm semiconductor laser, higher radiation power in the 1.56 and 1.94 μm lasers mainly influences their cutting properties, expanding the width and depth of the ablation zone, and has a smaller effect on their coagulation ability.

Conclusion. The findings of the study showed that the 1.56 and 1.94 μm fiber lasers have better coagulation properties in comparison with the 0.98 μm semiconductor laser. was statistically proven that all incision characteristics (width of the lateral coagulation zone, depth and width of the ablation zone) for the 1.56, 1.94, and 0.98 μm lasers depend on the power of laser radiation. The 1.94 µm laser is superior to the 0.98 µm laser in its cutting properties. 

Background. The problem of gastric cancer remains unresolved throughout the world, while chronic atrophic gastritis (CAG) increases the likelihood of its development by 15 times. In the Russian Federation, the incidence of gastric cancer (GC) is among the highest, with it prevailing among males. One of the leading mechanisms in molecular pathology of membranes is lipid peroxidation (LPO). The severity of oxidative membrane damage depends on concomitant diseases, contributing to emergence and progression of pathological processes and development of cancer. Currently, the problem of LPO is unsolved in biological systems.

The aim of this study was to investigate the state of LPO and antioxidant defense system in CAG and GC. Materials and methods. The parameters were studied in 45 patients with CAG and 50 patients with GC. The control group included 50 practically healthy volunteers without gastrointestinal complaints, who did not have changes in the gastric mucosa according to the fibroesophagogastroduodenoscopy (FEGDS) findings.

Results. In patients with CAG, an increase in malondialdehyde, superoxide dismutase, catalase, glutathione S-transferase, and glutathione peroxidase was found in the blood plasma compared with the control group. In patients with CAG, lipid peroxidation was activated, and the malondialdehyde level increased by 3.5 times relative to normal values. At the same time, the body fought against oxidative stress by increasing the activity of antioxidant enzymes, such as superoxide dismutase, catalase, glutathione S-transferase, and glutathione peroxidase. All patients with GC showed pronounced oxidative stress in the blood plasma in the form of a 45-fold increase in malondialdehyde. The activity of the main antioxidant enzyme superoxide dismutase was reduced in GC. Catalase was activated, which indicated pronounced oxidative stress, significant damage to blood vessels, and massive cell death. Glutathione-related enzymes (glutathione S-transferase and glutathione peroxidase) and the antioxidant protein ceruloplasmin were activated, which also indicated significant oxidative stress and severe intoxication in patients with GC.

Conclusion. Depending on the stage and type of cancer, an in-depth study of lipid peroxidation and factors of the antioxidant defense system can be used to correct therapy and prevent cancer and can serve as markers of progression and prognosis in gastric cancer. 

Background. Antigen-presenting cells (APCs), especially macrophages, play an important role in the body defense against various pathogens. Their dysfunction and polarization are associated with most inflammatory and autoimmune diseases. The inflammatory process is regulated by activation and / or inhibition of genes differentially expressed by macrophages. Successful correction of inflammation leads firstly to elimination of inflammatory stimuli and then to remodeling and restoration of tissues and organs. It was experimentally confirmed that silvercontaining bionanocomposites based on natural humic substances (HS) obtained from coal of different origin, as well as initial matrices of these HS, are capable of activating pro- and anti-inflammatory properties of macrophages.

Aim. To study cytotoxic, pyrogenic, and immunomodulatory properties (arginine balance) of initial HS samples and samples of silver nanoparticles ultradispersed in these HS matrices (HS-AgNPs) in the cell culture of peritoneal macrophages, as well as their effect on pro- and anti-inflammatory properties of APCs.

Materials and methods. Cultural and biochemical methods were used in the study.

Results. The study showed that the samples CHE-K, CHE-AgNPs, CHS-K, and CHP-K increased M1 macrophage polarization due to stimulation of the NO-synthase activity and inhibition of arginase. The samples CHI-K, CHIAgNPs, CHP-AgNPs, and CHS-AgNPs modulated an alternative M2 or M2-like state of macrophage activation. At the same time, HS are not cytotoxic at effective concentrations, and three out of four studied samples did not contain pyrogenic impurities.

Conclusion. The use of HS and their silver-containing bionanocomposites, which have the ability to greatly affect the polarization of antigen-presenting cells, is a promising research area in correction of the inflammatory response for solving an important social and medical problem of treating chronic wounds. 

Background. Community-acquired pneumonia (CAP) remains one of the most common infectious diseases, occupying an important place in the structure of mortality worldwide.

Aim. To evaluate the effectiveness of antimicrobial therapy for community-acquired pneumonia in hospitalized patients in real clinical practice.

Materials and methods. A retrospective, observational study was conducted, which included 236 patients hospitalized for community-acquired pneumonia at the Regional Clinical Hospital in Ryazan in 2019. Based on these case histories, an analysis of the effectiveness of the initial empiric antimicrobial therapy was performed.

Results. The initial empiric antimicrobial therapy in 73% of cases included administration of ceftriaxone, in 45% of cases – levofloxacin, in 14% of cases – azithromycin. It was found that initial antimicrobial therapy was effective in 58% of patients who did not require replacement for the antibiotic. A need for a change in the treatment regimen was significantly associated with an increase in the length of hospitalization (p < 0.001), heart rate upon admission (p = 0.032), myelocyte count in the complete blood count (p < 0.001), and urea and blood creatinine levels (p = 0.004 and p = 0.044, respectively). The selected antimicrobial therapy regimen was significantly associated with the expected treatment effectiveness (p = 0.039). The choice of levofloxacin in monotherapy or in combination with ceftriaxone was accompanied by a decrease in the relative risk of replacing the antimicrobial, compared with other treatment regimens (odds ratio (OR) = 0.86 (95% confidence interval (CI): 0.55–1.34) and OR = 0.57 (95% CI: 0.37–0.87), respectively).

Conclusion. Empiric antimicrobial therapy for community-acquired pneumonia in real clinical practice complies with current recommendations, however, at the same time, its ineffectiveness persists. Respiratory fluoroquinolones are most effective in treating pneumonia in hospitalized patients. 

Aim. To study the content of matrix metalloproteinase (MMP)-2, -3, -9 and tissue inhibitors of metalloproteinases (TIMPs) -1, -2, -3, -4 in the aqueous humor of patients with moderate primary open-angle glaucoma (POAG).

Materials and methods. The experimental group included 47 patients with verified moderate primary open-angle glaucoma. The control group consisted of 26 patients with uncomplicated cataract. The levels of MMP-2, -3, -9 were determined with Luminex Performance Human MMP Magnetic Panel 3-plex kit (R&D Systems, USA), the concentration of TIMPs-1, -2, -3, - 4 was determined with the Human TIMP Magnetic Luminex Performance Assay 4-plex kit (R&D Systems, USA). The study was carried out using flow-through field fluorometry on a Bio-Plex 200 double-beam laser analyzer (Bio-Rad, USA).

Results. The study showed a statistically significant increase in the levels of matrix metalloproteinase-2 and tissue inhibitors of matrix metalloproteinases-1, -2, -3, -4 in the aqueous humor of patients with moderate POAG compared with patients with uncomplicated cataract.

Conclusion. The obtained data on high concentrations and imbalance in the levels of matrix metalloproteinases and their tissue inhibitors in the aqueous humor of patients with moderate POAG confirm the role of local inflammation, as well as impairments in the structure of the extracellular matrix and its remodeling in the mechanisms of development of this pathology. 

Aim. To study the relationship between clinical, radiologic, and morphological features in nonfibrotic and fibrotic hypersensitivity pneumonitis.

Materials and methods. Clinical symptoms, data of high-resolution computed tomography, parameters of external respiration, and histological changes in the lung tissue obtained via open and transbronchial biopsies were studied retrospectively in 175 patients with hypersensitivity pneumonitis (HP). Statistical analysis was performed using the Statistica software.

Results. We found that the clinical error rate in the diagnosis of HP was 84.5%, among pathologists – 92%. Among all the variants of HP, the most common was fibrotic HP. It was shown that non-necrotizing granulomas and giant cells in the cavities of the alveoli, microcells, and interalveolar septa were more typical of nonfibrotic HP. In fibrotic HP, peribronchial fibrosis, smooth muscle metaplasia in fibrotic areas, and the presence of fibroblastic foci in the walls of terminal bronchioles are signs of differential diagnosis with usual interstitial pneumonia. The classical triad of histological signs was observed in 19.2% of patients with nonfibrotic HP and in 5.6% of patients with fibrotic HP.

Conclusion. Diagnosis of HP is complex and should be based on a multidisciplinary approach involving clinicians (pulmonologists), radiologists, functional diagnostics specialists, and pathologists. In this case, it is imperative to take into account and identify factors causing development of the disease, as well as the age of patients. 

Aim. To assess the concentrations of bacterial and eukaryotic metabolites mainly involved in indole, kynurenine, and serotonin pathways of tryptophan metabolism in a cohort of patients with obesity. Materials and methods. Using high-performance liquid chromatography with mass spectrometric detection, the concentrations of several serum metabolites, such as kynurenine, kynurenic acid, anthranilic acid, xanthurenic acid, quinolinic acid, 5-hydroxyindole-3-acetate, tryptamine, serotonin, indole-3-lactate, indole-3-acetate, indole-3- butyrate, indole-3-carboxaldehyde, indole-3-acrylate, and indole-3-propionate, were analyzed in a cohort of obese patients compared with healthy volunteers.

Results. It was found that serum levels of tryptophan metabolites of microbial and eukaryotic origin were significantly increased in obese patients. Therefore, the concentration of kynurenine in the blood serum in obese patients was 2,413 ± 855 nmol / l, while in healthy volunteers of the same age group, the level of kynurenine in the blood serum was 2,122 ± 863 nmol / l. In obese patients, two acids formed due to kynurenine metabolism; the concentrations of kynurenic and quinolinic acids were increased in the blood serum. The concentration of kynurenic acid in the blood serum in obese patients was 21.1 ± 9.26 nmol / l, and in healthy patients, it was 16.8 ± 8.37 nmol / l. At the same time, the level of quinolinic acid in the blood serum in obese patients was 73.1 ± 54.4 nmol / l and in healthy volunteers – 56.8 ± 34.1 nmol / l. Normally, the level of quinolinic acid is 3.4 times higher than the concentration of kynurenic acid, and in case of obesity, there is a comparable increase in these acids in the blood serum.

From indole derivatives, mainly of microbial origin, the concentrations of indole-3-lactate, indole-3-butyrate, and indole-3-acetate were significantly increased in the blood serum of obese patients. In obese patients, the serum concentration of 5-hydroxyindole-3-acetate was elevated to 74.6 ± 75.8 nmol / l (in healthy volunteers – 59.4 ± 36.6 nmol / l); indole-3-lactate – to 523 ± 251 nmol / l (in healthy volunteers – 433 ± 208 nmol / l); indole-3-acetate – to 1,633 ± 1,166 nmol / l (in healthy volunteers – 1,186 ± 826 nmol / l); and indole-3-butyrate – to 4.61 ± 3.31 nmol / l (in healthy volunteers – 3.85 ± 2.51 nmol / l).

Conclusion. In case of obesity, the utilization of tryptophan was intensified by both the microbiota population and the macroorganism. It was found that obese patients had higher concentrations of kynurenine, quinolinic and kynurenic acids, indole-3-acetate, indole-3-lactate, indole-3-butyrate, and 5-hydroxyindole-3-acetate. Apparently, against the background of increased production of proinflammatory cytokines by adipocytes in obese patients, the “kynurenine switch” was activated which contributed to subsequent overproduction of tryptophan metabolites involved in the immune function of the macroorganism. 

Nonalcoholic fatty liver disease (NAFLD) makes a major impact on morbidity and mortality among the workingage population in developed countries. In the lack of effective pharmacological methods, the leading role in treatment of NAFLD belongs to lifestyle modification, consistent and gradual weight loss, and its maintenance. The qualitative and quantitative structure of the diet, intensity of physical activity, and most importantly, regularity and consistency of implementation of lifestyle modification activities are the key to successful management of patients with NAFLD.

To date, there are very few studies on adherence to lifestyle modification activities in this group of patients, which is mainly due to a deficiency of methodological tools. The questionnaire “QAA-25” recommended by the Russian Scientific Medical Society of Therapists for quantitative assessment of adherence to treatment allows to assess both adherence to therapy in general and adherence to its individual components (adherence to drug therapy, adherence to medical counseling, and adherence to lifestyle modification), which requires further study taking into account features of therapeutic strategies in treating NAFLD. 

The review summarizes and analyzes the results of domestic and major foreign studies of recent years concerning gender characteristics of the epidemiology and development mechanisms of metabolic syndrome and urolithiasis as an associated disease. A deep understanding of gender aspects in the pathogenesis of these pathologies can form the basis for development of high-quality diagnostic algorithms and pathogenetically grounded approaches to treatment. 

The review analyzes the global experience in the application of nuclear medicine techniques for diagnosis of tumors and non-tumor pathologies of the brain. The main groups of radiopharmaceuticals currently used for imaging of malignant brain tumors and diagnosis of cognitive impairments and neurotransmitter system disturbances by means of single-photon emission computed tomography and positron emission tomography are described.

Modern approaches to the application of methods for radionuclide diagnosis in neuro-oncology and neurology are compared, and the main trends in production of new, more specific radiopharmaceuticals for visualizing brain tumors of various degrees of malignancy and diagnosing non-tumor pathologies of the brain are described. The review discusses the advantages and disadvantages of currently used techniques and radiopharmaceuticals for imaging of central nervous system disorders, depending on the clinical situation and specific diagnostic tasks.

In addition, the review presents consolidated recommendations of the leading scientific schools in neuro-oncology on the use of nuclear medicine techniques in patients with brain tumors at the stages of treatment and follow-up. The presented article examines the experience of domestic scientific schools in the development of radiopharmaceuticals for neuro-oncology. The features of the development and use of new radiopharmaceuticals in patients with brain tumors and neurodegenerative diseases are highlighted. The review is based on the analysis of literature included in the Scopus, Web of Science, MedLine, The Cochrane Library, EMBASE, Global Health, and RSCI databases. 

Immune cells and molecules, as well as synaptic transmission molecules play a regulatory role in the communication pathways of the entire body when it is necessary to engage all body resources in the fight against infections or tumor cells wherever they appear. In potential allergy, the neuroimmune network controls allergen tolerance maintenance at both local and systemic levels.

The review focuses on different neurotransmitters and our understanding of a balance and imbalance between the immune system and the nervous system in allergic inflammation, including allergic rhinitis. However, the pathogenesis of the two endotypes of rhinitis (conventional allergic rhinitis and local allergic rhinitis) and the impact of the neuroimmune network on it remain unresolved. 

Human papillomavirus (HPV) is a small epithelial, non-enveloped, double-stranded DNA virus that belongs to the Papillomaviridae family. HPV infection is one of the most common sexually transmitted infections, and certain types of HPV are known to be carcinogenic to humans. According to the scientific literature, there is reliable information about the role of highly oncogenic HPV types in the development of cervical, anal, vulvar, vaginal, penile, and oropharyngeal cancer.

Currently, a relevant and promising research area is the study of the role of HPV infection in prostate cancer (PC) and bladder cancer (BC), but scientific data on the potential pathogenetic relationship between these phenomena remain contradictory. An in-depth study of the question how herpes and human papillomavirus affect the origin of malignant tumors of the prostate and bladder, as well as the course of these diseases, and the prognosis of their development can become a source of information for development of new approaches to their diagnosis, prevention, and monitoring of morbidity. This literature review analyzes the results of modern studies on the role of oncogenic HPV types in the carcinogenesis of PC and BC. 

The literature review describes various methods for treating patients with lymphedema of the extremities. Statistics show an increase in the incidence and disability of patients with this pathology. However, the possibilities of therapeutic measures in lymphedema are far from perfect.

The analysis of literature data showed that the basis of treatment for lymphedema of the extremities is comprehensive conservative therapy with the use of pathogenetically grounded physical, mechanical, and medical methods. In complex schemes of conservative treatment for lymphedema, physiotherapy methods occupy a prominent place. The most common technique among them is regular combined decongestive therapy. This method is recognized by leading experts as the main one in treating patients with lower extremity lymphedema. Commitment of patients to treatment and their social and psychological counseling are of great importance. The choice of the volume and method of surgical intervention requires a difficult and individual assessment of pathological changes developing throughout the course of the disease.

Despite certain improvements in treatment methods, lower extremity lymphedema is still an unsolved issue. The experience of most specialists involved in lymphedema treatment demonstrates a reasonable balance between basic conservative and surgical treatment methods. Undoubtedly, results of evaluation of these methods will improve the choice of an optimal technique for treating patients with lymphedema of the extremities. 

Currently, a growing amount of data is emerging on the role of various environmental factors (nutrients, gut microbiota, etc.) on formation of depression. The impact on these factors can be effective not only in treatment of major depressive disorder, but also in its early prevention. Therefore, a more detailed study of environmental factors in depression can lead both to a better understanding of the etiology and pathogenesis of the disorder and to optimization of approaches to its treatment. The aim of the review was to assess the potential role of a number of environmental factors associated with nutritional aspects and characteristics of individual microflora, as well as to review the prospects of a strategy for affecting these factors in treatment and prevention of depression. 

Background. According to the currently existing hypothesis, epicutaneous sensitization is one of the leading mechanisms in the development of food allergy.

The aim of this review was to analyze immune mechanisms in epicutaneous sensitization and the role of skin barrier impairment.

We performed a literature search using PubMed, UpToDate, Web of Science, and Scopus databases by the key words: epicutaneous sensitization, atopic dermatitis, skin barrier impairment, food allergy. Articles were to be in open access and present the most relevant information on the topic. Studies were selected by the largest sample size and the highest citation index. Once publications were identified, they were reviewed by all the authors to select the studies that specifically addressed the theme of the review. A total of 101 publications from 1998–2000 were included in the study.

This review article discusses the data of experimental studies, sets out modern ideas about the hypothesis of a double exposure to an allergen, and presents research data proving the clinical significance of epicutaneous sensitization in relation to food allergy. Knowledge about the mechanisms of epicutaneous sensitization development is necessary to elaborate strategies for prevention of food allergy. One of the modern trends in prevention is the use of emollients, which are supposed to restore the skin response. However, studies on preventive intake of emollients do not present a similar viewpoint.

There is not enough evidence for or against the mechanism of epicutaneous sensitization as an indispensable condition for the formation of food allergies. Further research in this area is required. 

Aim. To consider application of convolutional neural networks for processing medical images in various fields of cardiology and cardiac surgery using publications from 2016 to 2019 as an example.

Materials and methods. In the study, we used the following scientific databases: PubMed Central, ArXiv, ResearchGate. The cited publications were grouped by the area of interest (heart, aorta, carotid arteries).

Results. The general principle of work of the technology under consideration was described, the results were shown, and the main areas of application of this technology in the studies under consideration were described. For most of the studies, sample sizes were given. The author’s view on the development of convolutional neural networks in medicine was presented and some limiting factors for their distribution were listed.

Conclusion. A brief overview shows possible areas of application of convolutional neural networks in the fields of cardiology and cardiac surgery. Without denying the existing problems, this type of artificial neural networks may help many doctors and researchers in the future. 

The article presents a case of diagnosis and treatment of coarctation of the aorta in a 20-year-old woman, who previously received follow-up care with the diagnosis of hypertension. This case demonstrates the importance of qualitative examination of young patients with hypertension, including tonometry in the lower extremities and transthoracic echocardiography. The peculiarities of this clinical case encompass a rarer, isolated type of coarctation of the aorta and high physical fitness of the patient, which reduced doctors’ alertness regarding this anomaly. After surgical correction, a significant decrease in the blood pressure was achieved; however, such patients need longterm follow-up in order to detect complications, such as aneurysms, restenosis, or residual stenosis. 

Extrapyramidal disorders are common adverse events in antipsychotic therapy. However, their diagnosis is difficult due to broad differential diagnosis, and often their specific clinical variant is not recognized, and timely intervention is not performed, which leads to severe patient suffering. This affects the quality of life of patients with schizophrenia and leads to their refusal to receive therapy, which aggravates the course of the disease. The article presents a clinical case of a 33-year-old patient at a psychiatric hospital with schizophrenia combined with such rare severe extrapyramidal disorders as antipsychotic-induced tardive dyskinesia and tardive dystonia.

The diagnosis was carried out in accordance with the criteria of the International Classification of Diseases, Tenth Revision (ICD-10). The intensity of clinical manifestations was assessed using the Positive and Negative Syndrome Scale (PANSS), the Abnormal Involuntary Movement Scale (AIMS), and the Barnes Akathisia Rating Scale (BARS). Compliance was assessed using the Method for Measuring Medication Adherence in Psychiatry. Detailed differential diagnosis of tardive dyskinesia and tardive dystonia with akathisia and Huntington’s disease was presented. Substantiated treatment strategy and positive clinical dynamics with increased compliance were described. 

Modern high-technology methods for ischemic stroke treatment (systemic thrombolysis, mechanical thrombectomy, thrombaspiration, stenting of cerebral arteries) can improve the rehabilitation potential and survival of patients. Important tasks here are selection for reperfusion and its performance on the greatest possible number of peracute patients. Mechanical thrombectomy combined with systemic thrombolysis is the most effective reperfusion strategy in the therapeutic window, but the availability of endovascular methods is limited to highly specialized centres. One way to solve this problem is to organize effective logistics with stroke patients, which will provide high-tech care for patients living far from large treatment centers due to regulated interaction between institutions at different levels.

The aim of the study was to improve emergency interaction related to transfer of peracute stroke patients from primary vascular units and district hospitals of the Krasnoyarsk region to Krasnoyarsk Regional Vascular Center for thrombectomy.